EPA, Global Health, The Lancet

Paris Climate Change agreement to be signed in New York

Susan Jaffe | Washington Correspondent for The Lancet | 19th April  2016

Secretary of State John Kerry will join world leaders at the United Nations headquarters in New York on April 22 to sign the landmark Paris Climate Change agreement, aimed at controlling greenhouse gasThe Lancet USA blog logoes and preventing what many scientists believe would be the harmful effects of global warming.

Representatives of some 155 countries  are expected at the signing ceremony, including President François Hollande of France, Canadian Prime Minister Justin Trudeau and other heads of state. …UN Secretary-General Ban Ki-moon has urged all countries to ratify the agreement as soon as possible.  “It is in their national interest to implement the agreement and reap the benefits of sustainable global climate action,” he said in an email to The Lancet.

…When 55 countries responsible for at least 55 percent of global emissions do so, the agreement takes effect.  That could happen this year said UN spokeswoman Devi Palanivelu, noting that several countries are coming to New York with ratification documents they will submit after signing the agreement.  But things are not moving as swiftly in the U.S.  [Continued here]  

Affordable Care Act, Drugs, The Lancet

US election: what are the candidates’ health-care pledges?

 lancet cover 2Volume 387, Number  10026 
2  April  2016 
WORLD REPORT    Democrats vying for their party’s presidential nomination have more detailed health-care plans than their Republican counterparts.  Susan Jaffe, The Lancet’s Washington correspondent, reports.

Billionaire real estate developer Donald Trump’s unorthodox campaign to become the Republican presidential nominee has dominated the 2016 political race, nearly overshadowing some unconventional contenders on the Democratic side.  The result is a political season that has defied the odds makers.

Former US Secretary of State and Senator from New York, Democrat Hillary Clinton may be well on her way to becoming the first woman in US history to win her party’s nomination for president. Vermont Senator Bernie Sanders, a self-proclaimed socialist, is trailing Clinton in the number of delegates needed to win the nomination. Yet his popular call for “a political revolution” continues to slowly raise his delegate count. [MORE]

 

Medicare Advantage, Medicare costs

When Medicare Advantage Drops Doctors, Some Members Can Switch Plans

By Susan Jaffe  | Kaiser Health News | March 29, 2016 | This KHN story also ran on  nprlogo_112x37

Eliza Catchings has been seeing doctors at the Christie Clinic in central Illinois since 1957. But just after receiving this year’s WellCare Medicare Advantage member card, the insurer told her the clinic was leaving WellCare’s provider network and she would have to choose new doctors.

“I was terrified,” said Catchings, 79, who gets care for diabetes and heart problems. But she was helped by a little-noticed change in federal policy.

Medicare Advantage plans sold by private insurers are an alternative to traditional Medicare, but they cover services only from doctors, hospitals and other providers that are in the insurer’s network. Although providers are allowed to drop out of the plans any time, members can usually change only during the annual sign-up period in the fall. There are exceptions, but until recently losing a provider was not among them.

After insurers dropped hundreds of providers in 2013, the Centers for Medicare and Medicaid Services issued rules giving people a “special enrollment period” to change plans or join regular Medicare if there was a “significant” change in their provider network. The policy took effect in 2015 and applies only to Medicare Advantage members, not to the plans CMS oversees in the health law’s marketplaces. …Yet officials didn’t explain what they considered significant or what would trigger the option.

In the past eight months, Medicare officials have quietly granted the special enrollment periods to more than 15,000 Medicare Advantage members in seven states, the District of Columbia and Puerto Rico based on provider cuts. These decisions offer important details about how members can get permission to follow their doctors who leave their plans. … Medicare doesn’t publicize the option, and few beneficiaries may know about it. Representatives who answered calls earlier in March to Medicare’s toll-free number said nothing could be done.  [Continued on Kaiser Health News or NPR] 

 

CDC, Global Health, NIH, The Lancet

Zika response threatened by funding shortage

Susan Jaffe | Washington Correspondent for The Lancet | 14 March 2016The Lancet USA blog logo

Congress hasn’t budged in the five weeks since President Barack Obama asked Congress for more than $1.8 billion in emergency funding to deal with the Zika virus. But Zika isn’t waiting.

In the weeks since the president’s request, the number of cases of the mosquito-borne virus among people who traveled to countries where transmission has been confirmed has almost quadrupled to 193, as of March 9. It is in nearly twice as many states — 32 and the District of Columbia — with Florida, New York and Texas topping the list. In Puerto Rico, the U. S. Virgin Islands, and American Samoa, the number of cases is 174, or 19 times higher, reports the US Centers for Disease Control and Prevention.  [continued here]  

FDA, Global Health, NIH, The Lancet

NIH hopes funding increases will continue

 lancet cover 2Volume 387, Number  10019
13 February 2016
WORLD REPORT   The US National Institutes of Health welcomed a record budget boost that might be the start of more sustained support. The Lancet’s Washington correspondent, Susan Jaffe, reports.

