EpiPen Maker Lobbied U.S. Preventive Services Task Force


According to a report in the Washington Examiner, drug maker Mylan lobbied the U.S. Preventive Services Task Force to require insurers to pay the full price of EpiPens by deeming the drug delivery device a preventative measure. Under the Affordable Care Act, health plans must cover preventive services 100% without cost-sharing regardless of whether deductibles have been met. EpiPens are used by people with severe allergies who go into anaphylactic shock.  They are not used to prevent anaphylaxis, they treat the symptoms once it occurs. For example, under ACA regulations, a flu shot is a preventive medicine. Once you have the flu, seeing your doctor for Tamiflu would be a treatment, not a prevention.

Is Obamacare’s Failure Intentional, to Promote Medicaid-for-All?


A recent commentary in the Wall Street Journal announced, “Obamacare’s meltdown has arrived.” Health insurance premiums all over the country have skyrocketed. Numerous insurers have pulled out of state and federal exchange marketplaces. Many consumers have only one choice of health insurer and can choose from only a couple different plans. State health insurance CO-OPs have been falling like dominos and the program is now all but defunct.

None of this should have come as a surprise. Over the years I’ve heard conspiracy theories that Obamacare was designed to fail to nudge a reluctant nation one step closer to a single-payer system of socialized medicine. Think of this as Medicaid-for-All.

Government And The Cost Of Dental Care


UntitledIn July 2015, former Enron board member, New York Times columnist, and champion of ever more government control of health care, Professor Paul Krugman, wrote a disturbing blog entry:

Wonkblog has a post inspired by the dentist who paid a lot of money to shoot Cecil the lion, asking why he — and dentists in general — make so much money. Interesting stuff; I’ve never really thought about the economics of dental care.

But once you do focus on that issue, it turns out to have an important implication — namely, that the ruling theory behind conservative notions of health reform is completely wrong.

For many years conservatives have insisted that the problem with health costs is that we don’t treat health care like an ordinary consumer good; people have insurance, which means that they don’t have “skin in the game” that gives them an incentive to watch costs. So what we need is “consumer-driven” health care, in which insurers no longer pay for routine expenses like visits to the doctor’s office, and in which everyone shops around for the best deals.

Krugman goes on to insist dentistry is a consumer-driven market: Insurance is far less prevalent in dentistry than in medicine, and most dental care is routine and preventive. Yet, he points out, costs of dental care have risen at the same rate as those of other health care, not at the rate of other consumer goods and services.

Health Jobs Grew Twice As Fast As Non-Health Jobs In September


BLSThis morning’s jobs report was a return to normal, with jobs in health services growing twice as fast as non-health jobs (0.21 percent versus 0.10 percent). With 33,000 jobs added, health services accounted for one fifth 156,000 jobs added. Ambulatory sites (with the exception of labs) added jobs at more than double the rate of hospitals. Nursing and most other residential care facilities were flat (Table I).

Consumer-Driven Health Plans Reduce Health Spending One Eighth


credit-card-2The Health Care Cost Institute has released its analysis of claims data for the years 2010 through 2014, examining consumer-driven health plans (CDHPs, which HCCI defines as High-Deductible Health Plans coupled with Health Savings Accounts or Health Reimbursement Arrangements). HCCI examines a database of claims submitted by Aetna, Humana, Kaiser Permanente, and UnitedHealthcare for their employer-sponsored group plans.

CDHPs shift payment from third-party bureaucracies (that is, insurers) back to patients directly. The results continue to impress:

Digital Health Entrepreneurs Raising More Capital Than Ever (Probably)


electronic-medical-record(A Version of this Health Alert was published by Forbes.)

A trio of new reports shows the fundraising landscape for new digital health ventures remains promising. New York’s Startup Health, an investor and accelerator, has released its report on the digital health venture market for the third quarter. Startup Health estimates $6.5 billion has been invested in digital health deals in the first three quarters of 2016, more than the $6.1 billion invested in all of 2015.

San Francisco’s Rock Health, also an investor, estimates $3.3 billion in new digital health funding through Q3. Startup Health’s figures are likely larger because Startup Health includes deals outside the United States (including a $500 million investment in a Chinses mobile medical service). Startup Health also includes deals as small as $52,000, while Rock Health has previously specified it only includes deals worth at least $2 million.

With respect to U.S.-based companies, both reports note the San Francisco Bay area continues to attract the most capital. According to Startup Health, the total is $1.2 billion – almost twice as much as New York or Boston. However, the pool is getting wider and deeper. Businesses in Philadelphia, Chicago, Minneapolis/St. Paul, Los Angeles, San Diego, Dallas, and Washington, DC, all saw good deal flow.

Who Benefits From The “Right to Try” Experimental Medicines?


doctor-mom-and-sonThe Goldwater Institute has had great success getting states to pass “Right to Try” laws. Right to Try allows a desperately sick patient to take an experimental new medicine before the FDA has approved it.

Since I last wrote about this policy in November 2014, 31 states have passed Right to Try. Further, U.S. Senator Ron Johnson (R-WI) has tried to get a federal Right to Try law through the U.S. Senate.

However, there has been push-back. According to Allison Bateman-House of NYU Langone Medical Center, “there is no confirmed instance of anyone getting a drug through Right to Try.” Jonathan Friedlaender, a survivor of advanced metastatic melanoma, has written a compelling essay in Health Affairs, which concludes Johnson’s proposed federal law would not improve access to experimental medicines.

The problem has two parts:

Health Facilities Construction Growth Up Amidst General Decline in August


Census2Construction of health facilities significantly outpaced other construction in August. Overall, health facilities construction starts increased 1.2 percent in July, versus a drop of 0.8 percent for other construction. Further, both private and public health facilities construction grew.

Construction of private health facilities grew 0.6 percent, versus a drop of 0.4 percent for other private construction. Construction of public health facilities increased a whopping 3.6 percent, versus a drop of 2.2 percent for other public construction. Is this what they mean by “infrastructure” spending – broken bridges and roads, while more VA and county hospitals spring up?

See Table I Below the fold:

Is Pet Health As Dysfunctional as Human Health Care?


clemvet1Health policy analysts have long blamed the inefficiencies that befall the U.S. health care system to our over-reliance on third party payment. About 89 percent of all medical care is paid for by third parties — either employer-sponsored health plans, Medicare, Medicaid or individual medical insurance. Indeed, about 90 percent of the U.S. population have some type of health coverage. Thus, one could make a valid argument that medical markets devoid of insurance should function more like normal consumer markets. For instance, there is significant evidence that cosmetic medicine and corrective eye surgery both experience lower price inflation than medical care. These services are rarely covered by insurance. Another notable medical market that does not rely on insurance is veterinary medicine.

GDP: Health Services Grew Almost 12 Times Faster Than Non-Health GDP


BEAThe media noted today’s third estimate of second quarter Gross Domestic Product was revised upward from the second estimate. It was a sharply revised estimate of health spending that led to the higher overall estimate. While the estimate of GDP was revised up by $12.9 billion, the estimate of health services spending was revised up by $16.2 billion. Spending on services other than health services was revised down.

In real (inflation-adjusted) dollars, services grew 2.9 percent (annualized, seasonally adjusted) from the first quarter. As a large component of services, health services grew 7.1 percent.  While real GDP growth was 1.4 percent, once health services is stripped out, non-health GDP grew just 0.6 percent.

See Table I below the fold: