Weekend update

The House and the Senate will be in session this coming week. On Wednesday at 11 am the Financial Services Subcommittee of the House Appropriations Committee will mark up its appropriations bill which includes FEHBP funding. The meeting will not be webcast. According to a Hill report, the House also is expected to consider and pass H.R. 436, one of the bills that cleared the Ways and Means Committee last week. This bill would repeal the medical devices tax and the prescription prerequisite  for any OTC drug coverage created by the ACA.

Reuters reports that Express Scripts and Walgreen's have decided to dismiss their lawsuit between them,but [both parties] said the dismissals did not mean they were any closer to reaching a new deal." The FEHBlog knows how expensive litigation can be so it's possible that the dismissial is completely independent of a new contract between the parties, but it has to be considered a step in the right direction.

The Washington Post reports on recent major data breaches at Howard University Hospital in Washington, DC, the University of Utah health care system, and TRICARE. Deven McGraw from the Center for Democracy and Technology  comments that

While the benefits of electronic health records far outweigh the risks, she [Deven McGraw] said, those risks can only be mitigated — not eliminated. “No matter how good you make the technology,” McGraw said, “we’ll never get the risk down to zero. But we can do a lot better than we have been doing.”

All three cases involved criminal activity against the health care providers which means that at least you have to stay one step ahead of the crooks.

Several years ago, the FEHBlog learned from medical experts that there are not that many preventive services that are worth performing annually on healthy people. The New York Times has a report this morning in which a doctor makes the same point.

As of today, only a few screening tests are recommended as useful for healthy, asymptomatic people by the Preventive Services Task Force and some of those — like blood pressure checks — don’t require a doctor visit and could be performed in a pharmacy. “If you follow their recommendations you hardly do anything to patients,” said Dr. Brett, adding that the most important intervention doctors perform on healthy patients may be counseling about habits. For new patients, he still does the full head-to-toe medical exam — though he does not routinely order blood work — and regards some parts as more or less playacting. Doctors have become accustomed to performing this ritual in years of training, and “patients come to expect it,” Dr. Cassel said. “Patients say, ‘hey, why didn’t I get my CXR?’ So many docs say O.K., and order one. You don’t really need all those tests and probably most of the physical exam.”

And of course the ACA generally mandates coverage without cost sharing on the theory that all preventive care bends the cost curve down.