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House Democrats, now in power, will steer health policy, attack drug prices

This is a Kaiser Health news story.

For the first time since passing the Affordable Care Act, Dem..

This is a Kaiser Health news story.

For the first time since passing the Affordable Care Act, Democrats will soon control the House of Representatives and its powerful health committees. But Republicans tightened grip on the Senate means those hoping for another round of dramatic, progressive reforms may be disappointed.

Empowered by voters outraged over Republican attempts to chip away at the laws protections for the sick, Democrats owe much of their midterm takeback to health care issues. And Democratic leaders say they are ready to get back to work, this time training their sights on skyrocketing drug prices, among other policy conundrums, with a majority of House votes and a slate of new committee chairmanships in hand.

In a few weeks, House Democrats will meet to elect their leaders, including several committee chairs who will be responsible for the nations health care policy and spending in the coming years. Hill denizens expect those currently serving as the top Democrat on most House committees to ascend to the chairmanships, with few if any members mounting serious challenges.

Those basking in a post-“blue wave” glow would do well to temper their expectations, recalling that the Republican-controlled House had already voted 54 times to unravel some or all of the Affordable Care Act by its fourth birthday in 2014. In most cases, Democrats in the Senate and White House stopped those efforts in their tracks.

With the Senate (and the presidency) remaining under Republican control and even fewer moderate Republicans left in the House after this election, Democrats will struggle to move legislation without Republican support. What they can do is hold hearings, launch investigations and generally unnerve the pharmaceutical industry, among other likely adversaries.

And theres a chance they could strike a deal with President Donald Trump, whose administration is moving to crack down on drug companies.

Who are the members most likely to wield the gavels? And what will they do with that power? Heres a look at some of the major committees that influence health policy — and the people who may lead them.

Pallone, who has served in the House for 30 years, became the top Democrat on this influential committee in 2015. Should he become chairman, he would be responsible for the broadest health portfolio in the House, which includes Medicaid, public health, insurance and drug safety. This is the committee that marked up the Affordable Care Act in 2009 (when Pallone chaired the health subcommittee) and the House Republican repeal effort in 2017.

Under the Trump administration, Pallone has touted his stewardship of bipartisan legislation reauthorizing the fees charged to manufacturers to review the safety of prescription drugs and medical devices. He has also called for hearings on “mega-mergers” like the proposed merger between CVS and Aetna and worked with other Democrats to counter Republican attempts to undermine the Affordable Care Act.

Unsurprisingly, his influence over health care issues has attracted a lot of money from pharmaceutical companies, health professionals, HMOs and other industry players. By mid-October, Pallone had received more than $945,000 in campaign contributions from the health sector for this election, according to the Center for Responsive Politics. According to a KHN analysis, nearly $170,000 came from political action committees associated with pharmaceutical companies.

Cummings could prove the pharmaceutical industrys biggest headache come next year. Having served as the committees ranking member since 2011 — a post that lacks the chairmans subpoena power — he has been champing at the bit to hold drugmakers accountable.

Shortly after Trumps inauguration, Cummings approached him about working together to lower the cost of prescription drugs (to no immediate avail), and he has partnered with other lawmakers to demand information from pharmaceutical companies about their drug pricing strategies. Previewing what a Cummings-led committee might look like, he has even launched his own investigations into drug costs, releasing reports with his findings.

Drugmakers have wasted few campaign contributions on Cummings: He has received just $1,000 from their PACs this election, according to data analysis by KHN.

In a statement to Kaiser Health News, Cummings said Democrats would conduct “credible, responsible oversight” of the Trump administration, adding: “For healthcare, that means investigating skyrocketing prescription drug prices, actions that would threaten protections for people with preexisting health conditions, and efforts to undermine the Medicaid program.”

Ways and Means oversees Medicare and influences health policy through its jurisdiction over taxes. Though Neal became the top Democrat on this committee in 2017, he has been involved in health care much longer, having played a part in the crafting of both the Affordable Care Act and the failed reform effort under the Clinton administration in 1993.

