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With new drug pricing order, Trump flirts with socialized medicine

President Trump’s recent executive order on drug prices gets almost everything right — except the solution. Ironically, that solution moves the United States toward socialized medicine, which the president vociferously opposes.

The order says, “Americans pay more per capita for prescription drugs than residents of any other developed country.” That’s certainly true for most brand name drugs, though Americans typically pay much less for generic drugs, which account for about 90 percent of all U.S. prescriptions — a fact often ignored in the health policy debates.

The EO is also correct that “Americans pay more for the exact same drugs, often made in the exact same places.” As a result, Americans “finance much of the biopharmaceutical innovation that the world depends on.” 

But Trump’s executive order won’t fix these problems. It will only make it as hard for American patients to obtain the newest, cutting-edge drugs as it is for many patients in foreign countries the president wants to emulate. 

The order forbids Medicare from paying more for drugs than the lowest price available in any member country of the Organization for Economic Cooperation and Development (OECD), after adjusting for per-capita income. Trump calls it a “most-favored-nation price.” 

The order claims those nations enjoy low drug prices because they “negotiate” with pharmaceutical manufacturers. But what the order describes as a negotiation is more akin to a hostage-taking — with their own citizens held for ransom. 

Bureaucrats in those nations’ systems – most of which are largely or completely controlled by the government – often refuse to cover drugs unless manufacturers sell the medicines far below fair-market prices. 

In Canada, for example, just 46 percent of new drugs approved worldwide between 2011 and 2018 are actually available to Canadian patients. And the average delay between approval and availability in Canada is 15 months. In the United Kingdom, it’s 59 percent and 18 months.

But in the United States it’s 87 percent and three months or less.

Those are months – and in some countries, years – that patients go without access to the newest treatments. Some drugs are never made available. 

The U.S. government doesn’t treat its people so callously — or at least it hasn’t. Medicare covers virtually every FDA-approved medicine, and it sets reimbursements based on prices in the commercial market. This market-based pricing ensures that the newest drugs are available and doctors, not government gatekeepers, decide which drugs to prescribe. 

It’s a shame that the president has adopted other countries’ socialized medicine prices because he so often criticizes foreign freeloading. 

Recall that when Trump took office, he saw that our NATO allies were not paying their fair share toward the alliance’s mutual defense, even though the members had for years committed to raising their defense spending to at least 2 percent of GDP to support the alliance. 

Trump did not respond to this inequity by swearing the United States would only spend as much as our stingiest ally. Instead, he called them out publicly and exhorted our allies

If the Supreme Court strikes down the Affordable Care Act, Trump’s health care order is not enough to replace it

Courtesy of Simon F. Haeder, Pennsylvania State University

The battle over the replacement of Justice Ruth Bader Ginsburg has refocused American attention on the future of the Affordable Care Act. The Supreme Court is scheduled to hear oral arguments Nov. 10 in a case seeking to overturn the law that brought insurance coverage to millions of Americans.

Meanwhile, Trump recently released his “America-First Healthcare Plan.” In it, the president claims significant achievements. He also outlines broad principles of his vision for the future of health care in America.

Over the past three years, the Trump administration has taken a number of steps to dismantle pieces of the ACA. And his recently introduced executive order lacks a number of key details and the legal grounds for enacting much of the proposal.

The two factors leave me – a health policy and politics scholar who has closely followed the Affordable Care Act – skeptical about the emergence of a meaningful replacement to the ACA that would expand insurance access should the Supreme Court invalidate the Obama administration’s signature achievement.

Trump’s moves on health care

President Trump campaigned and entered office with the pledge to “repeal and replace” the ACA. In his own words, there would be a “really great HealthCare Plan with far lower premiums (costs) & deductibles” right after the election.

Since 2016, Congress has made little headway besides eliminating the ACA’s penalty for not carrying insurance. This is the basis for the current lawsuit to be heard before the Supreme Court in November. The argument is that because Congress did away with the penalty, the individual mandate can no longer be constitutionally justified as a tax. As a result, the entire law should fall.

While Republicans have been unable to repeal the law, the Trump administration has taken a number of executive actions to limit its reach. In combination, these efforts have contributed to bringing the uninsured rate to 14% by 2019 from a low of 11% in 2016. This leaves millions of Americans without coverage and exposed to medical bills should they fall ill.

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With few details in Trump’s executive order on health care, the plan lays out goals for improved care and lower prices but offers no legal basis for implementing reforms. Brian Blanco via Getty Images

One of the major targets of the Trump administration has been reducing enrollment through the ACA’s marketplaces. Here, the administration shortened the periods in which people are allowed to purchase insurance and drastically reduced funding for individuals who help consumers enroll in coverage as well as advertising. It also withheld subsidies to support low-income individuals with out-of-pocket costs, which also caused problems to insurers offering plans to those people.

