National News Content

Some health care workers could be at risk for PTSD after pandemic

WXXI US News - Tue, 03/23/2021 - 5:00am
Health care workers around the globe have endured prolonged trauma throughout the pandemic. Long shifts. Difficult cases. At times hospital rooms and hallways overflowing with patients with no end in sight. While psychology experts warn that there are early indicators of post-traumatic stress disorder among medical workers, there are also newly proposed roads to healing. “There’s a huge amount of stress that’s being placed on everyone here in the hospital. And it’s sort of an insidious thing because it’s affecting everyone at the same time, ”said Matt Ferrantino, a lung specialist at Unity Hospital who works in the intensive care unit. Before the pandemic, the tough days -- ones that would leave staff emotionally and physically exhausted -- used to be spread out. Since not everyone was going through a tough day at the same time, other staff could lend support. That has not been the case this past year. Just after Halloween, Ferrantino fell ill with COVID-19. He was hospitalized --

Fed Chair Touts 'Much Improved' Economy 1 Year After Stocks Hit Pandemic-Era Low

WXXI US News - Tue, 03/23/2021 - 5:00am
Updated at 10 a.m. ET The economy is staging a strong but still incomplete recovery, Federal Reserve Chairman Jerome Powell is set to tell Congress on Tuesday, exactly a year after stock markets hit their lowest level during the pandemic. The economy is now "much improved," Powell is set to say according to prepared remarks , thanks to "swift and vigorous action" by Congress and the central bank to avoid an even more crippling downturn. But Powell is also set to say "the recovery is far from complete." Powell is appearing before a House committee Tuesday, along with Treasury Secretary Janet Yellen. They will then appear before a Senate panel on Wednesday. Yellen is set to add a similar note of cautious optimism in her prepared testimony . "While we're seeing signs of recovery, we should be clear-eyed about the hole we're digging out of," she's expected to say. "The country is still down nearly 10 million jobs from its pre-pandemic peak." Yellen and Powell's appearances on Tuesday come

‘Press 1 for English’: Vaccination Sign-Ups Prove Daunting for Speakers of Other Languages

Latest Updates From Kaiser Health News - Tue, 03/23/2021 - 5:00am

In late February, a week after Virginia launched a centralized website and call center for covid-19 vaccine preregistration, Zowee Aquino alerted the state to a glitch that could prove fatal for non-English speakers trying to secure a shot.

This story also ran on U.S. News & World Report. It can be republished for free.

Callers who requested an interpreter on its new 1-877-VAX-IN-VA hotline would be put on hold briefly and then patched through. Then the line would automatically hang up on them.

It was a startling discovery for Aquino, a community health manager, and her colleagues at NAKASEC Virginia, a nonprofit that works with Asian Americans across the state. The glitch was a “direct barrier to access,” she wrote to senior state officials, “and must be addressed immediately.”

But that wasn’t the only problem. Only two languages were offered when callers dialed in — “press 1 for English” or “press 2 for Spanish.” But Virginia is home to speakers of many other languages — Chinese, Korean, Vietnamese, Arabic, Mongolian, Amharic and dozens more — who would need the help of translators to get their place in line for a vaccine.

“There’s so much attention to, let’s translate flyers, right? We’re like, what’s the point of translating a flyer that says you can call ‘VAX in VA’ and we have all these languages, when the phone line doesn’t work consistently, or it’s not even set up well for non-English, non-Spanish-speaking populations?” said Sookyung Oh, the group’s Virginia director.

Concerns about equity have loomed large in the nation’s mass covid vaccination effort. Distribution of doses has been spotty among underserved populations, many of whom have been hit disproportionately by covid hospitalizations and deaths. As Aquino found, barriers to vaccinating those groups begin with providing basic information about the shots and getting people registered.

Several individuals in interviews said the immigrant populations they work with, including Asians and Latinos, are eager to be vaccinated. But the barriers are steep, including lower rates of technology literacy and how well they speak English, if at all.

“Especially in stressful situations, they are not trying to struggle through English,” said Oh, who described trying to secure a vaccine appointment for her mother — a Korean woman who lives in Philadelphia — as a “complete clusterf***” because the city’s registration portal isn’t available in that language.

President Joe Biden announced this month that by May 1 the federal government would launch a website and new call center to help people find vaccine appointments, but officials have declined to elaborate on whether the website will be translated into non-English languages and which languages will be available through the call center. A spokesperson for the Department of Health and Human Services did not respond to questions about language access.

Approximately 5.3 million U.S. households have limited English proficiency, according to the U.S. Census 2019 American Community Survey. And, it found, nearly 68 million people speak a language other than English at home.

The CDC’s website for covid-19 vaccine information is comprehensively translated into four languages: Chinese, Korean, Spanish and Vietnamese. The federal agency has drafted other flyers about vaccines, but which languages the materials are available in varies considerably. A “Facts about COVID-19 Vaccines” flyer is translated into nearly two dozen languages, including Arabic, French, Tagalog, Russian, Somali and Urdu. Other documents are not translated at all; if they are, Spanish is the most common translation.

“It’s really concerning that the information is not available in different languages,” said Bert Bayou, director of the Washington, D.C., chapter of African Communities Together, which works with immigrants across the metropolitan area.

Virginia in mid-February released a centralized online preregistration system and a new hotline for vaccinations, a full month after residents 65 and older and those with certain medical conditions could register for appointments. As of mid-March, the state health department’s portal could be translated only into Spanish, spoken by nearly 8% of the state’s population. Similarly, the District of Columbia’s vaccine preregistration website that launched this month was initially available only in English, although officials were working to have it translated into additional languages before the month is out.

