Tag: "Health Care Access"

Hits and Misses

Smiling NurseThree more states — Connecticut, Nebraska and New York — are in the process of allowing nurse practitioners to work without oversight from a doctor, in an effort to alleviate physician shortages.

Tom Sargent summarizes economics in 335 words. Or is it 297 words?

eHealth, Inc., an online insurance broker, is ObamaCare’s biggest winner.

If we had a drug to delay Alzheimer’s by five years, annual treatment costs would drop by almost half a trillion dollars a year.

Will Vermont Ever Get a Single-Payer System?

money-rollsJust two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it.

Although Act 48 required Vermont to create a single-payer system by 2017, the state hasn’t drafted a bill spelling out how to raise the additional $1.6 billion a year (based on the state’s estimate) the system needs. The state collected only $2.7 billion in tax revenue in fiscal year 2012, so that’s a vexingly large sum to scrape together…

Paying for this program would likely make Vermont the highest-taxed state in the nation, by quite a lot.

Megan McArdle.

Employers Switch from Commercial Insurance to Self-Insured Plans

According to Citibank’s top ranked analyst Carl McDonald:

By our analysis, since 2002, risk enrollment at the publicly traded plans has fallen by over 14 million lives…The emergence of private exchanges that rely on a risk model (like the exchange product offered by Aon Hewitt) could help slow the loss of risk enrollment but the benefits of self-funding are so significant for many employers that we believe risk enrollment will continue to shrink.

Headlines I Wish I Hadn’t Seen

Administration does not know if it has legal authority to delay ObamaCare mandates.

New Jersey woman’s ObamaCare insurance turned down by 96 doctors — still no appointment.

What’s more difficult than signing up for an ObamaCare insurance plan? Cancelling one.

What Are the Mortality Risks of Being Uninsured?

This is from Chris Conover:

Since the evidence is equivocal at best, let us — for purposes of discussion — average the point estimates from 4 studies…and compare this relative mortality risk (1.22) to other factors that elevate the annual probability of death.

546

Headlines I Wish I Hadn’t Seen

black-man-worriedWhy liberal cities are bad for blacks: Some of the most segregated cities in the U.S. are above the Mason-Dixon line, including Chicago, Milwaukee, Philadelphia and Detroit.

Flight 370: If nothing else can be learned from this bizarre hunt, one thing has become clear: There’s a ton of trash in the Indian Ocean.

Day care costs more than college in 31 states.

Processing backlog: Hundreds of thousands of consumers who may qualify for new Medicaid coverage aren’t getting it.

Can States Overturn the FDA’s Limits on Compassionate Use?

At National Review Online, Jillian Kay Melchior, reports on a cancer patient who has run out of therapies. There are medicines under development that might help, but drug-makers won’t let her have them under the FDA’s “compassionate use” doctrine.

ClVariety of Medicine in Pill Bottlesinical trials accept only “typical” patients — Mikaela’s rare form of kidney cancer has ruled her out, but for others in her situation, complications as common as diabetes or high blood pressure could also be reason for ineligibility. And the Food and Drug Administration’s approval process for “compassionate use” of an experimental drug outside of clinical trials is extremely arduous.

First, a pharmaceutical company has to be willing to provide the experimental drug — a high-risk proposition, given that an atypical result in an atypical patient can prompt the FDA to delay approval or require significant and expensive additional testing…And approval from a pharmaceutical company is just the first step. Next, patients and doctors must fill out an exhaustive paperwork disclosure to submit to the FDA, which is estimated to take at least 100 hours to complete. The FDA then begins a review, which is supposed to take no longer than a month — but if the agency’s reviewers have any additional questions or need more information, that 30-day clock is reset. Finally, the hospital’s institutional review board has to give approval — and if a patient is being treated at a small hospital that lacks such an administrative panel, the case has to be reviewed by a bigger facility, often one unfamiliar with the patient.

Hits and Misses

Costdog-1 to clone a dog: $100,000.

More lawlessness: Medicare Advantage plans will get a 0.4% increase in premiums instead of the 1.9% cut the ACA seems to require.

Is Starbuck’s recycling your paper cup? Probably not.

Consumer driven health care: There are about 1,600 walk-in medical clinics across the country and the number is projected to double in the next three years.

Are Foreign Drugs Safer Than You Think?

There are no reported examples of Americans dying by taking real, but F.D.A.-unapproved, medication bought online from a foreign pharmacy that requires valid prescriptions. This is after tens of millions of prescriptions have been filled online and internationally over the past 15 or so years, since online pharmacies were created. (NYT)

The Enrollment Numbers Aren’t What You Think

Confident BusinesswomanA new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere. Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income. (Kaiser Health News)