Happy National Doctors' Day!
About Covid-19
COVID-19 national emergency could end sooner than May “The Senate passed a resolution March 29 that would expedite the end of the COVID-19 national emergency from its planned May 11 deadline to immediately upon the signature of the president, and President Joe Biden has reportedly indicated he will sign it.”
Comment: It is not clear how this measure will move up action that affects Covid-19-specific laws.
About health insurance/insurers
Obamacare coverage mandate blocked for preventative care for HIV, cancer, diabetes and depression “A federal judge in Texas on Thursday blocked Obamacare's mandate that health insurance plans cover preventive care, including pre-exposure prophylaxis against HIV (PrEP) and screenings for cancer, diabetes and depression at no cost to patients.
U.S. District Judge Reed O'Connor in Fort Worth, Texas, previously found that the PrEP mandate violated a federal religious freedom law and that other preventive care mandates were based on recommendations by an illegally appointed task force.
The judge has now blocked the federal government from enforcing the mandates, a victory for conservative businesses and individuals that sued to challenge them in 2020.”
Comment: This ruling was a foregone decision, given the Texas venue. It will undoubtedly be appealed to the Supreme Court.
About hospitals and healthcare systems
Select Financial, Operating and Patient Characteristics of Physician Owned Hospitals Compared to Non-Physician Owned Hospitals Congress is considering lifting the near-total ban on physician-owned hospitals. The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) are obviously opposing this action. These organizations hired a firm to do a comparison between physician-owned and non-physician-owned hospitals. The charts provide a quick comparison. In interpreting the data, bear in mind that the number of the former are about 5% of the latter and that many are specialty hospitals that only deal with one “organ system,” usually cardiovascular or orthopedic.
About pharma
Clinical trial diversity craters out to lowest level in 10 years, IQVIA finds “despite recent efforts from the FDA, Big Pharmas, biotechs and sponsors alike, U.S. clinical trial diversity dropped to its lowest level of the decade, according to IQVIA’s report ‘Global Trends in R&D 2023.’”
States are moving to cap insulin prices A good summary of states’ actions to limit insulin costs. Also discussed are insulin-related supplies, like syringes and alcohol wipes. The article also delivers an important caveat: “State-level insulin caps can only apply to state-regulated plans, such as health plans for state employees, fully insured plans usually offered by smaller employers and some insurance policies sold on the Affordable Care Act marketplaces. They generally leave out people with self-insured employer coverage (typically offered by big companies) as well as the uninsured. Medicaid beneficiaries aren’t usually affected either, because they already pay little to nothing for their insulin.”
About the public’s health
Unravelling the commercial determinants of health This editorial from the Lancet presents an overview of a series of special articles on the commercial determinants of health. “The headline findings are startling: four industries (tobacco, unhealthy food, fossil fuel, and alcohol) are responsible for at least a third of global deaths per year. Yet much of the work to understand the harmful (or beneficial) impact of commercial actors has to date been done in health research silos. Each field faces many of the same tactical battles and strategies without a unified agenda to protect health. There is a lack of consensus across fields of health to define and understand the commercial determinants of health. The Lancet Series seeks to remedy this long-standing and complex situation with a consensus definition of the commercial determinants of health (“systems, practices, and pathways through which commercial actors drive health and equity”), a framing to understand commercial entities' impact on health, and a commitment to address its challenges in a holistic way.”
Evaluation of behavioral economic strategies to raise influenza vaccination rates across a health system: Results from a randomized clinical trial “After adjusting for age, gender, insurance, race, ethnicity, and prior influenza vaccination, none of the interventions increased vaccination rates. We conclude that patient portal interventions to remind patients to receive influenza vaccine during the COVID-19 pandemic did not raise influenza immunization rates. More intensive or tailored interventions are needed beyond portal innovations to increase influenza vaccination.”
Comment: Individualized messaging, like texts and phone calls, works to increase receipt flu shots.
Trends in the Prevalence of Lean Diabetes Among U.S. Adults, 2015–2020 “Diabetes increased significantly among lean adults with BMI of <25 kg/m2 from 4.5% (95% CI 4.3–4.7) in 2015 to 5.3% (95% CI 5.0–5.7) in 2020, representing a 17.8% increase (odds ratio 1.21; 95% CI 1.12–1.31), with no significant change among overweight/obese adults. Increases in diabetes prevalence among lean adults varied by subgroup with Black, Hispanic, and female populations seeing the largest growth.”
Comment: This data means we need to look more closely at the quality of diets and genetics in these populations.
Child and Teen Firearm Mortality in the U.S. and Peer Countries “Firearms recently became the number one cause of death for children and teens in the United States, surpassing motor vehicle deaths and those caused by other injuries…
We find that the United States is alone among peer nations in the number of child and teen firearm deaths. In no other similarly large or wealthy country are firearm deaths in the top 4 causes of mortality let alone the number 1 cause of death among children and teens.”
Comment: Do children have the right to life after they are born? How many must die before prudent and enforceable firearm laws are enacted?
About health technology
Scientists find 'ultracool' tiny needle that could someday deliver gene editing therapies “Gene editing has been limited to a few sites in the body because of restrictive delivery mechanisms. Scientists have now discovered a tiny needle that a bacterium uses to kill insect cells that could someday widen the world of gene editing therapeutics.
Researchers from the Broad Institute of MIT and Harvard and the McGovern Institute for Brain Research at MIT have found a way to use a natural bacterial system to create a new protein delivery system that could have applications for gene editing therapies such as those based on CRISPR-Cas9 as well as cancer treatments. The scientists…detailed their work in the journal Nature on Wednesday afternoon, describing a system that could be used to deliver a variety of proteins.”