Any agency that fails to inform limited-English speakers of how to access their services — in this case, vaccinations — could be found to have violated federal laws that prohibit discrimination in health care on the basis of race, color, national origin and other factors, said Mara Youdelman, a managing attorney at the National Health Law Program, a civil rights advocacy organization.

“If they launch a website and they choose not to have it translated into multiple languages, I would say at a minimum that they should have some taglines on the webpage about where to get more information,” Youdelman said. Even beyond the law, making the vaccination process as accessible as possible to non-English speakers is “the necessary thing to do and the right thing to do.”

Otherwise, she said, “we’re not going to reach the herd immunity we all want and need to get life back to normal.”

Fairfax County, the most populous county in Virginia, maintained its own registration portal, but officials only on March 15 launched a Spanish registration website, two months after the state significantly broadened vaccine eligibility. In the interim, Spanish speakers had been directed to download a PDF questionnaire, and then call a phone line to relay their information for an eventual appointment. Roughly 14% of the county’s population identifies as Spanish-speaking, according to the 2019 American Community Survey.

In Virginia, many immigrants are left with the heavily promoted VAX-IN-VA hotline, where access to interpretation services was uneven. The state eventually added a “press 3” menu option for help in a different language — although the “press 2” and “press 3” prompts are spoken in English — that allowed non-English and non-Spanish speakers to more easily connect with interpreters in more than 100 languages.

Yet their needs often fall to the back of the line because the languages are so discrete and, after Spanish, there’s no “obvious” third language that’s prioritized, Oh said. Census data shows that more than 1.3 million Virginians speak a language other than English at home, including about 310,000 who speak Asian and Pacific Island languages and 295,000 who speak Indo-European languages.

A state spokesperson said that, upon reviewing call logs, in some situations the callers were the ones who may have hung up while on hold, and other times call center agents may have accidentally hung up. Records showed that this occurred fewer than 10 times, mostly all during the first week.

“We had a small handful of issues but looking forward we have not uncovered any ongoing issues,” Vaccinate Virginia spokesperson Dena Potter wrote in an email. She did not respond to questions about whether state officials planned to translate Virginia’s preregistration portal into other languages and whether the system might violate federal civil rights laws.

Nationally, Asian Americans have had lower covid mortality rates than other minorities, including Black and Latino Americans. However, there are troubling signs that underscore the urgency to boost vaccination rates. According to data compiled by the American Public Media Research Lab, the four-week period between early February and early March was the deadliest stretch of the pandemic for Asian, Latino, white and Indigenous Americans. Roughly 3,730 new deaths were reported among Asian Americans. Among Hispanics, 16,780 new deaths were reported.

To figure out whether they’re eligible and to get vaccine appointments, non-English speakers rely on the clinics that treat them, English-speaking friends and family, and other nonprofits that serve immigrant communities. Without reliable information across languages, health centers and other nonprofits worry about what fills the void: Rumors and false information proliferate not only on U.S. social media platforms but apps like WhatsApp and WeChat used around the world.

“They’re not your Facebook and your Instagram chats,” said Andrea Caracostis, CEO of the HOPE Clinic in Houston, a federally qualified health center that treats patients from at least 60 countries. “I think language issues and misinformation from abroad is going to erode a lot of the work that we do.”

The Houston area is home to one of the largest Vietnamese populations in the country. In late January, the clinic prioritized Vietnamese seniors for shots after receiving about 500 doses from the city. To make it happen, Caracostis said, they partnered with local Vietnamese doctors, nurses and even medical students to help. Clinic staff members translated immunization release forms before patients showed up.

“It’s going to take a village,” she said.

Groups are assembling teams of volunteers to make preregistration calls and appointments, and setting up pop-up registration sites in church parking lots in poorer neighborhoods.

“You can answer questions right on the spot,” said Wanda Pierce, co-chair of Arlington County’s Complete Vaccination Committee, a 40-plus-person group formed to ensure equitable distribution of vaccines in that Virginia suburb of Washington. County officials have organized preregistration pop-ups, typically done alongside other services for low-income residents, such as clothing and food distribution. A recent pop-up held at Macedonia Baptist Church, a Black church in a lower-income area of the county, saw a handful of limited-English speakers preregister for vaccines, according to organizers.

Recent polling has found that vaccine hesitancy is dipping among minority groups; however, they are still more likely to take a “wait and see” approach than white Americans. And many are struggling to secure appointments.

A March poll from KFF found that among adults who have gotten at least one dose of vaccine, 39% said someone else had helped them find or schedule an appointment. Hispanic adults were more likely than white adults to say they did not have enough information about where or when they could get vaccinated.

Spanish-language needs and outreach to Latinos haven’t been adequately prioritized, said Luis Angel Aguilar, the Virginia state director of CASA. In addition to language access, “there’s not enough communication and information now on where and who to call,” he said.

“It’s so easy for people to give up and say, ‘You know, I tried,’” added Nancy White, president of the Arlington Free Clinic, which treats low-income minorities and counts Spanish, Mongolian and Amharic speakers among its patients.

The clinic, instead of signing up patients through Virginia’s preregistration portal, is using its own system to get its patients vaccinated since the clinic receives an allocation of doses directly from the county. After an early pilot program to vaccinate seniors 75 and older, Arlington Free Clinic this month began vaccinating people 65 and up and those with chronic medical conditions. It relies on over 100 volunteer interpreters to help patients navigate the health care system.

“You can do it,” White said of getting around language issues, “but it takes a lot of time and a lot of manpower.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


This story can be republished for free (details).

