Proving citizenship for Medicaid benefits
I opened this WaPo article expecting to read a bunch of excessively liberal bologna about how requiring people to prove that they're US citizens is unreasonable, and how we should waive the requirement and free healthcare for everyone hooray! But wait! I was wrong! For once the MSM shined some light on a side of the story relating to healthcare that I would have been completely oblivious to — this is a new thing for me. Please hold on a minute, I'm still coming to grips with this…
…okay I'm better now.
Tomorrow a rule goes into effect that will require 50 million people to prove their citizenship to curb fraud by illegal immigrants. Proofs allowed are passports and birth certificates — the article doesn't mention anything else being accepted — which seems like a reasonable expectation. The current medicare rules require only a declaration of citizenship undewr penalty of perjury. (A poor method if ever there was one.)
Then I read this, which left me scratching my head. (While I'm going to quote sections, it's worth it to read the whole thing, it's truly a piece that stands on its own.)
One plaintiff is Alphonso DeShields, who was born in his parents' home in Spartanburg, S.C., a few months after World War I began. For five years, he has lived in a nursing home in Northwest Washington. He has a severe heart condition, cancer and other ailments.
"With respect to each of the documents" Medicaid would have him supply, the lawsuit states, "Alphonso DeShields possesses neither an original of such a document nor a copy of such a document certified by the original issuing agency."
[...]
Among the plaintiffs in that case are Ruby Bell, 95, born in an Arkansas county that did not issue birth certificates until 1914, and George Crawford, 80, who is so incapacitated from strokes that he cannot speak. According to attorneys, the church members who care for Crawford in Illinois don't even know where to start looking for documents that would pass muster.
The article also mentions segregated hospitals that didn't allow black women into maternity wards, which meant no birth certificates.
On the one hand, I don't think the government should be dishing out money by the bucketful for non-citizens, but then how do you deal with the special cases mentioned in the article? I can't think of a solution that's workable and fair for everyone involved. I'm at a complete loss.
How do you fix this? Anyone have any ideas?
The only complaint I have with the article is the usage of "Medicaid" and "Medicare." I think they're referring to Medicare, but they say Medicaid. Any clarification on this point would be welcome.
[tags]Medicine, pharmacy, medicare, medicaid, immigration[/tags]
ACIP recommends Gardasil
Apologies for my lack of writing lately — I have been extremely busy with work and offline life. After tonight, things should go back to normal.
Anyway, looks like I was right about Gardasil not having an uphill fight:
A government advisory committee is recommending that all 11- and 12-year-old girls get a new vaccine to prevent the sexually transmitted virus that leads to most cases of cervical cancer. Moreover, the vaccine will get federal funding under the Vaccines for Children program.
Additionally, the vaccine can be given to girls as young as 9.
[...]
The Advisory Committee on Immunization Practices, ACIP, convened by Centers for Disease Control, also recommended routine use of the vaccine for women between the ages of 13 and 26 regardless of the status of pap-smear tests that measure precursors to cervical cancer.
This is good news for Merck, and for all women. Glad to see the religious retardsright was not able to derail Gardasil recommendation. This part stood out to me, because it notes that the decision was really a non-event:
In a note this morning that preceded the meeting, Timothy Anderson, pharmaceuticals analyst at Prudential Equity Group, had called the decision "a formality."
Hooray common sense!
[tags]Medicine, pharmacy, Gardasil, Merck, politics, religion[/tags]
Novartis as the next-gen pharmaceutical company? …It's possible.
I've mentioned Novartis several times here, and they are an interesting company in the way they're going about handling the generic drug market. With their acquisition of Sandoz, they've inherited an established generic drugmaker, but on the other hand, they've got their established "big company" infrustracture with all of its advantages and disadvantages. (Huge manfacturing capability and staying power, but lacking in agility.)
I've talked a lot about the Hatch-Waxman act and its 180 day exclusivity clause for the first generic drugmaker to file an ANDA with the FDA. In Novartis's case, they have the ability to basically hand their name-brand drug that has a patent expiring off to their generics division more effectively than an outsider could theoretically duplicate a drug. In theory, Novartis could file an ANDA the day after their brand-name drug was approved, which would mean that they'd be granted that extra 180 day window some ten years down the road. Their little ace-in-the-hole.
This would allow them to skip creating an "authorized" generic if they chose. Authorized generics are exactly the same as their brand-name drugs, and can be sold during that 180 day window — which of course drives the generic manufacturer batty because they don't quite have that total monopoly. This, of course, cuts into their profits, for reasons I've elucidated before.
By owning their own generics arm, Novartis can keep their drugs "in the family" with no competition for that 180 days. They simply choose not to license an authorized generic, and have their Sandoz arm be the first to the punch with an ANDA, which is relatively trivial because the drug was developed in-house.
