“The popularity of health savings accounts (HSAs) coupled with high-deductible health plans is equally distributed across consumers aged 25 to 54, with demand also coming from all income and education segments of the population, according to a new survey released today by the Blue Cross and Blue Shield Association (BCBSA).”
According to the Wall Street Journal and other press reports, “The World Health Organization, conceding that widely used malaria-fighting methods have failed to bring the catastrophic disease under control, plans to announce Friday that it will encourage the use of DDT even though the pesticide has been banned or tightly restricted in many parts of the world.” According to MSNBC.com, “the U.S. government already has decided to pay for DDT and other indoor insecticide use as part of President Bush’s $1.2 billion, five-year initiative to control malaria in Africa.” (It’s interesting to note on the WHO web site that European countries are experiencing “epidemics” of heart disease and diabetes similar to the U.S.)
The Centers for Medicare and Medicaid Services (“CMS”) have announced the 2007 Medicare deductibles and premiums for Parts A and B. The monthly Medicare Part B premium will increase $5.00 from $88.50 to $93.50 and for the first time the premium amounts will be higher for Medicare beneficiaries with over $80,000 in taxable income (single taxpayer) or $160,000 for those filing jointly. Part B covers physician’s and related medical services and supplies, such as diagnostic testing.
CMS explains that
The single most important factor driving the 5.6 percent Part B premium increase is the growth in traditional fee-for-service Part B spending per capita, as opposed to spending growth in Medicare Advantage. The phase-out of “budget neutrality” adjustments in Medicare Advantage payments helps account for the limited Medicare Advantage payment increase. The largest contributors to the 2007 premium increase by type of service are outpatient hospital services, physician-administered drugs, and ambulatory surgical center (ASC) services. Spending for outpatient hospital prospective payment services is growing rapidly and is projected to increase by 11.6 percent per capita in 2007. This is mainly due to an expected 7.9 percent increase in the volume and intensity of these services. In addition to the higher premium costs caused by this growth, it also results in a projected 6.5 percent increase in per capita beneficiary coinsurance payments (beneficiary coinsurance for hospital outpatient services can be as high as 40 percent). However, the 2007 premium increase is held down by a provision in current law that, if unchanged, will require a reduction in fees paid by Medicare to physicians of about 5 percent. Congress has acted to prevent such physician fee reductions from occurring in each of the last four years. Even with the fee reduction, however, the volume and intensity of physicians’ services is projected to increase by 4.9 percent in 2007, resulting in projected continuing pressure toward rising costs. As CMS has said repeatedly, the rapid growth in utilization of services and the wide variation across providers and geographic areas in the use of these services shows that Medicare needs to move away from a system that pays simply for more services, regardless of the quality of those services or their impact on beneficiary health. Medicare payments should provide better financial support to doctors and other health professionals in their efforts to achieve better health outcomes for Medicare beneficiaries at a lower cost. CMS is working closely with medical professionals and Congress to increase the effectiveness of how Medicare compensates physicians and other health care providers. CMS is also conducting demonstrations and pilot programs that pay providers more for better quality, better patient satisfaction, and lower overall health care costs
Of course, the medical community is fighting to restore the fee reduction that helps to control the Psrt B premium.The Medicare Part B deductible will increase from $124 to $131, the same percentage as the premium increase.Finally CMS explains that
Medicare Part A pays for inpatient hospital, skilled nursing facility, hospice, and certain home health care. The $992 deductible, paid by the beneficiary when admitted as a hospital inpatient, is an increase of $40 from $952 in 2006. The Part A deductible is the beneficiary’s only cost for up to 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $248 per day for days 61 through 90 in 2007, and $496 per day for hospital stays beyond the 90th day for lifetime reserve days. This compares with $238 and $476 in 2006. The daily coinsurance for the 21st through 100th day in a skilled nursing facility will be $124 in 2007, up from $119 in 2006.
On September 13, the House Federal Workforce and Agency Organization subcommittee approved by voice vote the Manager’s amended version of H.R. 4859, the Federal Family Health Information Technology Act, and sent it on to the full Government Reform Committee for its consideration. As previously reported in the blog, this bill would require Federal Employees Health Benefit Plans to provide their menbers with electronic health records. According to press reports, America’s Health Insurance Plans , a major industry trade association, had asked the Subcommittee chairman, Rep. Jon Porter (R-NV) to delay the legislation until health insurers develop standards for EHRs and the systems used to store and transmit them.”
