Petrie-Flom Intern’s Weekly Round-Up, 4/4-4/11

By Chloe Reichel

Following the release of information on Medicare billing practices, it was revealed that approximately 4,000 physicians each billed over $1 million in 2012. This data may shed light on medical billing procedures.

Despite a proposed 1.9 percent cut to the Medicare Advantage program, these cuts will not be implemented. On Monday the Centers for Medicare and Medicaid Services announced that funding to Medicare Advantage will increase by an average of .4 percent in 2015.

Though genetic testing is becoming cheaper and more accessible, many Americans refrain from getting tested. This is because the Genetic Information Nondiscrimination Act does not protect consumers from discrimination for life, disability, and long-term care insurance plans.

On Friday, Kathleen Sebelius, current Secretary of Health and Human Services, will resign from her role. Sebelius oversaw the oft-criticized implementation of the Affordable Care Act. Sylvia Mathews Burwell, director of the White House Office of Management and Budget, has been selected by President Obama to fill the role. Burwell served in the Clinton administration, and was president of the Walmart Foundation, prior to her work with the Obama administration.

This Thursday the European Parliament debated a petition that would prevent the allocation of EU funds for research, aid, and public health programs that involve the destruction of human embryos. The petition had 1.8 million signatures, and is seen as a sign of popular support for social conservatism.

Hawaii’s extensive health system has led to excellent health outcomes for the state’s residents and the state’s budget, since the state has some of the lowest healthcare costs in the nation. Hawaii has near-universal health insurance coverage, and starting forty years ago, has required employers to provide health benefits to their employees.

On Saturday, Maryland legislators voted to decriminalize possession of small amounts of marijuana. Those found in possession of less than 10 grams of marijuana will now be charged with civil fines, as opposed to criminal penalties.

Petrie-Flom Intern’s Weekly Round-Up, 3/28-4/4

By Chloe Reichel

In an attempt to increase transparency and accountability of Medicare, the Obama administration will release data about the services provided as a part of this program. The information will focus on the number and kind of services provided.

In the six months following the implementation of the Affordable Care Act, over seven million Americans signed up for insurance plans. These figures are in accordance with those estimated by congressional budget analysts.

Teva Pharmaceutical Industries has appealed a case to the Supreme Court about a generic form of its drug Copaxone. Teva is trying to keep their patent on the drug to prevent the manufacture of generics.

Judge David C. Bury, a federal judge in Tucson, will not stop the implementation of rules that restrict the usage of the abortion drug mifepristone in the state of Arizona. The legislation that restricted the usage of this drug went into effect on Tuesday.

On Monday, the last day for sign ups for health insurance plans under the Affordable Care Act, hundreds of thousands attempted to register for policies. The website HealthCare.gov had some glitches on this day, including a period of a few hours in which the site failed to accept applications.

The Affordable Care Act has allowed many Americans who were previously uninsured to sign up for health insurance, leading to increased usage of health services. This is creating new stresses for small health clinics, but also providing additional funds that allow these clinics to operate.

On Thursday the FDA approved a handheld antidote for painkiller overdoses. The naloxone device, made by kaleo Inc., is called Evzio.

An ethics report was recently released on the risks of long-term space travel. The report addresses physical and psychological risks associated with space travel.

Twitter Round Up

This week’s twitter round up features a variety of topics from our contributors, from discussions about health care spending and the Affordable Care Act to articles about environmental poisoning of soldiers in Iraq.

  • Amitabh Chandra tweeted that “Healthcare spending growth hits a 10yr high… so much for ‘ACA is bending the cost curve’” and shared an article from USA Today.
  • Frank Pasquale shared a blog entry by Larry Backer about Pennsylvania State University students’ worries about the rise of health care costs.
  • I. Glenn Cohen shared a link to an article in The New York Times entitled “‘Environmental Poisoning’ of Iraq Is Claimed” and states that many veterans suffer from environmental poisoning while the “IOM [is] not sure.”
  • Kate Greenwood retweeted Austin Frakt and an article from The Incidental Economist about the negative impact of the insurance market before the implementation of the Affordable Care Act on entrepreneurship.
  • Stephen Latham tweeted a link to his blog reporting on the recent announcement of the Public Health Committee of the Connecticut Legislature that it does not plan to vote on a bill addressing “Aid-In-Dying” or physician-assisted suicide despite “61% public support for the bill.”

Petrie-Flom Intern’s Weekly Round-Up, 3/21-3/28

By Chloe Reichel

The Hobby Lobby case that is currently before the Supreme Court may have effects far beyond the contraceptives mandate stemming from the Affordable Care Act. Other health care services and non-discrimination provisions may also be at stake.

