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Advances in Personalized Medicine

An article published Thursday in the journal Science describes the treatment of a 43-year-old woman with an advanced and deadly type of cancer that had spread from her bile duct to her liver and lungs, despite chemotherapy.

Researchers at the National Cancer Institute sequenced the genome of her cancer and identified cells from her immune system that attacked a specific mutation in the malignant cells. Then they grew those immune cells in the laboratory and infused billions of them back into her bloodstream.

The tumors began “melting away,” said Dr. Steven A. Rosenberg, the senior author of the article and chief of the surgery branch at the cancer institute.

…[T]he report is noteworthy because it describes an approach that may also be applied to common tumors — like those in the digestive tract, ovaries, pancreas, lungs and breasts — that cause more than 80 percent of the 580,000 cancer deaths in the United States every year. (New York Times)

See our previous posts here and here.

Headlines I Wish I Hadn’t Seen

Almost halfway through the year, only four hospitals and 50 physicians have achieved federal goals for electronic health records for 2014.

ObamaCare’s individual mandate penalty also delayed for policies bought off-exchange.

Second U.S. MERS case reported.

Can Safety Net Hospitals Survive?

The Need:

health-care-costsHealth-care providers faced between $74.9 billion to $84.9 billion in care costs for the uninsured and people who struggled to pay their medical bills, according to new estimates published in the journal Health Affairs. Using the lower of the two estimates, Urban Institute researchers calculated that hospitals provided $44.6 billion of the uncompensated care, publicly supported community providers delivered $19.8 billion, and office-based physicians provided about $10.8 billion.

Dwindling resources:

Some of the most notable cuts outlined in in the [Affordable Care Act] are to what’s known as Disproportionate Share Hospital payments under the Medicare and Medicaid programs. These safety-net hospitals are expecting to see a total $22.1 billion cut to Medicare DSH payments between the 2014 and 2019 fiscal years, and the ACA originally called for $17.1 billion in cuts to the Medicaid DSH program through 2020.

Jason Millman.

Hits and Misses

iStock_000008138385XSmallSobering facts about inequality.

The true story of Phineas Gage. HT: Jason Shafrin.

How many bills have been filibustered in the Senate during Obama’s presidency? Almost all of them.

“Reference pricing” for common procedures could save employers $9.4 billion.

Massachusetts was the first state to guarantee access to insurance. So why was it arguably the worst of any state in implementing ObamaCare?

Unnecessary Care

As many as 42% of Medicare beneficiaries in 2009 underwent unnecessary medical treatments, costing the federal government as much as $8.5 billion, according to a study published yesterday in JAMA Internal Medicine. The analysis is the first large-scale examination into what Medicare spends on procedures that are widely considered to be unnecessary, such as advanced imaging for lower back pain and placing stents in patients with controlled heart disease. (KHN)

Does Unemployment Cause Obesity?

Recent studies and surveys have shown a distinct relationship between unemployment and obesity, particularly for lower-skilled workers who struggle to find work — a search made more challenging by their weight.

In Hagerstown, where blue-collar jobs have gone overseas or to cheaper parts of the country, 8.4 percent are unemployed — well above Maryland’s 5.9 percent rate. Last month, Gallup identified the area as the third-heaviest place in the United States, with almost 37 percent of its residents obese. Local studies put the number even higher. (More)

Headlines I Wish I Hadn’t Seen

man-dodges-large-fine-isolated-white-229819158.4 million people will be subject to a tax penalty for failing to insure this year.

Phoenix VA officials deny secret wait list; doctors say they’re lying.

Allegation: 40-plus veterans died waiting for care.

VA scheduler in Texas: I was ordered to ‘cook the books’.

Why have our capital punishment protocols become worse in recent years? Answer: Liberals and government regulation.

It Could Become Harder to Talk to Your Doctor

…[A] new policy approved by the Federation of State Medical Boards in late April leaves phone calls out of the definition of traditional telemedicine platforms. That’s upset patient and doctor advocacy groups alike, who say the policy could exclude patients without access to more advanced technologies — particularly lower-income populations. (German Lopez)

Chronic Illness

Timothy Taylor summarizes:

5467546“According to the Centers for Disease Control and Prevention (CDC), chronic illness affects one of every two adults in the U.S., and they are responsible for 75 percent of health-care costs.”

Their report estimates costs for five most common chronic diseases: cancer, diabetes, heart disease, hypertension, and stroke. One set of costs are treatment costs; a much bigger cost is the reduction in GDP when people are unable to work to their usual productivity, or at all. Of course, the measure here underestimates the full social cost because it does not seek to place a monetary value on the costs of death and suffering.

Source: Milken Institute report.

Why Did Health Spending Slow Down Before It Sped Up?

Last quarter, spending on health care grew an astounding 9.9%. That’s the biggest percent change in healthcare spending since 1980.

What’s the reason? Many people blame it on the Affordable Care Act (ACA), more popularly known as ObamaCare.

But this assessment contrasts markedly with the picture the president painted for us only a few months back when he said that “health care costs are growing at the slowest rate in 50 years.” He and members of his administration attributed that to the ACA.

So which view is correct? Probably neither. It’s too soon for ObamaCare to have resulted in a big boost in spending. And the previous slowdown was underway over a decade. (See the chart).

annual-growth-rates-national-healthcare-spending