DCMedical News: Friday, February 26, 2021
DCMedical News-DCMN
Washington, D.C.
Friday, February 26, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Subscription information and archives here. The next edition of DCMedical News will be Tuesday, March 16, the next date that both the House and Senate are in session.
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking: Johns Hopkins (here) shows at 8:00 p.m. on 2-25-21 worldwide 112,956,305 COVID-19 cases, 28,406,385 U.S. cases, 25%. Deaths worldwide are 2,506,224, of which 508,088 are in the U.S., 20%.
Vaccines: Reaching the 50 million mark for first shots was celebrated by White House (The Hill reports, here), as Pfizer and Moderna prepare for variant booster shots (InsideHealthPolicy reports here). The Los Angeles Times reports (here) on a plan under which Blue Shield will assume responsibility for coordinating vaccination for coronavirus in California, and publishes the contract (here) which “grants the insurance giant far-reaching powers in overseeing the state’s distribution of doses . . . Blue Shield, which wields considerable influence in state politics, will immediately work to centralize the state’s COVID-19 vaccination program after a sluggish start due to a lack of available doses, complex regulations dictating which Californians should be prioritized, and data reporting issues.”
Policy: A Texas judge rules (here) that the CDC (and the federal government, generally) cannot create a moratorium on housing evictions, but noted that the States have done so in past emergencies. “This lawsuit presents the question whether the federal government has authority to order property owners not to evict specified tenants. Plaintiffs argue that this authority is not among the limited powers granted to the federal government in Article I of the Constitution, and thus the decision whether to enact an eviction moratorium rests with a given State. Disagreeing, the federal government argues that a nationwide eviction moratorium is within Article I’s grant of federal authority to regulate commerce among the States. Only that issue is posed here. This lawsuit does not question that the States may regulate residential evictions and foreclosures, as they have long done. For instance, during the Great Depression, 27 States enacted foreclosure moratoriums and other laws meant to mitigate the effects of a wave of foreclosures.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
FTC Looking for Information on Physician, Hospital Consolidation, and Prices
Following up its January 13 order on the matter (the “Resolution Directing Use of Compulsory Process to Collect Information Regarding Physician Group and Healthcare Facility Mergers”), the Federal Trade Commission has sent a 21-page inquiry to commercial health insurers (here), looking for information to “assist the Commission in studying the competitive impact of physician and healthcare facility consolidation in markets for healthcare services.” The extensive filings are due April 20.
Nurse Ambassadors to Patients Replace Detailing to Doctors
Two researchers from George Washington grapple with the phenomenon of “Nurse Ambassadors” pitching pharmaceutical products to patients (here) in JAMA. “A number of pharmaceutical companies offer nurse ambassador programs that typically involve company employed registered nurses who interact with patients to help facilitate the use of complicated medications that have been prescribed for the patient. However, some of these companies have been the subject of lawsuits alleging that their programs are inappropriately blurring the line between caregiver and marketer. In August 2020, the pharmaceutical company AbbVie agreed to pay California $24 million to settle a whistleblower case that involved its nurse ambassador program for adalimumab (Humira), while not admitting any wrongdoing. Nurse ambassador programs in part aim to ensure that patients continue the use of costly medications and have provided incentives to physicians and other clinicians to prescribe the medication. The programs continue to be largely unregulated by the federal government, with US Department of Justice guidance suggesting that the program could have an important role in patient interactions in some cases.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
The National Blue Cross and Blue Shield Association Weighs in With a National Health Insurance Policy Proposal
InsideHealthPolicy (here) reports that the “The Blues say lawmakers can extend coverage to all by building off the ACA and offer several proposals they say could insure another 9.2 million people and lower premiums by 19%,” by “supporting the temporary policies in the COVID-19 relief bill that increase the generosity of the existing tax credits and extend them to people earning more than 400% of the federal poverty level. . . The Blues also want the subsidies restructured so that more dollars flow to the younger adults who are often priced out of coverage . . .The Blues also call on Congress to incentivize states that have not expanded Medicaid by granting them three years of full federal funding if they expand their programs. Further, since nearly every region offers plans with zero-dollar premiums, the Blues say that marketplaces should automatically enroll people eligible for Medicaid or the no-cost ACA products and simplify enrollment for the remaining uninsured. The Blues urge Congress to fund a reinsurance program to help with the highest-cost patients . . . [and] also offer[s] several proposals for lowering consumers’ underlying costs. Congress should stop providers from charging unreasonable prices, and out-of-network charges should be capped at no more than a pre-established benchmark.” And “Congress should promote increased competition by hiking funding for the Federal Trade Commission. Lawmakers should require that the agency monitor mergers and other potentially anti-competitive practices” [see story above on FTC].
DRUGS & DEVICES
Intravascular Lithotripsy
Cardiovascular Business reports that IVL has gained FDA approval (here) for the treatment of severely calcified coronary artery disease; the technology is already approved for treating peripheral arterial disease. Research published in the Journal of the American College of Cardiology in October 2020 found that IVL “safely and effectively facilitates stent delivery and optimizes stent expansion in patients with severely calcified coronary lesions.”
READINGS & REFERENCES
The Lancet Commission Reports on the Trump Era, in 50 Pages
The Lancet publishes (here) the entire report, the result of a 33 member “Commission” examining health policy in the Trump Era, with social, historical and political flavor. The lead article, from Steffie Woolhandler, spreads the blame for health policy shortcomings widely: “Although the Trump administration policies posed a uniquely urgent threat to health, damaging neoliberal policies predated and abetted his ascendance: Life expectancy in the USA has lagged behind other wealthy nations since 1980 and began falling in 2014; The chronically high mortality of Native Americans started rising in 1999, while yawning disparities between Black and white people persisted and progress on racial equity in other domains (e.g., education, housing, income and policing) halted or reversed; Substance abuse deaths greatly increased; Income and wealth inequality widened; Incarceration increased four-fold, initiated by President Nixon’s racially motivated war on drugs and compounded by harsh laws enacted under Presidents Reagan and Clinton; Welfare eligibility restrictions implemented by President Clinton removed benefits from millions; Deindustrialisation spurred by trade agreements that favoured corporate interests over labour protections reduced economic opportunity in many regions of the USA, damaging health and increasing receptivity to racist and xenophobic appeals; Market-based reforms commercialised and bureaucratised medical care, raised costs, and shifted care toward high-income US residents.”
Select Coronavirus Public Health Resources and References (alphabetical):
AMA resource page for physicians here. AMA guide to medical education and COVID-19, 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.
JAMA Network’s COVID-19 resource center here.
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.
State actions, Kaiser Family Foundation, here.
The COVID Tracking Project (The Atlantic Monthly), here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
2021 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
March 16, 17, 18, 19, 22, 23, 24, 25
April 13, 14, 15, 16, 19, 20, 21, 22
May 11, 12, 13, 14, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.