Deadlines will be extended for people who need more time to complete their enrollment in insurance plans through HealthCare.gov. Those who apply will be given until mid-April to complete their applications.

Social media efforts led to the provision of an experimental drug to treat a young boy’s life-threatening infection. Bioethicists are now debating the ethics of this case and its implications for future social media interactions.

Due to stringent approval processes, researchers interested in studying marijuana face difficulty in attempting to do so. Despite growing interest in researching the substance, it can take years for researchers to begin their studies on marijuana.

Enrollment in health insurance policies through the Affordable Care Act reflect vast differences in the legislation’s implementation across the country. State-by-state enrollment data varies widely, and overall enrollment statistics neglect this important variation.

Tanning salons in New York are now forbidden from making claims about the health effects of their services. Previously, tanning salons in New York suggested that “sunlight prevents cancer,” a misleading statement considering the negative health effects of tanning.

Changes to Medicare’s policy manual have shifted the agency’s policies on paying for care used to maintain, rather than improve, patients’ health. Medicare will now pay for physical therapy, nursing care, and services for patients with chronic diseases.

Responding to a statewide public health crisis, Governor Deval Patrick has proposed a ban on the the opiate Zohydro. He has also suggested designating $20 million in funds for the purpose of bolstering treatment and recovery programs.

Twitter Round Up

This week’s twitter round up features a variety of topics from our contributors, from discussions about the troubles of patient matching to generic drug labeling and the readmission penalty.

Adrian Gropper shared a link to the most recent entry of his The Health Care Blog entitled “What You Need To Know About Patient Matching and Your Privacy and What You Can Do About It” in which he compares patient matching to “NSA surveillance.”

Amitabh Chandra tweeted that “the current readmission penalty, however well-intentioned, sure looks like a tax on minority and indigent serving hospitals.”

Frank Pasquale shared an article about the myths of high-protein diets and the potential consequences, including the quote that there is a “strong association between longevity and a low-protein, high-carbohydrate diet.”

I. Glenn Cohen shared a link to an article about “Intersextion: Germany Allows Patient to Choose ‘No Sex’ on Birth Certificate” and poses the question of whether or not the United States should follow Germany’s example in making such an allowance.

Kate Greenwood retweeted Alexander Gaffney including a link to a discussion of the new arguments being made about the generic drug labeling rule: “Opponents, Proponents of Generic Drug Labeling Rule Unleash New Argument and Supporters.”

Petrie-Flom Intern’s Weekly Round-Up, 2/28-3/7

By Chloe Reichel

The majority of people in La Crosse, Wisconsin have advance directives. The initiative to increase the utilization of advance care planning began as a way of helping patients, but resulted in large decreases in health care expenditures.

Due to Texas’ recently passed regulations on abortion clinics, two clinics closed this week. Abortion clinics in Texas are required to have a physician with admitting privileges at a hospital within 30 miles of the clinic under the new regulations.

A new law passed recently in Arizona would limit access to medication used for medical abortions. Planned Parenthood of Arizona filed a lawsuit this Wednesday to contest the law.

An HIV-positive baby treated with aggressive drugs immediately after birth was reportedly cured of the disease. This is the second such case of this treatment working, and is a promising development for the future of HIV treatment.

On Wednesday it was announced that Americans will be allowed to keep insurance plans that are not compliant with the Affordable Care Act. These plans will continue to be offered for the next two years.

Two surveys have found that uninsured Americans largely have not signed up for insurance following the implementation of the Affordable Care Act. Some suggest that the changes to the new healthcare law that have occurred since its adoption may be responsible for these low rates of enrollment.

In Washington state, people who operate medical marijuana dispensaries are worried about the effects of the state’s recent legalization of recreational marijuana. They worry that the increased demand for marijuana will put smaller dispensaries out of business.

Twenty-six states have introduced mandatory programs that emphasize private long-term care over nursing homes. Many states have modeled their plans after Tennessee, but long-term care in this state is suboptimal for many residents.

Petrie-Flom Interns’ Weekly Round-Up, 2/21-2/28

By Chloe Reichel

1) The Food and Drug Administration has proposed a new format for nutrition facts. The design would prominently feature calorie count and serving size to clearly communicate the nutritional content of the food.

2) A new blood test that screens fetal DNA has been found to be more accurate at predicting Down syndrome and Trisomy 18 than standard blood testing and ultrasounds. This new method of testing is “cell-free” and less invasive than amniocentesis, but positive results would have to be confirmed through traditional methods given the incidence of false-positives.