Categories: National News Content

Indiana School Goes Extra Mile to Help Vulnerable Kids Weather Pandemic

Latest Updates From Kaiser Health News - Tue, 03/23/2021 - 5:00am

After covid-19 forced Olivia Goulding’s Indiana middle school to switch back to remote learning late last year, the math teacher lost contact with many of her students. So she and some colleagues came up with a plan: visiting them under the guise of dropping off Christmas gifts.

This story also ran on USA Today. It can be republished for free.

One day in December, they set out with cards and candy canes and dropped by the homes of every eighth grader at Sarah Scott Middle School in Terre Haute, a city of more than 60,000 near the Illinois border where both Indiana State University and the federal death row are located. They saw firsthand how these kids, many living in poverty and dysfunctional families, were coping with the pandemic’s disruptions to their academic and social routines.

“You just have a better concept of where they’re coming from and the challenges they really do have,” Goulding said. “When you’re looking at that electronic grade book and Sally Lou hasn’t turned in something, you remember back in your mind: ‘Oh, yeah, Sally Lou was home by herself, taking care of three younger siblings when I stopped by, and I spotted her helping Johnny with his math and she was helping this one with something else.’”

The school’s experience provides a window into the hardships millions of families across the country have endured since last March, and exemplifies why education isn’t the only reason many Americans want schools to fully reopen. Schools like Sarah Scott help hold their communities together by providing households with wide-ranging support, which has become much tougher during the pandemic.

“A lot of our students are struggling emotionally,” said Sarah Scott’s principal, Scotia Brown. “They’re stressed because they’re falling behind in their work. Or they’re stressed because of the conditions they’re living with at home.”

Even before the coronavirus struck, kids at Sarah Scott faced significant obstacles that compounded the normal social challenges and surging hormones of middle school. They live in Vigo County, which has the state’s highest rate of child poverty and high rates of child neglect. Nearly 90% of students qualified for free or reduced-fee lunches. Some showed up needing to shower and change at the school, which has a food pantry that also offers clothes and hygiene products.

Things got more difficult for students when covid threw Sarah Scott’s normal schedule into disarray. Initially, the school went totally remote, then moved to partially in-person for the start of the 2020-21 school year. When covid spiked in October, Sarah Scott went remote again because not enough substitute teachers could fill in for quarantining staff. Since January, students have been spending part of each week in the school building, with no plans as of early March to open fully.

Kids were given laptops to use at home. But internet access can be problematic.

“Internet has been the worst,” said Samantha Riley, mother of seventh grader Mariah Pointer. “So many people are on it, it shuts down all the time.”

When that happens, she uses the Wi-Fi emitting from the school bus that sits in front of her apartment complex, one of several parked around the community to fill the gaps.

Even when the internet works, though, keeping kids on task at home isn’t easy. Heather Raley said she often cries from the stress of trying to make her seventh grade daughter engage online. “It just seems like we’re always butting heads over this,” Raley said. “It’s just a bigger battle getting the work done.”

As in many other communities, students are falling behind academically. Some don’t do any of their e-learning activities. Sarah Scott’s reports to child protective services for educational neglect — when caregivers aren’t getting their children to either in-person or remote classes — have more than tripled this school year.

Brown said she also worries about physical neglect and abuse, which is harder to detect when interacting with students remotely. “If you’re in an abusive home and you have to be there five days out of the week because you’re doing remote learning, you’re in that environment even more,” she said.

More time at home can also mean doing without necessities, including food.

The school helps by offering free breakfasts and lunches for in-person students and to-go lunches on remote days. Sometimes, the principal delivers boxes of groceries to students’ homes. The school recently secured a microwave for one family and an inflatable mattress for a student who’d been sharing a bed with his grandmother.

For some kids, the stress of the pandemic has worsened emotional problems and mental illness. Recently, a former Sarah Scott student who had moved out of state logged into her former teacher’s virtual class to say she planned to kill herself. The school contacted police, who checked on her. Referrals for suicidal students are up fourfold, Brown said.

School social worker Nichelle Campbell-Miller said it’s been tough counseling kids online or through text messages.

“I am all about building relationships and being in person and being able to dap you up or give you a hug and be like, ‘Hey, what’s up?’” she said, using a term for various greetings like fist bumps or elaborate handshakes. “So being online is extremely difficult for me, because you can’t really tell the tone of your student. When I’m talking to you in person, I can read your body language and I can gauge where you’re at.”

Right now, she said, the psychological well-being of her middle schoolers is even more important than education.

Many students, such as eighth grader Trea Johnson, come up against challenges on both fronts. Trea transferred to Sarah Scott two days before covid ended in-person learning.

“We struggle with school anyway,” said his mom, Kathy Poff. “Then when this pandemic came along, it just knocked our feet out from under us.”

His grades plunged. He began to hate school, Poff said. He didn’t attend his daily video meetings with his teachers. His mother fought with him to complete his online assignments.

“I usually get pretty bored,” said Trea, whose long, straight hair sometimes falls over his eyes.

Poff found him a therapist he meets with once a week. She said his mood and academic productivity have improved. He wants to be a computer programmer and has been coding in his spare time lately. She also moved his computer into her bedroom so she could better monitor him and has started paying him to do his schoolwork.

“I can’t even imagine what it would be like to be a 13-year-old going through this pandemic,” said Poff, 51, a single mother. “They’re going through changes anyway, adjusting to adolescence and figuring out who they are, and they don’t even have a social group to figure that out.”

Goulding, the math teacher, said she’s glad she and her co-workers can help provide stability and continuity during this trying period. One recent night, for example, she got a call from a truant boy’s grandmother, who said she was in poor health and raising him alone. The next day, the principal and social worker picked him up and drove him to school.

