DCMedical News: Monday, February 26, 2018
DCMedical News
Washington, D.C.
Monday, February 26, 2018
To our new readers: This is an independent newsletter, published every day that one or another House of Congress is in session. Subscription information will be found at the bottom of these pages.
THE BIG STORY TODAY IN HEALTH CARE
Guns have the attention of Washington, but the Supreme Court will focus today on unions and public employees, including millions of public sector employees in health care.
Today is the day for oral argument before the Supreme Court in the case of Janus v. AFSCME, widely seen as a vehicle for attack on public sector unions, the third in five years to be brought to the Court with the assistance of the National Right to Work Legal Defense (and other conservative) Foundations. The Economic Policy Institute (EPI) reports (here) on the impact of public sector unions. Prof. Robert Post (former Dean, Yale Law School) and Professor Charles Fried (former Solicitor General, now Professor at Harvard Law School), submit a brief (found here) which outlines the issues as well as a legal argument for “walking back” the all (unions and their members win) or nothing (some public employers and corporations win) outcome.
DOCTORS AND OTHER HEALTH PROFESSIONALS
The price of commitment to patients: possible burnout. In “Correlates and Outcomes of Physician Burnout Within a Large Academic Medical Center” (here), a study of 1,145 physicians in the Cleveland Clinic found that emotional exhaustion among primary care physicians was associated with higher communication scores, but also with higher probability of leaving the organization. The authors noted, “Physicians who give more to patients during clinical encounters may find themselves emotionally depleted. Consequently, low patient satisfaction scores are unlikely to identify physicians in need of burnout interventions.”
HEALTH INSURANCE, MEDICARE, MEDICAID, COMMERCIAL
“Failing Health of the United States,” an editorial in the British Medical Journal, (here). “Life expectancy in the US has fallen for the second year in a row. This is alarming because life expectancy has risen for much of the past century in developed countries, including the US. The decline in US health relative to other countries, however, is not new; it has been unfolding for decades. In 1960, Americans had the highest life expectancy, 2.4 years higher than the average for countries in the Organisation for Economic Cooperation and Development (OECD). But the US started losing ground in the 1980s. US life expectancy fell below the OECD average in 1998, plateaued in 2012, and is now 1.5 years lower than the OECD average.”
Idaho becomes a battleground for non-PPACA-compliant health insurance plans: January 5 saw the proposal of a new federal rule (here) with a new definition of “employer,” one which would enable Association Health Plans to offer health insurance to individuals unrelated by location, employer or trade. Now “Short-Term Limited Duration” health insurance plans (proposed rule here, previous Obama rule here) have been given a boost, with proposals to make them longer term, possibly indefinite in term, without the “Essential Health Benefits,” protection against pre-existent condition discrimination or subsidies of the more expensive PPACA-compliant plans. For Idaho, this means new lower-cost and lesser benefit plans offered through Idaho Blue Cross, one, for example, with no maternity coverage.
Money in the budget for risk corridor payments? Whoops! The Department of Justice (letter found here) corrects the impression that the Administration budget for FY 2019 (which had money for the risk corridor payments insurers think they are owed 2014-2016) meant that the government was conceding the merits of the lawsuit filed by the insurers to be paid. It was a mistake (!), so now you have a revised HHS budget, here.
OTHER PUBLICATIONS & READINGS
BiPartisan Governors Blueprint for Health Care, found here, from five Governors, calls for resumption of the Cost-Sharing subsidies, state pilot Medicaid programs and state employee benefit programs to be built on value-based Medicare experiments.
David Cutler, “What is the U.S. Health Spending Problem?” Health Affairs, March 2018, found here: Unnecessary medical spending as a cause of increased health and economic disparities, fewer people covered by private insurance, rationing care in public health programs, lack of funds for other social programs, distribution issues which, coupled with waste, “imply that efforts to address medical spending need to be among our highest priorities.”
Rita Ruben, “How Value-Based Medicare Payments Exacerbate Health Care Disparities,” JAMA February 21, 2018, found here, a summary of recent policy articles on VBP’s “reverse Robin Hood effect.”
EVENTS & MEETINGS
Your February & March Calendar:
February 26
12:00-1:30, Alliance for Health Policy, “Using State Flexibility to Improve Medicaid Long Term Services and Supports,” Hart Building room 902, info@allhealthpolicy.org.
1:00 Commonwealth Fund, Conference Call, “What is Really Driving High Prescription Drugs Costs and What can Congress and the Administration do to Rein Them In?” with the Honorable Henry Waxman (history alert!) and other authorities, RSVP for call-in at: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07ef5ae6ha6400ed66&oseq=&c=&ch=
February 27
10:00-11:30 a.m., The Future Role of Government in Health IT and Digital Health, Bipartisan Policy Center, 1225 Eye Street NW, Suite 1000, Washington, DC 20005.
February 28
10:00 a.m., Health Subcommittee (Energy & Commerce) hearing, “Combatting the Opioid Crisis,” first of three, schedule and witness list at https://energycommerce.house.gov/subcommittee/health-115th-congress/.
March 1
9:00 a.m. MedPAC, Ronald Reagan Building, Horizon Ballroom, 1300 Pennsylvania Ave, continuing March 2. Subjects on the 1st: Unified payment for post-acute care, hospital ED services, dual-eligibles, readmission reduction. On the 2nd: cost-effectiveness analyses, population-based quality measures.
MACPAC, advisory body on Medicaid and the Children’s Health Insurance Program, continuing March 2.
March 6
8:30 a.m., Roll Call/CQ News, “Health Care Decoded,” with representatives of CVS, AdvaMed, Kaiser, the Governors, et al, register at: http://go.cq.com/2018HealthCareDecoded_01.RegistrationPage.html.
9:00 a.m., Health Affairs on advancing health equity at the National Press Club, 15 or more journal article authors, focus on the March 2018 Health Affairs issue.
9:30 a.m., Brookings, “What’s Ahead for the Individual Health Insurance Market?--various think tankers.
Information at http://www.brookings.edu.
March 26
PTAC, Physician-Focused Payment Model Technical Advisory Committee, continuing March 27, information at www.regonline.com/PTACMeetingsRegistration or livestream at www.hhs.gov/live.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
DCMedical News is published every day that either the House of Representatives or the Senate is in session.
February publication dates remaining: 27, 28.
March publication dates: 1, 2, 5, 6, 7, 8, 9, 12, 13, 14, 15, 16, 19, 20, 21, 22, 23.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com