Healthcare Reads and News
The not – so – latest healthcare articles to arrive in my inbox. Pay attention to the xpostfactoid piece. What Andrew is detailing is there is assistance in getting better plans offering lower cost as defined by President Joe Biden’s Rescue Plan. People are not taking advantage of those discounts for lower cost healthcare insurance.
Also, the last two articles may be of greater interest.
“Violence against health workers ‘can no longer be tolerated,’ hospitals tell AG” (beckershospitalreview.com)
“Hospitals are bringing their concerns about violence against healthcare workers to U.S. Attorney General Merrick Garland.
While violence against workers at hospitals and health systems is not new — and organizations have long made efforts to reduce violence — the problem has been exacerbated during the pandemic, the American Hospital Association wrote to Mr. Garland in a March 23 letter.
The association cited examples of violence against healthcare workers as well as research published in 2021 indicating 44.4 percent of surveyed nurses reported experiencing physical violence and 67.8 percent reported experiencing verbal abuse during the pandemic.”
“Infamous Vitamin C Study May Rely on Fraudulent Data” | MedPage Today
“The data underpinning an infamous study of vitamin C for sepsis may be fraudulent, according to an analysis by an Australian physician and statistician that’s making waves among hospitalists and intensivists.
Kyle Sheldrick, MBBS, who is completing his PhD at the University of New South Wales, alleges that the pre- and post- comparison groups involved in the 94-patient study were too similar to be realistic.”
xpostfactoid: “HealthCare.gov should tell 600,000 low-income bronze plan enrollees: switch to silver”
This may be just plain ignorance on the part of the insurees or the navigators are missing the difference.
“BA.2 Is Behind More Than 1 in 3 COVID Cases in US” (medscape.com)
“More than a third of COVID-19 cases in the U.S. are now caused by the Omicron subvariant BA.2.
Although the proportion of BA.2 cases is increasing, overall infections are still declining from the record highs seen in January, according to Reuters.
For the week ending March 19, BA.2 accounted for 35% of U.S. infections, according to the latest data from the CDC. That compares with 22% a week before, which was revised down from 23%.”
“New Group Fights Push to Return Schools to ‘Normal’” | MedPage Today
“When Kaliris Salas-Ramirez, PhD, was getting ready to moderate a virtual town hall in December 2021, she thought she knew what to expect. The plan was to discuss “ways school communities can be kept safe” in the midst of a winter COVID-19 surge, according to the flyer for the event co-hosted by the American Federation of Teachers (AFT) and Parents for Responsive Equitable Safe Schools (PRESS).
The recommendations seemed straightforward enough: layered mitigation in schools with a combination of safety measures; more vaccination, testing, ventilation, filtration, and masks.
‘There were six scientists, each had a role, each had slides that they were going to present — this wasn’t something that we were negotiating on at that point,’ said Salas-Ramirez, an assistant medical professor at the CUNY School of Medicine in New York City.
Instead, a potential last-minute addition to the event caused what one Twitter user called an ‘explosion'”:
“The Evolving Role of the Medical Geneticist” | MedPage Today
“In the not-too-distant past, the focus for medical geneticists was diagnosis.
Now, genetics touches nearly every medical specialty, either via screening programs or treatments targeted to specific diseases. Ob/Gyns counsel women with BRCA mutations on breast and ovarian cancer risk. Neurologic conditions like spinal muscular atrophy and Duchenne muscular dystrophy have seen novel therapies come to market in recent years. And cancer drugs are tailored to tumors with specific mutations.”
“The dilemma of private practice physicians” (beckersasc.com)
“Physicians are flocking to employed models — almost 70 percent of physicians reported being employed at the end of 2020, with 1 in 5 being employed by corporate entities, according to a report from Avalere.
But some physicians believe the employment model lacks a critical element to patient care: Autonomy.
‘Small private practices give physicians the ability to provide the best care for their patients and to adapt to changes quickly and effectively,’ Joseph Anderson, MD, professor of Medicine at Dartmouth Geisel School of Medicine in Hanover, N.H., told Becker’s. ‘Small private practices are the lifeblood of U.S. medicine, and their ability to survive is vital to healthcare in this country.'”
“More supply chain disruptions to come & 6 more updates” (beckersasc.com)
Selected two issues which I thought were issues, the latter being the greater of the two.
“Here are six supply chain disruption stories reported during the last 10 days:
1. To help ease chronic blood shortages in the U.S., hospitals should partner with blood centers to increase donations and work with centers to host blood drives, America’s Blood Centers said.
2. States will see a significant reduction in shipments of COVID-19 monoclonal antibody treatments from the federal government beginning March 21 after the White House’s request for $15.6 billion in pandemic funding stalled in Congress.”
“The age group slowest to return to the workforce” (beckershospitalreview.com)
I picked two (numbers 2 and 3) off of the list which I thought were most interesting. There were others you nay find defining.
“2. Employment by those younger than 45 or age 65 and older rebounded to about their December 2019 levels by December 2021, with some slowness among those ages 25 – 34.
3. However, there was still an employment gap of more than 1 million Americans ages 45-54 and more than 800,000 Americans ages 55 – 64 by the end of 2021.”
“COVID Pandemic Fuelled 2021 Population Drop in 73% of US Counties” (medscape.com)
(Reuters) – The toll of the COVID-19 pandemic was reflected in a natural decrease last year in the population of nearly three-quarters of U.S. counties versus the two previous years, the census bureau said on Thursday.
More than 73% of U.S. counties experienced natural decrease, or an excess of deaths over births, up from 55.5% in 2020 and 45.5% in 2019, bureau data showed.
A little later in this article; “Between 2020 and 2021, population increased in about 65% of metropolitan areas within the 50 U.S. states and the District of Columbia.”
