Potpourri V

By November 21, 2009Commentary

The New York Times reports that drug companies have been raising prices at a good clip this year, presumably in anticipation of potential adverse effects from reform bills.  We have commented on this phenomenon before.  Seemingly unable to contain themselves, the pharmaceutical manufacturers are determined to maximize their profits whatever may come in the way of reform, and don’t appear to care that they may be reinforcing their negative public image.  They may also be inviting more specific legislation to force price rollbacks.  (NY Times Story)

The BBC has a story which illustrates the rapid development of wireless monitoring techniques.  (BBC Story) It discusses the use of band-aid type sensors to collect and stream information like heart rate, blood pressure and temperature.  A number of these devices are being tested and are beginning to make their way into medical care use.

Quite a furor was caused by the recommendation to reduce the amount of mammography screening.  Reform opponents immediately tied the change to rationing, which they claim will become widespread if the House or Senate bills were to be adopted.  That is quite unfortunate.  As is typically the case, the task force did an outstanding job of assembling and examining the evidence.  What people seem to misunderstand is that the changed recommendation is only peripherally about cost.  It is based on the harm that demonstrably has occurred because of the current excessive screening.  High rates of false positives lead to more testing and procedures, all of which have risks.  Lots of screening delivers radiation, which is risky in itself.  Patient anxiety is heightened for no good reason.  So the point of the revised recommendation is to create an overall better outcome for patients.  (USPTF Recommendation)

The White House through OMB released a statement about the nearly $100 billion in improper government payments last year, more than half of which were connected to health care.  (White House Statement) While there was a claim that much of the increase was due to a changed reporting method, no one seems to doubt that the government is wasting a lot of the taxpayers’ money.  And we want these people to run more of the health care system why?

Benefits firm Buck Consultants reported results of a survey on wellness programs.  (Buck Survey) The survey looked at 1100 organizations in 45 countries.  In other countries, employers are much more focused on stress relief and productivity improvement than cost savings, but of course in most other countries employers aren’t directly responsible for paying for employees’ health insurance.  On the other hand, employers in the United States are far more likely to offer a wellness program than companies in other countries are, although prevalence is growing around the world.    Incentives are also most prevalent in the US.

In another example of the growing utility of mobile health and telemedicine technologies, the Chicago Tribune has a story on the use of wireless transmission to check the status of implanted pacemakers.  (Tribune Story) The ability to track the performance of implanted devices in near-real-time eases the anxiety of patients and allows providers to identify problems before a device causes a significant adverse event.

Finally, the CDC has released a new study on smoking rates.  Forty-six million Americans still smoke, unchanged since 2004.  These people are primarily poor and uneducated; they can least afford to continue smoking.   (CDC Release) What is most disturbing is that billions have been spent trying to convince consumers to quit smoking, all kinds of legislative and regulatory restrictions on tobacco have been enacted, more than $200 billion was extracted from the industry in lawsuits (much of this went to benefit trial lawyers), taxes are sky-high  and yet we still have these rates of smoking.  How much more ineffective could the anti-smoking campaign be?  You wonder if governments really want people to quit smoking and therefore lose all that  tax revenue?

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