Today's News and Commentary

About health insurance

To Save Money, American Patients And Surgeons Meet In Cancun: This article is about self-insured businesses that fly their employees to “exotic locations” to have procedures performed in order to save money. This tactic has been tried on and off for decades. It can definitely save money and is safe- if nothing goes wrong.

Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals: This article details the increasing prevalence and cost of out-of-network billing for patients who were hospitalized or seen at the EDs at in-network hospitals between 2010 and 2016. “Of 5,457,981 inpatient admissions and 13,579 006 ED admissions… the percentage of ED visits with an out-of-network bill increased from 32.3% to 42.8%… during the study period, and the mean… potential financial responsibility for these bills increased from $220 ($420) to $628 ($865) ( all dollar values in 2018 US$). Similarly, the percentage of inpatient admissions with an out-of-network bill increased from 26.3% to 42.0%, and the mean… potential financial responsibility increased from $804 ($2456) to $2040 ($4967)…” Clearly this problem is growing in importance.

Medicare Plan Home Care Benefits Could Work: “Adding a mandatory home care benefit to all private Medicare plans [Medicare Advantage and well as Medicare supplements] sold in Minnesota could increase the plans’ premiums by about $20 per month — and cut the state’s spending on Medicaid nursing home benefits by about 21% by 2030.” It is an interesting way to reduce public long term care expenses.

About pharma

Amgen wins U.S. patent battle on arthritis drug Enbrel, thwarting Novartis: “U.S. District Judge Claire Cecchi in Newark, New Jersey, rejected arguments by Novartis’ Sandoz unit that the patents covering Enbrel’s active ingredient until 2029 should not have been granted because their concepts were already contained in previous patents.” Amgen will therefore be able to continue to charge branded prices for this drug.

Canada enacts drug price crackdown, in blow to pharmaceutical industry: In the biggest pharma reform since 1987, the Canadian government announced final regulations to lower drug prices by amounts expected to save Canadians C$13.2 billion ($10 billion) over the next ten years. Pharma companies may yet sue to block these regulations. Lower Canadian drug prices may further the arguments to import their drugs into this country.

About public health

Thermal Stabilization of Viral Vaccines in Low-Cost Sugar Films: This article describes a method to maintain vaccine efficacy for 2-3 months without previously required refrigeration. It is a real breakthrough in public health.