Still, Goulding lamented not seeing her most vulnerable students on the days when they are remote.

“How do I check on my kids? How do I make sure they’re eating? How do I make sure,” she paused to compose herself, her voice quavering, “they’re safe?

“You’re no longer thinking about, ‘How are they doing on their polynomials?’ You’re thinking about, you know, the reality of life.”

[Correction: This article was updated at 12:30 p.m. ET on March 25, 2021, to correct the grade level of Heather Raley’s daughter.]

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


This story can be republished for free (details).

Categories: National News Content

Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill

Latest Updates From Kaiser Health News - Tue, 03/23/2021 - 5:00am

A cost-saving change in Medicare launched in the final days of the Trump administration will cut payments to hospitals for some surgical procedures while potentially raising costs and confusion for patients.

This story also ran on The Washington Post. It can be republished for free.

For years, the Centers for Medicare & Medicaid Services classified 1,740 surgeries and other services so risky for older adults that Medicare would pay for them only when they were admitted to the hospital as inpatients. Under the new rule, the agency is beginning to phase out that requirement and, on Jan. 1, 266 shoulder, spine and other musculoskeletal surgeries were crossed off what’s called the “inpatient-only list.” By the end of 2023, the list — which includes a variety of complicated procedures including brain and heart operations — is scheduled to be gone.

CMS officials said the change was designed to give patients and doctors more options and help lower costs by promoting more competition among hospitals and independent ambulatory surgical centers. But they forgot one thing.

While removing the surgeries from the inpatient-only list, the government did not approve them to be performed anywhere else. So patients will still have to get the care at hospitals. But because the procedures have been reclassified, patients who have them in the hospital don’t have to be considered admitted patients. Instead, they can receive services on an outpatient basis.

CMS pays hospitals less for care provided to beneficiaries who are outpatients, so the new policy means the agency can pay less than it did last year for the same surgery at the same hospital and Medicare outpatients will usually pick up a bigger part of the tab.

“The impetus for this is for Medicare to save money,” said Dr. James Huddleston, a professor of orthopedic surgery at the Stanford University Medical Center and the chair of the American Association of Hip and Knee Surgeons’ Health Policy Council. “The oldest trick in the book is to say the patients don’t need to be cared for in an expensive hospital setting.”

But since seniors will still have to go to the hospital, “it’s sort of a distinction without a difference,” he added.

“This is not about a different care setting, or giving more choice to providers,” said Judith Stein, executive director of the Center for Medicare Advocacy. “It’s about Medicare billing practices that will further confuse hospital patients.”

When unveiling the final rule in December, then-CMS Administrator Seema Verma said the change would give seniors and their physicians more options for care “without micromanagement from Washington.” She promised the new policy would also let seniors avoid hospitals, especially during the covid-19 pandemic, and free up needed beds.

CMS did add services that it will cover when provided by ambulatory surgery centers this year, a spokesperson said last month, but those don’t include procedures that were on the inpatient-only list.

Dr. Catherine MacLean, chief value medical officer at New York City’s Hospital for Special Surgery, said CMS should have tested the change as a pilot project to be sure it’s safe for patients. “These are big procedures,” she said, with a lot of “cutting, sewing and bleeding” that require post-surgery monitoring due to a significant risk of complications, especially for patients with multiple health problems.

The change applies to adults who have government-run Medicare insurance, but some Medicare Advantage plans sold by private companies have similar policies.

CMS officials said the change was a response to numerous requests seeking assurance that payment requirements do not override physicians’ judgment and assessment of their patients’ conditions. But health care groups representing millions of providers opposed it.

Even though seniors getting this care will be considered outpatients, they may still stay in the hospital overnight or longer, often on the same floor as those who are admitted, getting the same nursing care, lab tests and drugs with one big difference: their bill.

Patients admitted to the hospital typically receive an all-inclusive package of services and pay only this year’s Medicare hospital deductible of $1,484 for a stay of up to 60 days. They also pay 20% of doctors’ charges. Medicare picks up the rest of the bill.

Outpatient services are charged differently, with the patient typically paying 20% of the Medicare-approved amount for each service. That’s one payment for the outpatient surgery plus, for example, a second payment for blood transfusions, and more payments depending on what may be included in the surgery charge and how many other separately billed items the patient needs. (And, like admitted patients, outpatients also pay 20% of doctors’ charges.)

As with other outpatient services, in most cases each charge cannot exceed $1,484. “However, your total copayment for all outpatient services may be more than the inpatient hospital deductible,” according to the federal government’s annual guide sent to all Medicare beneficiaries.

Patients will also be hit with a “facility fee” up to several thousand dollars to cover the hospital’s overhead costs, said Richard Gundling, senior vice president at the Healthcare Financial Management Association. After Medicare pays its portion, outpatients owe 20% of the facility fee. And because Medicare prescription drug plans don’t cover medication ordered for hospital patients, they’re treated as if they have no drug insurance and can be charged exorbitant amounts for drugs they routinely take at home.

Another item that can be tacked onto the bill for outpatients — but not admitted patients — is called “excess charges.” Providers who do not accept the Medicare-approved amount as full payment can charge up to an extra 15% of that amount. Medicare pays none of these extra charges.

These surprise expenses can add up even for people who buy supplementary or Medigap health insurance to cushion the sticker shock. These private policies cover some portion of the patient’s payments for Medicare-approved charges. Only the most expensive policies cover “excess charges.” Otherwise, when Medicare doesn’t cover something, Medigap doesn’t chip in, so the patient is on the hook for the total charge.

