Healthcare
NPR
People with mild or moderate hearing loss could soon be able to buy hearing aids without a medical exam or special fitting, under a new rule being proposed by the Food and Drug Administration. The agency says 37.5 million American adults have difficulty hearing.
Shots – Health News : NPR
Patients are months away from not having to worry about most surprise medical bills — those extra costs that can amount to hundreds or thousands of dollars when people are unknowingly treated by an out-of-network doctor or hospital.
The No Surprises Act — which takes effect Jan. 1 — generally forbids insurers from dropping such bills on patients and, instead, requires health care providers and insurers to work out a deal between themselves.
Some observers have speculated that the law will have the unintended consequence of shifting costs and leading to higher insurance premiums.
Many policy experts told KHN that, in fact, the opposite may happen: It may slightly slow premium growth.
The reason, said Katie Keith, a research faculty member at the Center on Health Insurance Reforms at Georgetown University, is that a new rule released Sept. 30 by the Biden administration appears to "put a thumb on the scale" to discourage settlements at amounts higher than most insurers generally pay for in-network care.
Why Hospitals and Health Insurers Didn’t Want You to See Their Prices – The New York Times
This year, the federal government ordered hospitals to begin publishing a prized secret: a complete list of the prices they negotiate with private insurers.
The insurers’ trade association had called the rule unconstitutional and said it would “undermine competitive negotiations.” Four hospital associations jointly sued the government to block it, and appealed when they lost.
They lost again, and seven months later, many hospitals are simply ignoring the requirement and posting nothing.
But data from the hospitals that have complied hints at why the powerful industries wanted this information to remain hidden.
It shows hospitals are charging patients wildly different amounts for the same basic services: procedures as simple as an X-ray or a pregnancy test.
And it provides numerous examples of major health insurers — some of the world’s largest companies, with billions in annual profits — negotiating surprisingly unfavorable rates for their customers. In many cases, insured patients are getting prices that are higher than they would if they pretended to have no coverage at all.
Planet Money : NPR
Last month, Michigan's two largest hospital systems, Spectrum Health and Beaumont Health, announced they wanted to become one. The $12.9 billion "megamerger" would create a health industrial complex spanning 22 hospitals, 305 outpatient facilities, and an insurance company. It would employ 64,000 people, making it the largest employer in Michigan. Local newspapers had expected the merger to "sail through" government approval. But now they're not so sure.
That's because President Biden recently signed an executive order saying his administration was serious about promoting competition, and he specifically singled out hospitals as an area where growing monopolization is a concern. The order, the White House says, "underscores that hospital mergers can be harmful to patients and encourages the Justice Department and Federal Trade Commission (FTC) to review and revise their merger guidelines to ensure patients are not harmed by such mergers."
Hospitals are a really important part of the American economy. Not just in terms of health and wellbeing, but in terms of dollars and cents. The largest chunk of America's healthcare spending goes to hospitals. And the hospital sector is one of the largest sectors in the overall American economy, accounting for about 6 percent of America's GDP. Hospitals do a lot of good things. They save lives. They create good jobs. But because of growing monopolization of them, Zack Cooper, an economist at Yale School of Public Health, worries that they're becoming like a "Dracula" that "sucks some of the vibrancy out of a lot of towns across the country."
Fund Single Payer Out of Existing Taxes
It bothers me that the only way that is being proposed to implement a new single payer healthcare system is to create a new tax. Why not fund single-payer healthcare out of existing taxes? Couldn’t enough fat and waste in government be cut to fund a new single payer healthcare benefit?
The United States Government, along with the many governments at the State and Local-level serve many more purposes and functions then they did in years past. While many of them are meaningful, there is also a lot of waste, fraud and abuse. Local government in particular is notoriously duplicative, when most local government functions could be provided by the state government.
I suggest radically downsizing the military and local police forces. We don’t need to be preparing against the next Soviet invasion, as the USSR is no more and cold war is history. Close prisons and jails, get rid of costly laws, like those against minor crimes and drug abuse. Allow private citizens and corporations to sue for monetary compensation, as a deterrent against property theft and minor injury or damage caused by criminals. Limit criminal appeals, replace long prison sentences with the death penalty. There is no reason to feed and clothe millions of people that offer nothing more for society.
