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The Center for Medicare and Medicaid Innovation (CMMI) is tasked with developing and testing new delivery and payment models for health care providers under Medicare, Medicaid and the Children’s Health Insurance Program. Under the 2010 health care law, Congress authorized CMMI to test models that have the potential to lower costs or improve outcomes. ... With CMMI, however, the secretary of Health and Human Services has implemented mandatory “demonstrations” that prevent program beneficiaries or providers from opting out of the experiment. (Rep. Tom Price, R-Ga., 9/7)

There’s a war raging in doctor’s offices— and in each case the winner’s decision can have a significant impact on the patient’s outcome. Increasingly insurance companies are overruling physicians’ recommended treatment plans in the name of cutting costs. This dynamic is problematic because in medicine, as trained and educated professionals, we doctors base our therapy decisions on the best available data, and apply what we know to be most effective to each individual clinical setting and patient. (Dr. Kevin Campbell, 9/8)

On May 25, 2016, Sen John Barrasso (R, Wyoming) introduced the Protect Continuing Physician Education and Patient Care Act of 2016, a measure intended to exempt pharmaceutical companies and medical device makers from reporting payments made to physicians for receiving continuing medical education (CME), medical journals, or textbooks. The legislation that this bill is designed to amend, the Physician Payment Sunshine Act, was the brainchild of Sen Charles Grassley (R, Iowa), and was passed as part of the Affordable Care Act. (Dr. Eli Y. Adashi, 9/7)

One of Donald J. Trump’s recent attack lines against Hillary Clinton focuses on her health: If she has nothing to hide, he asks in a tweet, why doesn’t she release her medical records to the public? For the moment, put aside Mr. Trump’s own revelations about his medical history, which consist of a hyperbolic, undated letter with little detail from his gastroenterologist. ... Instead, assume that Mrs. Clinton wished to take Mr. Trump’s request seriously, and release full and detailed medical records. It would not be easy, even for a V.I.P. with an army of staffers. (Margot Sanger-Katz, 9/7)

Sen. Jeanne Shaheen cares more about funneling taxpayer money to Planned Parenthood than she does about stopping the spread of the Zika virus. The Madbury Democrat made her priorities crystal clear again this week when she voted to block consideration of a $1.1 billion package to combat the virus. It’s the third time Senate Democrats have filibustered the bill. (9/7)

Biologic medications (“biologics”) have been described as miraculous given their potential to help patients suffering from a myriad of serious diseases in ways more traditional small molecule medicines cannot. These therapeutics provide the ability to treat many complex and life-threatening disorders including diabetes, rheumatoid arthritis, multiple sclerosis and a variety of cancers, and have become some of the most widely prescribed drugs. In fact, seven of the world’s top 10 selling drugs in 2015 were biologics. But biologics are expensive, costing on average 22 times more than traditional small-molecule medications. Indeed, drug spending for biologics accounts for 28 percent of all prescription drug spending, with both use and cost expected to grow. (Bert Liang, 9/7)

Frances Peabody’s timeless lecture to Harvard Medical School students, published in JAMA almost 90 years ago, spoke of the complex and deeply human experience of illness, as epitomized by the powerful observation “for the secret of the care of the patient is in caring for the patient.” Peabody emphasized how caring meant understanding for each patient how particular personal and emotional circumstances influenced his or her health. Today, clinicians encounter a level of complexity — co-occurring chronic and rare diseases, organ transplantation, artificial devices — that has completely altered the practice of medicine, while the personal experience of illness and the social context are as important as ever. (Donna M. Zulman, Nigam H. Shah and Abraham Verghese, 9/6)

Nearly a quarter century ago, the Supreme Court asked pro-choice and right-to-life advocates “to end their national division by accepting a common mandate rooted in the Constitution.” Nothing of the sort materialized. If anything, the social and political battles intensified, with states enacting 1074 abortion restrictions. The Court has not considered various appeals in the face of an avalanche of legislation, but on June 27, 2016, it struck down 2 onerous restrictions on physicians and clinics offering abortion services. (Rebecca B. Reingold and Lawrence O. Gostin, 9/6)

When I was pregnant with my first child, my ob-gyn referred me to a genetic counselor “just in case.” I have a condition called X-linked hypophosphatemia, or XLH, which results in a form of dwarfism. I was a spontaneous case; there had no been no history of XLH in my family before me. No road map. (Sheila Black, 9/7)

Reforms under the Affordable Care Act have reduced barriers to health care access by expanding insurance coverage to millions of individuals living in the United States. With primary barriers to access removed, secondary barriers, particularly related to transportation, have become increasingly important. In 2005, it was estimated that 3.6 million individuals failed to receive nonemergency medical care due to transportation barriers. These patients tended to be older, poorer, and ethnic or racial minorities. (Brian W. Powers, Scott Rinefort and Sachin H. Jain, 9/6)

Epinephrine is cheap. My office purchases a multi-dose vial for less than $10. That is why it is ironic that there has been so much discussion and debate recently about the increased cost of EpiPens, which are well-known auto-injectors for epinephrine. The reasons for the price uproar can be found in a combination of supply and demand, lack of competition, insurance deductibles and increasing allergies. (Dr. Robert Wiskind, 9/7)

Earlier this year, the U.S. Food and Drug Administration (FDA) announced that it was reflexively regulating the batteries, circuit boards, wires, and handful of constituents in e-liquids that comprise vapor technology products — as if they are the same as those leafy tobacco products infused with 5,000 chemicals and wrapped in cigarette paper.  “TAG!  You’re tobacco” the FDA said, as if that was all they needed to do to make the public safer.  Of course, nothing is further from the truth.  Much has been written about how the FDA’s tobacco regulations are so burdensome and so onerous that they make it nearly impossible for all but the largest tobacco corporations to seek much less secure approval for their products. (Tony Abboud, 9/7)

Here’s a shocking fact about your food: A company can decide for itself that a chemical is safe to use in food and doesn’t have to tell the Food and Drug Administration, the agency charged with protecting our food supply. If that same chemical was used to make a tennis racket, the company would have to notify the Environmental Protection Agency, giving the EPA the opportunity to review it for safety. Your sports equipment may be safer than what’s on your plate. (Tom Neltner, 9/7)