Headlines: May 17, 2011
by Meg Larkin
As the 2012 presidential election begins to make headlines, Republican candidates are divided over the issue of Medicare and Medicaid reform. Recently, Republican Presidential Candidate and former House Speaker Newt Gingrich criticized the Medicare and Medicaid proposals contained in the Ryan budget, calling them, “right-wing social engineering.” Meanwhile, Mitt Romney recently gave a speech defending the health reform law he signed as governor of Massachusetts in 2006 that provided the blueprint for the national health reform law. The Ryan proposal would privatize Medicare for those currently under the age of 55, with the Government contributing a set amount towards the purchase of private insurance. It would also transform Medicaid into a block-grant system giving States more discretion as to how to spend the money. Democrats have capitalized on the Ryan proposal as a campaign issue in some special elections already. It remains to be seen how the issue will affect the Republican primary elections next year.
In other health policy news, many nursing homes are asking for an exception from the 2010 health reform law. Many nursing homes either do not offer subsidized health care to their employees, or pay their employees so little that the employees cannot afford monthly premiums. According to the New York Times, “Among workers who provide hands-on care to nursing home residents, one in four has no health insurance. Among those who provide care to people living at home, one in three is uninsured.” Industry trade groups have argued that low Medicare and Medicaid reimbursement rates are what make the nursing homes unable to provide health care for their employees. Medicaid currently covers 2/3 of all nursing home residents. A number of options that would give nursing homes extra time to comply with the law are under consideration, but some experts in the health care field say that the lack of insurance among nursing home employees is scandalous. In theory, nursing home employees with health care would be more likely to seek treatment for illnesses, and less likely to transmit diseases to elderly nursing home residents.
Turning to public health concerns, the rate of autopsies has declined dramatically in recent years. The Washington Post reported that, “Today, hospitals perform autopsies on only about 5 percent of patients who die, down from roughly 50 percent in the 1960s.” Autopsies can be valuable in determining the true cause of death of patients, and in studying diseases like Alzheimer’s disease that can only be confirmed after the patient’s death. Autopsies may also identify diseases that clinicians and technology may fail to find or misdiagnose during the patient’s life. Although there is little current research on the topic, a JAMA article from 1998 found that autopsies showed misdiagnosis of cause of death in about 40% of cases. Now, about 40 percent of hospitals no longer perform autopsies. Some hospitals charge patients for autopsies, and while Medicaid and Medicare theoretically provide money for autopsies, the money may not end up getting spent for that purpose.
Finally, in research news, babies are being given MRIs in order to study the origins of diseases like dyslexia and autism. Researchers at Children’s Hospital Boston are using MRIs to compare the brains of infants whose families have a history of dyslexia and autism with babies whose families do not have a history of those disorders. Researchers know that many of these disorders start in early childhood, but they hope that the MRIs will help determine whether there are genetic factors or brain differences that indicate their presence before the disorders are normally detected.
Meg Larkin is a third year law student at Boston University. Please feel free to email her with any questions, comments, suggestions or concerns.