WHO Wants Healthcare Reform

Last week, we spoke about the Senate health committee chairman Lamar Alexander (Tennessee) and member Patty Murray (Washington) introducing a draft package of legislation. The draft packages goal is to cut healthcare cost (Click “here” if you want to go to that blog to catch up on that news).

However, the World Health Organization (WHO) announced, at the World Health Assembly, that a new resolution to improve the transparency of pricing for medicines, vaccines, and other health products is on the way.

The resolution advised member states to publicly share information on the prices paid by the government and other buyers for drugs, products, and additional pricing determinants. The goal here is to help the general population make more of an educated and informed decision and for more affordable pricing to expand across all products.

In past WHO resolutions, they have looked for particular components of transparency for healthcare products. However, a recent request was to examine the impact of pricing on cancer medicines.

“This resolution ties these aspects together to request transparency of inputs across the value chain of health products and their impact on actual prices paid,” a WHO spokesperson told FierceHealthcare.

Now, to make sure these goals are being met, WHO will provide a progress report back to the assembly in the year 2021. The report will include information on monitoring the impact of price transparency and the feasibility of web-based tools for sharing information. Member states will have platforms to share their progress as well.

“Member states must increase transparency in accordance with their national and regional legal frameworks and contexts, but the resolution promotes public sharing on net prices, inputs across the value chain, patent status information, and other relevant information to improve access.” Affordable healthcare is a huge must, no matter the size of the country, the population in that country, or how much that country is worth. WHO is attempting to help those who can not help themselves because of poor government choices.

However, reforming the United States system will be a significant group effort by the government, provider, and payer. The complex payer mix in the U.S. makes the government visibility on the actual prices paid very difficult. WHO did note that the member state has already cooperated in moving toward a common goal of bettering healthcare.

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Healthcare Reform is Coming

In hopes to end surprise medical billing, Senate health committee chairman Lamar Alexander (Tennessee) and member Patty Murray (Washington) introduced a draft package of legislation. The draft package aims to cut healthcare costs, starting with surprise medical billing and drug prices. The lawmakers believe they can pass the bill on a bipartisan basis. Alexander thinks it can be moved through the health committee in June and have it hit the Senate floor as early as July.

“These are common sense steps we can take, and every single one of them has the objective of reducing the healthcare costs that you pay for out of your own pocket.” Alexander says he is making a move to better the lives of many families and individuals alike.

The proposal would require every practitioner at an in-network hospital to take the patient’s insurance. For providers, that would mean they can choose to join the insurance networks that cover that hospital, or they can choose to send the bill through the hospital rather than sending separate bills to the patient or insurer. The bill also calls for insurers to pay providers the median contracted rate for the same services provided in a geographic area. It also requires insurers or providers initiate an independent dispute resolution process, or arbitration, for surprise bills over $750 (surprise bills under $750, the insurer will pay the median contracted rate). If this passes, surprise billings would be a thing of the past, helping save people money and stress.

Another topic on the proposal was cutting drug costs. The proposal would change the policy to stop drug makers of brand-named drugs from manipulating the system. This could help bring new, lower costing generics or biosimilars into the market. They also want to prevent unnecessary delay of drug approvals to citizens. This also calls for the elimination for loopholes where the first generic drug being submitted to the Food and Drug Administration (FDA) can block other generic drugs from being approved. The proposal calls for educating healthcare providers and patients on biological products and biosimilars (the low-cost version of biological products). This would also help generic drug and biosimilar companies speed up the drug-making process.

Senator Alexander wants to do his part in bettering America and hopefully begin to shine a light on a questionable healthcare system that causes Americans of all statuses to stress about their pocket more than their health.

Abortion Laws on Trial

Recently, Alabama’s governor signed into law the country’s most restrictive anti-abortion bill, which could put doctors who perform abortions with life in prison. The Republican governor, Kay Ivey signed the bill following approval by the Alabama Senate. Physicians who perform abortions could face up to 99 years in prison. Even attempting an abortion will be seen as a Class C Felony, putting the physician at risk of a 10-year prison sentence.

