Friday, July 31, 2015
Thursday, July 30, 2015
How immigrants help health reform succeed
Medicare turns 50 today, which has provided an opportunity for all manner of retrospectives and speculation about what the future holds. The Partnership for a New American Economy is publicizing one of my favorite arguments: that immigrants are a key reason that Medicare is still solvent.
Their 2014 study (Staying Covered: How Immigrants Have Prolonged the Solvency of One of Medicare’s Key Trust Funds and Subsidized Care for U.S. Seniors) concludes:
- Immigrants are subsidizing Medicare’s core trust fund
- Immigrants played a critical role subsidizing Medicare’s Hospital Insurance Trust Fund during the recent recession
- Medicare’s Hospital Insurance Trust Fund would be nearing insolvency if not for the contributions of immigrants in recent years
Bottom line: immigrants contributed $182 billion more to the Hospital Insurance Trust Fund between 1996 and 2011 than they received in benefits. Meanwhile, US-born citizens sucked out $69 billion more than they paid in.
But the argument for open integration goes far beyond the Medicare story. As I wrote back in 2011 (We need a liberal immigration policy to support health care reform)
- Immigrants innovate and create economic growth. This growth is how the country gets wealthier and better able to support health care expenses without raising tax rates
- Immigrants can use their intellectual capital and training –whether acquired abroad or here– to fill healthcare jobs such as primary care physician, pharmacist, nurse that would otherwise go unfilled
We have very stupidly made the US less welcoming to immigrants at the same time that talented people have more opportunities in their birth countries and while other countries have made it easier for educated immigrants to thrive. I partly blame the current state of affairs on the post-9/11 mentality. We’ll pay for it in the long run in healthcare and in the economy at large.
Image courtesy of Stuart Miles at FreeDigitalPhotos.net
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By healthcare business consultant David E. Williams, president of Health Business Group.
from Health Business Blog http://healthbusinessblog.com/2015/07/30/how-immigrants-help-health-reform-succeed/
via A Health Business Blog
Wednesday, July 29, 2015
Why am I getting so many spam invites on LinkedIn?
Over the last few days I’ve received several LinkedIn requests that don’t look real. Typically they are from “people” with the title of Research Associate or something similar. When I view the profile there is almost nothing there. However, they usually have at least one other connection with someone in my network. Here are a few examples — I’ve left off the connections we have in common so as not to embarrass anyone who’s blindly accepting LinkedIn invites.
My best guess is this is some sort of spam or phishing attempt. I’ve been reporting these profiles to LinkedIn but so far no acknowledgment from them and no way to connect with them by phone.
Anyone else seeing this? Leave a comment or tweet to @HealthBizBlog.
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By healthcare business consultant David E. Williams, president of Health Business Group.
from Health Business Blog http://healthbusinessblog.com/2015/07/29/why-am-i-getting-so-many-spam-invites-on-linkedin/
via A Health Business Blog
Tuesday, July 28, 2015
Monday, July 27, 2015
Four reasons Praluent is not Sovaldi
Watch out budget busters!
From the New York Times (New Drug Sharply Lowers Cholesterol, But it’s Costly)
Praluent, which analysts project will become a huge seller, is expected to become the next flashpoint in the growing controversy of escalating pharmaceutical prices, and health plans are expected to put in place strict measures to control which patients can use the drug and prevent it from becoming a budget buster.
This story and similar ones say Praluent may be like Sovaldi, an expensive Hepatitis C drug that has driven up healthcare costs over the past year or so. According to this narrative, health plans and pharmacy benefits managers are gearing up to do battle with the manufacturer and have learned their lesson from the Sovaldi experience. Maybe the payers will do a better job of managing Praluent expenses –I assume they can devise something better than whining about the expense to the general public while simultaneously rallying against price controls. But when the Praluent crisis is “averted” don’t let the payers pat themselves on the back too much.
I see four main reasons why Praluent will not be as much of a “budget buster” as Sovaldi:
- Praluent doesn’t cure anything
- There are good alternatives for most patients
- Praluent is an injection
- Praluent will have competition from the start
1. Praluent doesn’t cure anything
Sovaldi cures Hepatitis-C in something like 90 percent of patients. You can quibble with the numbers if you like, but the fact is this is a cure for many people who have waited for one –in many cases for decades. Take it for three months and you’re done with the drug and the illness.
What does Praluent do? It lowers cholesterol dramatically. Does it prevent heart attacks or strokes? No one knows, and we won’t have evidence about that for a couple years at least. In any case I’m sure it won’t cure heart attacks or strokes and I doubt it will reduce their likelihood by anything approaching 90 percent. And patients will have to keep using the drug indefinitely.
2. There are good alternatives for most patients
Statins work well and are available as inexpensive generics. Starting on a statin or increasing statin dosage is an option for most patients, including those who have already had a stroke or heart attack. A smaller group has a genetic condition that can’t be addressed by statins. Praluent sounds like a good choice for them.
3. Praluent is an injection
Sovaldi comes in a pill. It’s easy to swallow. Same with statins.
Praluent is an injection. Ouch. Sure it only has to be done twice a month and you can do it yourself, but who really likes a needle? I expect patients to want to try statins first.
4. Praluent will have competition from the start
Sovaldi was on the market for about a year before an (arguably inferior) competitive offering was introduced. That gave Gilead a big first-mover advantage, especially important for a drug people had been awaiting for a long time and then only needed to take for three months.
It appears that Repatha, a similar drug to Praluent, will come to market about the same time, with others to follow. Competitive pressures should keep prices in check.
5. The name evokes something nasty
I know I promised only four reasons, but I have fifth. The name reminds me too much of Soylent, the disgusting meal replacement product.
Image courtesy of digitalart at FreeDigitalPhotos.net
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By healthcare business consultant David E. Williams, president of Health Business Group.
from Health Business Blog http://healthbusinessblog.com/2015/07/27/four-reasons-praluent-is-not-sovaldi/
via A Health Business Blog
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