In addition, Stein warned that the new rule will “sometimes limit their Medicare coverage when they need care after leaving the hospital.” Medicare patients don’t qualify for nursing home coverage even if they stay in the hospital for the required three days. That time doesn’t count because they were not admitted to the hospital — something Medicare patients who are in the hospital for observation care have complained about for years, forcing some to sue the government for a change.

Outpatients may also find it more difficult to get home health care. Medicare pays home care agencies more for people after a hospital inpatient stay, but those who are not admitted may have trouble finding agencies willing to serve them at Medicare’s lower reimbursement, said Stein.

A procedure that was on the inpatient-only list can still be provided to an admitted hospital patient, if health care providers can justify the need based on their clinical judgment. But there’s no guarantee that CMS will agree the admission was necessary and cover it.

Since the Biden administration inherited the new policy, critics are hoping CMS will rescind it.

“The decision ought to be made by the surgeons in consultation with their patients,” said Dr. Joseph Bosco, a vice chair of NYU Langone Health’s department of orthopedic surgery and president of the American Academy of Orthopaedic Surgeons. “We don’t need the federal government or health insurance companies interfering in the doctor-patient relationship.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


This story can be republished for free (details).

Categories: National News Content

Democrats Eye Medicare Negotiations to Lower Drug Prices

Latest Updates From Kaiser Health News - Tue, 03/23/2021 - 5:00am

Democrats, newly in control of Congress and the White House, are united behind an idea that Republican lawmakers and major drugmakers fiercely oppose: empowering the Department of Health and Human Services to negotiate the prices of brand-name drugs covered by Medicare.

This story also ran on Fortune. It can be republished for free.

But they do not have enough votes without Republican support in the Senate for the legislation they hope will lower the price consumers pay for prescription drugs. That raises the possibility that Democrats will use a legislative tactic called reconciliation, as they did to pass President Joe Biden’s covid relief package, or even eliminate the Senate filibuster to keep their promise to voters.

Regardless, Democrats hope to authorize Medicare negotiations on payments for at least some of the most expensive brand-name drugs and to base those prices on the drugs’ clinical benefits. Such a measure could put Republicans in the uncomfortable position of opposing an idea that most voters from both parties generally support.

As chairman of a health and retirement subcommittee, Sen. Bernie Sanders (I-Vt.) on Tuesday was set to hold one of this Congress’ first hearings on drug prices, seen as a way for Sanders and his allies to highlight that drug prices in the United States are among the highest in the world.

Dr. Aaron Kesselheim, a Harvard Medical School professor who researches the drug industry and will testify at the hearing, said there is no practical reason the federal government cannot negotiate a price based on independent assessments of a drug’s clinical benefits — as every other industrialized nation, and even some state Medicaid programs, do.

“The real reason is the drug industry’s lobbying power,” he said.

Negotiating Medicare drug prices has ebbed and flowed as a political issue for years, repeatedly defeated in Congress under pressure from the pharmaceutical industry. The government has been banned from negotiating Medicare drug prices since the creation of the Part D prescription drug benefit in 2006. Instead, the optional private plans through which Americans get Medicare drug benefits negotiate with drugmakers.

It has been two years since Congress summoned executives from Big Pharma companies and pharmacy benefit plans to Capitol Hill for a scolding over skyrocketing prices and the loopholes and secretive contracts they use to block competitors and secure profits.

Despite then-President Donald Trump’s keen interest in lowering drug prices, most proposals by both Democrats and Republicans on Capitol Hill went nowhere under Republican leaders, who argue government intrusion in the free market would hamper future innovation. They point to an estimate from the Congressional Budget Office suggesting the cuts to drugmakers’ revenue under Medicare negotiations could lead to nearly 40 fewer new drugs being developed in the next 20 years.

The government currently approves about 30 drugs per year.

The drug industry, bolstered by its quick efforts to develop a vaccine, has seen public opinion turn in its favor after several years of sharp declines. In early 2020, before the pandemic shut down much of the United States, only about one-third of Americans rated the industry positively, according to a Harris public opinion poll. In February, as vaccination efforts ramped up, about 62% rated it positively — a larger turnaround than any other industry in the past year.

PhRMA, the lobbying organization that represents brand-name drugmakers, came out strong this month against the administration’s first drug-pricing action, a measure in Biden’s sprawling covid relief package that is expected to result in drugmakers paying higher rebates to state Medicaid programs for their drugs.

Brian Newell, a PhRMA spokesperson, suggested the fight is just beginning for Democrats. “The American people reject government price setting when they realize it will lead to fewer new cures and treatments and less access to medicines,” Newell said in a statement. “Our industry has partnered closely with policymakers in fighting the pandemic, and we hope they will partner with us to develop solutions that will lower drug costs for patients, protect access to life-saving medicines and preserve future innovation.”

The Power of Negotiation

Though they disagree on some of the details, such as how far penalties should go, Democrats are united on the need to address drug pricing. Biden, progressives like Sanders and moderates such as Sen. Joe Manchin (D-W.Va.) support proposals that would generally allow the government to set restrictions on brand-name drugs. Researchers say these drugs, initially priced without any competition or regulation, are a leading factor driving up costs for Americans, their employers and the government.

In 2019, the Democratic-controlled House passed legislation that would allow the secretary of Health and Human Services to negotiate the prices for at least 25 of the most expensive drugs marketed in the United States that lack at least one competitor — prices that could be available to people insured by private plans as well. Senate Republicans refused to consider the bill, arguing the policy would discourage drug development.

Top Democrats, including Sen. Ron Wyden of Oregon, chairman of the Senate Finance Committee, say that is likely to be incorporated into drug-pricing reform this year.

Under the 2019 House bill, the negotiated price could not exceed 120% of the highest price in one of six other industrialized nations. Drugmakers would face escalating penalties for not complying.

