Category: Health Policy

Promises Made – Promises Kept: President Biden’s Support for “Obamacare.”

Nov 2, 2022

BY MIKE MAGEE

As the saying goes, “History repeats!” This is especially true where politics are involved.

Consider for example the past three decades in health care. It is striking how many of the players in our nation’s health policy drama remain front and center. And that includes President Biden who recently commented on the 12th anniversary of the passage of the Affordable Care Act (Obamacare):

“The ACA delivered quality, affordable health coverage to more than 30 million Americans — giving families the freedom and confidence to pursue their dreams without the fear that one accident or illness would bankrupt them. This law is the reason we have protections for pre-existing conditions in America. It is why women can no longer be charged more simply because they are women. It reduced prescription drug costs for nearly 12 million seniors. It allows millions of Americans to get free preventive screenings, so they can catch cancer or heart disease early — saving countless lives. And it is the reason why parents can keep children on their insurance plans until they turn 26.”

The Secret Surveillance Capitalism That Suffuses Medicare

Oct 31, 2022

By MICHAEL MILLENSON

Imagine a government program where private contractors boost their bottom line by secretly mining participants’ personal information, such as credit reports, shopping habits and even website logins.

It’s called Medicare.

This is open enrollment season, when 64 million elderly and disabled Americans choose between traditional fee-for-service Medicare and private Medicare Advantage (MA) health plans. MA membership is soaring; within a few years it’s expected to encompass the majority of beneficiaries. That popularity is due in no small part to the extra benefits plans can provide to promote good health, ranging from gym membership and eyeglasses to meal delivery and transportation assistance.

There is, however, an unspoken price for these enhancements that’s being paid not in dollars but in privacy. To better target outreach, some plans are routinely accessing sophisticated analytics that draw upon what’s euphemistically labeled “consumer data.” One vendor boasts of having up to 5,000 “certified variables for every adult in America,” including “clinical, social, economic, behavioral and environmental data.”

Yet while companies like Facebook and Google have faced intense scrutiny, health care firms have remained largely under the radar. The ethical issue is obvious. Since none of this sensitive personal information is covered by the privacy and disclosure rules protecting actual medical data, it is being deliberately used without disclosure to, or explicit consent by, consumers. That’s simply wrong.

But a more fundamental concern involves the analyses themselves.

Start the Revolution without Us

Sep 13, 2022• 1

BY KIM BELLARD

Well, as usual, there’s a lot going on in healthcare. There’s the (potential) Amazon – One Medical acquisition, the CVS – Signify Health deal, and the Walmart – United Healthcare Medicare Advantage collaboration. Alphabet’s just raised $1b. Digital health funding may be in somewhat of a slump, but that’s only compared to 2021’s crazy numbers. Yep, if you’re a believer that a revolution in healthcare is right around the corner, there’s a lot of encouraging signs.

But I was in a Walmart the other day, and my thought was, these people don’t look like they care much about a revolution in healthcare. In fact, they don’t look like they much care about health generally. That’s not a knock on Walmart or Walmart shoppers, that’s an assessment about Americans’ appetite for changes in our health care.

That’s not to say we like our healthcare system. A new AP-NORC survey found that 56% felt that the US did not handle healthcare well (curiously, 12% thought we handled it extremely/very well – huh?). Prescription drugs, nursing homes, and mental health rated especially low. We’d like the government to do more, but not, it would seem, if it means we pay higher taxes.

Much of what is wrong is our own fault. We know that we eat too many processed foods, that the food industry scientifically preys on us to target our weaknesses for fat, sugar, and salt, that we’d rather sit than drive and drive than walk, and that we are poisoning our environment, and, in turn, ourselves. Given a choice between short term benefits versus long term consequences, though, we’ll eat that Oreo every time, literally and metaphorically.

Tick Tock (or TikTok) for US Health Care

Aug 16, 2022

BY KIM BELLARD

Yes, I know Congress just passed the Inflation Reduction Act, a big step forward in combating climate change that also has some important healthcare provisions (Medicare negotiating drug prices, anyone?), but, come on, TikTok is buying hospitals! I can’t pass that up.

To be more accurate, TikTok’s parent company ByteDance is actually buying hospitals, through two of its health subsidiaries. As first reported by South China Morning Post, and subsequently confirmed as a $1.5b deal by Bloomberg, ByteDance bought Beijing-based Amcare Healthcare, which runs eight women’s and children’s hospitals in four Chinese cities. As a private system, it targets expats and high income locals.

This is not ByteDance’s first foray into healthcare; in 2020 it bought Xiaohe Medical, an internet hospital, as well as a medical information site and a telehealth service. It is using its AI expertise to aid in drug discovery. Its health business are under the umbrellas of Xiaohe Health and Xiaohe Health Technologies.

And you were excited about Amazon buying One Medical.

Caring Does Not Pay

Aug 9, 2022

BY KIM BELLARD

Things are tough all over the job market. With a jobless rate at 3.5%, and with millions of people who left the job market in 2020 opting to not return to work, employers are having a hard time finding workers. Your favorite restaurant or retail store probably has a “Help Wanted” sign out. Checking your bag for a flight has never been more problematic, in large part due to staffing issues. Even tech companies are having trouble hiring.

But I want to focus on a crisis in hiring for three industries that take care of some of our most vulnerable populations – teaching, child care, and nursing. It seems that what we say we want for our kids and the sick isn’t at all what we actually do to ensure that.

Lou Lasagna and the MIC “Integrated Career Ladder” – More Than Just A “Revolving Door.”

