First, the policy news.
Trump has tied tax reform to health care reform. He has stated that there cannot be tax reform unless there is health care reform. Those that stalled the last proposal, the “ Freedom Caucus", an ultraconservative branch of the GOP, are reportedly in negotiations to prevent a stalemate as before.
Negotiating with Democrats is another matter. Trump has once again threatened to withhold health care subsidies that fund the ACA (Affordable Care Act) to get Dems to the table. This would entirely destabilize the health care insurance markets. At the same time, the new administration moved to finalize rules to stabilize the ACA marketplaces as they now currently exist. These rules were drawn up by CMS, (Center for Medicare and Medicaid Services) who oversees these and other Federal Health care programs. The intent of these rules is to ease the what insurance companies say is an undue burden placed on them by the ACA. It will shift some of the cost of care back to the consumer, ostensibly making insurers more likely to stay in the market, i.e offer health insurance at all. For example, these rule would allow higher deductibles, larger out of pockets, and increased prices for insurance. It is hard to conceive of health insurance companies needing a “break “more than the common consumer. However, they need to stay solvent in order to make sure there are enough such companies in the market to make it competitive.
Trump has signed a law withholding Federal Funds from clinics that provide abortion. This of course will also take down those providers from providing the general medicare care, birth control visits and cancer screenings that they would normally provide on a regular basis.
In good policy news, a bill has been introduced in Connecticut which would make pregnancy a “qualifying event”, meaning it would enable pregnant women to enroll in the ACA anytime, instead of just during the specified enrollment periods.
Aren’t you grateful when your medication can be purchased as a generic ? I am since it saves lots of money. Drug companies trying to recoup their losses try to keep generics out of the market as long as possible. Regulators such as the FDA ( Food and Drug Administration) intervene when the need for the drug is great or the company is believed to have recouped their expenses, or the cost of the drugs is simply too high. A bipartisan effort is underway to ensure timely access to generics. This could save the public billions of dollars.
Human Papilloma Virus (HPV) is on the rise in the US. Those who have been vaccinated are not part of this rise. Surprise !
A new study indicates that many primary care doctors and Ob/Gyns are continuing to recommend mammograms after 40 rather than begin them after 50 as the USPSTF (US preventive Services Task Force) recommends. That is because the USPSTF gauges effectiveness by death rates, rather than years of life. Death rates from cancer or non-cancer are low for women in both the 40s and 50s, and comparisons to not yield adequate numerical differences. Furthermore their metrics do not incorporate the value of early detection on the reduction of MORBIDITY (complications short of death) or the enhancement of quality of life. The USPSTF is comprised of epidemiologists and not clinicians. ACOG ( American College of Obstetricians and Gynecologists) recommends that screening mammograms begin at 40.
According to the CDC ( Centers for Disease Control) Texas has the highest repeat teen pregnancy rate in the country. Numerous voices in the State are calling for a state based no-cost provision of birth control. Why does this not make sense to everyone ?
On that front, it is not widely appreciate that long acting birth control such as IUDs can be places right after the baby is born. This is especially useful for patients who might not show up to their postpartum appointments.
In perhaps the most most important opinion piece of the week, the Catholic Democrats President Steven Krueger has described a problem in the Democratic party. He has noted Democrats seem reluctant to talk about ways to reduce abortion since it may imply they do not believe access to it is a fundamental right. He believes Democrats should come to the table with proposals to reduce abortion, thereby gaining ground on issues like birth control and provision of health care in general.
Stay tuned for more breaking news from the fascinating world of Obstetrics and Gynecology next week, here on Medical Monday.