THIS WEEK IN REVIEW: Monday, Oct. 7th – Friday, Oct. 11th

October 11, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, October 7th – Friday, October 11th

Since it’s Spooky Season™, I suppose we could kick off this pun-filled month by saying “Welcome to another weekly installment of Boo-points?” … or “Ghoul-points”… or “Witches Brew-points”? 

To start, we’ll skip the haunted houses and head straight to the White House! On Wednesday, The Trump Administration proposed exceptions to the Physician Self-Referral Law and the Federal Anti-Kickback Statute. These laws intend to prevent doctors from taking bribes, or referring patients to services that would financially benefit themselves. There will still be rules against fraud, the exceptions will rather allow for “value-based” payment arrangements, where doctors are paid based on patients’ health outcomes.

In an attempt to lift spirits, President Trump released an executive order on protecting and improving Medicare. It outlines a variety of broad goals on innovation, pricing, and consumer choice, but critics are concerned it will lead to higher costs and potentially expose seniors to surprise medical bills. In tandem with the executive order, Centers for Medicare & Medicaid Services (CMS) announced that seniors will have access to more high-quality health plans. By 2020, 81% of Medicare Advantage enrollees with prescription drug coverage will be in four and five star plans, an increase from 69% in 2017, and most recipients will have access to Medicare Advantage and Part D plans with four or more stars. CMS also announced a change to the Agency’s Nursing Home Compare Website. Nursing homes cited for incidents of abuse, neglect, or exploitation will now have an icon next to their name. This is to increase transparency and empower the consumer.

The Trump administration is also interested in pursuing other changes to healthcare cost policies- but only if Democrats can give it breathing room to do so (but that might be “witchful” thinking). Joe Grogan, Trump’s top domestic policy adviser, announced on Monday that the administration would like to support a bill lowering drug pricing like that of one proposed recently by Nancy Pelosi. Their support would have its own price however: that Democrats drop their attempt to impeach the president. Grogan believes that Democrats are currently distracted by impeachment attempts, and that if they’d just treat drug costs as a priority and stop their tricks, the administration would be willing to open its doors to a sweet compromise.

While the administration would like to lower drug pricing, it’s clear that pharmaceutical companies would find that… frightening. On Tuesday The Institute for Clinical and Economic Review (ICER), an independent non-profit research institute, released a report detailing that between the beginning of 2017 and the end of 2018, Americans overpaid $5.1 billion through unwarranted price hikes among just seven medications. ICER identified medications that were most likely to contribute to total drug cost increases, then identified these seven by determining that their increases were not justified on any findings showing increased benefits. 

One of the drugs on the list is Truvada, a drug used for pre-exposure prophylaxis (PrEP) to prevent HIV infection. Soon, California will be the first state to offer this drug to be dispensed through pharmacies without a prescription. The new law would also allow PEP, the post-exposure prophylaxis, the same prescription-free status. The law has two important safeguards built-in: first, it guarantees a 60-day maximum supply before a prescription is needed to prevent individuals from taking it too long without medical supervision. Second, patients must show proof that they have tested negative for HIV in the last seven days. 

California is looking out for its residents in another broader area through a ban on the pesticide chlorpyrifos — a potion, err, a pesticide commonly used on alfalfa, almonds, citrus, cotton, grapes, and walnuts crops. Environmental health officials view this as a “big win” as this substance has been linked to health defects in children including brain damage when inhaled or exposed to skin. The manufacturers of the pesticide have agreed to drop efforts to prevent the ban, allowing it to go into effect earlier than expected. 

In Louisiana, a court case on abortion will advance to the Supreme Court regarding the state’s ability to require doctors who perform abortions to have admitting privileges at local hospitals. While the decision may still be months away, Planned Parenthood is focusing on ways to stop additional restrictions on abortion rights through a large campaign focused on the 2020 elections. And for a final state update, Montana has now joined several other states that have enacted a temporary hex on the sale of e-cigarette flavors. In the business world, both Kroger and Walgreens are pulling those nicotine-filled USB drives from the shelves. The vaping-related death toll is now at 29, with well over 1,000 cases of vaping-related illness reported across the country. 

In closing, we ask a question: what do pet turtles and hot tubs have in common? Well, if you have the privilege of being the owner of one, the other, or both, make sure to take extra care, as both have been linked to disease outbreaks in the past few weeks. The Centers for Disease Control and Prevention (CDC) reported on Wednesday that 21 people in 13 states have been infected in a recent salmonella outbreak, and that 71 percent of cases have cited contact with turtles.  Similarly, a recent outbreak of Legionnaires disease in North Carolina has been linked to visiting the state’s Mountain State Fair, where lung infections were found to be more prevalent in people who engaged with hot tub displays that were presented at the fair. If either of these are something close to you, stay vigilant and take the time to reach out for more information. The CDC has helpful tips on outbreaks connected to pet reptiles and amphibians here (and tips for zombie outbreaks here.)

Stay spooky and creep it real!

 


This Week’s Viewpoints Writing Team:
Carina Clawson, Jo McClain, Steven Moore and Nana Owusu