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This Week in Health Care Reform - July 17th, 2015

Americans’ views of the health care law improve; a new (familiar) head of the agency overseeing Medicare and Medicaid is nominated; significant roadblocks still stand in the way of telehealth’s forward progress; and, a call for greater transparency in drug pricing is made.


Week in Review

Popularity Gains: Whether riding the crest of the wave left in the wake of the Supreme Court decision or genuinely gaining traction, public opinion surrounding the divisive health care law seems to be improving, at least, according to the latest polling data released by Gallup.  Their results show that 47 percent of Americans now approve of the Affordable Care Act, the highest level since 2012.  While 48 percent hold the opposite view, opinion is as evenly matched as it’s been in years.  Still, it’s hard to say that lawmakers on either side of the issue can now lay claim to any kind of mandate in where the law should go from here, as a separate survey aptly points out.  That poll, released by USA Today and Suffolk University, found that the majority of respondents believe officials should focus on improving the law, rather than repealing it.  However, by a more than 2-to-1 margin, Republicans polled said they wanted their lawmakers to continue their efforts to overturn the law (63 percent to 27 percent).

CMS Nomination: Having already served as acting administrator since March of this year, President Obama last week nominated Andy Slavitt to be the permanent head of the Centers for Medicare & Medicaid Services (CMS).  Pointing to the work he’s done to help iron out the wrinkles that plagued the launch of the government’s troubled website, the White House believes he’s the right person for the job.  Opponents, however, aren’t so sure, offering that whoever oversees the agency responsible for both Medicare and Medicaid “should be focused on what the American people expect him to do: Administer these important programs” rather than have his attention diverted to “the implementation of some gigantic, unworkable health care law.”  Politics notwithstanding, with new projections pegging the pace of Medicare enrollment at about 10,000 people every day, it’s clear that whoever fills the role will have plenty to keep him or her occupied.

Despite the promises offered and exhibited by the widespread adoption of telehealth, doubts persist amongst patients regarding its benefits, according to new research.  In a survey conducted by TechnologyAdvice Research, only 35 percent of respondents stated that they’d be comfortable with a virtual health care appointment.  Further, three-out-of-four went on to say that they’d be skeptical of a diagnosis made via telehealth.  However, those numbers drastically improve amongst younger patients with only 24 percent of 25-44 year olds saying they wouldn’t trust a virtual diagnosis.  This kind of shift to the care delivery paradigm takes time.  As attitudes and comfort-levels start to coalesce around the advances of modernity in the health care space, more institutions will have to adapt to keep up with the changing needs and demands of a digitally-evolving patient population.

Rx Transparency:
Having spent the past year-and-a-half serving as the poster child for runaway prescription drug prices, Sovaldi received, at least what appeared at first glance to be, something of a reprieve this week when a new study determined that the hepatitis C drug, manufactured by Gilead Sciences, along with its AbbVie-produced competitor, were “cost-effective”, despite price tags running as high as $1,000-a-pill.  However, it’s important to note that cost-effective doesn’t mean cheap in this case, only that the drug was deemed worthy of the price owing to its health benefits.  More importantly, though, and harder to dismiss, was the fact that more than half of the study’s panel of experts received payments or funding from either Gilead or AbbVie in the past year.  Regardless, it appears that Sovaldi has been supplanted by its successor, Harvoni, in terms of its popularity with patients and doctors.  Worryingly, that drug actually costs more than its predecessor, coming in at $1,350-a-pill.  With no end in sight to this unsustainable trend, it’s clear that this distressingly unstoppable force is on a collision course with the immovable object of finite resources, leading to increased calls for transparency in drug manufacturers’ pricing machinations.

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Looking Ahead

While supporters of the health care law continue to bask in the glow of their latest victory, opponents are busy mapping out their next steps.  For Republican lawmakers, that could mean attacking the law via the obscure budget tool known as reconciliation.  While some aren’t banking on the GOP’s chances of out-and-out repeal, party leaders urge patience, citing the absence of a timeline in accomplishing their goals. 

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