Facing a primary challenger who touted her support for “Medicare-for-all” in his deep-blue district, Neal denied that he opposes the progressive single-payer proposal. But he also said Democrats should focus on shoring up the Affordable Care Act, particularly its protections for those with preexisting conditions and caps on out-of-pocket expenses. (He won handily.)

The health sector was by far one of the top contributors to Neals re-election campaign this year, giving more than $765,000, according to the Center for Responsive Politics. Neals district includes the headquarters of several health insurers and other medical companies, which makes him a prime target for campaign contributions.

If chosen, Lowey would become the first woman to chair the powerful House Committee on Appropriations, holding the nations purse strings.

Like Neal and Pallone, Lowey was first elected to Congress in 1988, and she became the committees top Democrat in 2013. She has been a dedicated and effective advocate for investing in biomedical research into major diseases like diabetes and Alzheimers, as well as public health programs like pandemic preparedness.

She has also long championed womens health issues, proving a vocal critic of the Trump administrations proposed gag rule on Title X funding, among other policies. Watch for her to continue to push back on the administrations efforts to restrict access to abortion rights.

And on the Senate side, the Committee on Finance: Sen. Chuck Grassley, Iowa?

The rumor mill favors Grassley, the Republican who has served most recently as the chairman of the Senate Committee on the Judiciary, to replace retiring Sen. Orrin Hatch (R-Utah).

Senate Republican leaders have signaled that entitlement programs like Medicare and Medicaid could use trimming and, with Republicans emerging from the midterms with a slightly bigger majority, this committee could have its hands full.

Hatch proved a friend to the pharmaceutical industry, and his war chest reflected that, taking in more than $850,000 in campaign contributions from drugmaker PACs in the past decade alone, according to a Kaiser Health News analysis. But Grassley has taken a more adversarial approach to the industry, working with a Democratic colleague last summer to pressure drug companies to list their prices in direct-to-consumer ads, for instance.

Grassley held the chairmanship from 2003 to 2006, leaving him two more years at the top, should he want it. (Senate Republican chairs may serve for only six years.) But he might choose to stay on as head of the Judiciary Committee, in which case the next chairman may be the next-most-senior Republican: Sen. Mike Crapo of Idaho.

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

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Officials investigating 252 possible cases of polio-like illness AFM

Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 con..

Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 confirmed cases in 27 states, according to the Centers for Disease Control and Prevention.

The number of cases under investigation by the CDC is up 33 from last week, and the number of confirmed cases rose by 10, Dr. Nancy Messonnier, the director of CDCs National Center for Immunization and Respiratory Diseases, told reporters Tuesday.

Acute flaccid myelitis is a condition that has polio-like symptoms such as partial paralysis. The virus mostly affects children and young adults. The CDC said they do not know why the condition is impacting these individuals, but many believe it is caused by viruses. The CDC emphasized it remains a rare condition and said there have been no reported deaths from AFM so far in 2018.

The typical symptoms of AFM are similar to those of a severe respiratory illness, along with a fever, but then progress into neurological symptoms. Some patients with AFM feel weakness in their arms or legs, a loss of muscle tone or slower reflexes.

Some patients may also exhibit facial droop or weakness, difficulty moving their eyes and drooping eyelids or difficulty with swallowing or slurred speech. The most severe symptom is respiratory failure.

Messonnier said the CDC doesn't yet have enough information to definitively say what causes AFM and are casting a wide net for information. Part of that is studying the long-term health of AFM patients. Scientists are also looking for a pathogen in AFM patients' spinal fluid, but haven't yet found a pathogen that's a clear cause, she said.

The CDC said it sees an uptick in AFM cases every two years, and so far, the curve of the cases being investigated this year looks very similar to that of 2014 and 2016.

Officials don't expect many more cases in 2018 compared to 2016 and 2014, Messonnier said.

