DCMedical News: Tuesday, February 8, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
THE BIG STORY Tuesday, February 8, 2022
Masks and Mandates, Courts Involved in OSHA, HHS Rulings
The Wall Street Journal reports (here) that "Courts around the country are weighing how to apply the U.S. Supreme Court’s recent mixed guidance on the federal government’s power to impose Covid-19 vaccine mandates, as judges consider whether the Biden administration can enforce such requirements on groups including government contractors and federal workers. Last month, the Supreme Court issued a pair of divided rulings that pulled in different directions. In one, the court blocked the Biden administration’s most sweeping mandate, which required private employers to ensure their workers were vaccinated or tested weekly. But a second decision allowed a federal vaccine mandate for most healthcare workers."
An observer drew this lesson for the Journal: "A vaccine mandate that targets problems specific to a federal regulatory program will likely be upheld. A mandate that is simply an attempt to get as many people vaccinated as possible, or is a workaround for the government not having a general power of vaccination, will probably be struck down.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
NHS May Exert Greater Control Over GPs
England's Health and Social Care Secretary presses a plan for hospitals to employ more general practitioners directly, according to a report in BMJ (here). Frustration over lack of control of the GPs is cited, together with a theory that placing GPs in closer proximity to hospital-based specialists will reduce overutilization of hospitals. "As overstretched general practices face unrelenting demand from patients, and hospital waiting lists keep climbing, [Secretary] Javid reportedly sees the model as a way to keep more patients out of hospital. Better access of GPs to secondary care specialists could potentially improve the management of chronic diseases, which in turn ought to reduce admissions."
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Shoppable Health Care? Bring a Larger Purse, Say Researchers
A study in JAMA Network Open (here) asks, "Are prices of hospital services disclosed under the new federal hospital price transparency rule correlated with total costs of hospital-based care among commercially insured individuals?"
In a study of 4.5 million hospital-centered service purchases, the group found that "health care entities that billed for their services independently from the hospital were frequently involved in care delivery, and their reimbursements comprised substantial portions of the total costs of care. The disclosed hospital prices were weakly correlated with the reimbursements of independent health care entities . . . These findings suggest that prices disclosed under the new regulation may have limited value to patients attempting to make cost conscious health care choices."
SEIU Attacks HCA
The Service Employees International Union has unleashed a report (here, 58 pages; summary here, 18 pages) attacking HCA.
According to the report, "New research indicates America’s largest for-profit hospital system may be gaming the Medicare system and driving up healthcare costs for patients and citizens. HCA Healthcare, the nation’s largest hospital system, is engaged in practices that maximize profits at the expense of patient care, working conditions, and responsible corporate behavior. HCA’s hospital markups are in general more than twice the national average, and many HCA hospitals have markups as high as 12 or 13 times the cost of care — or even higher."
"At the same time, staffing levels in HCA’s hospitals lag the national average by about 30%, despite the fact that higher staffing levels are associated with better patient care, and the company pays tens of thousands of its employees poverty wages."
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MedPAC's Chair Reports on The Hospital Insurance Trust Fund and the Future of Medicare Financing
Michael E. Chernew, Ph.D., testified (here) before the Subcommittee o Fiscal Responsibility and Economic Growth of the Senate Finance Committee. He said, "The Medicare program faces a very challenging financial future. In 2021, the Congressional Budget Office (CBO) projected that annual Medicare spending would more than double in the 10-year period between 2021 and 2031, rising from $839 billion to $1.8 trillion. During this period, Medicare's share of total federal spending is expected to rise from 10.1 percent to 18.8 percent."
"CBO also projected the Medicare's Hospital Insurance (HI) trust fund --- which is largely financed by payroll taxes and funds Medicare's payments to hospitals and post-acute care providers, as well as a portion of payments to Medicare Advantage (MA) plans --- will become insolvent in 2027. The Medicare Trustees project that the HI trust fund will become insolvent a year earlier, in 2026. Without changes to current law or policy, the Trustees have estimated that ensuring the solvency of the trust fund for an additional 25 years would require the Medicare payroll tax to be raised from 2.9 percent to 3.7 percent. Alternatively, without revenue increases, Part A spending would need to immediately be reduced by 18 percent (about $70 billion in 2022), an amount that will grow over time if action is delayed (Boards of Trustees 2021)."
READINGS & REFERENCES
National Center for Health Statistics, CDC, Final Report on Births, 2020
The Center report (here) found:
"A total of 3,613,647 births were registered in the United States in 2020, down 4% from 2019.
The general fertility rate declined by 4% from 2019 to 56.0 births per 1,000 women aged 15–44 in 2020.
The birth rate for females aged 15–19 fell 8% between 2019 and 2020.
Birth rates declined for women aged 20–44 from 2% to 5% between 2019 and 2020.
The total fertility rate declined to 1,641.0 births per 1,000 women in 2020.
Birth rates declined for both married and unmarried women from 2019 to 2020.
The cesarean delivery rate increased to 31.8% in 2020.
Medicaid was the source of payment for 42.0% of all 2020 births.
OTHER REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 9, 28
March 1, 2, 3, 7, 8, 9, 10, 15, 16, 17, 18, 28, 29, 30, 31
April 1, 4, 5, 6, 7, 26, 27, 28, 29
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org