Friday, January 12, 2018

TGIF

Govexec.com reports that while Congress is making progress on an FY 2018 omnibus appropriations bill, it's likely that Congress will extend the current continuing resolution for a short period of time before it expires next Friday January 19. Reuters tells us that House Ways and Means Committee Chairman Kevin Brady (R TX) hinted that the omnibus bill may repeal the Affordable Care Act's high cost plan excise / Cadillac tax. Let's hope that Congress also provides relief in that bill from the recently restored ACA medical device and health insurer taxes. 

According to Health Payer Intelligence, NCQA has published a list of the top ten performing health plans in 2017 based on the various NCQA metrics.

The FEHBlog has been hearing anecdotally that this year's flu vaccine is less effective than expected. The New York Time's Upshot column explains why you still will benefit from the vaccine.
In 2010, researchers published a meta-analysis of all available flu shot studies. They showed that when a vaccine is considered effective, 1.2 percent of vaccinated people had the flu, while 3.9 percent of unvaccinated people had the flu. That’s an absolute risk reduction of 2.7 percentage points. This means that the number of people who needed to be treated for one person to see the benefit — a concept known as N.N.T. — was 37. Given the millions who are vulnerable to flu and the thousands of deaths each year, this is a big payoff in public health.
In studies in which the flu shot was considered ineffective, 1.1 percent of vaccinated people had the flu compared with  2.4 percent of  unvaccinated people. The absolute risk reduction was 1.3 percentage points, and the N.N.T. was 77.
Let’s say that this year’s flu vaccine is even worse than we think. Maybe the absolute risk reduction will be as low as 1 percentage point, making the N.N.T. 100. That’s still not that bad. Even at an N.N.T. of 100, for every 100 people who get a flu shot, one fewer will get the flu. That’s a pretty low N.N.T. compared with many other treatments that health experts recommend every day. * * *
The negatives of a flu shot are almost nonexistent, and significant side effects are very rare.
NBC News reports that "Cough medications that contain opioids like codeine should never be given by kids, and the medicines will now need to be labeled to make that clear, the Food and Drug Administration said Thursday. They’ll also carry bigger warnings about their dangers to adults, the FDA said."  This reminds me of a passage from Sam Quinone's Dreamland book where he explained that people addicted to opioids use FDA guidance like a roadmap. When the FDA warned on the Oxycodin label that the pill should be crushed, the addicted people who stole the medicine knew to crush it. Of course, the FEHBlog is not opposed to the FDA guidance which should have been issued years ago. The FEHBlog simply wants to point out how complicated this problem is.

Becker's Hospital Review informs us that healthcare now has surpassed manufacturing and retail as the largest employer of any sector in the U.S. economy. "There were 7 million more workers in manufacturing than in healthcare in 2000. In 2007, at the start of the Great Recession, there were 2.4 million more workers in retail than in healthcare. In 2017, the number of workers in healthcare surpassed workers in both manufacturing and retail."  This does not point to a high degree of efficiency in healthcare.

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