The best advice available is to wash your hands regularly, which lowers the chances of getting sick or spreading germs from many of the viruses linked to AFM, and protect against mosquito bites by using repellent, in addition to staying indoors at dusk and dawn.

The CDC said the vaccines your pediatrician suggests are very effective and children should continue to receive them on schedule even though there is no vaccine for AFM. (more…)

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‘Make-a-Wish’ wishes decrease trips to hospital for sick children: Study

A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in ..

A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in the Make-A-Wish program may give children better quality of life and reduce hospital visits and healthcare costs.

Patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients of similar age, gender, disease category, and disease complexity who would also quality for a wish but did not receive one.

What is the Make-A-Wish Foundation?

The Make-A-Wish Foundation is a non-profit organization whose goal is to provide children aged three to 17-years-old who have progressive, life-limiting, or life-threatening medical conditions, with experiences known as “wishes.” These wishes include “I wish to…” “go,” “be (someone for a day),” “meet,” and “have” (i.e. receive gifts.) The foundation is funded by contributions from individual donors, corporations, and other organizations.

What are the goals and mission of the Make-A-Wish Foundation?

The Make-A-Wish Foundation “serves a unique, and vital, role in helping strengthen and empower children battling illnesses.” And, “wishes make life better for kids with critical illnesses.”

How many “wishes” does the foundation grant?

The Make-A-Wish Foundation was founded in November 1980 and the first wish was granted in the spring of 1981 to Frank “Bopsy” Salazar, a 7-year-old who had leukemia. Bopsy had three wishes: to be a fireman, go to Disneyland, and ride in a hot air balloon — all of which were granted to him. Since then, more than 285,000 children in the United States and its territories have benefited from experiencing their wishes. The foundation granted 15,300 wishes last year alone; which means on average, a wish is granted every 34 minutes.

What are the potential benefits of receiving a “wish?"

There is a long-held belief that receiving a wish improves a childs quality of life and potentially improves their familys quality of life, enhances family bonding, reduces stress, increases hope and serves as a distraction from illness. (more…)

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To curb STD rise, doctors treat patients’ partners without an office visit

This is a Kaiser Health News story.

If patients return to Dr. Crystal Bowe soon after taking medi..

This is a Kaiser Health News story.

If patients return to Dr. Crystal Bowe soon after taking medication for a sexually transmitted infection, she usually knows the reason: Their partners have re-infected them.

“While you tell people not to have sex until both folks are treated, they just dont wait,” she said. “So they are passing the infection back and forth.”

Thats when Bowe, who practices on both sides of the North and South Carolina border, does something doctors are often reluctant to do: She prescribes the partners antibiotics without meeting them.

Federal health officials have recommended this practice, known as expedited partner therapy, for chlamydia and gonorrhea since 2006. It allows doctors to prescribe medication to their patients partners without examining them. The idea is to prevent the kind of reinfections described by Bowe — and stop the transmission of STDs to others.

However, many physicians arent taking the federal governments advice because of entrenched ethical and legal concerns.

“Health care providers have a long tradition of being hesitant to prescribe to people they havent seen,” said Edward Hook, professor at the University of Alabamas medical school in Birmingham. “There is a certain skepticism.”

A nationwide surge of sexually transmitted diseases in recent years, however, has created a sense of urgency for doctors to embrace the practice. STD rates have hit an all-time high, according to the Centers for Diseases Control and Prevention. In 2017, the rate of reported gonorrhea cases increased nearly 19 percent from a year earlier to 555,608. The rate of chlamydia cases rose almost 7 percent to 1.7 million.

“STDs are everywhere,” said Dr. Cornelius Jamison, a lecturer at the University of Michigan Medical School. “We have to figure out how to … prevent the spread of these infections. And its necessary to be able to treat multiple people at once.”

A majority of states allow expedited partner therapy. Two states — South Carolina and Kentucky — prohibit it, and six others plus Puerto Rico lack clear guidance for physicians. (more…)

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