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Proposals May Limit Insurance Choices And Squeeze Some Middle Earners
"President Obama and leading Democrats have stressed that people who like their employer-sponsored insurance would be able to keep it, under a health care overhaul. But they haven"t emphasized the flip side: That people who don"t like their coverage might have to keep it," Kaiser Health News reports. "Under the main health bills being debated in Congress, many people with job-based insurance could find it difficult to impossible to switch to health plans on a new insurance exchange, even if the plans there were cheaper or offered better coverage. The restrictions extend to any government-run plan, which would be offered on the exchange." But "there are a few exceptions: Workers would be allowed to buy insurance through the exchange if their job-based coverage gobbled up too much of their incomes or was too skimpy. Also, under the House proposal, people could get insurance through the exchange if they paid their entire premiums - a cost that would be prohibitive for many workers."
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Study Shows Decreased Risk Of Death From Opportunistic Infections With Earlier Antiretroviral Treatment
HIV-positive people with opportunistic infections who receive earlier antiretroviral treatment lower their risk of death compared with people who delay treatment, according to a new study conducted by the Stanford University School of Medicine and published in PLoS One, the San Jose Mercury News reports. The findings could lead to changes in recommendations for antiretroviral treatment protocol, specifically for patients diagnosed with HIV at an advanced stage, the Mercury News reports. The study included 262 HIV-positive participants at 39 health care sites across the U.S., and 20 participants in South Africa. During the yearlong study, the researchers found that among the participants who were treated promptly after developing an opportunistic infection, 14% died or developed another infection. The researchers also found that 24% of participants who deferred treatment for an average of 45 days died or had a decrease in health outcomes. According to the Mercury News, the question of when to start HIV-positive people on antiretroviral treatment remains unclear because of issues such as the high cost of medicines, side effects, and drug interactions or resistance. Andrew Zolopa, head of Stanford University School of Medicine"s division of infectious diseases and lead investigator of the study, said that physicians often treat HIV-positive people for an "acute crisis, then follow up later with treatment for HIV." He continues, "But that answer is wrong. The study shows very clearly that there is no safety downside to doing this -- and the benefit is quite substantial, reducing death by 50%." "Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people present late in the course of their illness with an opportunistic infection," Mitch Katz, director of San Francisco"s Department of Health who was not involved in the study, said. He added, "This study shows that it is lifesaving to treat those persons with antiretroviral drugs while they are still in the hospital." Katz said that the results could lead to changes in HIV/AIDS practices worldwide. The International AIDS Society, CDC and the British AIDS Society have developed guidelines recommending that early antiretroviral treatment be considered in patients with opportunistic infections, Zolopa said. In addition, NIH is considering an international study to examine earlier initiation of antiretroviral treatment involving more than 9,000 people from both developed and developing countries (Krieger, San Jose Mercury News, 5/15).
News of the day
New Data Show Cost Savings Achieved By Treating Mild And Moderate Alzheimer's Patients With Aricept(R)
Researchers attending the annual meeting of the International Society for Pharmacoeconomics & Outcomes Research (ISPOR), heard today that prescribing Aricept® (donepezil hydrochloride) as soon as patients are diagnosed with either mild or moderate Alzheimer"s disease saves the NHS money. The findings contradict the recommendation by NICE that these medicines are not cost effective in the early stages of the disease, a decision that has been the subject of much recent debate.
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House Democrats Unveil Bill That Would Create Insurance Exchange, Public Plan

House Democrats on Tuesday released an outline of their proposal to reform the health care system that would require that all Americans have insurance and that employers provide coverage or pay a penalty, The Associated Press reports. The bill also emphasized preventive care but omitted details about how to cover the costs. "On a hotly contested issue, the emerging House plan would give individuals the option of buying insurance provided by the federal government," the AP says. The so-called public plan has been a contentious one. Democratic senators on the Health, Education, Labor and Pensions Committee didn"t include a specific public-plan proposal in their legislation for now, in hopes of ironing out some disagreements with Republicans. Under the House plan, insurance companies would be banned from denying coverage or charging higher premiums because of pre-existing conditions. ""This is the year we have to do it," said Rep. Henry Waxman, the California Democrat who chairs theEnergy and Commerce Committee. Waxman was one of several senior Democrats who outlined proposed legislation to the party"s rank and file during the day" (Epso, 6/9). Some lawmakers are worried about how to pay for the legislation, which wasn"t explained in the House outline, The Hill reports: "A public option for healthcare insurance is essential for liberals in the caucus. Blue Dogs and New Democrats got less of what they wanted. Most notably, the plan ignores Blue Dogs" call for a government plan to be a "fallback option," if reform of private healthcare doesn"t work. ò€¦ "I"ve got my concerns," said Rep. Betsy Markey, D-Colo., a centrist lawmaker from a strongly Republican district. "We"ve got to address cost, quality and coverage, with cost being No. 1."" Drafts of the House bill are expected to be released by the end of the week (Soraghan, 6/9). The Wall Street Journal: "The draft House plan, presented to House Democrats at a meeting Tuesday, would require almost all Americans to have health insurance and provide subsidies to those with annual incomes as high as four times the poverty level...The plan presented Tuesday by Mr. Waxman and other key House Democrats is likely to define the liberal end of the negotiating spectrum. It would expand Medicaid by basing eligibility solely on income, said a House aide who helped draft the proposal. Currently, someone must be both poor and a parent, or meet some other criteria, to qualify" (Bendavid and Adamy, 6/10). President Obama met with Democratic members of the Ways and Means Committee to discuss the legislation Tuesday, Roll Call reports. "During the White House session, Obama reiterated his support for his own revenue-raising proposal, a plan to reduce deductions for higher income earners that has so far been rejected by Congress" (Koffler, 6/9). Meanwhile, members of the racial minority caucuses are readying their own bill to compete with the top House Democrat bill, Roll Call reports in a separate story. "But they conceded that some of their ideas are already being included in the package being put together by Democratic leaders, and they said they aren"t prepared to unite in opposition to that bill. The bill being introduced later this week by the Tri-Caucus - which includes the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus - focuses on the need to address racial and ethnic disparities in health care." (Bendery, 6/9) Republicans too are voicing their opposition. NPR reports (MP3): "But all that apparent togetherness on the part of the Democrats is serving only to unite the opposition, said John Kyl, the Senate"s second ranking Republican: "We are opposed to a government plan and the sooner it"s off the table the better"" (Morning Edition, 6/10). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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