DCMedical News: Friday, September 11, 2020
DCMedical News-DCMN
Washington, D.C.
Friday, September 11, 2020
DCMedical News is published every day both the House and the Senate are scheduled to be in session this year. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
The (Presidential and Other) Campaigns
White House adviser faulted: a 100 or so of Dr. Scott Atlas’ former colleagues at Stanford Medicine sent a public letter (here) noting that “we also have both a moral and an ethical responsibility to call attention to the falsehoods and misrepresentations of science recently fostered by Dr. Scott Atlas, a former Stanford Medical School colleague and current senior fellow at the Hoover Institute at Stanford University.”
Coronavirus
Tracking: by Johns Hopkins (here) shows on 9-10 at 8:00 p.m. EST worldwide 27,994,688 confirmed COVID-19 cases; 906,195 deaths worldwide; 191,727 U.S. deaths (21%).
Medicine and Science: The CDC (in the Morbidity and Mortality Weekly Report, here) reports that “Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care.” Lower than usual ED visits and hospital admissions were examined in five states in a JAMA Internal Medicine study (here) from early August.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Race and Medicine
The New England Journal of Medicine starts a new “Race and Medicine” page, here, while the Journal of the Association of American Medical Colleges publishes fourteen papers (here) addressing race and racism in medical education (and another on the introduction of climate change into the medical education curriculum, here). A study in JAMA (here) notes that “Tying [COVID, hospital] relief funding to [hospital] revenue resulted in allocations largely unrelated to health or financial needs. It also meant disproportionately Black communities receiving the same level of relief funding as other counties had greater health and financial needs.”
Interventional Radiology (IR) and Cost
A study in the Journal of the American College of Radiology (here) says that “Approximately 1 in 10 US inpatients are treated with IR during their hospitalizations. These patients are sicker, with about 4 times higher mortality and 2.5 times greater length of stay, accounting for almost one-fifth of all health care costs. These findings suggest that IR should have a voice in discussions of means to save costs and improve patient outcomes in the United States.” The IR community believes that some of its services are lower cost, higher quality or both, compared to surgeons performing the same procedures. For example, another study published in the ACR here reports that “A common service for dialysis patients costs about $100,000 less when delivered by an interventional radiologist rather than a surgeon . . . More than 600,000 patients each year require life-saving hemodialysis for end-stage renal disease . . . Fewer than 50% of all access conduits for dialysis remain viable for longer than three years and clinical guidelines recommend regular surveillance to guard for signs of impending failure. Interventions such as angiography, angioplasty stent placement and thrombolysis are typically performed by radiologists, surgeons or nephrologists . . . On average, the cost per patency year of dialysis in Medicare landed at roughly $174,000 for surgeons compared to $89,000 for nephrologists and $71,000 for [interventional] radiologists.” Two-thirds of rural hospitals have IR services, compared to almost all urban hospitals.
Pharmacists Approved by HHS to Administer COVID-19 Vaccines, Overriding State Licensure Regulation
An announcement by HHS (here) says “Subject to satisfaction of the requirements listed below, this guidance authorizes State-licensed pharmacists to order and administer, and State-licensed or registered pharmacy interns acting under the supervision of the qualified pharmacist to administer, to persons ages three or older COVID-19 vaccinations that have been authorized or licensed by the Food and Drug Administration (FDA).”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MedPAC Reports on a Wide Variety of Current Medicare Topics
At its meeting September 3-4 the Congressional advisory group had presentations on Medicare payment policy (here); the COVID pandemic and Medicaid (here); Medicare access and clinical laboratory fees (here); value based purchasing in skilled nursing facilities (here); private equity and Medicare, a report requested by Congress, here; the expansion of telehealth in Medicare, here; and Medicare coverage for vaccines, here.
CMS Administrator Verma was faulted by Congress (here) for expenditures on consultants for her image, a follow up to a GAO report (here) on that issue.
DRUGS & DEVICES
Vaccine Safety Pledge by Major Pharma Manufacturers
STAT reports (here) that “Amid broad mistrust of FDA and Trump administration, drug companies seek to reassure public about Covid-19 vaccine safety.” The companies made their statement in full page ads in major newspapers. The STAT report notes that “In recent weeks, top U.S. health officials have further damaged the Food and Drug Administration’s reputation for making independent, science-driven decisions. Last month, FDA commissioner Stephen Hahn misrepresented data about the ability of blood plasma from recovered Covid-19 patients to treat the disease after Trump falsely touted the treatment as a breakthrough . . . Health secretary Alex Azar, who made a nearly identical false claim that blood plasma could reduce Covid-19 deaths by 35%, has not recanted his remarks. Hahn also generated alarm when he told the Financial Times in late August that the FDA would consider an emergency authorization for a vaccine candidate that has not completed a Phase III clinical trial, the final stage of testing for safety and efficacy typically required for an approval. Already, the Trump administration’s rhetoric, and scientists’ criticisms, have led to dramatic shifts in how Americans view the FDA and vaccine safety.”
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical):
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
The Guardian and Kaiser Health Network, report on health professionals dead from COVID-19, here.
JAMA Network’s COVID-19 resource center here.
Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports.
New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here.
The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
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
September 14, 15, 16, 17, 22, 23, 24, 25, 30
October 1, 2
November 16, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.