Category: Healthcare

COVID-19: Audit Cites ‘Distortion, Suppression Of Facts’ In Nursing Home Reporting Under Cuomo

Mary Pat Campbell

Link: https://dailyvoice.com/new-york/northsalem/news/covid-19-audit-cites-distortion-suppression-of-facts-in-nursing-home-reporting-under-cuomo/828102/

Excerpt:

The state Health Department intentionally “misled the public” regarding the number of COVID-19 deaths in nursing homes under former New York Gov. Andrew Cuomo’s administration, according to a scathing audit from the Comptroller Thomas P. DiNapoli.

When the COVID-19 pandemic swept through New York, the Department of Health was not prepared to respond to the infectious disease outbreaks in nursing homes, according to the audit, which helped lead to the inaccurate virus-related death count in facilities.

Auditors found that health officials undercounted the death toll in nursing homes by at least 4,100 residents and at times more than 50 percent, despite claims from the former governor, who said the state was doing well in protecting seniors.

Author(s): Zak Failla

Publication Date: 17 March 2022

Publication Site: New York Daily Voice

What are the Implications of Long COVID for Employment and Health Coverage?

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/what-are-the-implications-of-long-covid-for-employment-and-health-coverage/

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Excerpt:

Preliminary evidence suggests there may be significant implications for employment: Surveys show that among adults with long COVID who worked prior to infection, over half are out of work or working fewer hours (Figure 2). Many conditions associated with long COVID—such as malaise, fatigue, or the inability to concentrate—limit people’s ability to work, even if they have jobs that allow for remote work and other accommodations. Two surveys of people with long COVID who had worked prior to infection showed that between 22% and 27% of those workers were out of work after getting long COVID. In comparison, among all working-age adults in 2019, only 7% were out of work. Given the sheer number of working age adults with long COVID, the employment implications may be profound and are likely to affect more people over time. One study estimates that long COVID already accounts for 15 percent of unfilled jobs.

Author(s): Alice Burns

Publication Date: 1 Aug 2022

Publication Site: KFF

John Hancock to Pilot 50-Cancer Detection Test

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/09/20/john-hancock-to-pilot-50-cancer-detection-test/

Excerpt:

John Hancock wants to find out what happens when life insurance insureds get a blood test that might reveal early signs of about 50 different types of cancer.

The Boston-based Manulife subsidiary is working with Munich Re and other reinsurers to offer a pilot program that will pay either 50% or 100% of the cost of Grail’s Galleri cancer screening test for insureds in the John Hancock Vitality wellness program.

John Hancock will not get individual test results for the insureds who use the pilot program, nor will the program results affect the participants’ coverage, premiums or Vitality points.

Author(s): Allison Bell

Publication Date: 20 Sept 2022

Publication Site: Think Advisor

Covid Still Kills, but the Demographics of Its Victims Are Shifting

Mary Pat Campbell

Link: https://khn.org/news/article/covid-still-kills-but-the-demographics-of-its-victims-are-shifting/

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Excerpt:

Californians age 75 and older made up 53% of covid deaths through July in 2022, up from 46% in 2020 and 2021. Only about 6% of the state’s residents are 75 and older. And white Californians 75 and older outnumber Latinos in that age group about 3 to 1.

In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and for several months in 2021 older residents were much more likely to be vaccinated than younger Californians.

“Now, the vaccination rates have caught up pretty much with everybody except for kids, people under 18,” Brewer said. “You’re seeing it go back to what we saw before, which is that age remains the most important risk factor for death.”

Author(s): Phillip Reese

Publication Date: SEPTEMBER 21, 2022

Publication Site: KFF

U.S. drug shortages put people with life-threatening illness at risk

Mary Pat Campbell

Link: https://www.upi.com/Health_News/2022/09/16/drug-shortages-lorazepam-cancer/6681663190912/

Excerpt:

Adderall and monkeypox vaccine represent only the tip of the iceberg when it comes to drugs now in short supply in the United States — some badly needed by patients who are seriously ill with life-threatening diseases.

