Mid-week update

Earlier today, the Senate Homeland Security and Governmental Affairs Committee cleared for full Senate approval the President's nominations of Dr. Jeff T.H. Pon to be OPM Director and Michael Rigas to be OPM Deputy Director and Chairman Ron Johnson's bill (S. 2221) to repeal the Affordable Care Act's multi-state program.  That program already is dying on the vine. Federal News Radio provides background on the story.

The Centers for Medicare and Medicaid actuary issued a projection of health care spending from 2017 to 2026. Cost curve up.  Here's the Healthcare Dive story on the report.

There's a lot of press reports on an Aetna case in California where the Aetna medical director, who since has left Aetna's employ, admitted in a deposition that he had relied on the Aetna nurse's review of the medical records when he requested additional testing before granting necessary pre-authorization for a medical service. Here's Healthcare Dive report. 

The medical profession is expressing outrage because it hates the practice insurer pre-authorization. The press accounts are equally overheated. The Affordable Care Act was supposed to avoid these disputes by requiring that all insurer decisions on medical necessity, etc., be referred to an independent medical review organization. This case arose in 2011 when that part of the law was in effect. In other words, the medical director did not have the final say. Yet, the FEHBlog does not see any mention of IRO review in the articles. IRO review is much more cost effective than litigation.

On the bright side, the Wall Street Journal reported yesterday that

In a bag of backyard dirt, scientists have discovered a powerful new group of antibiotics they say can wipe out many infections in lab and animal tests, including some microbes that are resistant to most traditional antibiotics.
Researchers at Rockefeller University in New York reported the discovery of the new antibiotics, called malacidins, on Monday in the journal Nature Microbiology.
It is the latest in a series of promising antibiotics found through innovative genetic sequencing techniques that allow researchers to screen thousands of soil bacteria that previously could not be grown or studied in the laboratory. To identify the new compounds, the Rockefeller researchers sifted through genetic material culled from 1,500 soil samples.
“We extract DNA directly out of soil samples,” said biochemist Sean Brady at Rockefeller’s Laboratory for Genetically Encoded Small Molecules, a senior author on the new study. “We put it into a bug we can grow easily in the laboratory and see if it can make new molecules—the basis of new antibiotics.”

Bravo.