About the public’s health
Vaccine researchers are preparing for Disease X: Throughout history we have faced diseases that no-one had ever seen- for example, AIDS. As a public health measure, how do we prepare for these crises in a systematic fashion as opposed to one-offs as they arise? The Coalition for Epidemic Preparedness Innovations (CEPI), a charity in Oslo, Norway, is coordinating such efforts. Read the story to learn what is being done in this area.
Health systems begin offering waivers for care to furloughed federal workers: During the government shutdown, federal employees retain their health insurance. However, while they are not being paid, they still have out of pocket responsibilities. Particularly, this time of year is when deductibles are most onerous. This article explains how some health systems are pitching in to help these workers. The remaining question is what happens to independent contractors who are not being paid? They will have a hard time even paying their premiums.
Medicare experiment could put more pressure on insurers to save money on prescription drugs: Continuing the government’s efforts to save money from pharma payments, CMS announced a new voluntary program for Medicare D plans. After a patient has spent $5100 out of pocket, he or she is responsible for an additional 5% of costs. The rest of the amounts are picked up by CMS (85%) and the insurance plan (10%). CMS is offering insurers the opportunity to share more of the savings in this category if they do a better job of controlling costs (though how much is yet to be determined). The plan is voluntary and starts next year.
UnitedHealthcare, fueled by federal probes, sues generics makers for price fixing: As previously reported, the federal government is suing a group of generic drug manufacturers for price fixing. Now UnitedHealthcare is joining other insurers (like Humana) seeking to recover overpayments due to the collusion. Between the antitrust action and the insurer suits, the manufacturers could be responsible for billions of dollars in payments.
Comparison of Wait Times for New Patients Between the Private Sector and United States Department of Veterans Affairs Medical Centers: The Federal government is offering more private care options to veterans in order to make services more accessible. However, this study found that over the past few years the VA has shortened waiting times to the point where, on average, many service are provided more quickly than in the private sector. The reasons are twofold- the VA is getting better and the private sector is getting worse. Now the question is how can the private sector learn from the VA?
Trump Proposals Could Increase Health Costs for Consumers: I previously reported on the government’s proposal to allow insurance companies to increase out of pocket expense maximums. To this initiative is being added changes in the calculation of what counts to that maximum. Particularly, if a patient buys a branded drug when a generic is available, only the lower copay for the generic will count toward the annual maximum. Further, coupons will not be allowed to count at all.
These changes are possible because the government has the authority to impose its calculation for healthcare cost inflation. The new computation will also reduce the number of those eligible for ACA exchange subsidies. According to the article: “ The Trump administration estimated that the changes would save the government $900 million annually in subsidies in 2020 and 2021 and $1 billion a year in 2022 and 2023. In addition, it predicted that 100,000 fewer people would have coverage through the insurance exchanges created under the Affordable Care Act.”