Following up on his September 1 subcommittee hearing, Rep. Jon Porter (R Nev) will hold a meeting of his House Federal Workforce and Agency Organization subcommittee to markup and vote on H.R. 4859, the Federal Family Health Information Technology Act. The meeting will be held tomorrow at 2 pm. The Federal Times reported on the meeting earlier today.
Embattled Bristol Myers Squibb CEO Peter Dolan and (gasp) his company’s general counsel Richard Willard were terminated today based on the recommendation of retired Federal Judge Frederick B. Lacey who is monitoring the company’s compliance with its deferred prosecution agreement with the federal government. Mr. Dolan was under shareholder fire for his mishandling of the Plavix patent dispute discussed in the Drug Wars Updates, among other issues. The Wall Street Journal notes that Mr. Dolan is the third major U.S. drug company CEO to be shown the door in the past 16 months.
Merck & Co., Whitehouse Station, N.J., last year pushed then-CEO Raymond Gilmartin into early retirement after withdrawing the painkiller Vioxx from the market in 2004. Pfizer Inc., the world’s biggest drug maker, ousted Henry McKinnell in late July, replacing him with a former lawyer. As at Bristol-Myers, the stocks of both companies have been battered in the past two years.
Here are The Wall Street Journal’s 2006 Technology Award winners for Biotech-Medicine and Medical Devices:
Biotech-Medicine
Pfizer/Nektar Therapeutics, U.S.
Nominees: Both companies say too many individuals were involved to single out individuals.
Innovation; Exubera, a powdered inhalable insulin for the treatment of diabetes.
Medical Devices
Incisive Surgical, U.S.
Nominee: John L. Shannon, Jr., President and CEO
Innovation: Insorb, a mechanical skin stapler that places absorbable staples underneath the skin.
Very cool.
More encouraging news was released today in the public health campaign against cancer, the second deadliest disease in America after heart disease. According to a report in the most recent issue of the journal Science, researchers from Howard Hughes Medical Institute (HHMI), Johns Hopkins University, Case Western Reserve University School of Medicine, and a team of researchers from The Kimmel Cancer Center at Johns Hopkins have identified 189 genetic mutations that play a major role in the development of breast cancer and colorectal cancer.
Foodconsumer.org reports that
“Only by understanding this blueprint of cancer will we be fully able to understand the mechanism of what makes a cancer a cancer and to think about strategies for diagnosis, prevention and therapy,” said Dr. Victor Velculescu, senior researcher on the project and an assistant professor of oncology at [the] Kimmel Cancer Center.
The [research] team found far more mutated genes in tumor cells than they had expected. They found 189 genetic mutations in the tumors, which are suspected to be involved in causing cancer. The main point was that these genes were never implicated in cancer previously.
“Scientists who have seen these data have told us that it keeps them up all night thinking,” said Bert Vogelstein, a co-researcher in the study. “It will hopefully open up a large number of opportunities in many areas of cancer research.”
The researchers had theorized that they would find a maximum of 90 mutations that alter protein structure. Through crosschecking, the researchers identified an average of 11 genes in each cancer that were most likely involved in how the cancer presented itself. Approximating this to the human genome, the researchers say an average of about 17 genes are expected to have critical involvement in the development of each cancer.
The researchers found another startling fact. No two cancers were similar even if the genes were the same, meaning that different genes presented in different ways for the same type of cancer in different individuals. The genes contributing to breast cancer were different from those mutated in colorectal cancers.
This is just the beginning of a federally financed effort, called the Cancer Genome Atlas, to map the genetic mututations that cause the various forms of cancer. It is hoped that the effort will lead to the development of new drug treatments for this terrible disease.
Nexium is the purple pill that you’ve seen on TV, a proton pump inhibitor to treat acid reflux disease. AstraZeneca sold $4.6 billion dollars worth of this medication in 2005. In July 2005, TRICARE, the Defense Department’s health care program for military retirees and active duty dependents, reclassified Nexium as a non-formulary drug on the ground that cost effective alternatives like now over the counter Prilosec were readily available.
Today UnitedHealthcare, the Nation’s second largest health insurance company, announced that it will stop covering Nexium on the same ground. According to the Associated Press report, UnitedHealthcare took the action because it “had expected costs in the category to slow after generic and over-the-counter versions of Prilosec, the predecessor drug to Nexium, became available in 2003. But that didn’t happen” — possibly because of aggressive advertising of the drug particularly at the time when Prilosec, another AstraZeneca product, lost its patent protection. UnitedHealthcare expects to cut its proton pump inhibitor expenses in half as a result of this and related actions.