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The “Lie of the Year” Perpetuated

May 29, 2012
7:42 am

Does fact-checking even matter in today’s throw-anything-at-the-wall political environment?

In 2011, the PolitiFact blog, which measures political assertions and advertising against reality, gave its “Lie of the Year” award, if you can call it an award, to the claim that reforming the Medicare program to enable seniors to choose from a menu of private health plans would “end Medicare.”  The TV ads cited by PolitiFact showed a politician pushing a grandmother in a wheelchair off a cliff.

PolitiFact called these accusations “a scare tactic that works.”

Unfortunately, even though this line of attack has been discredited, the early stages of the 2012 congressional campaigns are still finding granny staring over the edge of the abyss.  This weekend, the Capitol Hill publication The Hill cited campaigns that are targeting members of Congress who voted for the budget proposed by Congressman Paul Ryan (R-WI), saying these votes are tantamount to ending Medicare.

That’s a particularly misleading claim given the fact that Congressman Ryan, working with Senator Ron Wyden (D-OR), has modified his original Medicare reform proposal to allow beneficiaries to choose between conventional fee-for-service Medicare and a choice-and-competition system similar to the Federal Employees Health Benefits Program.

It’s also outrageous to scare seniors with these accusations when Medicare reform proposals wouldn’t affect current beneficiaries.

Even if they don’t want to admit it in the context of a heated 2012 election, every member of Congress, be they Democrat or Republican, knows that entitlement reform is inevitable.  Our demographic changes, specifically the 7,000 new Medicare beneficiaries joining the program daily, demand it.   Ideally, the 2012 elections would serve as a forum for a national discussion on how to create a Medicare program sustainable for future generations.

That won’t happen if politicians give the 2011 “Lie of the Year” an opportunity to become a repeat winner.

The Price of Not Knowing

May 24, 2012
1:26 pm

The last few years have seen a big push in various quarters to restrict the interaction between physicians and pharmaceutical company representatives.  Harvard University, for example, declared that pharma reps could not visit doctors at its affiliated health institutions without a written letter of invitation laying out explicit terms for the visit.  The Veterans Administration has developed a litany of restrictive regulations, even dictating where pharmaceutical representatives are allowed to stand and wait for a doctor.

The rationale for these restrictions is, of course, the notion that physician judgment and independence will be clouded by meeting with a company representative that has an interest in bringing attention to a particular product.

What if, however, by closing the door on these interactions, physicians are also shutting out knowledge that is critical to patients?

A Temple University professor of healthcare management and marketing has asked that question, and the research his team developed has just been published in the Journal of Clinical Hypertension.  The upshot of their findings is that doctors who restrict access to pharmaceutical representative are slower to adopt new therapies and also less responsive to negative information about potentially-harmful medications.

This is a comprehensive study analyzing the clinical decisions of over 50,000 physicians.  It found that physicians with more restrictive pharma access policies took 1.4 to 4.6 times longer to being prescribing an innovative new drug for Type 2 diabetes and were four times slower to reduce usage of an older diabetes treatment that had received FDA warnings for cardiovascular safety.

This is an issue that warrants and will continue to be the subject of discussion within the healthcare community.  Some of the most important healthcare innovations of the past century have come as a result of physician-industry collaboration.  In protecting physician independence and attacking potential conflict-of-interest situations, we have to be careful that the pursuit of some perceived standard of purity doesn’t undermine patient care.  Information has incalculable value and there is a price for not having it.

Unclogging Pennsylvania Courts

May 15, 2012
2:30 pm

This month, we’ve seen even more evidence that states enacting medical liability reform are having a significant impact in reducing the number of frivolous lawsuits, thus providing speedier justice to plaintiffs who have suffered legitimate injuries and deserve compensation.  Pennsylvania is the latest state spotlighting the value of reform.

Of course, Pennsylvania reforms are not exactly new.  The state took action back in 2003 to address a situation in which, according to a Philadelphia Daily News columnist, “courts were clogged with cases and lawyers hit Vegas-level jackpots.”  The state began requiring attorneys to produce certificates of merit from medical professionals to prove that a legitimate case existed and it declared that cases must be tried in the same jurisdiction in which the alleged injury took place.   That put an end to ‘venue shopping,’ in which attorneys strived to get their cases tried in Philadelphia with its notoriously free-spending juries.

What’s new is the evidence that these reforms have had an effect.  The state Supreme Court announced last week that the number of medical malpractice cases filed in the state was down 44 percent in 2011 compared to the years before liability reforms were instituted.  With higher standards being required, attorneys are less likely to invest time and resources into questionable litigation.

There are still cases, though, that must have less than impeccable merit. In 2011, seven of every 10 liability cases were won by the defendant health providers.

It should be noted that Pennsylvania physicians and hospitals insist that further reforms are still necessary, that it is difficult to recruit new physicians to a litigation-heavy state and too much defensive medicine is being practiced.

Still, this is significant progress.

The Medical Device Tax: Beating Up on the Little Guys

May 01, 2012
8:43 am

We need a better understanding of exactly why the medical device tax contained in the Affordable Care Act is so harmful to both the U.S. economy and the future of medical innovation.  Advocates of the tax say it’s no big deal for multinational, multibillion dollar corporations to pay a few extra bucks toward health reform implementation (even though those companies are being forced to lay off employees, because of the tax, at a time our economy can least afford it).

But it’s also the smaller companies, those that scrap for capital to fund exciting new innovations, that are taking a beating from this tax.  The fact that this tax is applied to revenues, not to profits, is particularly devastating for smaller innovators that are still trying to get to the point of being highly profitable.

Take Spectranetics, a Colorado Springs-based medical laser manufacturer, as a prime example.

At a panel discussion hosted by the Colorado BioScience Association, the CEO of Spectranetics pointed out that his company generally earns about $1.5 to $3 million on approximately $135 million in annual revenues.  If the device tax was applied this year on Spectranetics’ income, the company would have to pay the government slightly over $3 million, essentially wiping out the resources that could be invested into product development, clinical research or additional hiring.

And, as the company pointed out, it can’t compensate for the tax by raising prices doctors and hospitals pay for the medical lasers because healthcare providers are also being squeezed with comparatively low Medicare and Medicaid reimbursement rates.

At a time in which our economy needs an infusion of well-paid jobs and our growing healthcare needs require new medical innovation, the Spectranetics case is just one of many examples demonstrating why Congress needs to reconsider the medical device tax.