Posted by Adam Thompson on Thursday, September 2, 2010 at 2:10 pm
At least 7 states who are making a fuss and suing the Feds over the new health care law are quietly taking funds made available by the law. $5 billion was set aside by the Affordable Care Act to help employers (states and Fortune 500 companies included) by offsetting the cost of health care benefits for early retirees until they are eligible for Medicare.
Also getting in on the act are some of the countries richest corporations and owners, including Tea Party financiers David and Charles Koch who oppose the law. Koch Industries owns several oil refineries and well-known brands like Brawny paper towels, Dixie cups, and Stainmaster carpet. Who else is doing the two-faced political tango? None other than 12 corporations who serve on the board of directors of one of the health care law’s most strident opponents, the US Chamber of Commerce.
The government subsidy covers 80% of claims between $15,000 and $90,000. As health care costs have risen steeply over the past few decades, more employers have cut back on retiree benefits. These subsidies help employers maintain coverage for retirees until they are eligible for Medicare, and also until the health care law’s provisions to expand access to coverage are fully implemented by 2014.
The states suing the feds over the new law but also reaping its financial rewards include Arizona, Idaho, Indiana, Louisiana, Michigan, Nebraska, and Nevada. Alaska is also joining a suit to overturn part of the law while accepting the early-retirees’ funds.
Check out Kaiser Health News for more.
Category: Uncategorized
Posted by adair parr on Wednesday, September 1, 2010 at 8:13 pm
The 6-month anniversary of the passage of the new health care reform law is approaching. While the law is not perfect, it is a very solid start. On September 23rd, many important new provisions take effect, including: the end of pre-existing condition denials for children, the elimination of life-time benefits caps, and an end to insurance companies dropping patients when they get sick.
New research by the Herndon Alliance (and others) shows that the public remains confused and misinformed about the new law. In fact, many people don’t know the law passed and therefore won’t be attempting to access the benefits that are becoming available, such as:
* no-cost preventative care and annual exams
* coverage expansions that will allow young adults to access insurance through their parents’ policies until they reach age 26
Physicians are among the most trusted messengers on health care. The NPA Foundation is developing resources to help you reassure a nervous public and even nervous colleagues that doctors do support meaningful and comprehensive reform of our complicated and broken health care system. These include:
1) Posters, Waiting Room Handouts & Info Cards
No-cost public education materials including: wall posters, waiting room handouts and postcard size info cards are now being developed. The posters will be mailed on September 13th with the hope that you will begin displaying them during the 6-month anniversary week (September 20th).
Click here to order free materials
(Materials will also be available to download and print yourself beginning 9/13)
2) Work-site Education Kits
We are developing materials for you to share with colleagues and staff about the new benefits that will take effect on September 23rd. These resources will be free, easy-to-use materials designed for lunch hour staff meetings as well as Grand Rounds. We will also have materials designed for patients.
3) Physician Speakers Needed
Are you interested in speaking briefly at a public education event in your own community? Many are being planned for the week of September 20th. We are looking for physicians willing to:
a) speak for 2-3 minutes at events, along with other allies, designed to help people understand the upcoming benefits , and/or
b) participate in media events and outreach, including in-person & phone-based press conferences, interviews, letters to the editor and Op-Eds
**You do not need to be a “policy expert.”** We are looking for physicians who are dedicated to high quality, affordable health care for all, who can tell quick compelling stories about how upcoming provisions in the health reform law will make a difference in their your patients’ lives. We will be able to provide talking points and needed background information.
Work-site, public education, and media outreach events are in the planning stages now. Please contact Becky Martin or Sarah Wallace directly if you interested and they will be happy to provide you with more information:
Becky Martin, Project Manager
National Physicians Alliance (NPA)
National Physicians Alliance Foundation (NPAF)
becky.martin@npalliance.net
Sarah Wallace, MPH
Field Organizer
National Physicians Alliance (NPA)
National Physicians Alliance Foundation (NPAF)
sarah.wallace@npalliance.net
Category: Uncategorized
Posted by adair parr on Wednesday, August 25, 2010 at 8:19 am
NPA members Rupin Thakkar and Bob Crittendon were appointed a member of the Workforce Advisory Group and Lisa Plymate has been appointed to the Low Income Populations Committee of the Health Reform Implementation in Washington State. Congratulations to both! NPA appreciates your commitment to health care reform implementation.
