Headlines: October 30,2009
by Meg Larkin
On Thursday, Nancy Pelosi unveiled the House’s health reform bill. While similar in many respects to its Senate counterpart, the house bill includes a broader public option with no opt-out provision and would raise money by taxing wealthy individuals instead of high-cost insurance plans. Karen Ignagni, president of health insurance lobby AHIP has made a strong statement in opposition to the house bill, claiming that it would raise costs for average families and harm hospitals. She also points to the bills lack of substantive cost containment measures as a “missed opportunity.”
Included in the bill is a provision that would impose $20 billion in new taxes on the sale of medical devices. This has been lowered from a $40 billion fee on device makers that was included in the original Senate version of the bill. The change is due in part to resistance of moderate democrats such as Sen. Evan Bayh of Indiana to the fee. The bill also includes steep new taxes on drug manufacturers. The House bill also includes provisions authorizing payment of doctors for end of life counseling. While this provision caused a stir this summer with public figures like Sarah Palin complaining that the government was setting up “death panels,” the publicity may have actually helped the provision gain the support it needed to stay in the bill.
Eleven people have been indicted in Manhattan on charges of defrauding the nation’s existing public health insurance plan. The individuals understated their income on Medicaid applications in order to qualify for health benefits ordinarily reserved for low-income citizens.
The shortage of H1N1 vaccine may be imposing a political cost on the Obama White House. While the White House took many steps to stay ahead of the crisis and avoid the mistakes of past administrations in dealing with flu outbreaks, slower than expected vaccine production is raising questions about the Government’s response. Internationally, concerns about swine flu are affecting Saudi Arabia’s preparations for the Muslim pilgrimage of Hajj. With help from the American Centers for Disease Control and Prevention, Saudi Arabia is designing a strategy to minimize the spread of swine flu as millions of pilgrims come to Mecca at the end of November. Precautions being taken include advising high-risk populations to stay home and encouraging pilgrims to bring their own face masks and hand sanitizer.
According to the Centers for Disease Control and Prevention, there were 1.8 million to 5.7 million cases of swine flu in the United States during the epidemic’s spring wave. Additionally, on Thursday federal officials announced that 25 million more doses of the swine flu vaccine were ready, and many states are expected to hold vaccination clinics this weekend. A setback occurred in New York’s ongoing efforts to vaccinate school children when two children inadvertently received the H1N1 vaccine without parental consent. While both children suffered no ill effects, the city’s Health Department is trying to figure out what happened and evaluate how they can prevent similar incidents in the future. In Washington DC, swine flu is doubling absence rates at public schools. Although the schools are staying open, there is a lot of scrambling to keep students who are absent caught up in their work.
Research and Technology:
In order to combat the growing shortage of intensivists in hospitals, some providers are turning to technology for a solution. eICUs are remote command centers that enable intensivists to supervise Intensive Care Units in multiple hospitals at once. According to the Wall St. Journal, “At UMass Memorial Medical Center, a study of 6,400 patients in seven adult intensive-care units monitored by eICU showed substantial benefits in reducing both costs and mortality, according to the hospital's director, Craig Lilly.” Dr. Lilly is now studying the benefits of remote monitoring for community hospitals with funding from the Cambridge-based New England Healthcare Institute.
An article published in today’s New York Times looks at the tendency of some doctors to bend the rules of clinical trials in order to gain access to experimental drugs they believe are the only hope for severely ill patients. A main concern is that by manipulating entry of patients in to the trials, doctors may be compromising the value of the trial results even if they are improving treatment outcomes for their individual patients. On a related note, there is increasing concern that all pertinent facts are not included on prescription drug labels. Some data, which would be relevant to prescribing physicians, and was discovered in clinical trials is not included on standard packaging. This has led to a debate over whether drugs should have a standardized drug fact box similar to the nutrition information box on packaged foods.
A study published in the Lancet has found promise in gene therapy for “Leber's congenital amaurosis (LCA), a rare inherited disorder which causes gradual deterioration in vision and can lead to blindness by the time the patient is 20.” An article in the BBC points out that early intervention in children produced the best results in improving eye function.
Meg Larkin is a second year law student in Boston University’s Health Law Concentration. Please feel free to email her with suggestions, comments, or questions.