Then another state chimed in with a new abortion law. Missouri Senate passed a bill that will prohibit abortions after eight weeks. The bill is being called the “Missouri Stands for the Unborn Act,” which bans abortions after the detection of a heartbeat. However, they aren’t as strict as Alabama is with this new law. The law will allow for the procedure to be done if the mother caring could be in harm.

Currently, the law has not taken effect yet in Alabama. So, as of right now, abortions are still very much legal, medical procedures. However, this Act will be brought to court by Planned Parenthood and ACLU.

“The ACLU of Alabama, along with the National ACLU and PPFA, will file a lawsuit to stop this unconstitutional ban and protect every woman’s right to make her own choice about her healthcare, her body, and her future.”

“PLEASE REMEMBER: This bill will not take effect anytime in the near future, and abortion will remain a safe, legal, medical procedure at all clinics in Alabama.” The ACLU took to Twitter to state these, and it seems like this Act could have some powerful foes to get through before it even falls into place.

Another state that also dipped its feet into the new strict abortion laws is Georgia. Governor Brian Kelly signed a law on May 7th that would ban abortions as soon as a heartbeat was detected. The law does allow for women to abort against incest or rape, but the victim would have to report it to the police, and the abortion can’t be done after 20 weeks.

With these states being so close to Florida, it could affect patients coming here to try and get abortions. However, with these acts going to trail in most cases with Planned Parenthood, we could see this as a huge mishap and waste of time.

Take Care of Yourself

Working in the medical field is no easy task, daunting hours, stressful situations, and maybe a negative work environment can lead to depressing thoughts, poor diets, and lack of exercise and sunlight.

One fantastic way to relieve that stress is going outside. Just by going outside for 15 minutes can improve one’s mood and even better their day.

Sara Moss Wolfe Wrote, “Nature is my medicine,” and “look deep into nature, and then you will understand everything better.” Sometimes being with nature can be therapeutic after a long or stressful work day and we recommend that you look into getting some outside time during your day.

Maria Perez-Johnson, DO stated, “Taking a deep breath the minute I walk outside into the real world takes me away from any pain or suffering that I may have encountered.” No matter what your pain may be, sometimes you need to take a moment to relax your brain. Especially for everything that has happened after Hurricane Micheal and the destruction he has left behind.

Medical professionals often try to voice the importance of being outside to their patients. Being outside can give you vitamin D and can better moods.

However, you don’t need to sit outside and take everything in. You can always take up outdoor activities too. Something as easy as jogging around your area or going for walks can improve health and mental state. Having better health and a better mood going into work can lead to better decision making and having a happier time at work. Patients want to see a smiling face as their welcomed by the person who is trying to take care of them. This can also cause more significant interaction with patients and to gain their trust more easily and quickly to provide them the help they need.

But, you can not forget that you’re human too. You need positive things in your life, and this should be keeping a healthy diet, exercising, going outside, and surrounding yourself with other positive people.

However, a great way to do that would be to become a member of the Emerald Coast Medical Associate. We have meetings for our physicians where you can be more up to date with information, meet great colleagues and be in a positive environment.

New Tech Means Better Living

Israel is making a large payment on big data in medical research and treatment. There are plenty of startups and large companies that are parsing anonymized medical data, outcomes and results for patients, and patient data for signs on how diseases develop, how they can be treated, and how they can be prevented. The large payment is a $300 million investment in the big data digitization project. This would help make anonymized data available to researchers, pharmaceutical companies, and medical institutions.

The investment that Israel is making could be a huge step forward in helping patients who are suffering from whatever disease they have quicker, easier, and possibly more affordable. Medical data is an incredible resource that can be used to save lives and also enable personalized medicine too. This new technology could help medical professionals predict and even intrude on the disease before a condition or illness appears.

One form of this big data to enhance care is K, a mobile app that enables patients to receive personalized search results based on other patients similar to them. K uses a large number of anonymized doctor visits in Maccabi over the last 25 years. This data is then personalized for users and gives a highly reliable passage of what their symptoms might be saying. To use this app, the patient needs to answer a series of easy questions, and then the app measures against similar cases collected during general practitioner visits.