Put spending caps on medical professionals and doctors, limit spending at both primary schools and colleges. People can make existing resources go further, there is no need for always investing in the latest technology or a fancy new building. Just make everything go further. Make everything in education and healthcare lower cost.
And remember all the savings that could be gotten by eliminating Medicaid and Medicare, along with regulations on Healthcare Companies. All that money could be put into the single-payer pot.
I think before we propose a new tax to fund healthcare for all in our country, we should be looking harder at cutting existing spending in governemnt.
Why LYMErix failed and there’s no alternative yet.
We had one, once. The Food and Drug Administration approved LYMErix, manufactured by SmithKline Beecham (now GlaxoSmithKline), for use in 1998. LYMErix worked by inducing antibodies into human blood, which would then go into any ticks that attached to your body. There, they would neutralize the bacteria that cause Lyme, Borrelia burgdorferi, before the bacteria could go from the tick into you. In clinical trials, the shot showed about 78 percent effectiveness after the required three doses (hey, I’d take it). But some patients who got the shot after it went on the market testified that they developed arthritis after vaccination. The FDA investigated, but decided the evidence that the vaccine was linked to patients’ arthritis wasn’t strong enough to withdraw its approval for LYMErix. Sales fell nonetheless, and the company pulled the vaccine in 2002.
The story of LYMErix’s downfall has become a case study in the history of vaccines, in part because of its complexity. In his book on the Cutter Incident—a disastrous episode in the mass distribution of the Salk polio vaccine—and its impact on vaccine production, vaccine historian Paul Offit described what happened with LYMErix as a story about liability. The Lyme vaccine was an optional shot, so it wasn’t covered by the National Vaccine Injury Compensation Program. (The program was set up in the 1980s to encourage pharmaceutical companies to continue production of vaccines by reducing the fear of liability.) Because of that exemption from the federal program, writes Offit, there was no cushion between the manufacturers of LYMErix and anyone who might claim it caused their arthritis. The vaccine “was left to survive the abuses of personal injury lawyers and the inaccurate media reports that inevitably follow.” Advertisement The perception was that people got Lyme disease from their beautiful lawns in Connecticut.
This is how I have seen it explained, in shorthand form: We don’t have a Lyme vaccine because of anti-vaxxers. Retelling the LYMErix story in 2018, Vox’s Brian Resnick described it as “a stark reminder of how anti-vaccine mania of the past few decades is leaving us all more susceptible to disease.” Brittany Flaherty pointed out in a 2019 STAT piece about the Lyme vaccine that LYMErix hit the market at a bad time for vaccine hesitancy and anti-vax activism. The infamous Lancet report claiming that the MMR shot was linked to autism was published in 1998 (it does not; the paper has been widely debunked and retracted), and the rotavirus vaccination RotaShield was withdrawn from the market in 1999, after a number of infants who received it suffered intussusception, or bowel obstruction. There was an unease in the public climate around any new shot, especially an optional one.
But there’s another reason LYMErix had trouble: It had what I think of as a “New England problem.” The perception was that people got Lyme disease from their beautiful lawns in Connecticut. “For many individuals in Lyme-endemic areas, it is precisely the environmental privilege of being able to live in or close to ‘nature’ that makes possible the environmental risk of Lyme disease,” wrote Abigail Dumes, an anthropologist who has published a book about Lyme. Lyme does not stand to affect everyone; it is dependent on the range of the deer tick and cannot be transmitted between people, so it has a unique status among infectious diseases. The LYMErix shot was not like the MMR vaccine, a key tool of public health that would be recommended for all children so that transmissible diseases would stop spreading; it was seen as a choice, one made by privileged adults who wanted to live freer of fear. Chinh Le, a member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, called the shot a “yuppie vaccine” for people who “will pay a lot of money for their Nikes and their Esprit and shop at L.L.Bean’s” and who “will have no consideration for cost-effectiveness when they want a vaccine because they’re going to travel to Cape Cod.” (I’m in this picture, and I don’t like it!) Historian Robert Aronowitz cites Le’s testimony in a retrospective of LYMErix as evidence that regulators were lukewarm about the shot. Aronowitz notes that the lack of enthusiasm showed up in their recommendations for who should get it: The government issued a “should consider” recommendation for people at high risk for tick bites in areas where Lyme was present, and a “may consider” for people sometimes exposed to tick habitats. Some experts Aronowitz interviewed thought these designations may have made it hard to encourage uptake.