3) A new method of IVF which utilizes three different sources of reproductive material is being considered by the FDA. The method implants the nucleus of one egg into an enucleated donor egg in order to avoid potential diseases caused by mitochondrial DNA.

4) A glitch with Maryland’s health exchange has left the state without the capacity to decide which of the state’s residents are eligible for Medicaid. The state has decided to keep making payments, despite not knowing the eligibility status of the recipients.

5) Health care co-ops introduced after the implementation of the Affordable Care Act have been struggling to get enrollments. The existence of larger, well-established insurance providers has made it difficult for co-ops to gain a foothold in the market.

6) The San Diego City Council passed legislation this past Tuesday that permits no more than 32 medical marijuana dispensaries to open in the city. This was a revision from the initial plan, which allowed for 131 dispensaries.

7) Gene sequencing has proven itself a valuable technology in diagnosing and informing treatment decisions for uncommon diseases. This technology is predicted to be a promising tool in the realm of more common diseases as well.

8) Mayor Vincent C. Gray, of Washington, D.C., reiterated on Thursday that insurers in the District must cover treatment for gender dysphoria. This policy, which bans medical discrimination on the grounds of gender identity, initially went into effect in March of 2013.

Twitter Round Up

This week’s twitter round up features a variety of topics from our contributors, from the correlations between cancer survival rates and funding to blog posts about possible criminalization of drinking while pregnant.

Frank Pasquale tweeted that “there’s a direct correlation between funding and survival rates” regarding cancer from an entry of the blog “Every Breath I Take: A Blog about my Journey with Lung Cancer.”

Art Caplan tweeted about flu vaccinations again this week in order to bring the Rhode Island ACLU’s attention to the CDC’s determination that “getting the flu vaccine this season reduced risk of flu-related doctor’s visits by 61 percent.”

Amitabh Chandra tweeted an article from the Annals of Internal Medicine discussing bariatric surgery and its greater effects on weight loss and diabetes remission than nonsurgical measures to combat obesity.

Stephen Latham tweeted a link to his blog post about the “Criminalization of Drinking While Pregnant in the UK?” which discusses current “plans to bring legal action to establish liability for criminal damages by women who drink while pregnant, with resultant damage to their newborns.”

Petrie-Flom Interns’ Weekly Round-Up, 2/14-2/21

By Chloe Reichel

1) Belgium’s recent vote to legalize euthanasia for children has drawn international debate and criticism. The law would allow terminally ill children to end their lives, provided that they have parental consent.

2) Lawmakers in California have proposed adding a warning label on soda and juice that has sugar added and over 75 calories per 12 ounces. The labels would warn against the health risks associated with consuming sugary beverages.

3) The Food and Drug Administration announced today that it will hold a meeting on the topic of changing the over-the-counter monograph system. Currently, the processes of publishing and changing a monograph are very time consuming.

4) Monsanto is producing new strains of vegetables without using GMOs. Instead, they are selectively crossbreeding different varieties of plants.

5) A recent study conducted by a group at Stanford University released findings that seriously injured patients with insurance are less likely to be transferred to trauma centers than uninsured patients. The group hypothesized that this difference in trauma care can be explained by the fact that non-trauma center hospitals have a financial incentive to keep insured patients under their care.

6) The sale and use of electronic cigarettes will be regulated in Beverly Hills, as decided by the Beverly Hills City Council earlier this week. Los Angeles passed similar legislation this December.

7) Enrollment in health insurance plans for one fifth of people who have registered under the Affordable Care Act was not completed, due to their failure to pay the first premium. Some insurers have granted more time for subscribers to pay their premiums.

8) Wendy Davis recently said that she would support restricting abortion access to the first twenty weeks of pregnancy, but filibustered last year against a bill containing that provision because of the wording of the bill and the other restrictions included within it.

Blogger Twitter Round-Up

By Parker Davis

This week’s twitter round up features a variety of topics from our contributors, from the chemical imbalance theory to infant mortality rates and IVF conception rates.

Frank Pasquale tweeted an article from The Star about the shift of the chemical imbalance theory related to mental illness from an agreed upon medical principle to simply another tactic used by marketers for pharmaceutical companies.

Art Caplan shared two updates regarding current rates of flu vaccination. The first was a retweet of a map graphic showing the “rate of nonmedical vaccine exemptions by state,” and the second was an update based on the records of the Immunization Action Coalition regarding the “now more than 400 organizations with mandatory flu” vaccines for health care workers.