However, one of the most innovative uses of big data in medical tech today would be the collaboration between Israel’s Maccabi HMO’s MK&M Big Data Science Institute and IBM. The project aims to assist doctors in automatically identifying breast cancer using mammography images from HMO’s database, which then teaches computers how to detect breast cancer in images. The system analyzes millions of images and then looks for lesions, markings, and other characteristics that could indicate cancer presence.

These advanced systems and others like them have the ability to eliminate diseases, provide effective treatment for patients, reduce costs, assist medical professionals, and relieve human misery. As a community, we should be excited to embrace this new, ever-evolving tech.

Another valuable resource available to our physicians is the Emerald Coast Medical Association member meetings. In these meetings, you will learn new information, meet fellow medical professionals, and have the ability to present your own views and concerns.

 

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CDC is Listening

In March of 2016, the Centers for Disease Control and Prevention (CDC) released its guideline in an attempt to control widespread opioid abuse that claimed 20,000 U.S. lives in 2015 alone. The guideline was intended for primary care clinicians and advised them to prescribe other treatments before jumping to opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.

The CDC has since been under pressure from healthcare professionals because of the controversial federal guideline for prescribing opioids. On February 28th of this year, the CDC released a letter (written by Deborah Dowell, M.D., chief medical officer at the CDC’s National Center for Injury Prevention and Control) stating:

“The CDC will revisit the Guideline as new evidence and recommendation become available to determine when gaps have been sufficiently closed to warrant an update.”

In light of this letter, we could be witness to some much-needed changes for the opioid issue, which is a step in the right direction.

Additionally, the letter mentions the use of opioids in the treatment of cancer and sickle cell patients; They make it clear the guideline was never meant to restrict access to pain management for patients with those conditions.

One of many voices heard, Roy Silverstein, M.D., president of the American Society of Hematology, pointed to people with sickle cell disease that suffer from severe, chronic pain,

“which is debilitating on its own without the added burden of having to constantly appeal to the insurance companies every time a pain crisis hits and the initial request is denied.”

As we’ve stated in the past, even in situations where the medical professional would be denied, other forms of treatment besides opioids should be considered. The CDC changing things around could be a massive win for the medical field, professionals and their patients alike. Patients who have been denied their help haven’t gotten any better, and some have taken their lives because of it. Because of these changes, hopefully  now we’ll see more patients getting the much-needed help they deserve.

Want to stay up to date on medical news? Emerald Coast Medical Association can do just that and so much more if you’re a member. A few of the perks offered by ECMA are critical updates and CME emerging trends in clinical practice and practice management, as well as a Group Health Insurance Plan that creates cost savings and ownership in the ECMA Medical Malpractice Program with Medical Protective.

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Weight-Related Cancers on the Rise

Recently, J. Leonard Lichtenfeld, the interim Chief Medical and Scientific Officer for the American Cancer Society posted some findings by the society,

“What if I told you that our children were being exposed to a known carcinogen…The carcinogen is excess weight.”

The American Cancer Society posted the report that shares the details of their findings on the medical journal Lancet Public Health. They also published another work in 2003, in the New England Journal of Medicine that shared evidence of cancer risks increase with excess body weight.

The piece published to Lancet used 12 cancers that are known to be linked with being overweight and obese, and 18 other common cancers that are provenly not related to being overweight. With 6 of the 12 those cancers showing an increase in younger people, whereas 2 of the 18 showed similar cases.

“What is even more disturbing about the new data is the observation that for the weight-related cancers, the risk is increasing among progressively younger people, mirroring an increase in overweight and obesity we’re seeing in the U.S.” The link between the two factors may be something more severe or something we should not worry about.  Do you think the connection between weight-related cancers and obesity are connected?

The authors of the report also pointed out that as of 2014 1 of 3 children and adolescents are overweight or obese, and 78.2 percent of Americans (from 22 to 74 years of age) are also in the same situation. These numbers should have us very worried about the nation’s health.

