|Selected news articles which highlight important policy issues.||
News: Weekly Archives
News for the week of 03-30-2005
Tysabri, an important new multiple sclerosis drug, is still off the market. It may never return now, since a third case of fatal PML, or progressive multifocal leukoencephalopathy, has surfaced in a patient with Crohn’s disease who was taking the drug. Unlike the two prior patients afflicted with PML, this patient wasn’t taking Tysabri in combination with Avonex, another MS drug that was implicated in the earlier deaths. Still, researchers speculate that a combination of immunosuppressive drugs and Tysabri may be causing PML. Does this mean that Tysabri is unsafe? Researchers and physicians seem to disagree.
“For many years we have used other, more dangerous treatments for MS,” said Dr. Jeffrey Horstmyer, director of the MS Center at Mercy Hospital in Miami. “Even if Tysabri has the rare side effect of PML, it still likely safer than a lot of other things being used.”
One other expert called Tysabri’s withdrawal “perfectly ludicrous”, but said that “with product liability attorneys hiding behind every bush, there’s no alternative to pulling it.” There should be an alternative. More of an effort needs to be made to quantify the relative risks and benefits of new treatments versus standard therapies, and to take account of potential drug-drug interactions in patient groups likely to be on multiple drug therapies. And, last but not least, pharmaceutical companies that are in full compliance with FDA regulations should be given some safe harbor from the plaintiff’s bar.
Medicare Puts Data Comparing Hospitals Onto Public Web Site
Consumer driven health care can only succeed if consumers can access critical information about provider quality. Thankfully, the Bush administration and the Centers for Medicare and Medicaid Services are helping to provide that information.
In a move to provide clear, unbiased information about the quality of hospital care, Medicare is launching a Web-based database that consumers can use to see for themselves how local institutions stack up against each other. The Web site, Hospital Compare…[offers] data on 17 widely accepted quality measures in treating heart attack, heart failure, and pneumonia. It shows how most of the nation’s general hospitals perform compared with state and national averages, as well as against their [local] peers.
Mark McClellan, the CMS Administrator, hopes that this will be a “big step toward supporting and rewarding better quality, rather than just paying more and supporting more services.” The Web site may not be perfect, or cover other critical quality measures (like hospital infection rates), but it is a terrific beginning.
New Ethics Rule Cost NIH Another Top Researcher
Another respected NIH researcher has resigned from the agency in the wake of restrictive new conflict-of-interest rules.
James F. Battey, chief of the [NIH’s] high-profile human-stem-cell program and director of that agency’s deafness institute will retire in September after more than 20 years…citing his inability to comply with strict new conflict-of-interest rules that have roiled the NIH internally and prompted a backlash in the broader science and business community.
Battey manages a family trust that contains assets—bequeathed to him by his father—that he will be forced to divest under the current rules. Sensible conflict of interest rules are one thing—and invaluable for a public institution with enormous financial clout like the NIH. The current rules go too far, however, and should be relaxed. Otherwise, the NIH will continue to bleed talent.
Is free health care worth a 3-month wait? Ask Canada
Canada’s universal health care program seems like a panacea to some policymakers in Congress. But for many Canadians, the system promises much more than it ever delivers.
Americans who flock to Canada for cheap flu shots often come away impressed at the free and first-class medical care available to Canadians, rich or poor. But tell that to [Canadian] hospital administrators constantly having to cut staff for lack of funds, or to the mother whose teenager was advised she would have to wait up to three years for surgery to repair a torn knee ligament.
Canada’s “free” health care system is supported by draconian cost-controls that ration health services. This means that patients may have to wait weeks or months for medical services that Americans take for granted. According to one Canadian think tank, “the average wait for surgical or specialist treatment is nearly 18 weeks, up from 9.3 weeks in 1993.” If you’re a patient with chest pains who needs an EKG to diagnose a potential heart attack, that wait may turn out to be a death sentence.
Canadians, of course, are proud of their system, no matter what its flaws. It is, in many ways, more a symbol of national character than anything else. Americans, however, should remember that that Canada’s “free” health care comes with a long, long wait.
Doctors Lobbying to Halt Cuts to Medicare Payments
Medicare and Medicaid were engineered in an era when constituents in the programs were few and the services they used cheap. Now they serve millions of Americans, and their payment model rewards physicians and hospitals for treating patients without regard for the quality or appropriateness of the treatment provided.
Policymakers could head off the fiscal crisis facing both programs by changing how the nation reimburses care for the poor and elderly. If they do, they will face enormous opposition from entrenched interests.
Doctors are mobilizing a nationwide lobbying campaign to stave off cuts in their Medicare fees as Congress hunts for ways to rein in the soaring costs of the insurance program…Doctors said that if the cuts took effect, they would be less likely to treat Medicare patients because the payments would not cover the costs of care.
Neither across-the-board cuts nor across-the-board increases are appropriate in a system where quality varies widely. Indeed, “the chairman of the Medicare Payment Advisory Commission, an independent panel, said [the formula for paying doctor’s fees] had severe flaws.” In fact, it mandates “a national goal for spending with ‘no incentive for individual physicians to control the volume of services’ they provide.” Policymakers should leverage this crisis to make quality a national health care priority.
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