Today's News and Commentary

About insurance

Blue Cross and Blue Shield of Texas and Sanitas USA to Open Medical Centers in Dallas and Houston: In another cross functional joint venture, these two companies are opening primary care clinics in Dallas and Houston. The difference from many other examples in this category is that they will be open to self-pay and Medicare patients as well as Blue Cross members.

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Here are two articles summarizing the federal governments thoughts about revamping the way it pays for care. The first is about MedPAC’s thoughts regarding Medicare abandoning fee for service. The second reports on Adam Boehler’s (director of the Center for Medicare and Medicaid Innovation) speech yesterday at the American Hospital Association conference. The focus was on post-acute care bundles.

Mulvaney, administration officials emerge from Camp David summit planning health care rollout 'fairly shortly': In the latest update on when the GOP will offer its own healthcare proposal, it will not wait for after the 2020 election as the President most recently announced. Instead, his acting chief of staff said it will come “fairly shortly.”

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DOJ asks for speedy hearing in case that could kill Obamacare: On the theme of “repeal (or kill) and replace,” the Justice Department has asked for an accelerated appeal of the ruling that could invalidate the ACA.

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About the public’s health

Lost Productivity From Heart Attack, Stroke Are Twice Direct Medical Costs, Study Finds: In addition to paying attention to social determinants of health, this article is a reminder that we should account for non-medical costs of illness in making cost-benefit decisions.

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The Economic Burden of Elevated Blood Glucose Levels in 2017: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes, and Prediabetes: Speaking of costs, those for diabetes are still growing. “The economic burden associated with diagnosed diabetes (all ages), undiagnosed diabetes and prediabetes (adults), and gestational diabetes (mothers and newborns) reached nearly $404 billion in 2017…” More multifaceted approaches are still needed. More taxes on sugary drinks, for example?

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In a Poor Kenyan Community, Cheap Antibiotics Fuel Deadly Drug-Resistant Infections: This is a well-written article about antibiotic resistance as a global issue. Because generic antibiotics are cheap and plentiful in developing countries, and because they are available without a prescription, they are being used indiscriminately—causing bacterial resistance to emerge. Mobile populations spread these organisms, causing global public health problems.

Read the article (NY Times but appears to be open access)

New York orders measles vaccinations in Brooklyn amid outbreak, mayor says: The mandate covers all unvaccinated people and carries a $1000 fine for non-compliance. More governmental entities are moving to these mandates as measles continues to be spread.

Read the story (Washington Post but appears to be open access)

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians: These guidelines come from the academic professional society of internal medicine (adult medicine) specialists and concerns the frequency of mammography for normal risk women. One screen is out- physician exam for breast masses. Self-exam was eliminated as an effective detection strategy for screening normal risk women a number of years ago.

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Judge rules New York county can’t ban unvaccinated children from schools, parks: Recall the previous story about Rockland County, NY banning unvaccinated children from public places? Nevermind. A “a state judge put the injunction on hold.”

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Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study: Many healthy people are still buying dietary/nutritional supplements hoping that it will reduce their mortality risk. This study found that: ‘Use of dietary supplements is not associated with mortality benefits among U.S. adults.”

Read the research abstract

About pharma

The 5 drugs to watch in 2019: In order to accurately recommend premiums and out of pocket costs, healthcare actuaries need to know not only current but future costs of care. Optum (the non-insurance part of United HealthGroup) issued its 2019 list of 5 drugs to watch for their impact on health care costs.

Read about these drugs

ViiV Healthcare's Dovato approved in US as first two-drug single-tablet regimen for patients with treatment-naïve HIV: HIV treatments have become simpler, as medications no longer need to be taken as often, and combinations pills have been introduced. This announcement is about approval of the first two-drug single-tablet for patients with treatment-naïve HIV.

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Two new research studies show promise for treating problems with aging brains. The first study (in mice) found that blocking the gene CD22 enhanced the ability of microglia to clear debris- improving spatial memory and associative memory. The second study used 25 min of electrical “stimulation, frequency-tuned to individual brain network dynamics…The end result was rapid improvement in working-memory performance that outlasted a 50 min post-stimulation period.”