Headlines: February 19, 2010
by Meg Larkin
The Dartmouth Atlas, which has been at the center of many of the White House’s health care reform proposals is widely criticized in an analysis that appears in the New England Journal of Medicine this week. The analysis suggests that much of the Atlas is “flawed” and “should not be used to compare the relative efficiency of hospitals.” The Atlas has long been at the center of the national conversation on practice variation across geographic regions and spending on end of life care. Researchers at Dartmouth insist that the study should not be used to set hospital reimbursement rates and pointed out that, “the larger issue was that just because a hospital charges a lot does not mean that it delivers good care.”
With health reform on hold and the economy in dire straits, many states are being forced to make cuts to Medicaid. As unemployment has risen more people have enrolled in Medicaid, putting pressure on the government program. Medicaid is paid for by both states and the federal government and makes up a large portion of most state budgets. States are responding to the increased enrollment by cutting the amount paid to providers and sometimes reducing the benefits available to Medicaid enrollees. According to the New York Times, “A survey released Thursday by the Kaiser Family Foundation found a record one-year increase in Medicaid enrollment of 3.3 million from June 2008 to June 2009, a period when the unemployment rate rose by 4 percentage points. Total enrollment jumped 7.5 percent, to 46.9 million, and 13 states had double-digit increases.”
Private health insurers are also suffering from the country’s economic woes. With high rates of medical inflation and adverse selection in the individual market for health insurance, many private insurers are resorting to widely criticized premium rate hikes. Because it is harder to raise premiums for employees because rates are usually negotiated with employers who have more pull than individuals, many insurance companies, including Anthem in California, are dramatically raising prices in the individual insurance market. Insurers insist that in order to lower rates medical costs need to be contained and more people need to enter the insurance pool.
With new FDA restrictions on cigarette labeling poised to take effect this summer, companies are trying to circumvent the law by using colors to send messages to consumers. Now that words like light and mild are banned, cigarette companies are using lighter colors on cigarette packages to signal that they contain light cigarettes. The National Cancer Institute has pointed out that “light” cigarettes may be more dangerous than regular cigarettes because smokers tend to inhale more deeply or smoke more. According to the New York Times, the FDA has begun a review of color coding in cigarette packages.
In other regulatory news, the FDA has issued warnings about the use of certain long acting asthma drugs. The drugs may dull the warning signs of an oncoming asthma attack and make it harder for patients to react appropriately. The FDA says that the drugs should be used in combination with traditional asthma treatments and for as short a time as possible. The drugs only pose an increased risk to asthma patients, not people who suffer from other lung diseases.
Meg Larkin is a second year law student at Boston University. Please feel free to email her with any questions, comments, suggestions or concerns.