KHN’s ‘What the Health?’: Boosting confusion

Reviewed by Emily Henderson, B.Sc.Nov 18 2021

With covid caseloads rising across much of the country, several governors and mayors are unilaterally expanding access to booster shots, getting out ahead of federal health officials.

Speaking of federal health officials, President Joe Biden has finally selected a nominee to head the Food and Drug Administration. If confirmed by the Senate, it would be Dr. Robert Califf's second stint at the agency that oversees an estimated one fifth of all products sold in the United States. Califf previously served — for less than a year — under President Barack Obama.

Califf's nomination, however, could be complicated by the news of a dramatic increase in Medicare premiums for 2022, prompted largely by the FDA's approval of a controversial drug to treat Alzheimer's disease not yet been proved effective.

This week's panelists are Julie Rovner of KHN, Tami Luhby of CNN, Sarah Karlin-Smith of the Pink Sheet and Rachel Cohrs of Stat.

Among the takeaways from this week's episode:

• Democratic leaders in the House say they expect to vote soon on a bill funding Biden's climate change and social policy agenda. Even some moderates, who have been concerned about the price tag, suggest that passage looks likely. But the Congressional Budget Office has not yet released its full estimates of the cost of some of the more controversial health items in the bill, and those numbers could prompt calls for revisions.
• Califf appears on track for Senate confirmation because he is expected to get support from most Democrats and some Republicans. Several Democrats, however, have already criticized the nomination, complaining the FDA was not tough enough on the drugmakers behind the opioid epidemic and needs a leader who will change that culture.
• At the Department of Health and Human Services, at least three Senate-confirmed positions dealing with social services remain unfilled. Those include the assistant secretary for the Administration for Children and Families, a commissioner for the Administration for Native Americans and a commissioner for that agency’s children, youth and families bureau.
• Medicare officials announced the standard monthly premium for the Part B program, which covers doctor and other outpatient medical services, would rise next year by more than $20. Part of that increase is a hedge in case Medicare decides to cover the cost of a new controversial Alzheimer's drug, Aduhelm.
• Aduhelm is priced at $56,000 a year and involves other costs related to testing for side effects. Although the drug would likely be used by a small number of beneficiaries, its high cost influenced the sharp increase in premiums, Medicare officials said.
• If Medicare opts not to cover Aduhelm, it's not clear if or how beneficiaries might recoup the money spent on the premiums.
• The FDA appears to be moving toward the Biden administration's desire to make all American adults eligible for additional covid vaccine shots, known as boosters. Some scientists within the administration have been reluctant to take that step, but new evidence provided by the drugmakers bolsters the effort to get younger people extra doses.
• The move by states and cities to make younger adults eligible for the boosters may not be legal under the special-use authorization the FDA gave several of the vaccines. But it hasn't been challenged.
• Confusion over who is eligible for the shots may undermine the federal government's efforts to assure the country that the covid vaccines are effective and a good choice. Still, people hesitant to get the shots do not appear to be convinced by many arguments.
• Biden's order that large workplaces establish vaccine mandates is on hold as it is being challenged in federal court. The issue will likely end up before the Supreme Court, and some advocates for workers fear that the justices could use the case as an opportunity to roll back federal protections in the workplace.

Also this week, Rovner interviews Dan Weissmann, host of the "An Arm and a Leg" podcast, about his new project, a "first-aid kit" newsletter to help consumers make better decisions about their own health care.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The Atlantic's "Why Health-Care Workers Are Quitting in Droves," by Ed Yong.

Also, Stat's "The Catholic Hospital System Ascension Is Running a Wall Street-Style Private Equity Fund," by Rachel Cohrs.

Tami Luhby: Politico's "‘We Don't Fix This Because We Just Don't Care About Old People,'" by Joanne Kenen.

Sarah Karlin-Smith: KHN and InvestigateTV's "As Big Pharma and Hospitals Battle Over Drug Discounts, Patients Miss Out on Millions in Benefits," by Sarah Jane Tribble and Emily Featherston.

Rachel Cohrs: Modern Healthcare's "Why the Justice Department Is Targeting Private Equity," by Tara Bannow.

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