Viewpoints: Shop around for health coverage; 'gaming' Obamacare; FDA and painkillers

Oct 1 2014

The New York Times' The Upshot: Auto-Renewing Your Health Plan May Be Bad For You, And For Competition

My colleagues Margot Sanger-Katz and Amanda Cox wrote recently that shopping around for the best price can be crucial for people renewing their coverage on the health insurance exchanges this fall. But evidence suggests that many people probably won't do that. Not only is that bad for them, but it can also harm competition, which is bad for everyone. A basic truth about health insurance, as with many other things, is that people hate to shop around and change products. They have a status quo bias. That bias can be exacerbated by a large number of plan choices, as consumers in some exchanges face (Austin Frakt, 9/29).

The Wall Street Journal's Washington Wire: The Flaw In Using Medicare Price Caps As A Cost-Control Model
Recent articles have suggested capping health-care prices at a percentage above Medicare payment levels as a way to bring down health costs. But evidence suggests that, rather than reducing overall spending levels, Medicare's price caps don't effectively control health costs (Chris Jacobs, 9/29). 

The Wall Street Journal: How To Game ObamaCare
Liberals are suddenly everywhere claiming that the GOP's "worst nightmare" is coming true: ObamaCare is working, premiums are rising only modestly or even falling, and more insurers are choosing to participate. But this new optimism papers over some unusual market dynamics that suggest a business strategy to game ObamaCare's rules (9/29).

Bloomberg: Runaway Obamacare Spending Will Cost Democrats 
[A] new study out ... from Bloomberg Government threatens to bring the Affordable Care Act back to center stage -- and in a way that will likely hurt the electoral chances of incumbent Democrats, all of whom voted for the law. The study found that federal spending on Obamacare and related legislation has far exceeded anyone's estimates (or imaginations). To date, the report concludes that the health-care law has cost taxpayers $73 billion. And that number doesn't include projected spending on the law's Medicaid expansion, which if included would bring costs to more than $90 billion. The study's estimate is even higher than the Congressional Budget Office's "high" cost projection for the law -- $71.2 billion by the end of 2014 (Lanhee Chen, 9/26).

Los Angeles Times: Why So Many Injury Claims From L.A. Public Safety Workers?
Los Angeles' police and firefighters take paid injury leave at significantly higher rates than public safety employees elsewhere in California. Why? Is it more strenuous or stressful to work in the city of Los Angeles, compared with L.A. County or Long Beach? Does the city have an older workforce more prone to injury? Or is it just so easy to game the system in L.A. that filing an injury claim has become a routine matter in the police and fire departments? (9/29). 

The Washington Post: Reverends Like Us Should Never Oppose Access To Abortion Or Sex Ed
It is a cliché -; and a false one -; that the community of faith has only one opinion about reproductive rights. Believers often feel compelled to offer compassion and support to individuals and families who are making the profound decision whether to continue a pregnancy, become a parent, plan for adoption, or seek an abortion. But just as people from different traditions (and even people inside the same tradition) hold varying views on these issues, so do their clergy (Harry Knox and Alethea Smith-Withers, 9/29). 

USA Today: FDA Undermines Painkillers Fight: Our View
The most prescribed drugs in America -; painkillers containing addictive opioids -; are also driving the deadliest drug problem in America. On average, 46 people a day die from painkiller overdoses, and 1,150 more land in emergency rooms. Deaths from illegal drugs don't even come close. Last year alone, doctors wrote about 180 million prescriptions for hydrocodone and oxycodone, nearly one for every adult in the United States (9/29). 

USA Today: FDA: Combating Opioid Abuse
Today, more Americans tragically die from drug overdoses than from any other form of death by injury. A staggering 40% of those deaths involve prescription opioids. Identifying solutions to prevent prescription opioid abuse while ensuring that patients with debilitating pain have access to effective treatment is a top priority for FDA. As a public health agency, FDA reviews drugs using a scientific approach within our legal framework and not only considers those who abuse opioids, but also those who use them responsibly (FDA Commissioner Margaret A. Hamburg, 9/29). 

The New York Times: A New Attack On Antibiotic Resistance
Antibiotic-resistant germs are an increasing threat, causing at least 23,000 deaths and two million illnesses in the United States each year, and requiring treatment costing $20 billion in direct medical expenses. The Obama administration announced some good measures this month that should help reduce the overuse of antibiotics in humans and much, though perhaps not all, of the overuse in animal husbandry that together are fueling the emergence of drug-resistant germs (9/29). 

JAMA Internal Medicine: The Strange Allure Of State "Right-To-Try" Laws
Right-to-try laws revive a decades-long debate about balancing early access to unapproved medications
for terminally ill patients with requirements for demonstrated safety and effectiveness. ... The problem is that all these efforts are unlikely to actually help the patients with life-threatening diseases. Indeed, these laws may be harmful if they draw attention and resources away from efforts to develop effective treatments, engender confusion about the FDA pathway for compassionate use of medications, or create false hopes for terminally ill patients. ... At a time when the federal government is increasingly unpopular, an agency that oversees opioids, abortifacients, and other controversial drugs may be an appealing target for state politicians. ... expertise-based federal regulation should be improved, not targeted (Patricia J. Zettler and Henry T. Greely, 9/29).

JAMA Internal Medicine: Improving Medical Device Regulation
The FDA has regulatory responsibility for a wide range of products, from simple and low-risk tools, such as crutches, to more complex and higher risk devices, such as implantable cardioverter defibrillators. ... The mission of the FDA is to protect the public health by providing reasonable assurance that marketed medical devices are safe and effective and to promote the public health by streamlining regulatory processes and eliminating unnecessary barriers to medical device innovation. At times, the agency has rightfully been criticized for pursuing one goal at the expense of the other. In recent years, the FDA's Center for Devices and Radiological Health has been actively undertaking reforms to advance both goals simultaneously and to improve the scientific rigor of its operations (Elisabeth M. Dietrich and Dr. Joshua M. Sharfstein, 9/29).