Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Congress' Dithering On Zika; Fixing Medicare Drug Spending; Doctor Pay
When members of Congress visit their districts over the Memorial Day recess, we hope they keep in mind a warning from Tom Frieden, director of the Centers for Disease Control and Prevention. The Zika virus, for which there is no effective vaccine or therapy, can infect a person in a flash, he said during a visit to The Post on Thursday. ... The Republican congressional leaders, Senate Majority Leader Mitch McConnell (Ky.) and House Speaker Paul D. Ryan (Wis.), have vowed to end gridlock on Capitol Hill. But in response to Zika, they have inexcusably dithered. (5/30)
It's hard to say which is more crazy: Washington's failed system for keeping drug costs under control, or the resistance to a modest attempt to change it. The problem is obvious: In addition to paying doctors for treating Medicare patients, the federal government also pays them 6 percent of the cost of any drug administered in their office. The financial incentive for doctors is to prescribe the most expensive drugs available. (5/31)
The Medicare Access and CHIP Reauthorization Act, known simply as Macra, was enacted to replace the outdated and dysfunctional system for paying doctors under Medicare. The old system, based on the universally despised sustainable-growth rate formula, perennially threatened to impose unsustainable cuts in physicians鈥 fees. Macra passed Congress with bipartisan support and President Obama quickly signed it. Unfortunately, the law empowers the federal bureaucracy at the expense of the doctor-patient relationship, putting the quality of American health care at risk. (James C. Capretta and Lanhee J. Chen, 5/31)
Recently, I lost a day at work when my Upshot colleague Austin Frakt emailed me first thing in the morning to tell me that headlines were appearing declaring that an 鈥渆xplosive new cellphone-cancer鈥 study was making the rounds. As I have long been interested in this topic, I started to read the headlines and news. 鈥淐ellphone-Cancer Link Seen in Rat Study,鈥 said Time. 鈥淐ellphone Radiation Linked to Cancer in Major Rat Study,鈥 said IEEE Spectrum, a magazine for engineers. I was dismayed to say the least. 鈥淕ame-changing,鈥 as a quotation in a Mother Jones headline put it, seemed like a bit of an overreach. (Aaron E. Carroll, 5/31)
A little-discussed medical crisis in the United States finally seems to be getting a lot of attention: our massive shortage of living organ donations. Lawmakers introduced legislation last week that may make it easier to reward people who donate their organs, which would hopefully help close the gap. As of January, more than 121,000 people were on waiting lists to have failing organs replaced, with about 100,000 of those in need of new kidneys. And the problem is getting worse: A surge in kidney failure created a situation in which people being added to wait lists outnumber those receiving transplants 2-to-1. (Robert Gebelhoff, 5/31)
Lately, there has been a national uproar over the rising cost of medicine in the U.S. While this is an important public debate, it largely overlooks the critical importance of innovation, which is desperately needed for medical conditions that have no treatment. Welcome to the world of rare disease. There are 30 million Americans affected by 7,000 rare diseases, and, of those, only 5 percent have Food and Drug Administration-approved therapies. (Klane K. White and David Fajgenbaum, 5/31)
The recent announcement by Vice President Joseph Biden of a cancer cures 鈥渕oonshot鈥 has brought renewed attention to the goals of 21st-century cancer care. Not since the late President Nixon鈥檚 declaration of War on Cancer has so much focus been directed toward the experiences of the 1.66 million persons diagnosed with cancer annually in the United States. The framing of this initiative is focused on accelerating scientific progress against cancer as a disease, with little attention to equity or to the experience of those living with cancer and its consequences. As billions of dollars are invested in seeking the cure for cancer, attention to the quality of life of people living with cancer and the effect of cancer treatment are at least as important to address and far more achievable in the near term. (Arif H. Kamal, Thomas W. LeBlanc and Diane E. Meier, 5/31)
In an interview with WRAL鈥檚 David Crabtree, BCBSNC CEO Brad Wilson conceded that he was a strict grader and that 鈥渙n a good day鈥 he might give the ACA a C+. He acknowledged that the health law had provided coverage to 500,000 previously uninsured North Carolinians (鈥渁 very good thing鈥), but also warned that after 2-1/2 years of operation, it was very clear that the financial underpinning of the Obamacare exchanges was not stable. (Chris Conover, 5/31)
During my twenty-five years as president and CEO of the Jewish Healthcare Foundation (JHF), I have learned how to help people navigate the health care system. But I have struck out miserably when it comes to helping people facing behavioral health issues. ... The consequences of not addressing the adolescent behavioral health crisis are severe and may span generations. Half of all mental illnesses begin by age fourteen, according to the World Health Organization. Yet, the average time between when teens presented behavioral health symptoms and when they received treatment was about a decade, according to research that was published in 2005 in the Archives of General Psychiatry and funded by the National Institute of Mental Health. When left untreated or treated ineffectively, such problems can alter the course of a young person鈥檚 life. (Karen Wolk Feinstein, 5/31)
Like vision and dental, hearing health care plays a vital role in one鈥檚 quality of life. If affordable hearing device expansion is the overall objective of opening up the regulatory framework, then the first step should be increasing coverage instead of deregulating cheaper, less reliable devices. (Cate McCanless, 6/1)
In most realms of commerce, if a product fails to deliver what鈥檚 been promised, consumers are financially covered through refunds and warranties. This has never been the case with pharmaceuticals and medical devices. Increasingly, however, that鈥檚 going to change. (Rita E. Numerof, 5/31)
After nearly a decade of opposition, Boston may be on the verge of getting its first for-profit walk-in clinic. Although it鈥檚 not yet official, it appears the city鈥檚 Zoning Board of Appeals has approved an urgent-care center application in West Roxbury. Almost 3,000 鈥渃onvenience鈥 clinics in 41 states have served 10 million people. ... No community needs the clinics more than Boston. A recent survey of 15 metropolitan markets found that Boston patients experience the longest average wait to get a doctor鈥檚 appointment 鈥 45.4 days. It took city residents an average of 66 days just to get an appointment with a family physician. Is it any wonder that they turn to emergency rooms for treatment? (Jim Stergios, 6/1)
Every year, 1 in 6 Americans gets sick and 3,000 die from food they eat. To combat this, President Barack Obama signed the Food Safety Modernization Act in 2011, the most significant reform in more than 70 years. It鈥檚 taken a lawsuit and more than five years to finalize the rules, some of which will not be fully implemented until 2022. (5/31)
When I trained in pediatrics three decades ago, the neonatal intensive care unit was among the busiest areas in Vanderbilt Children鈥檚 Hospital. ... Research in the intervening years has taught us that stress caused by bright lights, loud, continuous noise and painful stimuli such as blood tests hurts the fragile, still-developing brains of premature infants. Noise, especially, is a concern. (John Barnard, 5/29)