Health Business Blog

Health care business consultant and policy expert David E. Williams share his views

Medicare hires ombudsman to be “voice” of the beneficiary

CMS has hired an ombudsman as mandated by the Medicare Modernization Act of 2003. The ombudsman has a number of responsibilities:

  • Assist with complaints and inquiries from beneficiaries
  • Assist in collecting information for filing appeals
  • Help with enrollment and disenrollment problems
  • Assist with premium issues
  • Work to ensure beneficiaries understand and can exercise their rights

The ombudsman, Dan Schreiner, is currently a health care policy analyst. He has worked in the Dept. of Health and Human Services before and at T. Rowe Price, where he focused on participant services.

It will be interesting to see how Mr. Schreiner defines the role and what he can achieve.

Coal fired autism?

A study in the journal Health and Place documents a correlation between mercury emissions from coal plants and autism rates in 1200 Texas school districts. According to the abstract,

There was a significant increase in the rates of special education students and autism rates associated with increases in environmentally released mercury. On average, for each 1000 lb of environmentally released mercury, there was a 43% increase in the rate of special education services and a 61% increase in the rate of autism. The association between environmentally released mercury and special education rates were fully mediated by increased autism rates.

No one has been able to figure out what is happening with autism. Some studies have suggested the incidence of autism has risen by a factor of 10 in recent decades, while other argue it can be explained by increased diagnosis. It will be a long while before we really understand what is happening and why.

Increasing disclosure of hospital pricing

The Hospital Price Disclosure Act has been introduced in the House. It would require hospitals to report average and median prices for their 25 most common procedures and 50 most prescribed medications, reports Modern Healthcare.

According to a press release from co-sponsor Rep. Dan Lipinski (D-IL),

When consumers start comparing health care facilities on costs, the facilities will respond accordingly, driving costs down and quality up.

Don’t hold your breath.

J&J decides to balance drug risks and benefits in DTC ads

Saturday I posted about an Economist editorial calling for an increased emphasis on risk/benefit assessment of marketed drugs. The editorial suggested it would be in the drug companies’ long term interest to embrace this approach.

Today’s Wall St. Journal reports that J&J is:

…unveiling a new approach to TV and print campaigns… putting drug risks on a more equal footing with drug benefits.

In a speech Friday to the Pharmaceutical Research and Manufacturers of America (PhRMA), where he is now the chairman, J&J CEO William Weldon said:

“If our industry is to retain the important right to talk directly to consumers, each of our companies in its own way must work to make DTC what it very definitely can be –a way to educate and counsel consumers in improving their health.”

From Beanie Babies to pacemakers

Four $6000 pacemakers were stolen from a Sacramento hospital and at least two were sold on eBay for about $200 each. One was implanted by a physician in Arizona, another was seized from his clinic, and two are missing. Beyond the original theft, it’s not clear if any laws were broken.