Pharmacists tell UPI of scrambling to meet patients’ urgent needs amid current shortages ranging from basics like sterile water and saline to antibiotics, sedatives and cancer-fighting medications.

….

As of Thursday, the Food and Drug Administration reported 184 drug shortages nationwide. The Association of Health-System Pharmacists put the figure higher, tracking a scarcity of 210 drugs.

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Conserving the supply of a drug once healthcare providers know it’s going to become scarce may include setting guidelines for the medication’s use and rationing doses, the Association of Health-System Pharmacists’ Ganio said.

That occurred this spring after GE Healthcare shuttered its facility in China that makes injectable contrast solutions used to highlight CT scan image because of local COVID-19 policies.

“As of now, that shortage has been fixed. But the underlying fragility of the system continues … and there is no reason it couldn’t happen again,” Dr. Matthew Davenport, vice chair of the American College of Radiology’s Commission on Quality and Safety, told UPI in a recent phone interview.

Author(s): Judy Packer-Tursman

Publication Date: 16 Sept 2022

Publication Site: UPI

Can the CDC Repair Its Reputation?

Mary Pat Campbell

Link: https://knowledge.wharton.upenn.edu/article/can-the-cdc-repair-its-reputation/

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Excerpt:

The Centers for Disease Control and Prevention must learn from the mistakes it made during the height of the COVID-19 pandemic if it wants to win back public trust, according to Wharton health care management professor Ingrid Nembhard.

She thinks CDC Director Rochelle Walensky is on the right path to do just that. Walensky, who was appointed by President Joe Biden in 2021, has announced a major overhaul to modernize the agency and get the public messaging right.

….

Nembhard is particularly hopeful about Walensky’s focus on changing the culture at the CDC. The infrastructure to conduct the science and disseminate the information is vital, but so is the culture. Reports have surfaced that paint the agency as clunky with a risk-averse culture.

“If you have all of the structures but nobody is speaking up, where are you?” Nembhard said. “You don’t have all the information that you need, and I think that’s been one of the realities that we’ve seen them having to deal with. You really do need to have your systems in place to be flexible, to be able to manage under ever-changing circumstances.”

Author(s): Angie Basiouny

Publication Date: 13 Sept 2022

Publication Site: Knowledge @ Wharton

Polio Is Back in the US and UK. Here’s How That Happened

Mary Pat Campbell

Link: https://www.wired.com/story/polio-is-back-in-the-us-and-uk-heres-how-that-happened/

Excerpt:

Start with the vaccine formula—or formulas, actually, because there are two. They were born from a ferocious mid-20th century rivalry between scientists Jonas Salk and Albert Sabin. Salk’s formula, the first to be approved, is injected; it uses an inactivated version of the virus, and protects against developing disease, but does not stop viral transmission. Sabin’s formula, which came a few years later, used an artificially-weakened live virus. It does block transmission, and—because it is a liquid that gets squirted into a child’s mouth—it is cheaper to make and easier to distribute, since it doesn’t require trained healthcare workers or careful disposal of needles. Those qualities made the Sabin oral version, known as OPV, the bulwark of polio control, and eventually the main weapon in the global eradication campaign.

The oral vaccine had a unique benefit. Wild-type polio is actually a gut virus: It locks onto receptors in the intestinal lining and replicates there before migrating to the nerve cells that control muscles. But because it’s in the gut, it also passes out of the body in feces and then spreads to other people in contaminated water. The Sabin vaccine takes advantage of that process: The vaccine virus replicates in a child, gets pooped out, and spreads its protection to unvaccinated neighbors.

Yet that benefit concealed a tragic flaw. Once out of every several million doses, the weakened virus reverted to the neurovirulence of the wild type, destroying those motor neurons and causing polio paralysis. That mutation would also make a child who harbored the reverted virus a potential source of infection, rather than protection. That risk is what caused rich nations to abandon the oral version: In 1996, when wild polio was no longer occurring in the US, the oral vaccine caused about 10 cases of polio paralysis in children. The US switched to the injectable formula, known as IPV, in 2000, and the UK followed in 2004.

