Weekend Wrap-Up / Miscellany

  • The Las Vegas Sun featured a roundtable discussion on the public health care crisis caused by the Endoscopy Center of Southern Nevada.
  • The Houston Chronicle reported on the dispute between insurers and the doctors who practice concierge care after United Healthcare dropped several of those doctors from its network.
  • The Chicago Tribune reported on the shuttering of a chain of physician staffed retail clinics called Medical Marts. “Unlike the burgeoning number of retail clinics that are largely staffed by advanced-degree nurses known as nurse practitioners, Medical Marts staffed its clinics with two full-time primary-care physicians, as well as two full-time medical assistants or licensed practical nurses. In contrast, the nurse physician model retail clinics are expanding like hotcakes. According to the Tribune, “CVS Caremark Corp. subsidiary MinuteClinic, for example, said last week it recently opened its 500th clinic. Meanwhile, Deerfield-based Walgreens said it has nearly 150 of its Take Care brand clinics and plans to have 400 in its stores by the end of this year.”
  • The New York Times reported on the debate over the proper dosage of an expensive prescription drug —

    The drug in question, Cerezyme, is used to treat a rare inherited enzyme deficiency called Gaucher disease. Some experts say that for most patients, as little as one-fourth the standard top dose would work, saving the health care system more than $200,000 a year per Gaucher patient. “It is economic malpractice to give a much higher dose of an expensive drug than is required,” said Dr. Ernest Beutler, an authority on Gaucher disease at the Scripps Research Institute. Some other Gaucher specialists argue otherwise, saying that skimping on the medicine could endanger patients.

    Meanwhile, Wal-Mart announced last week that its $4 generic drug program has saved Americans over $1 billion since it was introduced in 2006.

  • Finally, the House and Senate passed their fiscal year 2009 budget resolutions last week. According to the Federal Times,
    The House bill was approved on a 212-207 partisan vote late Thursday. It adds $22 billion above the administration’s request for domestic programs like education and veterans benefits. But it would allow some of the Bush tax cuts to expire in 2010. Republicans claim that amounts to a $683 billion tax increase over the next five years.
    The Senate version, which passed 51-44, makes fewer changes to domestic programs, but adds money for Iraq reconstruction and global AIDS initiatives. Senators overwhelmingly approved an amendment to extend some of the president’s tax cuts, including one for low-income earners.
    The White House has threatened to veto any spending bills that go above the president’s domestic spending request.