Wednesday, November 12, 2008

Midweek Miscellany

  • Senate Finance Committe Chairman Sen. Max Baucus (D Mont.) released his health care reform plan blueprint today. The Baucus plan is similar to the current Massachusetts connector system which requires individuals to purchase health insurance, a so-called individual mandate. President elect Obama's plan involves mandatory coverage of children, an employer play or pay mandate, similar to that in San Francisco, and expanded coverage of adults though a national health insurance exchange. Neither plan evidently would affect the FEHBP directly. However, there is the Medicare for All approach exemplified by H.R. 676 that would scrap all employer sponsored coverage, including the FEHBP: "SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act."
  • Business Insurance reports on a PriceWaterhouseCoopers study of the projected cost of the President elect's plan. “'Obama’s proposal is likely to increase revenues but lower margins for providers, pharmaceutical companies and health plans that increasingly depend on government payment,'” the report said."
  • Speaking of transitions, reports on the top vacancies at OPM that the new President will be filling and Government Health IT reports on AHIC Successor Inc.'s operational approach, which involved value cases.
  • CMS has selected four companies -- Google Health, HealthTrio,, and PassportMD -- for a pilot personal health record ("PHR") program under which traditional Medicare beneficiaries in Arizona and Utah can choose one of the selected PHR companies to maintain their health record information electronically.
  • reports that Wellpoint, in cooperation with a self funded employer sponsored health plan, is "testing the concept of arranging and paying for you and a companion to travel to India for a joint-replacement procedure that could cost a fraction of what it would at your local hospital."
  • reports on a drug study funded by the prescription benefit manager Medco Health Solutions. According to Medco's press release,

    In the largest study of its kind to date, researchers at Medco report that [proton pump inhibitors] PPIs [such as Nexium] inhibit the effectiveness of clopidogrel, the number two prescription drug in the world, thus increasing the risk of a major cardiac event, such as heart attacks and strokes by 50 percent. Since PPIs mimic the effect of a variant gene, which also renders clopidogrel ineffective, this study further suggests a potential role for genetic testing.

    "Considering the widespread use of these two medications, this important research adds to a growing body of evidence raising questions about their concurrent use and suggests further research is needed," said Dr. Robert Epstein, a lead study author, chief medical officer, Medco. "With this research in hand, we intend to open a dialogue with the major clinical organizations to advance the discussion around the guidelines that govern the use of Plavix."

  • The American Medical Association is developing a health insurer code of conduct. According to the AMA's press release -- issued in the middle of Heal the Claim month -- "ninety-two percent (92%) of physicians polled said that insurance company incentives and disincentives regarding treatment protocols may not be in the best interest of the patients."" But then again may be they are, and doctors are not refusing the insurers' Benjamins.

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