Polio vaccination requires several doses to create full protection, and once that occurs, children are protected against both wild-type and vaccine-derived versions of the virus. So the international vaccination campaign continued to rely on OPV, arguing that the risk would diminish as more children received protection. That was a reasonable gamble when the effort was new and health authorities thought it would take 10 to 12 years to achieve eradication. But thanks to funding shortfalls, political and religious unrest, and the Covid pandemic—which imposed a slowdown not just on eradication activities but on all childhood vaccines—it’s now been 34 years, and the job is not done. Meanwhile, last year in 20 countries there were a total of 688 cases of paralysis of what’s called “circulating vaccine-derived poliovirus,” and only six cases of wild-type polio, in three nations.

Author(s): MARYN MCKENNA

Publication Date: 24 Aug 2022

Publication Site: Wired

Rapper Fat Joe Says No One Is Making Sure Hospitals Post Their Prices

Mary Pat Campbell

Link: https://khn.org/news/article/rapper-fat-joe-hospitals-price-transparency-fact-check/

Excerpt:

Rapper Fat Joe takes on hospital industry executives in an advertisement, contending that many hospitals are disobeying a law that requires them to publicly post the prices they charge cash-paying patients and insurance companies for every service they offer.

The ad, paid for by a group called Power to the Patients, states, correctly, that hospitals must list their negotiated prices and asserts that the rule helps patients by making it harder for them to be overcharged. The ad also blames politicians and regulators because the price information is still not necessarily available.

…..

Hospitals have dragged their feet, and compliance is spotty. Studies have found that many hospitals have posted at least some data but that large shares of the facilities have failed to post everything required.

….

In early June, CMS issued penalty fines of about $1.1 million against two Georgia hospitals — Northside Hospital Atlanta and Northside Hospital Cherokee — that are owned by the same company. Those were the first fines issued under the new rules.

As of late July, the agency had sent 368 warning notices to hospitals and issued 188 corrective action plan requests to hospitals that had previously received warning notices but had not yet corrected deficiencies, according to a statement from Dr. Meena Seshamani, deputy administrator and director of the Center for Medicare.

Author(s): Julie Appleby

Publication Date: 10 Aug 2022

Publication Site: Kaiser Health News

Think You’ve Never Had Covid-19? Think Again

Mary Pat Campbell

Link: https://www.wsj.com/articles/think-youve-never-had-covid-19-think-again-11658741403

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Excerpt:

Dr. Ding is a member of a shrinking club of people who are pretty sure they have never been infected with SARS-CoV-2, the virus that causes Covid-19. Geneticists and immunologists are studying factors that might protect people from infection, and learning why some are predisposed to more severe Covid-19 disease.

For many, the explanation is likely that they have in fact been infected with the virus at some point without realizing it, said Susan Kline, professor of medicine at the University of Minnesota Medical School. About 40% of confirmed Covid-19 cases are asymptomatic, according to a meta-analysis published in December in the Journal of the American Medical Association.

More than two years into the pandemic, most people worldwide have likely been infected with the virus at least once, epidemiologists said. Some 58% of people in the U.S. had contracted Covid-19 through February, the Centers for Disease Control and Prevention has estimated. Since then, a persistent wave driven by offshoots of the infectious Omicron variant has kept daily known cases in the U.S. above 100,000 for weeks.

Yet some people haven’t gotten sick or tested positive.

Author(s): Julie Wernau

Publication Date: 25 Jul 2022

Publication Site: WSJ

Hospitals Are Flouting — And Fighting — Price Transparency Rules

Mary Pat Campbell

Link: https://www.levernews.com/hospitals-are-flouting-and-fighting-price-transparency-rules/

Excerpt:

The vast majority of U.S. hospitals are ignoring a new bipartisan federal law that requires the facilities to make their service prices available to the public, new research shows, and the Biden administration is facing growing criticism for not doing enough to enforce compliance with the landmark rule.

Now one state, Colorado, has taken matters into its own hands, passing an innovative law to bring its hospitals into compliance with the federal price transparency requirements — despite health care lobbyists’ efforts to sink the legislative effort.

….

