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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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Flu vaccine delays for over-65s ‘resolved by weekend’

GPs and patients frustrated by a shortage of the new flu vaccine for over-65s are being told the fin..

GPs and patients frustrated by a shortage of the new flu vaccine for over-65s are being told the final delivery batch will arrive by Saturday.

NHS England said there would be enough vaccines for everyone to be protected ahead of winter.

But doctors' leaders said more guidance should have been given to GPs and patients to avoid disruption over the phased delivery of supplies.

Older adults are advised to get the flu jab by early December.

This gives time for protection before flu starts to circulate, normally later in the month.

However, the staggered delivery of supplies of the over-65s vaccine from the manufacturer Seqirus to GPs and pharmacies means some older patients have not been able to be vaccinated.

Cancelled appointments

In a survey of 650 GPs in Pulse, nearly 70% said there had been a shortage of this flu vaccine at their practice.

That meant they could not vaccinate as many elderly patients as they would have liked.

Some GPs said they had to cancel appointments while others said it had created staffing problems.

But a spokesperson for NHS England said that this week, "100% of vaccines will have been delivered by the manufacturer to those surgeries and pharmacists who placed an order on time". (more…)

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NHS bosses look to overhaul cancer screening

Cancer screening programmes are to be reviewed following high-profile mistakes that have put thousan..

Cancer screening programmes are to be reviewed following high-profile mistakes that have put thousands of patients in England at risk.

NHS England has asked former government cancer tsar Sir Mike Richards to look at what changes are needed.

Three national schemes cover breast, cervical and bowel cancers.

On Wednesday, it emerged letters about the cervical cancer tests that should have gone to 40,000 women between January and June had not been sent.

About 4,000 of them were results of tests, the remainder were letters inviting them for screening or reminding them tests were due.

Between 150 and 200 of the test results that were not sent out detailed abnormal results.

NHS bosses have been able to contact all those affected.

The service in charge of distributing letters is provided for NHS England by Capita.

Looking at the merits of outsourcing screening was going to form part of the review, NHS England said.

The problems come just months after it emerged 174,000 women had not been invited for breast cancer screening, after mistakes had gone undetected for years. (more…)

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Superbug risks fail to dent attitudes to antibiotics

Warnings about drug-resistant superbugs arent enough to change most peoples behavior on using antibi..

Warnings about drug-resistant superbugs arent enough to change most peoples behavior on using antibiotics, according to a Europe-wide poll out Thursday.

The Eurobarometer survey reported seven in 10 people who received information telling them not to take antibiotics unnecessarily said it didnt change their views on using them.

Excess use of the drugs is contributing to a growing threat of antimicrobial resistance and related infections. As germs multiply they can develop the ability to defeat the medicines designed to kill them — and those infections could be killing more than 33,000 people a year in Europe, according to recent estimates.

“It is ridiculous,” European Health Commissioner Vytenis Andriukaitis said in response to the fact that people arent responding to warnings, at an event in Brussels Thursday. “We have science on one hand and lack of trust on the other.”

“Unless we act decisively, immediately and together, we could face a public health and financial disaster,” he added.

The EU is failing to gain traction with its effort to get member countries to combat the rise of resistance.

The Eurobarometer survey showed the number of people who had taken antibiotics in the last 12 months fell from 40 percent in 2009 to 32 percent in 2017. But less than half of people said they were aware that antibiotics dont work to treat viruses, and 20 percent said they take antibiotics to treat flu or colds.

Seven percent of people said they took antibiotics without having seen a doctor or getting a prescription.

Andriukaitis said the survey, which polled around 27,400 people in 28 countries, shows Europeans “are still not sufficiently aware of the dangers of AMR.”

A report from the European Centre for Disease Prevention and Control (ECDC) on Thursday raised particular concern about the rise of superbugs in hospitals and care centers — estimating there are around 8.9 million cases of health care-associated infections in European facilities each year, many of them caused by multidrug-resistant bacteria. (more…)

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