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This Week in Health Care Reform - January 20th, 2017

The costs of repeal are projected as efforts to do away with the health care law advance; critics assail drugmakers’ latest tactic; and, telehealth applications continue to confer benefits.

Week in Review

Cost of Repeal: With Republican-led efforts to repeal the Affordable Care Act advancing in Congress, a new analysis seeks to ground the impacts of that repeal in practical context.  Released by the nonpartisan Congressional Budget Office (CBO) earlier this week, the report estimates that 18 million Americans would lose their coverage in the first year alone should the health care law come off the books.  Within ten years, that number spikes to 32 million.  A separate study takes those impacts a step further, examining the corollary costs of repeal.  Published by The Commonwealth Fund, that study estimates that up to 3 million jobs could be lost if key provisions of the law are repealed.  Further, losing those provisions could wind up costing states up to $1.5 trillion in reduced gross state product by 2023.  Politics aside, experts continue to socialize lawmakers to the costs – both, expected and unexpected – of repeal.  And, against this backdrop, new polling speaks to a growing public wariness regarding these efforts.  In a just released poll from inside-the-Beltway publications Morning Consult and POLITICO, nearly two-thirds of registered voters said Congress shouldn’t repeal the Affordable Care Act without a replacement plan.  Separately, a new poll from Reuters/Ipsos, found that a quarter of Republicans don’t even want to see the law repealed.  And, finally, according to results from a new national NBC News/Wall Street Journal poll, the health care law is currently riding its highest level of public support.
Orphan Drugs: At a time when the pharmaceutical industry finds itself under constant (arguably, self-inflicted) scrutiny, a new investigation only promises to revitalize opponents’ attacks against drugmakers and their questionable tactics.  That analysis, by Kaiser Health News, shines a light on a bill passed more than 30 years ago and how pharmaceutical companies have manipulated that law to their decided benefit.  Signed into law by then President Ronald Reagan in 1983, the Orphan Drug Act was meant to motivate the drug industry to develop new medicines for people whose rare diseases had largely been ignored.  However, despite its original intentions, the financial incentives built into the law have resulted in drugmakers taking advantage of the Orphan Drug Act by bringing to market orphan medicines, targeted at comparatively smaller patient populations (fewer than 200,000), but with astronomical price tags.  And, while the benefit to those patients is hard to deny, what’s even harder to ignore is that those benefits are meaningless if they’re priced out of reach.  With close to half of all new drugs approved by the FDA last year being orphan drugs, it’s clear that drugmakers have identified a lucrative, new revenue stream and are looking to capitalize.

Telehealth Benefits:
Technology continues to weave its way into our evolving relationship with our own health care.  Already, we’ve seen how wearable devices have promoted greater consciousness around leading a more active lifestyle.  Now, researchers have discovered that these wearables may also have a role to play in helping doctors diagnose their patients, while also determining a course of treatment.  And, as barriers to telehealth’s growing application ease, so, too, does our willingness to deploy its utilization in hitherto unforeseen areas of practice.  For instance, in Chicago, new telestroke units are slated to hit the streets soon.  These specially-equipped mobile units will be capable of diagnosing and treating stroke victims before they’re taken to the hospital.  And, according to a new study, women with gestational diabetes were able to successfully meet recommended health targets when their office visits were supplemented by telehealth conferences.  Health specialists have also begun to tap into telehealth’s potential, leveraging mobile platforms in order to offer care to a broader array of patients, often in remote areas.      

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Looking Ahead

As decision-makers look to reshape the contours of health care in this country, experts offer up a policy agenda with particular emphasis on stabilizing the insurance marketplace and intensifying the fight against chronic disease.  Meanwhile, stakeholders, too, are being urged to adopt a cautious approach as they learn to navigate an uncertain landscape.

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