Sanders and some Democrats took a slightly different path in the previous Congress, sponsoring a package that would enable Medicare negotiations, as well as allow the importation of drugs and broadly tie drug prices to median drug prices in Canada, the United Kingdom, France, Germany and Japan.

But party leaders prefer the House proposal for negotiating prices as a model for this year’s efforts.

In addition to allowing negotiated payments for drugs, Democrats also want to cap prices so they could not rise faster than inflation and limit how much Medicare beneficiaries pay out-of-pocket each year.

Democrats say there are more savings to be gained through giving negotiating power to the government, which would have more heft than any individual plan. In 2017, Medicare accounted for about 30% of the nation’s total retail spending on prescription drugs, according to KFF.

Advocates of Medicare negotiation often cite the Veterans Health Administration as a possible model, noting the government already negotiates with drugmakers on behalf of retired service members and often secures drug prices that are about 35% lower than those paid by Medicare beneficiaries.

Flashback to 2019

Fresh off the campaign trail and invigorated by polls showing about 8 in 10 Americans believe drug prices are unreasonable, senior lawmakers from both parties called the leaders of brand-name drugmakers and pharmacy benefit managers to testify about rising drug costs in early 2019.

That year saw a wave of bills introduced, the most ambitious of which constrained the cost of brand-name drugs through direct price controls. Trump, who bucked his party and supported Medicare negotiation and other price-setting measures, offered a series of changes that mostly fell apart under court challenges.

Sen. Chuck Grassley (R-Iowa) and Wyden, then the chairman and top Democrat on the Finance Committee, respectively, unveiled a proposal that, among other measures, would cap the price Medicare pays for brand-name drugs to the pace of inflation and trigger rebates if prices rise too quickly.

Medicaid already uses a similar inflation cap — and tends to pay lower prices on drugs than Medicare. The HHS inspector general has said Medicare could collect billions of dollars from the drug industry if it followed Medicaid’s lead.

But other Republicans refused to support Grassley on the bill, saying inflation caps amount to government intrusion in the free market, and Republican leaders never brought it up for a vote. Even Wyden said he was not sure he could vote for the proposal unless he was afforded an opportunity to offer a broader cost-containment measure, including price negotiation.

“We’re not going to sit by while opportunities for seniors to use their bargaining power in Medicare are frittered away,” Wyden said at the time.

The former legislative partners are still pushing the issue. Grassley has continued to press lawmakers to consider the earlier bill. Wyden has said he intends to “build off the bipartisan work” he did with Grassley and work with the House-passed Medicare negotiation bill as Democrats consider a reform package this year.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


This story can be republished for free (details).

Categories: National News Content

‘An Arm and a Leg’: In Vaccinating Philadelphia, A Mix of the Good, the Bad and the Ugly

Latest Updates From Kaiser Health News - Tue, 03/23/2021 - 5:00am

Can’t see the audio player? Click here to listen.

In Philadelphia, the good, the bad and the ugly have all been on vivid display in the covid vaccine rollout.

The Bad comes with a giant serving of gall: For a while, the city put its mass-vaccination program in the hands of Andrei Doroshin, a 22-year-old with no experience in health care but what, from all reports, seemed a healthy interest in making money. It did not go well. In this episode, we get a deep dive from public-radio reporter Nina Feldman, who uncovered the debacle.

The Ugly is systemic racism: When selecting who would run the mass-vaccination program, the city seems to have largely ignored the Black Doctors COVID-19 Consortium, an effective group of licensed, experienced, Black health care professionals led by Dr. Ala Stanford.

“I think we have to look, not just in Philadelphia, but at the deep rooted problem that allows you to look at an organization that has been doing the work and overlooks them primarily for another group that’s unestablished, younger, not led by a physician and white,” said Stanford.

The Good is the work that Stanford and the consortium have been doing, which throws the Bad and the Ugly into stark relief. Since last spring, they’ve been working tirelessly and creatively to address disparities in the care that Black Philadelphians receive for covid-19.

Those disparities include a lack of good vaccine information from trusted sources.

And, a project called The Conversation: Between Us and About Us, hosted by comedian W. Kamau Bell, is working to address them:

We talked with one of the project’s leaders, Dr. Rhea Boyd, author of a recent New York Times essay, Black People Need Better Vaccine Access, Not Better Vaccine Attitudes.

(Disclosure: The project is backed by KFF. KHN, which co-produces “An Arm and a Leg,” is an editorially independent program of KFF.)

Here’s a transcript of this episode.

“An Arm and a Leg” is a co-production of Kaiser Health News and Public Road Productions.

To keep in touch with “An Arm and a Leg,” subscribe to the newsletter. You can also follow the show on Facebook and Twitter. And if you’ve got stories to tell about the health care system, the producers would love to hear from you.

To hear all Kaiser Health News podcasts, click here.

And subscribe to “An Arm and a Leg” on iTunesPocket CastsGoogle Play or Spotify.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


This story can be republished for free (details).

