Headlines: January 11, 2009
by Meg Larkin
President Obama is calling for Congress to pass health reform quickly. The President stressed that some benefits would be immediately available including less expensive coverage for people with preexisting conditions. However, most provisions of the health care bill would not come into effect until 2014. In order to accomplish passage of the bill in the near future, House democrats held a caucus-wide conference call last Thursday. Major differences currently exist between the House and the Senate bills in the area of taxes. While the Senate bill would tax high end insurance plans, the House bill would raise taxes on high income Americans. Many liberals in the House find President Obama’s open support of the Senate plan troubling.
Both health care bills include the creation of a Value Index that would enable them to penalize hospitals that are less efficient and reward those that are more efficient through the Medicare payment system. Based on the Dartmouth Atlas, which studies regional practice variation, the Index was lobbied for by lower cost hospitals in the Northwestern United States such as the Mayo Clinic. However, the Value Index has been criticized by generally higher cost hospitals in major metropolitan areas. Those hospitals claim the Northwestern clinics are more cost effective because they treat more homogenous populations with fewer preexisting conditions and a higher likelihood of carrying private insurance. Additionally, the Value Index will use regional rankings to penalize high cost areas and reward low cost areas. This means that a high cost hospital in a low cost area may be rewarded and vice versa. The Value Index would be created and administered by the Cambridge-based Institute for Healthcare Improvement.
A new government study projects that health care costs will rise minimally under the proposed Senate bill. According to the Washington Post, “The study found that health spending, which accounts for about one-sixth of the economy, would increase by less than 1 percent than it otherwise would over the coming decade even with so many more people receiving coverage.” The Senate bill would extend coverage to 34 million people who are currently uninsured.
A study in the January issue of Obstetrics & Gynecology found that almost half of all women who use the injected contraceptive Depo-Provera experience significant loss of bone mass. Smoking and insufficient calcium intake increase the risk of substantial loss of bone mass. According to the New York Times, researchers were concerned about the loss of bone mass because it can take a long time to recover and increases the risk of fractures.
In other reproductive health news, the morning after pill is increasingly popular in India. The pill, which prevents the implantation of a fertilized egg in the uterus, is widely available over the counter in India. While abortion is legal, it is risky with many doctors performing in unsanitary conditions and as many as 20,000 women die annually after undergoing a botched abortion.
A new study in the New England Journal of Medicine has found that Hospitals could prevent infections by treating the bacteria present on a patient’s skin when he or she enters the medical facility. By using methods of screening, scrubbing or pre-treating to remove the bacteria before surgery, hospitals may be able to greatly reduce the risk of the bacteria entering the body through a skin laceration during surgery. However, the more advanced disinfectant procedures are more expensive than the iodine solution typically used when patients undergo surgery.
Despite the promise of telemedicine in improving patient outcomes, many providers are hesitant to adopt the technology. Researchers studying eICU technology at the University of Texas in Houston found that most providers chose to have as little involvement as possible from the physician conducting remote monitoring at the eICU. Many doctors in the study felt that the telemedicine technology was intrusive and some also worried about the effect that the remote monitoring system would have on their relationship with patients. The lack of acceptance by providers makes it difficult for researchers to assess the potential benefits of the technology for patients.
Finally, researchers at the Johns Hopkins School of Medicine have found that a combination of therapies to treat Alzheimers may be more effective at combating the plaque formation that causes cognitive decline. According to the Boston Globe, Scientists suspect Alzheimer’s may be caused by a protein called amyloid beta, generated by two enzymes that drugmakers have been targeting individually with experimental treatments.” The researchers at Johns Hopkins found that treating mice with Alzheimers with two therapies that partially blocked each enzyme had the potential to slow plaque formation while avoiding some of the serious side effects of blocking either enzyme completely. However a cocktail therapy is still years from use in humans.
Meg Larkin is a second year law student at Boston University. Please feel free to email her with any comments, questions, suggestions, or concerns.