Viewpoints: Downside Of Privatizing Medicaid; Medicare Advantage Stars And Poor Seniors
A selection of opinions on health care from around the country.
Des Moines Register:
Privatizing Medicaid No Cure For What Ails It
Medicaid is a massive government program that consumes about 476 billion tax dollars each year. Given its size, and the bureaucracy that surrounds it, it stands to reason that a certain amount of fraud is unavoidable. ... That point is underscored in a new report from the DHHS Office of Inspector General. It shows that roughly 12 percent of the Medicaid-funded service providers who have been kicked out of their state-run Medicaid programs for fraud or quality issues are still able to participate in other states’ Medicaid programs. ... One of the main culprits is managed care, which should be of concern to Iowans since the state is now moving toward the privatization of Medicaid administration. The OIG found that 25 of the 41 states that use managed care to deliver Medicaid services don’t require providers to be enrolled with the state Medicaid agency. That’s a problem because the states cannot terminate providers, even for fraud, if they are not directly enrolled in the program — a critical deficiency that DHHS says it’s working to correct. (8/10)
Forbes:
Modernizing Medicare: Supporting Minorities And Low-Income Patients
In order to address quality of care issues that are especially germane to low-income beneficiaries, the government ranks the performance of [Medicare Advantage] MA plans on a 5-star scale. ... The problem is that as currently structured, the Stars system gives unfairly low grades to plans enrolling the lowest-income enrollees. That’s because a significant fraction of the performance measures are driven in part by patients’ socioeconomic conditions and determinants of health, not actual plan or provider performance. Importantly, the majority of measures of performance are not adjusted for patient characteristics or socioeconomic status. (Doug Holtz-Eakin and Len Nichols, 8/10)
The Washington Post:
A Debate Over U.S. Pharmaceuticals Is Snagging The Trans-Pacific Partnership Deal
For the Obama administration, the heady feeling over congressional passage of trade-promotion authority in June has given way to at least temporary frustration. Twelve-nation talks in Hawaii that many thought might produce a final Trans-Pacific Partnership (TPP) agreement instead broke up at the end of July with no deal. Sticking points range from a three-way dispute over truck tariffs involving Mexico, Japan and the United States to market access for New Zealand’s dairy products in North America. ... No issue caused more conflict in the latest round of talks — or in the general political debate over the TPP — than the question of intellectual property and other protections for the U.S. pharmaceutical industry. (8/10)
The Baltimore Sun:
The Solemnity Of Abortion
I find I need to write about the damage the Planned Parenthood videos are doing to women who've had abortions. Not from the angle of the filmmakers, but from the angle of the clinic staff and doctors and the leadership of Planned Parenthood. The thing that has many people disturbed, even outraged, on either side of this issue is the seemingly cavalier attitude toward the aborted fetuses by the clinic personnel. They laugh, they make jokes, they appear to haggle over the price of the body parts and they describe making it "less crunchy." And every woman who has had an abortion is now is wondering "Did they talk like that about my abortion?" (Bunnie Riedel, 8/10)
JAMA:
New Therapies In The Treatment Of High Cholesterol
On July 25, the US Food and Drug Administration (FDA) approved alirocumab (Praluent), the first in a new class ... [of drugs]. Approval of a second medication in the class is expected shortly. ... early results suggest these drugs have a powerful effect on levels of low-density lipoprotein cholesterol (LDL-C), likely more potent than statins. ... This class also poses a new challenge for health care payers. It is an expensive specialty medication that targets a very common condition; more than 73 million adults (32%) in the United States have elevated LDL-C. As a reference, when sofosbuvir, which is used to treat hepatitis C, was approved and marketed over a year ago, it shocked the health care system because of the high cost and relatively large eligible population, up to 3 million infected individuals. Unlike new therapies for hepatitis C, which represent a cure for most patients, [the new cholesterol drugs] will be used long-term—generally for the remainder of the lives of treated patients. As a result, most payers, both government and commercial, should begin to consider thoughtful ways to rationalize the use of these medications. (William H. Shrank, Jane F. Barlow and Troyen A. Brennan, 8/10)
USA Today:
Taking Women’s Health To Heart
Here’s a fact that should make your blood pressure rise: Heart disease and stroke cost the United States almost a billion dollars a day. A billion dollars. That's more than the annual budget of the Small Business Administration; more than twice the annual funding for the Peace Corps. ... Women’s health is at the heart of the epidemic we face. Cardiovascular disease is the top killer of women in the United States; it kills more U.S. women each year than all cancers combined, and has claimed more women’s lives than men’s for more than 20 years. (Ronald O. Perelman, 8/10)
The New York Times' Taking Note:
Preventing Suicide In America’s Jails
Suicide has long been a problem in the corrections system, where a considerable portion of inmates suffer from mental illness. But new federal data show that suicide has reached crisis proportions in local jails, where psychiatric care appears to be particularly poor. This situation is especially alarming, given that 12 million people — many with mental illnesses — will cycle through local jails this year. (Brent Staples, 8/10)
The New York Times:
N.F.L.’s Bogus Settlement For Brain-Damaged Former Players
Thanks to the ham-handedness of the National Football League’s Hall of Fame, the inane “deflategate” scandal, which has been the dominant N.F.L. headline this off-season, was pushed to the sidelines this weekend and replaced by a genuinely important issue facing the country’s dominant sports league and its players. That issue is the serious cognitive impairment that appears to affect so many former professional football players. (Joe Nocera, 8/11)
