|Selected news articles which highlight important policy issues.||
News: Weekly Archives
News for the week of 01-24-2006
An About Face on Hormone Therapy
In 2002, a study warning that hormone-replacement therapy “increases [a woman’s] risk for heart attack and stroke” received enormous media attention. Since then, about 3,600 lawsuits have been filed against pharmaceutical companies over various hormone treatments used to alleviate the symptoms of menopause. This week, however, a new, study challenged the science underlying the earlier warning.
In a sharp reversal in thinking about the risks and benefits of menopause hormones, new research shows that early use of the drugs may actually lower a woman's risk for heart disease.
The finding, published this week in the Journal of Women's Health, contradicts warnings issued nearly four years ago that hormone use increases risk for heart attack and stroke. That widely publicized warning, based on the government-funded Women's Health Initiative study, caused millions of women to abandon hormone replacement therapy. The government had halted the study early, citing concern over the risk posed to trial participants, and sales of hormone drugs plummeted. …
This latest research, which, like the WHI study, was funded by the National Institutes of Health, takes a significant step toward untangling the science. The newest study bolsters the theory that with hormones, timing is everything. Younger women who use the drugs at the onset of menopause likely face fewer risks and more benefits. But the drugs are far more risky if started in older women long past menopause, according to the new research.
One of the experts in the new study, Dr. JoAnn Manson, was also lead author of the earlier study. Dr. Manson told the Journal that the original study was too broadly interpreted,” and that “it’s an oversimplification to say hormone therapy is good for all women or bad for all women…Clearly the truth lies somewhere in between.” Unfortunately, our legal system isn’t designed to find the nuanced truth, but to declare winners and losers (and hand the winners a big cash payday). Given these perverse incentives, it’s no wonder that the results of the original study led to a media-hyped panic and tidal wave of litigation. Emerging research on HRT underscores need for vigorous federal preemption of state tort lawsuits, so that science, not lawsuits, guides best medical practice.
Enrollment Triples in Plans Offering Health Savings Accounts
While critics snipe at the President’s plans to expand access to HSAs, the market for high deductible plans that qualify for HSAs has tripled in the last 10 months.
Enrollment in high-deductible insurance plans that qualify for contributions to tax-sheltered health savings accounts — the Bush administration's way of adding market forces to the health business — tripled to 3 million people in the last 10 months, the health insurance industry reported Thursday.
"This is a very significant success story," said Karen Ignagni, president and chief executive of America's Health Insurance Plans, the trade association for companies that underwrite virtually all such plans.
But the 3 million enrollees in plans that qualify for the accounts represent a small percentage of the 198 million Americans who, as of 2004, were covered by private insurance — or even of the 46 million who have no insurance at all.
"Is it a success story? Yes and no," said Paul Fronstin, a health economist with the Employee Benefit Research Institute. "Three years ago, the market didn't exist. But it still amounts to only a fraction of Americans who have private insurance."
HSAs only came into existence in 2003, so they can hardly be faulted for undoing the nation’s 60-year old legacy of employer-provided health care. But the President’s proposals -- to level tax treatment between HSAs and employer-provided health insurance, to create a national market for health insurance, and to offer consumers more information about health-care outcomes -- should all help tip the balance in favor of consumer-driven health care, and away from the expensive, consumer-unfriendly system we have now.
If the government decided to pay for Americans’ automotive costs, carmakers would be lambasted for the high prices they charged government, and policymakers would demand price controls on automakers to help rein in government spending. The same thing happens in government programs like Medicaid, where state governments are continually trying to tamp down on drug prices.
Five years after Maine adopted the first state drug price regulations, which force drug makers to finance discounts to the uninsured, legislators in all 50 states have been active on the pharmaceutical front. Around the country last year, state legislatures considered more than 600 proposals involving pharmaceuticals, and 43 states passed bills, according to the National Conference of State Legislatures. Many drug industry issues are on legislative agendas again this year. And this Friday in New York, an association of lawmakers from New York, West Virginia, eight other states and the District of Columbia plan to meet to discuss their plans for pursuing industry regulation.
State policymakers are focusing on a slow-moving, and unpopular target (pharmaceutical companies), but not the right one. Drugs are only a relatively small part of state Medicaid spending, but garner the headlines because of spiraling Medicaid costs and the millions of Americans who lack health insurance. These are different problems that require different solutions—for instance, more affordable insurance and Medicaid reforms to keep costs under control. But implementing these solutions would require that legislators reject populist rhetoric and focus on structural reforms. Thankfully, governors in Florida and South Carolina are doing just that by injecting HSA-style reforms into Medicaid, and empowering Medicaid recipients to utilize services in a more cost-effective manner.
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