KHN’s ‘What the Health?’: News You Might Have Missed

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Lately it has been too busy with health policy, so congressional vacations provide an opportunity to explore some important stories that people may have missed, such as Medicare’s decision to dramatically limit the coverage of the controversial new drug Aduhelum for the treatment of Alzheimer’s disease. Even if Congress is out, states are rushing to limit or expand access to abortion before a major Supreme Court ruling is expected this spring or later this summer.

This week’s panelists are KHN’s Julie Rovner, The New York Times’ Margot Sanger-Katz, Politico’s Joanne Kenen and the Johns Hopkins Bloomberg School of Public Health, and Politico’s Alice Miranda Olstein.

In this week’s episode Takeway:

• The decision by the Center for Medicare and Medicaid Services to limit it to those beneficiaries who are enrolled in Medicare’s Aduhelm Clinical Study, despite intense pressure from patients and advocacy groups who are frustrated by the lack of new therapies for it. Destructive disease. But the federal agency has also been influenced by the arguments of some researchers and public health experts that previous research on the drug was flawed.
• The dust from Medicare coverage for Aduhelm points to a source of tension in the U.S. health system: there are overlapping authorities of various government agencies. The dispute arose between the FDA, which approved the drug despite serious questions about its effectiveness and safety, and the CMS, which had to decide whether to cover the cost of a highly controversial drug that is too expensive. But similar tensions have arisen between the FDA and the Center for Disease Control and Prevention over the schedule and eligibility for the Covid-19 vaccine.
• A recent Bloomberg report has raised concerns that the federal government is paying extra for beneficiaries enrolled in private Medicare Advantage plans. More progressive Democrats in Congress have long complained about this, but Republicans are strong supporters of the Medicare Advantage program.
• Despite some complaints on the left about the additional funding of this Medicare plan, they have been growing. That is, partly because traditional Medicare programs have the responsibility of sharing the many loopholes and costs that middle-income people are nervous about carrying on their shoulders, and Medicare Advantage has become attractive to them. This has complicated the previous party politics with the program.
• The Biden administration is reportedly in talks with several states to set up programs to import cheap drugs from Canada. For Democrats, it could be a strong campaign – much like Capitol Hill’s effort to lower the price of insulin – to try to help people with a serious pocketbook problem. Drug prices have been a constant consumer concern.
• However, it is unclear whether Canada is interested in helping the United States with a drug import program and, even if it does, there is no indication that the amount of drugs that Canadians can supply will significantly affect prices in that country.
• The governor of Oklahoma has signed a bill that would make abortion a crime, and the governor of Florida on Thursday approved a bill that would remove the abortion limit from 24 weeks to 15 weeks. As the country waits for the Supreme Court to rule on a case this summer that could overturn or weaken the landmark Rowe vs. Wade Deciding, conservative states are running to find ways to limit or prohibit abortion.
• If the Supreme Court does not maintain Rowe In conclusion, it is unlikely that state clinics that reserve the right to an abortion will be able to meet their needs.
• Yet with the growing movement in the Conservative state, abortion-rights advocates were shocked this week when a Texas prosecutor filed a murder charge against an aborted woman. The complaint, however, was quickly dismissed.
• The CDC released new data this week that showed an increase in cases of gonorrhea and syphilis in 2020 – probably the result of poor access to healthcare in the early stages of the epidemic. Although diseases can be easily cured with antibiotics, the general public may not realize the need for physician care or the devastating consequences of letting the disease go untreated.
• The CDC also said that drug overdose deaths reached record highs last year.

Also, for extra credit, the panelists recommend their favorite health policy stories of the week that they think you should read:

Julie Rovner: Politico by David Lim and Lauren Gardner “Rats occupy FDA offices after leaving food in epidemic”

Margot Sanger-Katz: Health issues “Many Medicare beneficiaries do not meet the prescription for high-priced specialty drugs,” by Stacey B. Dusetzina et al. Al

Joanne buys: Vox’s “America Needs More Doctors and Nurses to Survive Next Epidemic,” by Dylan Scott

Alice Miranda Olstein: Politico by Alice Miranda Olstein and Krista Maher “Republicans see CDC policy change as ‘massive political loss for Democrats'”

Also discussed in this week’s podcast:

Bloomberg’s “major insurers are scamming billions from Medicare, whistle-blowers say,” by John Tozier

KHN’s “Researchers: Medicare Advantage Plan Costs Billions More,” by Fred Schultz

KHN’s “What’s Health?”

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