Category: Uncategorized,health care implementation,healthcare workforce,high quality health care for all,physician leadership
Posted by Adam Thompson on Thursday, August 19, 2010 at 2:47 pm
The New York Times reports that 20% of Americans, insured and uninsured, visited the E.R. at least once in 2007, for a total of 117 million visits. Of the uninsured, 7.4% made at least two visits in 2007, compared to 5.1% of privately insured patients.
Generally, the most frequent visitors were of poor health and from lower incomes. While there was slight elevated use among Medicaid recipients, Americans older than age 75, and African-Americans, factors of age, race, and ethnicity were not as significant in determining E.R. use as income and health status. Interestingly, Americans with and without a usual source of medical care were equally likely to visit the E.R.
The data was compiled by the National Center for Health Statistics.
Category: Uncategorized
Posted by adair parr on Friday, August 6, 2010 at 6:15 pm
The First Circuit Court of Appeals, a federal appeals court, upheld a Maine law restricting the use of prescription information by companies. The law allows doctors to opt out of having their prescriptions tracked by companies, who use the information for marketing purposes. The Court upheld a similar law in New Hampshire last year.
The plaintiffs challenged the constitutionality of 22 Me.Rev.Stat. Ann. tit. 22, § 1711-E(2-A), which allows prescribers licensed in Maine to choose not to make identifying information available for use in marketing prescription drugs to them. Section 1711-E(2-A) does not directly prohibit marketing, but it prohibits certain entities from using or selling such information for marketing purposes if the prescriber has opted to protect the confidentiality of his prescribing data.
The ruling represents a defeat to the pharmaceutical companies, who use the data to market prescription drugs. This is a step forward for the Unbranded Doctor Campaign. Patterns and preferences in prescribing can be analyzed by companies, who then target doctors for particular prescribing patterns.
You can read the decision here.
Category: Uncategorized,industry-physician relationships,integrity & the medical profession,pharmaceutical industry-physician relationship
Posted by adair parr on Thursday, July 29, 2010 at 6:49 pm
The Los Angeles Times reports that since the passage of the Affordable Care Act many providers across the country are working together to create alliances which provide coordinated care for patients. In San Antonio, for example, three hospitals are competing to form alliances with local doctors, who are giving up private fee for service practices in order to be on the team. This is a wonderful example of the type of unified approach to medical care which may result in improved quality and efficiency of care with reduced costs. See the article here.
Category: Uncategorized,health care implementation,healthcare workforce,high quality health care for all
Posted by adair parr on Tuesday, July 27, 2010 at 8:31 pm
NPA President, Dr. Valerie Arkoosh spoke to the Pennsylvania HCAN group on July 21. She provided an overview of the changes that health care reform will bring to Pennsylvania. Check out this piece on her speech.
Category: Uncategorized,from the national office,health care implementation,healthcare workforce,high quality health care for all
Posted by adair parr on Sunday, July 25, 2010 at 4:38 pm
Families USA recently released a guide to the implementation of health care which highlights the important dates over the next 90 days. This guide highlights effective ways to make health care reform a reality in a consumer-friendly way. The guide highlights the provision which will allow young adults to stay on their parents insurance plans until age 26.
The guide also highlights the fact that small businesses with fewer than 25 employees are now eligible for a tax credit if they pay 50% of their employees health premiums. Information on calculating the credit is available here.
Please check out the guide to see how you can make a difference in the next 90 days!
Category: Uncategorized,health care implementation,healthcare workforce,high quality health care for all
Posted by adair parr on Sunday, July 25, 2010 at 12:55 pm
NPA Board Member David Grande got a mention in this article in The Harvard Crimson discussing the recent changes to Harvard Medical School’s conflict of interest rules. The new rules prohibit faculty from accepting personal gifts and giving industry-sponsored talks at events where the material is prepared in advance by the company. In addition, when a faculty member is conducting research on technology owned or licensed by a particular company, compensation from that company to the faculty member is now limited to $10,000 annually.
Category: Uncategorized,industry-physician relationships,integrity & the medical profession,pharmaceutical industry-physician relationship
Posted by ChrisPMcCoy on Thursday, July 15, 2010 at 1:34 am
Is rosiglitazone (Avandia) safe?
That was the question discussed for two days at a FDA hearing outside Washington, DC. I attended the second day of the hearing to represent patients and the NPA during the open public testimony. I focused
my comments; on the perspective of patient trust, as well as the impact of conflicts of interest on the discussion.
