Healthcare Outsider

• Thalidomide, a drug striking fear into the hearts of 1950s parents, may now be used to treat nosebleeds and cancer. [Reuters]
• Despite healthcare reform’s emphasis on prevention, including a focus on fitness, diet and screenings, the Congressional Budget Office thinks spending money on playgrounds to improve fitness will still increase medical spending. [The New York Times]
• On a related note, Americans eat 31 percent more packaged food than fresh food. [The New York Times]
• On a further related note, are some health-conscious consumers getting the message? Anemic increases in revenue at companies like Campbell Soup and H.J. Heinz may encourage former competitors to team up to purchase ingredients at reduced rates. [The Wall Street Journal]
• While new corporate governance outlined in Pharma Giant Merck’s settlment requires the company to do what it should have been doing all along, some analysts argue that the changes don’t go far enough to protect consumers. [Dealbook]
• XMRV, a recently identified virus transmitted in a similar manner to HIV, has been linked to chronic fatigue syndrome, though it does not appear to cause symptoms in everyone. Public-health officials estimate that up to 10 million people in the US could be infected. [The Wall Street Jounral]

-HCO

• Good news! You might not be vacinnated, but not to worry, the rate of H1N1 vaccination coverage among healthcare workers is still below half, according to the Centers for Disease Control and Prevention [ModernHealthcare.com]
• In using the state’s power to disapprove insurance rate increases for the first time (which has been on the books since 1977), Mass. State Insurance Commissioner denied 235 of 274 proposed rate increases by insurance companies.  Detractors say, “j’accuse motivation politique!” [The New York Times]
• On a related noted, Main state court will soon rule on a decision by the state’s Superintendent of Insurance denying an insurance company’s request for a premium increase, citing tough economic times.  [The Wall Street Journal]
• Good weekend reading: Care to read a good “whodunit?”  Yesterday The New York Times asked, “Are you buying Illegal Drugs?”  Apparently, Eli Lilly and other Pharmaceutical companies have failed to use “track-and-trace” technology for prescription drug bottles, which may increase theft and exposes patients to drugs that may be improperly stored or altered in the black market. [The New York Times]

-HCO

• Despite the unavoidable loss of Lipitor, the world’s number one selling drug, Pfizer’s CEO believes that the company’s success is inevitable.  His strategy for success includes taking diversification seriously . . . “9 semi-autonomous business units meant to diversify the company’s products,” seriously. Analysts say, best of luck. [New York Times]
• According to some, the Administration’s Independent Payment Advisory Board, included in health care reform legislation and intended to control excessive spending, is “the largest yielding of sovereignty from the Congress [to the Executive branch] since the creation of the Federal Reserve.” Boo! [Wall Street Journal]
• Following the careful study and redesign of hotdogs, nervous parents, famous athletes, and even orthopedists, are calling for tighter regulation of after-school sports.  The proposal: all children must wear helmets to bed. [Wall Street Journal]
• Some charge that Eli Lilly, Merck, GlaxoSmithKiline and Pfizer’s  efforts to improve the transparency of their funding for clinical trials through new online searchable databases is as clear as Lehman’s Repo 105 program. [New York Times]

-HCO

The New York Times Reports that last month, GlaxoSmithKline (the pharmaceutical company that can do nothing right) recalled a popular dental adhesive called Super Poligrip from the market because it contained high levels of Zinc, and some people who used the cream had shown some adverse symptoms associated with the effects of Zinc poisoning (they were dying.) Zinc – you probably know it as the last ingredient listed on your unopened bottle of Centrum. You may also be familiar with its usage as an anti-corrosive, a component used to galvanize steel, and an adhesive agent in denture creams. What you probably didn’t know is that studies like this one (from the American Journal of Clinical Nutrition) have identified the metal as a toxic agent, and that long-term exposure to it can lead to nerve damage, anemia, and death.
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• Despite concerns over health risks, FDA approves cholesterol drug to prevent heart attacks in healthy people . . . . . . conveniently for AstraZeneca, healthy people are inclined to take drugs they don’t need.
• Despite their initial reluctance, health insurance companies buckle under pressure from administration and angry parents, agree to cover children with pre-existing conditions.  Unpopular puppies snubbed.
• Republican Governor of Georgia seeking to impeach Democratic Attorney General for refusing to file lawsuit challenging health care reform.  Perhaps on a related note, dramatic increase in swine flu hospitalizations at Georgia hospitals.
• As usual, your mother was right.  Brushing your teeth is crucial to your health and losing them may kill you.

-HCO

Now that the health care bill seems like it might actually pass, the next question is how we are going to pay for it. While the Congressional budget office suggests the measures will save us billions, estimates for the final cost have been all over the place. Regardless of how much we finally save, the government is still going to spend billions of dollars expanding Medicaid coverage and providing subsidies for employers. Our options are to continue piling on to our already colossal debt, or to find some other way to pay for it. Here is one suggestion…
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Medicaid, the national medical insurance program designed to provide coverage for the least advantaged Americans, has been slowly losing funding since being created as part of the 1965 social security act. Now, as medical costs continue to skyrocket, small practices are losing money because their states have set standard payment rates lower than the costs of the treatments. Rather than lose money and their practices, small town physicians are opting out of treating Medicaid recipients. This trend is sending the nation’s poor and sick on costly hunts for doctors who will agree to treat them. [CNN Money]

In light of this, it’s tough to tell why people might be clamoring for health care reform…

-Michael B. Sauter

A Danish study on stents has yielded some interesting results. It has shown that using the supposedly superior drug-coated version of the device creates a much higher risk for heart-related death than “bare metal” stents. While the study also determined that the drug coated stents  (which are small, surgically implanted, latticed tubes used to prevent blood clots) do decrease the risk of clotting and other complications, this fact is more than offset by the news of an apparently higher risk of cardiac mortality. [Reuters]

Stents are easily one of the most controversial medical devices in modern medicine. They’re expensive, and may not actually do anything useful except relieve pain in patients with heart disease.

-Michael B. Sauter

The recipients of a popular form of artificial hip replacement are beginning to find out the hard way that their prosthetic may have some design flaws. Doctors have encountered all kinds of problems with the so called metal-on-metal design, which replaces the connection of the hip and leg bones with a metallic ball and socket. What has been happening, physicians believe, is that constant friction between the two pieces of cobalt and chromium has been shearing off tiny fragments of metal into the surrounding area. This has caused some “undesirable” side effects including, but not limited to: tissue damage, bone deterioration, and pain hotter than the fire of a thousand suns. If you’ve had one of these protheses installed, walk, do not run, to your nearest doctors office to discuss alternatives. [NYT]

-Michael B. Sauter

HCO knows many of you are still holding your breath while the political dust settled before passing judgement about the bipartisan health care summit last week. Did the Democrats win? Did the Republicans win? Did the  win? The Atlantic Wire has a nice collection of opinions on how things went. which, in aggregate, prove string theory. (because all things apparently happened at once)

If we were to guess, based on our national history of health care legislation, and summits in general, everyone probably lost.

-Michael B. Sauter