About health insurance
McConnell and Kaine want to raise the federal smoking age to 21: Finally, some rational bipartisan cooperation: “Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Tim Kaine (D-Va.) introduced a bill Monday to raise the federal minimum age to purchase tobacco from 18 to 21, a measure they say is aimed at reducing teen use of e-cigarettes.”
California eyes health care for immigrants in US illegally: France covers illegal immigrants as a matter of public health. But this measure may be “no good deed goes unpunished.” These illegal immigrants may not be eligible for legal status if they are receiving public welfare benefits.
‘Medicare for All’s’ rich benefits ‘leapfrog’ other nations: This article is a nice summary pointing out that “Medicare for All” not only provides more benefits than does other countries’ public systems, but also eliminates the private sector, on which other countries rely to relieve excessive waiting times.
Variation Among Primary Care Physicians in 30-Day Readmissions: Medicare is continuing to look at the quality pf physician performance and linking it to payment. One measure is 30-day readmission rates. This study looked at primary care physicians in Texas and found that for their fee for service Medicare patients, the variation in readmission rates is very low. If the findings are found to be more generalizable, this metric will need to be reassessed for certain physician groups.
Read the research (Full article is by subscription but this summary makes the point)
About the public’s health
Provider and Staff Feedback on Screening for Social and Behavioral Determinants of Health for Pediatric Patients: This research highlights that gathering social determinants of healthcare is important, but the information also needs to be customized to the local patient population.
Contributions of Health Care to Longevity: A Review of 4 Estimation Methods: How much does medical care contribute to increased longevity? The exact figure depends on study methodology, but it is clear any benefit is dwarfed by the contribution of public health measures. The authors conclude: “The results converge to suggest that restricted access to medical care accounts for about 10% of premature death or other undesirable health outcomes. Health care has modest effects on the extension of US life expectancy, while behavioral and social determinants may have larger effects.“ It is interesting that today’s NY Times also has a story on this subject.
Freestanding emergency departments in Texas do not alleviate congestion in hospital-based emergency departments: To expand access to care and relieve overcrowed ERs, many communities and hospitals have opened up free standing ERs or urgent care centers (FrEds). Have they accomplished their mission? At least in Texas, the answer is they “did not help relieve congestion in nearby hospitals in major metropolitan areas in Texas. By offering more treatment options to patients, FrEDs are associated with increased usage of emergency services.” The same increase in service delivery has been found in some telemedicine programs.
IBD [Inflammatory Bowel Disease]Rx Tied to Pharma Payments to Docs: Many healthcare systems do not allow its physicians to receive anything of value from pharma companies. The results of this study are one reason. “The researchers accounted for patient volume, and the associated prescription cost was still significantly related to the value of industry payments, with every $1,000 in industry payments associated with a $3,846 increase in prescription claims (P<0.001, R2=7.64%, 95% CI $3,285 to $4,407)…”
About medical technology
The top 11 medtech approvals of 2018: The online publication Fierce Biotech has just issued its top 11 medtech approvals of 2018.
About healthcare law
Supreme Court Refuses to Hear Case on Doctrine Preventing Military Medical Malpractice Lawsuits: “The lawsuit had failed from succeeding in the lower courts due to a 1950 Supreme Court case, Feres v. United States, which established the controversial legal precedent known as the Feres doctrine. The doctrine prevents service members on active duty from leveraging medical malpractice lawsuits against the armed forces under the Federal Tort Claims Act for injuries and negligence.” Read the article for the whole story. To show how controversial this issue is, Justices Ginsburg and Thomas joined in the dissenting opinion.