Let me set the scene. The meeting was held in a hotel ballroom. A giant U-shaped table for the 33 members of the two combined FDA advisory committees filled half of the room. Behind the table along the wall, sat staffers from the FDA, representatives from GSK, the uniformed members of the Public Health Service, and dozens of others. There was a large screen in the corner projecting
the slides, as well as screens in front of all of the committee members showing the same material. The other half of the room, separated by a rope (“Committee members only beyond this point”), was set aside for the public and the media. There was a small section in the front for the invited speakers (such as Dr. Nissen, who started this discussion with
his article in 2007), as well as those who had registered to speak during the open session (like me). There were also two rows of chairs for
the media, but media overflowed into the general seating area. Laptops, Blackberries, iPhones, and the like were being used by nearly everyone in the rows of chairs. Outside of the ballroom, the hallway was crowded with camera crews from the national media, each of whom had marked out their spot with tape on the floor. There were two large HD TVs with a closed-circuit feed from the hearing room – both surrounded by chairs and more media.
At the heart of the matter for discussion by the advisory broad was this issue: Do we have enough evidence based on the meta-analysis of adverse events in small randomized trials combined with observational studies to remove rosiglitazone from the market? Or do we need to conduct an additional, large, thorough randomized study to refute the concerns?
After a day and a half of listening to presentations from the clinical researchers, FDA reviewers, experts in trial design, the drug manufacturers and of course the public, the panel had nine questions to answer and report back to the FDA. The panel voted 18-6 (with 9 saying incomplete data) that rosiglitazone had “significant safety concerns” for cardiovascular events compared to other diabetic medications. When compared to just pioglitazone, the vote was 21-3-7. At the end of the day, a majority of the panel recommended either removing rosiglitazone from the market or restricting access.
But these are just recommendations from an advisory panel. The FDA commissioner will make a decision about rosiglitazone in the near future. Whatever the final decision, I am now confident that the FDA made that decision based on a thorough discussion, with what is best for our patients as primary concern, not only with rosiglitazone, but also setting a precedent about how drugs should be assessed for safety.
Reflecting on the day, I came away re-assured that the FDA has a rigorous way to debate challenging questions. In this era of sound-bite politics and talking heads with plenty of experience talking and little experience actually leading … it was refreshing to watch experts weigh the conflicting and incomplete evidence, all while trying to make the best decision for patients and the public health. It is unfortunate that discussion in the political sphere has come to the point of devaluing and denigrating “experts” and “elites”. There are definitely times, and this is one, where we want to technocrats to be engaged in the process. It was also refreshing to hear, as they discussed their rationale, that everyone recognized that individuals, acting in good faith and with patients’ best interests at heart, could look at the same data and come to different conclusions. There isn’t a clearly “wrong” answer to this question.
I was pleased in the way that the entire discussion was in the open to the public, as were the votes. I should recognize how trust is powerfully enhanced by this culture of openness. (A side point about democracy: In a representative democracy, when individuals are voting to represent themselves and their own interests, that vote should be secret – like on election day. However, when votes are being made on behalf of others, those votes must be public so that we know how our government is making decisions on our behalf.)
As I watched the committee take its voice (which was punctuated by humorous comments about the non-intuitive voting system: “I met to vote for [A], but I think I voted for Pat Buchanan”), I thought about how I would vote if I were on the committee. Having read much of the published literature on rosiglitazone since 2007, I’m well aware of the risks, as well as the methodological problems of all of the studies. But as a provider, I could not start a new patient on rosiglitazone – maybe it doesn’t increase risk of heart attacks, but do I want to take that chance with a patient’s life, especially when we have other options for treating diabetes? On the other hand, during the public forum, a patient testified about his ten-year experience on rosiglitazone (MI-free) and how he credits it for keeping him healthy. Would I want to completely remove it from the market, understanding that a very real (and very unintended) consequence could be that patients would simply stop taking diabetes medication altogether rather than switching to something safer? I believe we need to remove unsafe medications from the market – to not do so would rapidly erode trust in medicine. But there is also a slow erosion of trust if we leave questions unanswered about safety. And how do we empower patients to make decisions about their medical care? Should we simply leave it up to patients to research the risks and benefits (by asking their physician, or through the Internet, or going to medical school)? Should the FDA make some of those decisions, as they have been empowered to do so by laws written by the people’s representatives in Congress?
Regardless of the FDA’s final decision on rosiglitazone, this is a complex issue that we will need to explain to our patients. But after watching the FDA in action today, I trust that this process will be open and public so that we all understand the factors that were weighed in making that challenging decision.
Category: Uncategorized