Aug 4, 2022

BY MIKE MAGEE

The New York Times recently shined a light on the FDA’s top science regulator of the tobacco industry, Matt Holman, who announced his retirement after 20 years to join Phillip Morris. As they noted, “To critics, Dr. Holman’s move is a particularly concerning example of the ‘revolving door’ between federal officials and the industries they regulate…”

As a Medical Historian, I’ve never been a fan of the casual “revolving door” metaphor because it doesn’t quite capture the highly structured and deliberate attempts of a variety of academic medical scientists over a number of decades in the 2nd half of the 20th century to establish and reward an “integrated career ladder” that connected academic medicine, industry and the government.

The Impact of COVID-19 on Shared Priorities for International Cooperation in Active and Healthy Aging

Aug 2, 2022

By ELIZABETH BROWN, CATALYST @ HEALTH 2.0

IN THIS MINI-SERIES, WE WILL BE TAKING A LOOK BACK AT THE IDIH WEEK 2022 USA REGIONAL WORKSHOP, TITLED THE IMPACT OF COVID-19 ON THE SHARED PRIORITIES FOR INTERNATIONAL COOPERATION IN ACTIVE AND HEALTHY AGING, WITH A DIFFERENT BLOG POST DEVOTED TO EACH OF THE THREE COMMON PRIORITIES THAT WERE REFINED THROUGHOUT THE IDIH PROJECT: INTEROPERABILITY BY DESIGN, DATA GOVERNANCE, AND DIGITAL INCLUSION.

INTRODUCTION: THE REGIONAL WORKSHOP PANELISTS AND BACKGROUND OF THE PANEL

For the past three years, Catalyst has been involved in the IDIH Project, which has recently concluded (you can read more about the overall project findings here). IDIH (International Digital Health Cooperation for Preventive, Integrated, Independent and Inclusive Living) – funded under the European Union Horizon 2020 Research and Innovation Program – was aimed at fostering cooperation in the field of Digital Health for Active and Healthy Aging (AHA) between the European Union and five Strategic Partner Countries (Canada, China, Japan, South Korea, and USA), especially focusing on four key areas that embrace common priorities of all countries/regions involved: Preventive Care, Integrated Care, Inclusive Living, and Independent and Connected Living.

Following an expert-driven approach, experienced and renowned experts, executives, and advocacy groups from the six regions (Europe, China, Canada, Japan, South Korea and USA) were brought together by IDIH in a Digital Health Transformation Forum working to define more specific priorities in Digital Health and Ageing, and identifying opportunities for mutual benefit and priorities for international cooperation.

During IDIH Week 2022, Catalyst ran a Regional Workshop aiming to explore the impacts of COVID-19 on AHA.

At the Core, Tuskegee Has Never Been Resolved

Jul 27, 2022

BY MIKE MAGEE

July 25, 1972 was fifty years ago this week and it is a day that all AP Science journalists know by heart. As Monday’s AP banner headline read: “On July 25, 1972, Jean Heller, a reporter on The Associated Press investigative team, then called the Special Assignment Team, broke news that rocked the nation. Based on documents leaked by Peter Buxtun, a whistleblower at the U.S. Public Health Service, the then 29-year-old journalist and the only woman on the team, reported that the federal government let hundreds of Black men in rural Alabama go untreated for syphilis for 40 years in order to study the impact of the disease on the human body. Most of the men were denied access to penicillin, even when it became widely available as a cure. A public outcry ensued, and nearly four months later, the “Tuskegee Study of Untreated Syphilis in the Negro Male” came to an end.”

Be Careful What You Wish For

Jul 19, 2022• 1

BY KIM BELLARD

I read the Stat News investigative piece “Health care’s high rollers,” by Bob Herman and colleagues, with interest but not much surprise. I mean, is anyone surprised anymore that healthcare CEOs often make a lot of money, and didn’t let a crisis like the pandemic dampen that? As Kaiser Family Foundation’s CEO Drew Altman told them, “Health care has become big business. We have a lot of people making a lot of money in health care, and we still have an affordability crisis in health care.”

I periodically see Twitter threads lamenting how little of that healthcare spending actually goes to physicians, yet people often still blame them for that spending. Physicians make a pretty decent living (an average of $322,000, according to the 2022 Medscape Physician Compensation report), although that compensation depends on specialty, gender, race/ethnicity, and location. But maybe, just maybe, the problem in healthcare is that we’re not paying physicians enough – not nearly enough.

I think I know how to fix healthcare.

M4A as a Swing Issue

Jul 14, 2022

BY MIKE MAGEE

“There’s common ground there—not the warm belonging of full creedal agreement, perhaps, but a place, even a welcoming place, where we can stand together.” Ian Marcus Corbin, Research Fellow, Harvard Medical School

Most Americans would love to believe this statement. But political reality intervenes. A March, 2022 Pew Research Center analysis found our two major parties to be “farther apart ideologically today than at any time in the past 50 years.”

Take, for example, Presidential hopefuls, Florida Gov. Ron DeSantis and Sen. Marco Rubio (R-Fla.). They see political pay dirt on the jagged peaks of America’s culture wars with the governor taking on Disney for defending LGBTQ employees by introducing the his “Stop W.O.K.E. Act“, while Rubio goes one step further with his “No Tax Breaks for Radical Corporate Activism Act”.

In academic circles, you increasingly find references to “what’s the matter with…debates.” The phrase derives from a 2004 book “What’s the Matter with Kansas?” written by historian Thomas Frank, which spent 18 weeks on the New York Times Bestseller List.