| Three years ago this month, as alarms were sounding across the country about the over-prescription of opioid painkillers, the federal government issued course-correcting guidelines for primary care doctors. But in a letter sent to the Centers for Disease Control and Prevention on Wednesday, more than 300 medical experts, including three former White House drug czars, contend that the guidelines are harming one group of vulnerable patients: those with severe chronic pain who may have been taking opioids for years, without becoming addicted, so they can function in daily life and work. The leaders say the guidelines are being used as cover by insurers to deny reimbursement and by doctors to turn patients away. |
Many things affect your health. Genetics. Lifestyle. Modern medicine. The environment in which you live and work.
But although we rarely consider it, the degree of competition among health care organizations does so as well.
Markets for both hospitals and physicians have become more concentrated in recent years. Although higher prices are the consequences most often discussed, such consolidation can also result in worse health care. Studies show that rates of mortality and of major health setbacks grow when competition falls.
In 2010, CMS established the Hospital Readmissions Reduction Program under the ACA. Two years later, the government began fining hospitals with high rates of readmission within 30 days of a hospitalization for pneumonia, heart attack, or heart failure. But a study finds the program may have led to more patient deaths. “Why are policies that profoundly influence patient care not rigorously studied before widespread rollout?” the researchers ask. “[W]e remain uncertain about whether it has had unintentionally deadly consequences. That should be a bracing reminder that before we are seduced by promising but untried ideas, we need to first demand robust evidence that they will not harm patients.”
When a federal judge in Texas struck down the Affordable Care Act on Friday, ruling that its mandate requiring most people to buy health insurance was unconstitutional, it thrust Obamacare into the spotlight right at the deadline to sign up for next year’s coverage.
Open enrollment was scheduled to end on Saturday in most states, and every year, a surge of people sign up at the last minute.
The Centers for Medicare and Medicaid Services sent out an email to millions of Americans on Saturday trying to allay concerns, and HealthCare.gov displayed a red banner alerting people that the court’s decision would not affect open enrollment.
Representative-elect Alexandria Ocasio-Cortez, the New York Democrat who has become a darling of the progressive left, was quoting from an article in The Nation about “massive accounting fraud” committed by the Pentagon from 1998 to 2015. But her suggestion that the $21 trillion in military transactions could have “already” paid two-thirds the cost of a “Medicare for all” health care system goes beyond what the article reported — and is misleading.
A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage.
The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year.
Judge James E. Boasberg of Federal District Court for the District of Columbia, an Obama appointee, ruled that the Trump administration’s approval of the plan had been “arbitrary and capricious” because it had not adequately considered whether the plan would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.”
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