The US Congress recently approved the largest single increase in funding for the National Institutes of Health (NIH) in 12 years—a US$2 billion raise that was twice as much as President Barack Obama requested. But almost as soon as NIH supporters stopped cheering, they began to worry about next year’s budget, and the challenge of a new public health threat, Zika virus.

NIH Director Francis Collins told The Lancet that the funding boost “was enormously gratifying”. But if it is “a one-hit wonder”, he said “it won’t be sufficient to take full advantage of the remarkable scientific opportunities and talent that is out there”.   [Continued here] [podcast here]

 

CDC, FDA, Global Health, NIH, The Lancet

Congress Wrangles Over Funding for Zika Research

Susan Jaffe | Washington Correspondent for The Lancet | 12th February 2016

President Barack Obama asked Congress this week for more than $1.8 billion in emergency funding The Lancet USA blog logoto respond to Zika virus and administration officials wasted no time in explaining why at four congressional hearings less than two days later.

While such Capitol Hill visits are part of the budget process, the looming virus adds a new urgency to the proceedings–though not necessarily enough to deter controversy. [Continued here]

Drugs, FDA, The Lancet

Shkreli pleads the Fifth on drug price hikes

Susan Jaffe | Washington Correspondent for The Lancet | 10th February 2016

Like many Americans, members of Congress are frustrated and angry about the huge spikes in prescription drug prices. While a congressional hearing held last week to investigate the practice united Democrats and Republicans in outrage, it did not reveal potential solutions.

     The unwilling star witness was Martin Shkreli, the former head of Turing Pharmaceuticals who was responsible for the company’s decision to raise the price of Daraprim, used to treat toxoplasmosis, a parasitic infection that affects HIV patients, from $13.50 to $750 a pill. [Continued here]  

Drugs, Long term care, Medicare costs, Medigap

Buying Supplemental Insurance Can Be Hard For Younger Medicare Beneficiaries

By Susan Jaffe | February 3,  2016 | Kaiser Health News in collaboration with Money magazine

Danny Thompson’s kidneys have failed and he needs a transplant but in some ways, he’s lucky: Both of his sons want to give him one of theirs, and his Medicare coverage will take care of most his expenses.

Danny Thompson    (Heidi de Marco/KHN) 

Yet the 53-year-old Californian is facing another daunting obstacle: He doesn’t

have the money for his share of the medical bills and follow-up drugs, and he can’t buy supplemental insurance to help cover his costs.

“It’s frustrating to be in the shape I’m in,” said Thompson, who depends on dialysis instead of his kidneys to cleanse his blood. “My plan is to get a transplant so I can go back to work.”

Almost one in four Medicare beneficiaries has such a policy, known as Medigap, which is sold by private insurance companies. It can help pay for costs Medicare doesn’t cover, including the 20 percent coinsurance required for medical expenses, including certain drugs, plus deductibles and co-payments. Those expenses have no out-of-pocket limit for beneficiaries.

Money cover

This KHN story also ran on Money.

Federal law requires companies to sell Medigap plans to any Medicare beneficiary aged 65 or older within six months of signing up for Part B, which covers doctor visits and other outpatient services. If they sign up during this guaranteed open enrollment, they cannot be charged higher premiums due to their medical conditions.

But Congress left it to states to determine whether Medigap plans are sold to the more than 9 million people younger than 65 years old who qualify for Medicare because of a disability. [Continued in Kaiser Health News or Money magazine.]

Long term care, Medicare costs

Hospitals Step Up To Help Seniors Avoid Falls

By Susan Jaffe | Kaiser Health News | January 12, 2016     This KHN story also ran in washingtonpost SMALL logo

Falls are the leading cause of injuries for adults 65 and older, and 2.5 million of them end up in hospital emergency departments for treatment every year, according to the Centers for Disease Control and Prevention. The consequences can range from bruises, fractured hips and head injuries to irreversible calamities that can lead to death.

Despite these scary statistics, a dangerous fall does not have to be an inevitable part of aging.   Risk-reduction programs are offered around the country, including several at hospitals in the Washington area.  [Full article from Kaiser Health News  and The Washington Post]    [Watch video of  balance training class] 

Drugs, The Lancet

Some Congress members say a 1980 law may curb rising drug prices

Susan Jaffe | Washington Correspondent for The Lancet | 13th January 2016

No single federal agency reviews US drug prices, but 51 members of  the U. S. House of Representatives have discovered a 35-year-old law that allows the governmeThe Lancet USA blog logont to control huge hikes in drug costs.  And they want the Department of Health and Human Services and National Institutes of Health (HHS) to use it.  Earlier this week the group led by Texas Democrat Lloyd Doggett wrote to HHS Secretary Sylvia Matthews Burwell and NIH director Dr. Francis Collins to explain why. [Continued here]

FDA, NIH, The Lancet

Budget boon for biomedical research

Susan Jaffe | Washington Correspondent for The Lancet | 31st December 2015

budget 123115The US Congress has become famous for political gridlock  but sThe Lancet USA blog logohortly before going home for the holidays, members approved a 2,009-page budget for fiscal year 2016 with generous increases for some key health and science agencies, most notably the ailing National Institutes of Health. [Continued here.]