Amitabh Chandra tweeted an update of the infant mortality rates of Pakistan versus India: “In 1960, India and Pakistan had the same infant mortality rate (155/1000). Today, Pakistan’s is 71/1000, which is what India had in 1995.” He also tweeted a Wikipedia article regarding infant mortality driving child mortality.

Stephen Latham tweeted a link to his blog reporting on “US IVF Conceptions at All-time High” which discusses the potential effects of not insuring people for assisted reproduction and encouraging implantations of multiple embryos.

Richard Epstein tweeted several times about the contraceptive mandate including links to the John Batchelor Show online.

Twitter Round-Up 2/12

This week’s twitter round up features a variety of topics from our contributors from the hunger crisis in America to the contraceptive mandate and the Lancet/Oslo Commission on Global Governance for Health.

Frank Pasquale tweeted an article from MSNBC about the millions of residents of New York suffering from hunger and the American hunger crisis overall (2/12).

Art Caplan was a guest of Southern California Public Radio, where he discussed the proposal in Rhode Island to mandate flu shots for children from 6 months to 5 years enrolled in preschool or daycare.

In response to a New York Times article about Medicaid expansion, Amitabh Chandra tweeted in support of allowing Medicaid beneficiaries to buy insurance on an exchange.

Stephen Latham tweeted a link to his blog responding to the Lancet/Oslo Commission on Global Governance for Health.

Richard Epstein tweeted his article in “Defining Ideas” about the contraceptive mandate and his view on the strength of the classical liberal case versus the religious case against the law.

New PHLR (and George) Papers

Laura Brennan, Ross Brownson and Tracey Orleans have come out with an important paper reviewing the evidence on policy and environmental strategies for reducing childhood obesity. Twenty-four strategies and 2000 published and gray literature documents are covered.  This is a menu of more-or-less evidence backed ideas for intervention.

Sam Harper and colleagues come out with an interesting new argument for primary seat belt laws, based on a disparities analysis. Looking through the lens of education level, they  (well, we, since I am one of the authors) find that, while primary enforcement has a powerful affect at every educational level, the impact is greater on people with less education.  Thus, existing SES differentials in seat belt use could be reduced if all states (finally) went to primary enforcement.

Even kids like paternalism?  Well, that may not be the best interpretation of this next study. Williams and McCartt surveyed New Jersey teenagers about three GDL requirements that are unique to that state: minimum licensing age of 17; application of full GDL rules to beginners younger than 21; and requiring license status decals on vehicle plates of GDL drivers.  84% liked licensing at 17, and 77% approved applying Gthe rules even to older novices.  The decal policy was approved by only 23% — but a PHLR study showed it works, so I say get used to it.

Two new tobacco law studies round out the week’s harvest.  Heikki et al. map the diffusion of health warning regulations since 1966, showing a big impact of the FCTC. Finally, in a paper that may start some arguments, Kevin Callison and Robert Kaestner report that adult smokers may not be as responsive to cigarette taxes as many believe.  They suggest it will take increases on the order of 100% to get a further 5% reduction in smoking rates.  Well, I’m okay with that.

Over on the George side of things, Peter Jacobson and Wendy Parmet have posted a thoughtful response to Larry Gostin’s Bloomberg commentary in the Hastings Center Report.  They are helping us move away from a habitual application of the paternalism critique and reminding us that public health can play in the democracy sandbox pretty well.

Petrie-Flom Interns’ Weekly Round-Up, 1/31-2/7

By Chloe Reichel

1) On February 11, the FDA will launch its “Real Cost,” anti-smoking campaign. The $115-million campaign is geared toward discouraging teenagers from smoking by emphasizing the “personally relevant” effects of smoking.

2) Lawsuits against the manufacturer of Pradaxa, Boehringer Ingelheim, have revealed internal documents about the dangers of the drug. The drug, a blood thinner, has been associated with over 1,000 deaths.

3) By October 2014, CVS will no longer sell tobacco products. CVS has decided to implement this ban because, increasingly they see their role as providing health care, and tobacco products cause negative health effects.

4) Naxolone, a drug that is used to reverse the effects of opiate overdoses, is now available to patients in California through their doctors. Prior to the creation of this law, the drug was much less widely available–primarily it was administered in emergency rooms.

5) Following the implementation of the Affordable Care Act, between 1 to 2 million Americans have enrolled in Medicaid. A study from Avalere Health states that this number increased only partially because of the ACA.

6) This Thursday, the Food and Drug Administration released regulations to guarantee that infant formula is safe for consumption. The regulations stipulate that certain nutrients are included in the product, and require tests for pathogens.