DCMedical News: Thursday, February 6, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, February 6, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
Health Care in the State of the Union Address
Health care issues appeared in the President’s State of the Union Address (complete remarks from The White House as prepared, here).
“We eliminated the very unpopular Obamacare individual mandate penalty — and to give critically ill patients access to life-saving cures, we passed right to try.”
And “The next major priority for me, and for all of us, should be to lower the cost of healthcare and prescription drugs — and to protect patients with pre-existing conditions. Already, as a result of my Administration’s efforts, in 2018 drug prices experienced their single largest decline in 46 years. But we must do more. It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, unfair, and together we can stop it. I am asking the Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients. We should also require drug companies, insurance companies, and hospitals to disclose real prices to foster competition and bring costs down.”
And “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America.”
And “Tonight, I am also asking you to join me in another fight that all Americans can get behind: the fight against childhood cancer.” And “Many childhood cancers have not seen new therapies in decades. My budget will ask the Congress for $500 million over the next 10 years to fund this critical life-saving research.” And “I am asking the Congress to pass legislation to prohibit the late-term abortion of children who can feel pain in the mother’s womb.”
House to Consider CMS Healthy Adult Opportunity (Block Grant) Proposal
The House of Representatives is scheduled to vote today on a non-binding resolution (H. Res. 826, here) of disapproval over the block grant proposal from CMS, known as the Healthy Adult Opportunity program (here). Republican members of the Energy and Commerce Committee wrote “Thirty-six House Members sent a letter to Secretary Azar and Administrator Verma voicing opposition to the Healthy Adult Opportunity proposal before CMS had even published the plan. Ready, fire, aim. And tomorrow [Thursday], House Democrats will place a hastily written resolution on the House floor condemning the proposal without any review -- no hearing, markup, or any pretense of regular order.”
Supremes to Consider Expediting Obamacare Decision
Bloomberg reports that “The U.S. Supreme Court signaled it will use its Feb 21 private conference to discuss whether to consider the fate of the Affordable Care Act on a fast-track schedule that would mean a decision by the end of June.” The two cases are at https://www.supremecourt.gov/search.aspx?filename=/docket/docketfiles/html/public/19-840.html, (California v. Texas) and United States House of Representatives v. Texas, docket at https://www.supremecourt.gov/search.aspx?filename=/docket/docketfiles/html/public/19-841.html
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Women Needed in Medical Leadership Positions says AAMC
The Association of American Medical Colleges has called (here) for more women in medical leadership positions, more research funding to women, more encouragement for women to enter higher paying medical specialties. “Women have comprised almost 50% of medical school graduates since 2004, but they make up just 35% of the physician workforce . . . Within medical specialties, women represent far higher numbers of physicians entering primary care specialties than nonprimary care specialties. For instance, 63% of pediatricians are women, compared to just 18% of cardiologists and 5% of orthopedic surgeons.” The cause? Not career choices by women, or a desire to have families, but “We know that many women are pushed out of medical and scientific careers because of gender bias, harassment, and abusive cultures that actively exclude them,” according to the research director at the AAMC who is co-leading the gender equity project.
The AAAMC also has some thoughts and a new statement (here) about the challenges of attracting physicians to rural areas.
Physicians Who Prescribe Stimulants Paid by Pharma
“Use of prescription stimulants doubled from 2006 to 2016 in the United States and, as of 2013, it resulted in more pharmaceutical expenditures for children than any other medication class.” In a study of five years’ of Open Payments records totaling $20 million (here), pediatricians had the highest percentage of all physician specialties receiving marketing funds (5-year prevalence, 19.2%), or one in five.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospital Building in 10 days, or 10 years?
The BBC reports (here) on the building of 1,000 bed Huoshenshan hospital in Wuhan City in 10 days, time lapse photography at https://www.bbc.com/news/av/world-asia-china-51348297/coronavirus10-days-of-hospital-building-in-60-seconds?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axioscities&stream=cities. Practice apparently helps: a hospital was built in Beijing in 7 days during the SARS crisis. The Wuhan video is 60 seconds.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Health Spending in the U.S. and OECD Countries, and Comparative Results
The Commonwealth Fund (study here, news release here, graph here) has updated its 2015 study of health spending in the U.S. and in OECD Countries. Data from the Organisation for Economic Co-operation and Development (OECD) was used to assess U.S. health care system spending, outcomes, risk factors and prevention, utilization, and quality, relative to 10 other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom, and also to compare U.S. performance to that of the OECD average, comprising 36 high-income member countries.
The now familiar results, largely unchanged: “The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average. Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. The U.S. outperforms its peers in terms of preventive measures — it has one of the highest rates of breast cancer screening among women ages 50 to 69 and the second-highest rate (after the U.K.) of flu vaccinations among people age 65 and older. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.”
READINGS AND REFERENCES
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 7, 10, 11, 12, 13, 25, 26, 27, 28
March 2, 3, 4, 5, 9, 10, 11, 12, 23, 24, 25, 26, 27, 30, 31
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.