EPA, Global Health, The Lancet

Paris climate change agreement faces hurdles in the USA

Susan Jaffe | Washington Correspondent for The Lancet | 31st December 2015
Only a few hours after thousands of representatives from 195 countries approved the landmark Paris cliThe Lancet USA blog logomate change agreement, President Barack Obama stepped before the TV cameras at the White House to congratulate them. It Paris 2offers the best chance we have to save the one planet we have,” Obama said. “We’ve shown that the world has both the will and the ability to take on this challenge.”
But the international consensus to reduce global warming failed to move the Republican candidates competing for Obama’s job.  {Continued here.]
Drugs, FDA, Medicare costs, The Lancet

As drug prices go up, some point consumers up north

Susan Jaffe | Washington Correspondent for The Lancet | 8th December 2015
Pharmaceutical sticker shock has renewed American interest in drugs sold in other countries, particularly our northern neighbor.
Many Americans and even government health programs are feeling squeezed by rising drug costs, with federal officials reporting last week that US The Lancet USA blog logohealth care spending in 2014 rose at the fastest rate since 2002 “in part due to the introduction of new drug treatments for hepatitis C as well as of those used to treat cancer and multiple sclerosis.”120815
Treatments for hepatitis C, which affects around 3 million people in the USA, can cost more than $100,000, Health and Human Services Secretary Sylvia Matthews Burwell said at an unprecedented day-long conference on drug pricing HHS hosted last month.
“And that’s an issue for both patients and the organizations and governments that serve them. Since more than three out of four infected adults are baby boomers, this disease has become one of the main cost drivers for Medicare’s prescription program.  Impacts have also been significant in state Medicaid programs.”
…Prompted by the HHS conference and recent price hikes, two leading Senate Republicans, Charles Grassley of Iowa and John McCain of Arizona want Burwell to use a provision of a 2003 law to certify that drug importation is safe and would significantly reduce drug prices.  [Continued here.]
Drugs, Long term care, Medicare costs

Decline of Medicare subsidized drug plans leaves seniors with less choice

By Susan Jaffe, Kaiser Health News | November 21, 2015 | and also published in USA Today logo 2012
Even though health problems forced Denise Scott to retire several years ago, she feels “very blessed” because her medicine is still relatively inexpensive and a subsidy for low-income Medicare beneficiaries covers the full cost of her monthly drug plan premiums. But the subsidy is not going to stretch as far next year.

Denise-Scott-04

That’s because the premium for Scott’s current plan will cost more than her federal subsidy. The 64-year-old from Cleveland is among  the 2 million older or disabled Americans who will have to find new coverage that accepts the subsidy as full premium payment or else pay for the shortfall. As beneficiaries explore options during the current Medicare enrollment period, there are only 227 such plans from which they can choose next year, 20% fewer than this year, and the lowest number since the drug benefit was added to Medicare in 2006, according to the Centers for Medicare & Medicaid Services. [Continued in USA Today, Kaiser Health News and PBS NewsHour]
Drugs, FDA, Medicare costs, The Lancet

USA grapples with high drugs costs

 lancet cover 2Volume 386, Number  10009 
28 November 2015
WORLD REPORT   More Americans are getting health insurance, including coverage for prescription drugs, but high prices may make them inaccessible. Susan Jaffe, The Lancet’s Washington correspondent, reports.
 Patients in the USA pay more for prescription drugs than almost anywhere else in the world, forcing as many as one in four who can’t afford the high prices to go without their medicine last year, according to a Kaiser Family Foundation survey. So even though more Americans have health insurance, the new therapies and cures that can prevent more expensive health complications might be out of reach.
After several well-publicised, huge spikes in drug prices—including Turing Pharmaceutical’s increase for pyrimethamine (marketed as Daraprim) from US$13·50 to $750 a pill—the problem is drawing unprecedented attention from nearly every quarter: the Obama Administration, Congress, state officials, health insurance companies, drug makers, as well as the physicians and their patients who have clamoured for help for years. It also surfaced during this month’s Democratic presidential debate.
Heather Block, a patient advocate from Delaware who spoke at a day-long pharmaceutical forum hosted by the US Department of Health and Human Services (HHS) earlier this month, pays $9800 a month for the drugs she takes to treat breast cancer that has spread to her liver and lungs. Although she has Medicare coverage, she is still responsible for a share of her medical expenses. “Innovation is meaningless if nobody can afford it”, she said. “I still face financial insecurity and eventually bankruptcy—if I live that long.”     [Continued here ]