Categories: National News Content

Netanyahu Seeks Reelection As Weary Israelis Return To The Polls

WXXI US News - Tue, 03/23/2021 - 3:29am
JERUSALEM — For the fourth time in less than two years, Israelis are voting Tuesday as Prime Minister Benjamin Netanyahu seeks to maintain his grip on power after a record-breaking 12 consecutive years in office. Indicted for alleged bribery and fraud, he has refused to resign, polarizing the country between diehard supporters and enraged opponents, and sparking a political gridlock that has led Israel to hold elections more frequently than any other major democracy. Netanyahu no longer has former President Donald Trump's policy gifts and pre-election boosts . Instead, a world-leading COVID-19 vaccination drive and a quick reopening of the economy ahead of this weekend's Passover holiday has brought Netanyahu a surge of admiration that he hopes will carry him to victory. "We went from slavery to freedom," said retired postal worker and Netanyahu voter Herzel Guetta vacationing in Jerusalem after a long period of lockdowns, borrowing a phrase from the Passover story of the biblical

Coming up on Connections: Tuesday, March 23

WXXI US News - Mon, 03/22/2021 - 11:39pm
First hour: Remembering Daniel Prude, and discussing Daniel's Law Second hour: "#porchportraits:" The story of Geneva through the pandemic

10 People, Including Police Officer, Killed In Colorado Grocery Store Shooting

WXXI US News - Mon, 03/22/2021 - 9:27pm
Updated March 23, 2021 at 4:06 AM ET Ten people were killed by a gunman in Boulder, Colo., during a mass shooting at a grocery store that left a trail of bodies, including one police officer, officials announced on Monday evening. Law enforcement personnel said Monday that police had the suspect in custody and there was no further danger to the public. By 1 a.m. MT Tuesday, police still had not released the suspect's name. Boulder police Chief Maris Herold identified the officer killed during the shooting at the King Soopers grocery store as Eric Talley. She said Talley had been on the force since 2010. Herold called Talley a hero and said the 51-year-old was the first officer to arrive at the scene after receiving calls of a "possible person with a patrol rifle." The investigation into the shooting is expected to last a minimum of five days, according to Herold. "I am so sorry about the loss of officer Talley. ... We will be working night and day," Herold said. "I know there are

Homeschooling Doubled During The Pandemic, U.S. Census Survey Finds

WXXI US News - Mon, 03/22/2021 - 8:05pm
Updated March 23, 2021 at 10:51 AM ET In a year when so much about schooling has changed, add this to the list: A significant increase in the number of households where students were homeschooled. That's according to data from the U.S. Census Bureau's Household Pulse Survey, an online survey that asks questions about how the pandemic is changing life in U.S. homes. When the survey began, the week of April 23-May 5, 2020, 5.4% of U.S. households with school-aged children reported homeschooling. By the fall, that number had spiked: 11.1% of households with school-age children reported homeschooling in the Sept. 30-Oct. 12 survey. The Census Bureau says that figure is twice the number of households that were homeschooling at the start of the 2019-2020 school year. Homeschooling rates increased most dramatically among respondents who identified as Black. The proportion of Black homeschoolers increased fivefold, from 3.3% in late spring to 16.1% in the fall. And there was significant

NOAA Upgrades Forecasts As Climate Change Drives More Severe Storms

WXXI US News - Mon, 03/22/2021 - 7:46pm
The National Oceanic and Atmospheric Administration upgraded the computer model that forecasters use to predict the weather one to two weeks in the future, called the Global Forecast System. The new model is better at predicting where hurricanes will form and how intense they will be as well as where and when snowstorms and rainstorms will occur, and how much precipitation will fall. "This is going to have a fundamental impact on the forecasts that are provided day to day," says Louis Uccellini, director of the National Weather Service. Climate change is driving more severe weather across the country. In recent years, Americans have experienced record-breaking hurricanes, wildfires, heat waves and rainstorms. In many cases, federal weather forecasts have not provided accurate information. The most striking example was in 2012 when the model was slow to predict that Hurricane Sandy was going to make landfall. During the 2019 hurricane season, the federal weather model underperformed the

Democrats Reviewing Whether To Overturn A Certified Iowa U.S. House Election

WXXI US News - Mon, 03/22/2021 - 7:28pm
The House Administration Committee is reviewing a challenge brought by defeated Iowa Democrat Rita Hart against freshman Republican Rep. Mariannette Miller-Meeks, who won the race by just six votes. Attorneys for the two candidates submitted initial legal briefs to the panel on Monday. In a terse 23-page brief , Miller-Meeks' counsel broadly denied Hart's claims and said the burden was on Hart to prove that a state-certified election should be overturned. "We don't have to prove anything at this point, and that's something I think is important to emphasize: The congresswoman has a certificate of election, and that demonstrates that she is the winner of the race under Iowa law," Alan Ostergren, an attorney representing Miller-Meeks in the complaint, told reporters on Monday. Hart's team alleges that there are 22 ballots that should have been counted in the election and that if they had, she would have won by nine votes. Hart's campaign has cited examples including five absentee ballots

Marty Walsh Confirmed As Labor Secretary

WXXI US News - Mon, 03/22/2021 - 6:22pm
Copyright 2021 NPR. To see more, visit ARI SHAPIRO, HOST: A former union leader will run the Labor Department for the first time in more than four decades. Today the Senate confirmed outgoing Boston Mayor Marty Walsh as the next labor secretary. Walsh will take office during a pandemic that has left millions unemployed and shined a new focus on how people work. To talk about this, we are joined by NPR's Sam Gringlas. Hi, Sam. SAM GRINGLAS, BYLINE: Hey, Ari. SHAPIRO: Marty Walsh is not exactly a household name, so tell us about him. GRINGLAS: Well, maybe the most important thing to know is that Walsh has really deep roots in organized labor. Before he was mayor, he led the Boston building and trades council. It's a union that represents a lot of construction workers. And he's also from this working-class neighborhood in Boston. He talks a lot about how that background will shape his approach to the job. At his confirmation hearing, he said this work is really personal. (SOUNDBITE OF

Marty Walsh, Boston Mayor With Union Roots, Confirmed As Labor Secretary At Key Time