Against the backdrop of limited federal enforcement, Colorado is leading the charge on creatively bringing hospitals into compliance, thanks to a new state law: House Bill 1285.

The law, recently signed by Gov. Jared Polis (D) and effective starting this August, has dual goals of accelerating the timeline on which hospital systems must meet the federal mandate, and curbing the crippling medical debt that plagues more than 100 million Americans.

The measure adds a state-level enforcement mechanism by requiring that hospitals be in compliance with the federal pricing transparency act in order to send Coloradans to collections for medical bills.

David Silverstein, founder and chairman of patient advocacy organization Broken Healthcare, wrote the bill and spearheaded the effort to get it across the finish line.

Author(s): Aditi Ramaswami

Publication Date: 27 Jun 2022

Publication Site: The Lever

End the Tax Exclusion for Employer‐​Sponsored Health Insurance

Mary Pat Campbell

Link: https://www.cato.org/policy-analysis/end-tax-exclusion-employer-sponsored-health-insurance-return-1-trillion-workers-who?au_hash=uEDWOOo1RrC6QDCrTTk5sH9lnJyuweZdaUf8ZDik8E0

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Excerpt:

The “tax exclusion” for employer‐​sponsored health insurance shields workers from paying income or payroll taxes on such benefits. The exclusion is an accident of history that predates modern health insurance and is roughly as old as the income tax itself. It fuels excessive health insurance coverage, medical spending, and health care prices and ties health insurance to employment. It has required Congress to intervene countless times to address problems it creates.

The exclusion requires a worker to let her employer control a sizable share of her earnings, to enroll in a health plan that is likely not her first choice, and to pay the remainder of the premium out of pocket. Overall, the tax code effectively threatens U.S. workers with $352 billion in additional taxes in 2022 if they do not let their employers control $1 trillion of their earnings. The additional tax that workers pay if they do not accept those terms constitutes an implicit penalty.

The tax code thus limits a worker’s ability to make her own health decisions. In the United States, compulsory health spending accounts for 83 percent of overall health spending, the ninth highest share among 34 advanced nations. The tax exclusion is the single largest contributor to compulsory health spending.

Reforming the exclusion would free U.S. workers to control $1 trillion of their earnings that employers currently control, give consumers more health care choices, and make health care more accessible. Building on the bipartisan success of tax‐​free health savings accounts appears to present the best politically feasible opportunity for reform. The United States will not have a consumer‐​centered health sector until workers control the $1 trillion of their earnings that the exclusion forces them to let employers control.

Author(s): Michael Cannon

Publication Date: 24 May 2022

Publication Site: Cato

When a Tax Break Is Actually a Tax Penalty

Mary Pat Campbell

Link: https://reason.com/2022/06/08/when-a-tax-break-is-actually-a-tax-penalty/

Excerpt:

When is a tax break actually a tax penalty? When it’s the tax exclusion for employer-sponsored health insurance. 

That’s what Michael Cannon, Cato Institute’s director of health policy studies, convincingly argues in his recent paper, End the Tax Exclusion for Employer-Sponsored Health Insurance. His paper is a compact lesson in the ways that some supposed tax breaks can effectively function as tax penalties, not only distorting markets, but invisibly penalizing people for their choices. And it’s a reminder of the ways that seemingly minor, offhanded policy decisions, made with little thought to long-term consequences, can exert a haunting influence long after they are made.

The tax exclusion for employer-sponsored health insurance is exactly what it sounds like: a carve-out for health coverage offered through the workplace. 

…..

But he argues that, in practical terms, this tax break actually acts as a stealth penalty on workers who want to make their own health insurance choices. Typically even a generous employer only offers a handful of health plans, and those plans are unlikely to take the exact form an employee would otherwise choose on his or her own. If an employee wants to purchase any other plan, however, he or she would have to do it with money first received—and taxed—as cash compensation. Thanks to taxation, it would be worth a lot less. Thus the tax exclusion acts as a tax penalty on any employee who wants to choose their own health insurance. 

Author(s): Peter Suderman

Publication Date: 8 Jun 2022

Publication Site: Reason