“Moderna says its low-dose COVID shots work for kids under 6” | Modern Healthcare
“Moderna’s COVID-19 vaccine works in babies, toddlers and preschoolers, the company announced Wednesday — a development that could pave the way for the littlest kids to be vaccinated by summer if regulators agree.
Moderna said that in the coming weeks it would ask regulators in the U.S. and Europe to authorize two small-dose shots for youngsters under 6.”
“Doctors Finding Hurdles to Using Pills to Treat COVID-19” (medscape.com)
This is similar to every other treatment I have read about. If you can get the treatment early on, you avoid or prevent (less likely) a severe form of Covid.
“High-risk COVID-19 patients now have new treatments they can take at home to stay out of the hospital — if doctors get the pills to them fast enough.
Health systems around the country are rushing out same-day prescription deliveries. Some clinics have started testing and treating patients in one visit,
The goal is to get patients started on either Pfizer’s Paxlovid tablets or Merck’s molnupiravir capsules within five days of symptoms appearing. That can prevent people with big health risks from growing sicker and filling up hospitals if another surge develops.”
I qualify for a subsidy on my marketplace plan, but not so much that silver or even bronze is free. So I understand the article is not pertinent to me – I think.
Most of my medical expenses are doctors copays. I estimate that I will not reach the deductible. I calculate that I am better off with a bronze plan. (For the year in which I had a hospital visit, I shot past the out-of-pocket limit, but the difference was less than I would have paid in premiums for those other four years.)
My options looked nothing like this:
The silver plan I saw had a $150 per month higher premium and about a $2000 lower deductible. Better off with silver if and only if I surpass the deductible by a chunk.
So, here is the question. Did I miss something? Are Oregon plans different? Or perhaps I made too much to see the plans offered at less than 150% FPL? Healthcare.gov no longer shows me the plans I did not choose. I think that even though I have a marketplace plan, I do not know enough to help others with theirs.
Arne:
Tough questions for which I have no answers too. Being on traditional Medicare + Supplemental and Part D is pretty good. The Advantage people are in for a surprise. Andrew Sprung wrote the comparison. He may be able to answer. I suspect, given your background, you have too high of an income.
Keep me in the loop. I know others or I can find the answers. This goes back to revealing information which you may not want to do.
This is also temporary much like the child tax credit.
Arne:
I noticed you are not up to date on CSRs etc.
This is taken from Xpostfactoid. The 200% is temporary and I doubt it would fit you considering what little I know of you. Andrew is the expert on the explanation for ACA insurance plans the same as Coberly being such on SS. With Biden’s Rescue Plan there was a change in the costs of Silver healthcare plans for those with incomes <150% FPL being free and a 2% cost between 150% and 200%. 11 states where higher-income ACA marketplace enrollees went for cheap gold plans
It is an interesting read. Much of this will go away in a year as Manchin and Republicans stymie progress in making healthcare more available without tackling costs of it.
Run,
When I was laid off, I could either take a job at lower pay or figure out how to retire early. I worked contracts until I was 59.5 and retired when the last contract ended. My income is whatever I want to withdraw from my 401k. Keeping my income low gives me a marketplace subsidy. My reaction to covid has been to spend even less.
All this (and seeing your posts on AB) keeps making me think I should understand more about CSRs and silver plans, but when I actually check the plans, I find that bronze is cheaper (in years I stay out of the hospital). I think there is a discontinuity at 200% FPL. I suppose I could avoid taxes successfully by living off savings to make me look that poor, but I have no interest in that.
Arne:
My point was just to show you what was going on today with commercial healthcare insurance. The ACA is flawed as it feeds commercial healthcare and commercial healthcare insurance. There is no cost control. The overwhelming issue still being touted is blaming the patient for the overuse of healthcare when the opposite is true.
And Congress has endorsed essentially the same approach to cutting health care costs, an approach came to be called “managed care” by the mid-1980s. Based on the assumption that U.S. health care costs are double those of other wealthy nations because doctors order services patients don’t need, the solution is to “manage” doctors and provide financial incentives that nudge them to cut services.
ACOs Did Not Cut Costs
While some of this is true is terms of doctors ordering more service, Americans tend not to use healthcare due to costly pricing.
Over the last two decades, research has clearly demonstrated that overuse of medical care isn’t why health care costs are rising. Per capita health care costs in the U.S. are high compared with other nations because the prices at which medical services and drugs are sold is excessive.
Kip Sullivan and I have had conversations about cost versus pricing. As I explained to him, we see pricing. How do we know whether prices are legitimate if we do not understand costs. Germany has been having issues setting prices because they do not know costs and the healthcare companies do not tell them.
Another factor is administrative. With single payer you have one payer. Medicare as an example of this has administrative cost on ~3%. commercial insurance has administrative costs of ~15% while hospitals have administrative costs of ~14%. This impacts pricing to the patient before insurance negotiated prices which are typically two and three times what Medicare pays out.
Commercial healthcare insurance and the Medicare version of it called Medicare Advantage can not compete with Medicare even if Medicare is Fee for Service. It is because of over coding for next years care, denial of care, etc that Advantage plans are profitable.
I read your comment and understand being laid off and looking for work. I have a Masters degree and a couple of other degrees. I spent two years one time working for a tree service cutting trees down and chipping branches juts to keep my family in one place till I could find good work. Probably been laid off a half a dozen times. Always found a better job that paid more. Retired at 70 and my wife did similar. We maxed out on SS. We can get by on SS. Our retirement funds are being rolled over. It was a plan.
I worked globally.
Arne:
Additionally, I am not going to accuse you of making a bad decision. We each have to do what we need to do at that moment in time.