WXXI US News - Mon, 03/22/2021 - 6:18pm
Marty Walsh, the two-term mayor of Boston, was confirmed as the Labor secretary by the Senate in a 68-29 vote on Monday, becoming the first union leader to run the department in over four decades. Walsh will become the head of the Labor Department at a critical time, as the pandemic has left millions unemployed and raised concerns about workplace safety. The former union leader will also serve in a Biden administration that has pledged to protect the power of unions and is looking to raise the federal minimum wage to $15 an hour. "Right now, this work is critical to the future of our economy, our communities, and our families," Walsh told senators at his confirmation hearing last month. "I believe we must act with urgency to meet this moment to strengthen and empower our workforce as we rebuild." Chris Lu, who served as deputy labor secretary under President Obama, says he can't imagine a bigger moment than right now for the department. The unemployment rate remains above 6 percent and

AstraZeneca vaccine deemed safe, waiting FDA approval

WXXI US News - Mon, 03/22/2021 - 5:59pm
UPDATE: A safety board overseeing AstraZeneca's COVID-19 vaccine trial is raising concerns about the company's data . In an unusual post-midnight statement released on March 23, the National Institute of Allergy and Infectious Diseases said the Data Safety and Monitoring Board, which monitors the trial, is concerned "outdated information" may have been included in the trial results. ---- A clinical trial confirmed that the new AstraZeneca two-dose vaccine is safe and highly effective although the National Institute of Allergy and Infectious Diseases said the Data Safety and Monitoring Board, which monitors the trial, is concerned "outdated information" may have been included in the trial results. . The University of Rochester Medical Center was part of the late-stage trial, which included over 32,000 volunteers in 88 sites across the United States. The released results showed that the vaccine is 100% effective at preventing severe COVID-19 ailments like hospitalization and death, and

Joe Prude reacts one year after the death of his brother Daniel Prude

WXXI US News - Mon, 03/22/2021 - 5:40pm
This week marks one year since Daniel Prude's encounter with Rochester Police that resulted in his suffocation, and ultimately, his death. Prude was in Rochester visiting his older brother, Joe, who didn’t learn the details of Daniel’s death until months later. Police bodycam footage showing Daniel Prude the night he was restrained was released to the public in September, six months after his death. Since then, the name Daniel Prude has been the subject of local protests, along with national and political conversations, on institutionalized racism in police departments and mental health accessibility. To Joe Prude, the name Daniel Prude is his “happy-go-lucky” younger brother. He describes Daniel as being competitive and a bit of a comedian. “He would keep you laughing like a real jokester,” said Prude. “He would have given you the shirt off of his back if a person really needed it.” Joe Prude said the past year has been a non-stop whirlwind for his grieving family. He adds that the

U.S. Joins EU In Sanctions Against China Over Treatment Of Uyghur Muslims

WXXI US News - Mon, 03/22/2021 - 5:36pm
China and the European Union traded sanctions against each other's officials Monday and the U.S. joined the U.K. and Canada "in parallel to measures by the European Union" to protest "human rights violations and abuses" in the western Xinjiang region. The EU imposed travel and economic sanctions on four of China's officials in response to the imprisonment of hundreds of Uyghur Muslims. Among those the EU sanctioned was Chen Mingguo, the director of the Xinjiang Public Security Bureau, because of the treatment of Uyghurs in Xinjiang. The sanctions are the first the EU has imposed since 1989, in protest of China's treatment of the Tiananmen Square demonstrators in Beijing. In response, China has dealt its own sanctions against 10 European individuals and four entities. "This move, based on nothing but lies and disinformation, disregards and distorts facts, grossly interferes in China's internal affairs, flagrantly breaches international law and basic norms governing international

Senate Swears In New Head Of Security After Insurrection Shakeup

WXXI US News - Mon, 03/22/2021 - 4:45pm
Karen Gibson begins her duties Monday as the U.S. Senate's sergeant-at-arms, the chief law enforcement officer for the upper chamber. She replaces Michael Stenger, who resigned following the Jan. 6 attack on the U.S. Capitol by a mob of Trump supporters. Gibson is a retired Army lieutenant general who served as director of intelligence for U.S. Central Command. She'll be joined in the SAA office by new Deputy Sergeant-at-Arms Kelly Fado, who was an aide to former Senate Democratic leader Tom Daschle, and by a new chief of staff, Jennifer Hemingway. According to Senate Majority Leader Chuck Schumer, D-N.Y., it's the first time since the office was created in 1789 that its leaders are all women. On the Senate floor Monday, Schumer called it a "great and historic day." The sergeant-at-arms, formally known as the sergeant-at-arms and doorkeeper of the Senate, "is charged with maintaining security in the Capitol and all Senate buildings, as well as protection of the members themselves,"

Big Tech Showdown Looms As Biden Taps Top Critics Lina Khan, Tim Wu

WXXI US News - Mon, 03/22/2021 - 4:41pm
Lina Khan, a prominent antitrust scholar who advocates for stricter regulation of Big Tech, may be about to become one of the industry's newest watchdogs. President Biden on Monday nominated Khan to the Federal Trade Commission, an agency tasked with enforcing competition laws. She is the splashiest addition to Biden's growing roster of Big Tech critics, including fellow Columbia Law School professor Tim Wu, who announced earlier this month he would join the National Economic Council. The news suggests the White House is preparing for a showdown with the tech industry at a time when federal and state regulators are already pursuing investigations and lawsuits challenging the dominance of Amazon, Apple, Facebook and Google. Biden has also called for the repeal of Section 230 of the Communications Decency Act, a legal shield for Internet platforms that has come under fire from both Democrats and Republicans. Direct and plain-spoken, Khan and Wu are among the most high-profile legal
Syndicate content