Celebrity Apprentice And Medical Innovation Have Something Important In Common

 

696012-f43ef348-7dbf-11e3-89a5-f01a1cd39a6c(A version of this Health Alert was published by Forbes.)

A new report should help President Trump find his way out of the confusion suggested by his very mixed signals on the role of medical innovation to American prosperity and patients. Last month, he said research-based drug-makers’ practices were “disastrous,” the industry was “getting away with murder,” and suggested the federal government should dictate prices of medicines.

A couple of weeks later, he told pharmaceutical executives: “You folks have done a terrific job over the years … The U.S. drug companies have produced extraordinary results…” To cap it off, he promised to end “global freeloading.” “Foreign price controls reduce the resources of American drug companies to finance drug R&D and innovation.”

High Drug Prices? Don’t Fall for ‘Fake News’ Blaming the Middleman

 

The tab for Americans’ prescription drugs is rising. High drug prices have not escaped notice by politicians, from Bernie Sanders to Senator Ted Cruz — including President Trump. Not all drug prices are outrageous, it’s really just a handful of over-priced drugs that have given the rest a bad name. Most of the drugs Americans take are affordable, but prices for a few drugs exceed the average mortgage payment.

Republican Medicaid Reform Would Save $110 Billion to $150 Billion in 5 Years

 

money-rollsArguably more important than repealing and replacing Obamacare, a longstanding Republican proposal to change how Congress finances Medicaid would reduce the burden on taxpayers by $110 billion to $150 billion over five years, according to a new analysis by consultants at Avalere.

Currently, state spending on Medicaid is out of control because Medicaid’s traditional funding formula incentivizes the political class to overspend. For every dollar a state politician spends on Medicaid, the federal government pitches in at least one dollar via the Federal Medical Assistance Percentage (FMAP). This actually rewards states for making more residents dependent on Medicaid.

Fixed-Dollar Tax Credits Would Reduce Individual Health Insurance Premiums

 

UntitledghgSonia Jaffe and Mark Shepard of the National Bureau of Economic Research (NBER) have written a new paper, which compares the effects of fixed-dollar subsidies for health insurance to subsidies that are linked to premiums. They conclude fixed-dollar subsidies reduce taxpayers’ costs and improve access. Unfortunately, the structure of subsidies in U.S. health insurance has moved in the other direction.

Tax credits that subsidize health insurance offered in Obamacare’s exchanges are based on the second-lower cost Silver-level plan in a region. Intuitively, this implies insurers will not compete too much because that would drive down subsidies. As long as subsidies chase insurance premiums, premiums will be higher than otherwise.

Jaffe and Shepard examine evidence from Massachusetts’ health reform (“Romneycare”), which dates to 2006. Its costs are still spiraling, and Jaffe estimates one factor is its design of subsidies, which is similar to Obamacare’s:

GPS Tracker for Grandma

 

walkawayI was perusing a health news website and ran across an advertisement for SmartSole, a GPS insole tracking device. It’s developed for Alzheimer’s patients and those with cognitive impairment who make be at risk of wondering away from their caregivers.

This is an example of the way technology can be harnessed to lower cost. Some nursing homes refuse to accept patients who are at high risk of running or wondering away. The alternative is locked-down, secure facilities that are more expensive and less convenient for family members. This type of technology could even be used in the future to help mom and dad could live independently while being monitored remotely.

Medical Errors Third Leading Cause of Death?

 

Apparently medical care is bad for you!

According to data from the British Medical Journal, in an article brought to us by Vox, a quarter of a million people died of medical errors in 2013. Medical errors were exceeded as a cause of death only by cancer (585,000 people) and heart disease (611,000 people).  Death from motor vehicle accidents paled in comparison (34,000) – as did death from firearms (34,000) and suicide (41,000).

Slow Growth, Downward Revision in Health Jobs

 

blsLast month’s job report showed an explosion in health jobs versus non-health jobs. Revisions to previous data in this morning’s very strong jobs report indicate those data were not correct.

Health jobs increased only 0.12 percent in this morning’s jobs report, versus 0.16 percent for non-health jobs. With 18,000 jobs added, health services accounted for only eight percent of new nonfarm civilian jobs.

This is a welcome development. The previous disproportionately high share of job growth in health services was a deliberate outcome of Obamacare. If this trend persists, it will become increasingly hard to carry out reforms that will improve productivity in the delivery of care.

Ambulatory sites added jobs at a much faster rate than hospitals (0.41 percent versus 0.21 percent). This was concentrated in outpatient care centers and home health. This is a good sign because these are low-cost locations of care.

See Table I below the fold:

American Health Insurance Is Upside Down

 

Writing in The Week, Ryan Cooper shares a chilling story about an Obamacare Gold-level health insurance policy that let its beneficiary down when he needed it most:

Stewart is 29 years old, and was pursuing his Ph.D in American history at Texas Christian University until ill health forced him to withdraw. He lives in Ft. Worth, Texas, with his wife of six years, who is a junior high school teacher in a low-income district. They own their home. Before he came down with complications from cirrhosis caused by autoimmune hepatitis, he says he led a scrupulously healthy lifestyle — he does not drink or do any other non-medical drugs, he says, and was a devoted hiker before disaster struck. And he was insured — indeed, he had a gold plan from the ObamaCare exchanges, the second-best level of plan that you can get.

But now he faces imminent bankruptcy and possibly death.

(Ryan Cooper, “This is How American Health Care Kills People,” The Week, January 14, 2017.)

Health Construction Picked Up in December

 

Census2Health facilities construction turned around in December, growing 0.6 percent versus a decline of 0.3 percent in starts for other construction. Health facilities construction accounted for almost 6 percent of non-residential construction starts. However, the growth was all in private health facilities.

Construction of private health facilities grew 1.2 percent, versus an increase of 0.2 percent for private non-health facilities. Private health facilities construction starts accounted for less than 4 percent of private nonresidential construction starts. Construction of public health facilities dropped by 1.5 percent. However, construction of other public facilities dropped by even more, 1.8 percent. In other words, health facilities construction outpaced non-health construction by 1.0 percentage points in the private construction market, versus only 0.3 percentage points in the public construction market (Table I).

Private Sector Health Benefits Grew 17 Percent Faster Than Wages Last Year

 

blsReleased yesterday, the Bureau of Labor Statistics quarterly Employment Cost Index showed private sector health benefits increased 2.7 percent in 2016, versus only 2.3 percent for wages.

Overall, private-sector benefits grew only 1.8 percent, indicating non-health benefits would have grown little if at all. State and local government workers’ benefits grew 3.1 percent, 72 percent faster than private-sector benefits!