Bridget Carroll Archives

Manhattan Institute senior fellow Avik Roy and Columbia University's Gillian Metzger discuss the Supreme Court's hearing of the case with WSJ Legal reporter Ashby Jones.

Yesterday the FDA's Arthritis Drugs Advisory Committee voted 21-0 that anti-nerve growth factor (NGF) agents should continue to be developed to treat osteoarthritis pain.

From Bio Century:

Because the joint destruction was increased in patients taking anti-NGFs with NSAIDs, the panel felt studies in OA could continue if concomitant NSAID use is excluded and additional safeguards are put in place. These could include measuring biomarkers of joint destruction and increasing use of MRI. The panel did not feel anti-NGFs should be restricted to refractory OA patients despite an increase in joint destruction seen in clinical trials.

Read Paul Howard's analysis of the FDA's anti-NGF in his blog post, "Chronic pain relief: too much of a good thing?"

(This article is re-posted from Megan McArdle's blog at TheAtlantic.com where Avik Roy will be guest blogging over the next two weeks.)

Avik S. A. Roy

Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act--its expansion of Medicaid coverage to 16 million more Americans--may actually reduce those individuals' access to health care.

White's report comes on the heels of numerous studies that show that patients on Medicaid, our national government-run health-care program for the poor, do far worse on health outcomes than do those on private insurance, and in some cases, worse than those with no insurance at all. (For an extremely deep dive into these studies, see my three-part series on the topic.)

1) Medicaid underpays doctors for their expenses

Why does this occur? The main reason is that Medicaid underpays doctors and hospitals to care for Medicaid beneficiaries. Medicaid's reimbursement rates are around half of those paid by private insurers. In many cases, Medicaid pays doctors less than it costs to care for Medicaid patients, meaning that doctors face the choice of caring for the poor, and going broke, or shutting their doors to Medicaid patients. One survey found that internists were 8.5 times as likely to accept no Medicaid patients at all, relative to those with private insurance. Another found that two-thirds of kids on Medicaid were denied a doctor's appointment for a serious condition, relatively to only 11 percent for the privately-insured. . .

Lauren Neergaard at the Associated Press reports President Obama will ask Congress for $80 million in new money to spend for Alzheimer's research in 2013. Right now the National Institutes of Health spends $450 million a year on Alzheimer's research compared to the $3 billion spent annually on AIDS research.

Our sister site, PointofLaw.com is hosting a friendly debate on medical malpractice damages. MI's own Ted Frank is debating Professor Shirley Svorny of the Cato Institute on whether med-mal damages hurt consumers. Svorny authored a report released by Cato earlier this fall arguing that existing empirical evidence suggests that "medical malpractice awards do track actual damages" and that noneconomic damage caps and other "policies that reduce liability or shield physicians from oversight by carriers may harm consumers." Frank finds her paper not only contradictory but counterproductive.

Read more on Frank and Svorney's featured discussion and be sure to follow the debate on Twitter at #POLdiscussion!

From PointofLaw.com:

A couple of weeks ago, we discussed how the poorly-drafted PPACA will end up being unworkable, a function of it being passed in a hurry through parliamentary tricks to get the skin-of-the-teeth votes it needed. The next step of that dance is occurring, with the Obama administration blithely claiming that it can ignore the statutory language, and Senator Hatch warning the administration not to act so lawlessly. . .

The FDA filed an appeal yesterday regarding the implementation of their controversial graphic warning labels for cigarette packets. Cigarette cartons would feature images of cigarette-induced diseases and death by smoking on the top half of the pack. Our sister site, PointofLaw.com, cites the constitutional ramifications of the FDA's efforts and why they may not win this appeal.

Walmart is looking to join Walgreens and CVS' "Minute Clinics" as part of a growing number of retail health clinics nationwide. Many Americans don't have a primary care doc, or at least one they see regularly. To meet the need for quick and effective health services, big-box retailers have opened clinics within their own stores. Paul Howard, in his Manhattan Institute study, "EASY ACCESS, QUALITY CARE: The Role for Retail Health Clinics in New York," argues that retail clinics offer an affordable and efficient alternative to the doctor's office or in the case of the uninsured, the emergency room. Julie Appleby quotes him on Kaiser Health News today:

In-store medical clinics, such as those offered by Walmart and other retailers, could also be players in another effort in the health law: encouraging collaborations of doctors and hospitals who want to win financial rewards for streamlining care and lowering costs. Such collaborations, known as "accountable care organizations," might contract with in-store medical clinics, says Paul Howard, a senior fellow with the Manhattan Institute for Policy Research. He has studied retail clinics, some of which have recently expanded to offer services beyond simple tests and vaccinations, such as helping monitor patients with diabetes or high blood pressure.

Read Howard's study on retail clinics here.

Find Julie Appleby's article reposted at MSNBC, NPR, and National Journal.