Then as we look back to work published in 2003,

“The fact is, these warnings have not exactly received a lot of traction. The irony, of course, is the association between body weight cancer gets a fraction of the attention of other, much smaller risks.” The older published work was not taken as seriously as it should have been and unfortunately, because of that, the situation hasn’t gotten better.

However, how do we make these numbers deplete?

“We can try to do something about this as individuals: We can try to eat more fruits and vegetables and less red and processed meat and other processed foods; we can try to be more active.” As a group, Americans can make better health choices, and try to avoid unhealthy alternatives. Americans need to get out more and make better life choices to make sure they can cap out on their experiences and life in a whole.

We (Emerald Coast Medical Association) have written some other papers on how to stay healthy, and we recommend that you read those too.  J. Leonard Lichtenfeld left his readers with this,

“We haven’t worked this hard to fail. We always work hard to succeed, to improve our lives. Now it is clearly the time to take on this challenge, to make a difference, and avoid what appears to be a looming catastrophe when it comes to a disease we all dread. And that disease is cancer.”

Emerald Coast Medical Association doesn’t just care for your health, but we also care for your opinion and wellbeing. Feel free to leave a comment and discuss how you feel about weight-related cancers and obesity. Also, we will always do our best to keep you informed, and you’ll always have a voice we want to hear.

Insurance Struggles?

Any medical professional knows how difficult it can be to deal with some insurance companies and helping their patient get what they need to better their health. However, before we get into the topic, we want you to know that this is a safe and fantastic place to share your opinion and give feedback on our forum.

 

For this blog, we will be talking about Robert Bonakdar, MD, who is a family physician and his interaction with an insurance company regarding one of his patients. Bonakdar’s patient, Joan, has lower back pains that have affected her for many years. She had been through a lot trying to better her severe pain by trying all sorts of procedures and medicines. Unfortunately, her pain hasn’t gone away. Her lower back issues make it challenging to work, be a mother, and a friend in everyday life. Bonakdar came up with this conclusion:

“After our long consultation and review of her records, my prescription was simple – biofeedback, a non-drug treatment in which patients learn to control bodily processes that are normally involuntary.”

Biofeedback would help Joan get her life back on track and Bonakdar saw no issues with this prescription. However, the insurance denied the request and saw this as experimental. Do you think this prescription was experimental?

Bonakdar is located near the border in San Diego and is an unwilling expert on experimental treatments. As he states,

“I have begged patients not to go to Mexico for ozone or non-approved stem cell therapy because it is experimental.  In contrast, the treatments we requested for Joan are far from experimental.”

Recently, both acupuncture and biofeedback were recommended as first list treatments by the American College of Physicians (ACP). So, that would give even more reason why Bonakdar pointed Joan in that direction. Now that the insurance company has denied the request, Joan’s back pain won’t get any better. Insurance companies have been known to deny non-drug treatments that have proven to be successful. Has this kind of problem happened to you? Has an insurance company denied one of your patients treatment that you know would work?

However, denying patients non-drug treatments could be coming to a rest. Some states are working toward getting non-drug treatments covered by insurance companies. Also, at the national level,

“I (Bonakdar) recently advised the congressionally-mandated Pain Management Best Practices Inter-Agency Task Force. They recently published draft recommendations providing some of the most meaningful progress to date in creating a balanced approach to pain as well as the education needed to get there. Their plan includes a comprehensive plan for pain care, including access to treatments such as those recommended for Joan.”

Are you with Bonakdar and want these changes to come or do you think the system should stay the way it is toward non-drug treatments? Or, maybe you have your own idea. Let’s us know in the comments section below.

Is Medicare For All the Solution?

Medicare For All is a universal health care plan that was developed by Vermont Senator, Bernie Sanders. This would be built off what former President Barack Obama had with the Affordable Care Act (ACA), also known as Obamacare. Medicare For All is a solution that would help give health insurance at affordable rates, covering primary and specialty healthcare, vision, hearing, dental, mental health,addiction services, and many other essential health care solutions.

