THIS WEEK IN REVIEW: Monday, Sept. 9th – Friday, Sept. 13th

September 13, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, September 9th – Friday, September 13th

The weather can’t seem to make up its mind here in Charlottesville- burning hot one day to rainy and chilly the next. But you know what’s the one thing that always stays consistent? Our love for health policy! 

On Tuesday, census data revealed that the uninsured rate in the United States had risen from 7.9 percent to 8.5 percent between 2017 and 2018. According to officials, the 0.6 percent rise (equaling about 2 million Americans) comes from a decrease in the number of people receiving coverage from Medicaid and other public programs.  While the census did not explicitly cite a causal factor in people losing Medicaid coverage, experts have cited increases in administrative requirements as a contributing factor (i.e. work and reporting requirements)

This comes at a time of great political interest in healthcare, as in both the hallways of Capitol Hill and on presidential debate stages, Democrats seek to challenge President Trump’s promise of being “the party of healthcare.” On the debate stage in Houston last night, presidential candidates reiterated support for a number of different plans they have backed throughout the campaign, ranging from strengthening the Affordable Care Act (ACA) to Sen. Bernie Sanders’ (D-VT) single-payer Medicare-for-All plan. House Speaker Nancy Pelosi (D-CA) blamed the President directly for the rise in the uninsured rate, saying he had forced people to “live in constant fear of an accident or injury that could spell financial ruin for their families.”

Speaker Pelosi is working on another aspect of healthcare, testing the waters with a plan that would allow for the negotiation of drug prices by the federal government beyond Medicare. During the 2016 election, Trump had initially supported drug pricing negotiations, but we will have to wait and see if Speaker Pelosi can get him to endorse her plan. Trump has already backed a plan from Senate Finance Committee Chairman Chuck Grassley (R-IA) and prominent member Ron Wyden (D-OR), but their plan does not include negotiation. Meanwhile, that same duo is requesting that the Department of Health and Human Services (HHS) use regulatory authority to reform direct and indirect remuneration (DIR) in Medicare Part D in an effort to promote pricing clarity and lower out-of-pocket costs. 

In other drug news, the large scale suit launched by thousands of localities against Purdue Pharma may soon be coming to a close. On Thursday, the parties reached a tentative settlement wherein the company will be dismantled and reassembled into a public benefit trust, a for-profit organization whose funds will benefit areas recovering from the opioid crisis.

Philadelphia’s attempt at combating the opioid crisis is facing pushback by the Trump Administration. Safehouse, a non-profit which is attempting to create the nation’s first medical professional-supervised opioid injection site, is facing a legal dispute directly argued by U.S. Attorney William McSwain. The government is citing the “crack house statute” a law that prevents organizations from enabling the unlawful use of controlled substances. Advocates for the organization state that the purpose of the law, which was passed during the height of the cocaine epidemic in the 1980s, was not meant to impede efforts to combat a public healthcare emergency.

While the administration doesn’t view such sites as potential options for combating the opioid epidemic, it might entertain creative solutions for other nation-wide concerns. President Trump was recently presented the option for a study to identify whether tracking individuals with mental illnesses could prevent potential violence. Stopping Aberrant Fatal Events by Helping Overcome Mental Extremes (SAFEHOME) would allow the government to track such individuals through mobile technologies, such as cell phones and high-tech watches, in an attempt to prevent them from committing violence. This would be one of the first programs to fall under the management of the Health Advanced Research Projects Agency (HARPA), a proposed federal organization that would seek creative ways to solving complex public health problems.

Following reports of six vaping related deaths and hundreds of vaping-related lung illnesses nationwide, the Trump Administration announced Wednesday its plans to ban flavored e-cigarettes. This move by the administration to combat youth vaping use comes in response to the FDA’s warning letter to Juul Labs this week over the company’s controversial marketing and promotional practices. Former New York City Mayor Michael Bloomberg has also jumped into the battle against vaping with a pledge of $160 million to support e-cigarette bans at the local, state, and federal levels. 

On an international scale, the world’s second-largest Ebola outbreak in history is occurring in the Democratic Republic of the Congo. According to the World Health Organization, there have been more than 3000 confirmed cases and more than 2000 lives lost. The WHO has declared the outbreak a public health emergency of international concern, the highest possible warning level. To make matters worse, the WHO has announced that it is running out of funds to help combat the disease. In more positive news, two experimental drugs for Ebola are showing promise, increasing the survival probability by about 60%. Hopefully, these new treatments will help bring an end to this deadly epidemic soon. 

That’s all for now! Stay dry…or warm…or cool…?

 


This Week’s Viewpoints Writing Team:
Avery Bullock, Annie Duncan, Jo McClain, Steven Moore and Nana Owusu