2012 Potpourri XXXVII

Certificate of need programs require a license for certain kind of health facilities to be built or equipment to be utilized.  Their underlying premise is that controlling supply will lead to less spending.  Research in the Journal of Urology looked at the impact of certificate of need programs for the use of intensity modulated radiation therapy, which is often used in prostate cancer treatment.  The researchers compared states with such certificate of need programs with those that did not have them and found no significant difference in spending on the therapy or its utilization.   (Urology Journal Article)

According to a regular poll conducted by Gallup regarding public attitudes on health care, 59% of Americans are satisfied with the total cost they pay for health care.  Responses on this question have been remarkably consistent since 2002.  Interestingly, however, Medicaid and Medicare recipients are much more satisfied with what they pay than are privately insured persons.  That gap is growing and is now 76% for the government covered beneficiaries versus 57% for the privately covered ones.  No such gap existed for most of the 2000s.  While most respondents appear satisfied with the cost of their own health care, a very large majority are very dissatisfied with what the country spends on health care. (Gallup Poll)

The Hay Group does physician compensation surveys and the most recent ones examines likely 2013 pay for doctors.  The average salary increase appears to be around 2.6%, which is about the same as the actual 2.5% increase that occurred in 2012.  Primary care doctors who work in group practices will likely see increases of 3.0%, while those employed by hospitals will only see a 2% rise in pay.  In 2012, group-based physicians’ pay rose 5% while the hospital-based primary care doctors rose 2%.  Specialists can expect to see about the same level of increase as primary care doctors in 2013, the same as they received in 2012.      (Phys. Comp. Survey)

In another area polled by Gallup, most Americans do not think it is the responsibility of the federal government to ensure that everyone has health care coverage.  Currently 54% think this is not a government duty while 44% think it is.  This is a slight change from the prior three years, which found the public basically evenly divided, and a very sharp change from the early 2000s, when as many as 69% of Americans thought the federal government should ensure the availability of health care coverage.  Apparently the reform law debate and outcome has brought home some unpleasant realities to more people.  At the same people widely view our system as too expensive and the overall view of health care coverage has become less positive.  (More Gallup Poll)

One rationale for high brand-name drug prices has been the high cost of drug development and the fact that multiple drug candidates fail for every one that makes it through to approval.  Exactly how much is spend in developing a drug on average has been the subject of some intense debate.  The latest study from the Office of Health Economics in England, which should be somewhat impartial, suggest that it cost around $200 million to get a drug to market in the 1970s and about $1.9 billion in the 2000s.  That is quite a jump, in large part attributable to stricter requirements for approval.  At the same time, success rates are falling, meaning that each successful drug carries the weight for more failures.   (Drug Cost Release)