Not much is known on where funding would come from for this new health care solution. However, it is sure to be discussed soon with the 2020 elections coming up.

The first thing that needs to be viewed is how this will pass through Congress. The current House of Representatives may be inclined to pass this Medicare For All plan, whereas, the Senate would be completely opposed. This could change come 2020, but there will still be many opposers, including Republicans and moderates, the insurance lobby, and other special interests. This new plan would require a total reboot of our current healthcare, which would cause a reworking of the tax code, rearranging of national priorities, and either cause reconstruction or abolishment of the health insurance industry.

With our current healthcare system, some like it, and some hate it. However, more people are without health care than individuals who have health care. Most people will agree that, as a nation, we need to improve health insurance coverage and make it more affordable. President Obama attempted to do so, but unfortunately, due to some flaws in the ACA, it wasn’t all that people hoped for. However, people are becoming hopeful for this Medicare For All plan because they want an expansion of Medicare. Some also support a single payer system, backed by the government, but it doesn’t have to be Medicare.

With the Medicare For All plan possibly destroying the health insurance industry we have now, some citizens are becoming irate. This would mean the abolishment of health insurance plans through employers and private health insurances that users currently have in place.

There is also the giant question in the air of, “who pays for it?” Medicare is not free, and it isn’t all that cheap depending on the individual’s circumstances, needs, and preferences. There are also still costs that Medicare doesn’t cover for some patients, creating even more issues for Medicare For All. Big-ticket items that aren’t covered by Medicare could begin to overwhelm the patient. There is also the government’s single-payer plan, which would cost somewhere in the 30 trillion dollar range over a decade, which would make US citizens pay more in taxes.

This new Medicare For All plan could be very overwhelming and could cause many issues. It could also bring in a new affordable health insurance policy that is easier to acquire.

One thing that isn’t overwhelming is how Emerald Coast Medical Association takes care of its physicians at all government levels. Our Board of Governors routinely take their time to advocate for patients and physicians at the local, state, and federal level. What’s your stance on this issue? Voice your opinion in the comments section below.

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Health Tips for Busy Physicians

 

Working in the medical field can be incredibly taxing. Not having a lot of downtime and always having to perform at your best can be tiring. Medical professionals have a stressful job and role in society. Here are a few tips for keeping your health in good condition.

Diet is the most important thing for any person who is always busy. Just like any other highly active individual, you need to make sure you are eating healthy. A great way to start the day is by eating a healthy breakfast. Keep away from unnecessary sugars in the morning. As for lunch, you want something filling and packed with good proteins while trying to avoid red meats. Make the meal well-balanced by adding in some low-glycemic carbohydrates, like brown rice or whole wheat bread. For most people, a high intake of carbs for lunch can cause one to sloth. Snacking can also be used to boost some energy through the day. Eat things like fruits, fiber bars, nuts, and make sure you’re drinking enough water to stay hydrated. Try to stay away from sodas and other sugary drinks throughout the day. Coffee and tea, however, can be kept to a max of 2 cups throughout the workday.

The next tip would be to stay active. This does not have to be going to the gym early in the morning or late at night. Staying active could be walking around your job site, instead of just sitting or standing. During your lunch break, try to utilize the time to take a walk if possible. Using the stairs more often can burn calories quickly even if you’re moving at a reasonable pace. Try to do other cardiovascular activities outside of work to keep your health in good condition and keep you at peak performance.

The last tip has to do with mental health. It’s best to be mentally ready for every day, so go into each with a positive outlook. If you go into a day negatively, it can affect how you act toward colleagues and patients alike. Try to avoid negative colleagues when possible because they can bring your mood down too. Be mentally calm, and greet others with positivity. Breathing exercises or other forms of meditation can go a long way before, during, or after a workday. Another thing to keep in mind is if your thoughts are getting negative during the day or after, it’s best to talk to someone. Sometimes talking it out can get things off your chest and take some of the stress off as well.

Stay healthy, stay positive, and be the change you want to see.

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