The remaining questions are whether this is a violation of current anti-trust law, and can Sandoz compete as an agile player on the fast-moving, cutthroat generic drug turf now that it's owned by a giant company?
(This post was inspired by an article at Fool.com, whose author didn't quite connect the dots to my satisfaction.)
[tags]Medicine, pharmacy, Novartis, Sandoz, antitrust, generic drugs, Big Pharma[/tags]
J&J buys Pfizer's OTC unit
Johnson & Johnson snapped up Pfizer's OTC unit, which I mentioned was on the auction block about a month ago. The total? $16.6 billion — a $1.6 billion more than GSK's bid.
The deal will allow J&J to expand its household presence by buying a stable of products that includes Listerine mouthwash, Nicorette smoking cessation treatments, Sudafed cold and allergy products, Rolaids antacid, Benadryl allergy medicine, Rogaine baldness treatment and antacid Zantac.
Fun, fun, but still not terribly exciting. (JNJ's stock is down $1.43 (2.33%) as of this writing, and Pfizer is up. I wouldn't be terribly thrilled if I was a J&J investor right now. This doesn't really seem like it'll be a super-profitable move, and I wonder if J&J is just doing it to expand their already prodigious consumer products line, or if this fits into some larger, unknown strategy.
[tags]Johnson&Johnson, J&J, mergers and acquisitions, M&A[/tags]
Fish oil better than Ritalin? I remain skeptical.
Here's another story that you can file under the "I'll take this more seriously when more research is done" category. Apparently fish oil works as well as Ritalin in calming hyperactive, ADHD children.
Before I started writing here, I was a science journalist — I covered developments in the world of science that interested me. I did it for myself and for an established publication. Anyway, I quickly learned to develop a skeptical attitude, particularly when somewhat extreme claims were made. I consider this to be one of those. Things like this set off my BS radar:
Psychiatrist Dr Sami Timimi (CORR) said: 'It stands to reason that using a natural supplement that has few dangers or side-effects must be preferable to using drugs which have considerable dangers associated with them.
'This is a non-toxic way of doing something that might make a difference.'
First off, natural supplements can be just as toxic and dangerous as synthetic ones. Second, "natural" substances aren't usually studied because there simply isn't a lot of money in them because they can't be patented. Third, OTC supplements (like herbals and fish oil) aren't regulated by the FDA, so what you're actually getting can vary from manufacturer to manufacturer — and from bottle to bottle from the same manufacturer. And yes, I realize this study was conducted Down Under, where the laws might be different.
None of the above are smoking guns when it comes to invalidating this story, they're just things to keep in mind.
The Australian researchers looked at the effect of eye q (CORR) fish oil capsules on a group seven to 12-year-olds with ADHD.
Some were given the capsules, while others took a placebo or dummy capsule.
Within three months, the behaviour of those on the fish oils had dramatically improved and, by seven months, many of the children were less restless and doing better at school.
If true, this is fantastic news. Until other studies corroborate these findings, I'll treat this with a healthy dose of skepticism rather than gospel. But it certainly is interesting.
[tags]Medicine, pharmacy, fish oil, omega-3, ADD, ADHD, Ritalin, Concerta[/tags]
Pharmacists as prescribers of medication
I was reading on Kevin, MD the other day a post about pharmacists "wanting" to prescribe. The article was about Canada, but we're rapidly moving in that direction here in the United States as well, with the PharmD degree being the only one that's offered.
This article is pretty long, so you may wish to get a cup of coffee or something before you read it, but I do think it's very relevant to healthcare today. The sections:
- The retail misconception
- Healthcare as a collaboration
- A problem of medical records?
- Making a diagnosis vs determining treatment options
- Pharmacists are already prescribing today
- Who's more qualified?
- Random talking points
- Conclusions
An uphill fight for Gardasil? Unlikely.
There's a story at TheStreet.com from yesterday about Merck's new vaccine, Gardasil. It suggests that unless the vaccine gets endorsement from ACIP, it's not going to be the blockbuster that everyone thinks it will be.
On June 29, Gardasil goes before the Advisory Committee on Immunization Practice which consists primarily of experts in public health, infectious diseases and pediatric care. Although states have the ultimate say in what vaccines are required of school-aged children, the ACIP's opinion carries considerable influence in the public health arena for vaccinating children and adults.
Failure to win ACIP support would likely doom Gardasil. Lukewarm or narrowly defined support could deflate sales of a vaccine that many analysts believe will be an annual $1-billion-plus seller. Some peak sales estimates are upward of $3 billion.
My prediction? ACIP will endorse it, and the only reason they wouldn't would be due to opposition from the religious right. How could they not endorse the vaccine, given that it's just about 100% effective?
[tags]Medicine, pharmacy, gardasil, merck, hpv, vaccines, cancer, oncology, genital warts, cancer vaccine[/tags]