The administration has also worked to expand alternative insurance plans like so-called short-term, limited-duration health plans and association health plans. While these plans have lower premiums, they do not carry the consumer protections of the ACA like preexisting condition coverage. They also do not pay for prescription drugs

If the Supreme Court strikes down the Affordable Care Act, Trump’s health care order is not enough to replace it

<span class="caption">The Supreme Court will face another challenge to the Affordable Care Act that is more likely to succeed with the death of Justice Ruth Bader Ginsburg.</span> <span class="attribution"><a class="link rapid-noclick-resp" href="https://newsroom.ap.org/detail/SupremeCourtHealthOverhaulLawsuit/16788a32df5e42e6b50c77aeea97f7d5/photo?Query=affordable%20care%20act&mediaType=photo&sortBy=arrivaldatetime:desc&dateRange=Anytime&totalCount=3323&currentItemNo=31" rel="nofollow noopener" target="_blank" data-ylk="slk:AP Photo/Susan Walsh">AP Photo/Susan Walsh</a></span>
The Supreme Court will face another challenge to the Affordable Care Act that is more likely to succeed with the death of Justice Ruth Bader Ginsburg. AP Photo/Susan Walsh

The battle over the replacement of Justice Ruth Bader Ginsburg has refocused American attention on the future of the Affordable Care Act. The Supreme Court is scheduled to hear oral arguments Nov. 10 in a case seeking to overturn the law that brought insurance coverage to millions of Americans.

Meanwhile, Trump recently released his “America-First Healthcare Plan.” In it, the president claims significant achievements. He also outlines broad principles of his vision for the future of health care in America.

Over the past three years, the Trump administration has taken a number of steps to dismantle pieces of the ACA. And his recently introduced executive order lacks a number of key details and the legal grounds for enacting much of the proposal.

The two factors leave me – a health policy and politics scholar who has closely followed the Affordable Care Act – skeptical about the emergence of a meaningful replacement to the ACA that would expand insurance access should the Supreme Court invalidate the Obama administration’s signature achievement.

Trump’s moves on health care

President Trump campaigned and entered office with the pledge to “repeal and replace” the ACA. In his own words, there would be a “really great HealthCare Plan with far lower premiums (costs) & deductibles” right after the election.

Since 2016, Congress has made little headway besides eliminating the ACA’s penalty for not carrying insurance. This is the basis for the current lawsuit to be heard before the Supreme Court in November. The argument is that because Congress did away with the penalty, the individual mandate can no longer be constitutionally justified as a tax. As a result, the entire law should fall.

While Republicans have been unable to repeal the law, the Trump administration has taken a number of executive actions to limit its reach. In combination, these efforts have contributed to bringing the uninsured rate to 14% by 2019 from a low of 11% in 2016. This leaves millions of Americans without coverage and exposed to medical bills should they fall ill.

Trump health care executive order event
Trump health care executive order event

One of the major targets of the Trump administration has been reducing enrollment through the ACA’s marketplaces. Here, the administration shortened the periods in which people are allowed to purchase insurance and drastically reduced funding for individuals who help consumers enroll in coverage as well as advertising. It also withheld subsidies to support low-income individuals with out-of-pocket costs, which also caused problems to insurers offering plans to those people.

The administration has also worked to expand alternative insurance plans like so-called short-term, limited-duration health plans and association health plans. While these plans have lower premiums, they do not carry the consumer protections of the ACA like preexisting condition coverage. They also do not pay for prescription drugs or hospital stays. And unlike

Oakland County Rescinds Local Emergency Order Citing State Order

OAKLAND COUNTY, MI — The Oakland County Health Division is rescinding local emergency order 2020-12, which required people in the county to wear facial coverings when outside their home.

Michigan Department of Health and Human Services Director Robert Gordon on Monday issued an order restricting gathering sizes, requiring face coverings in public spaces and places limitations on bars and other venues. Oakland County officials said the state order covers what was initially held up by the local order.

“We must remain vigilant with wearing a face covering, social distancing and other protection measures to not regress in our fight against COVID-19, Oakland County Health Officers Leigh-Anne Stafford said.

Don’t miss important updates from health and government officials on the impact of the coronavirus in Michigan. Sign up for Patch’s daily newsletters and email alerts.

Oakland County Executive David Coulter said it is the government’s job to keep residents safe, adding that is what his administration has tried to do at the local level amid the coronavirus pandemic.

“It is vital that we maintain the measures that are critical to limiting the spread of the virus and allowing businesses to stay open, schools to re-open and our hospitals to operate safely,” Coulter said. “I support the actions taken by the Governor throughout the pandemic and agree that our State and Local health departments have independent authority – and must now use it – to protect the health of all Michigan residents.”

As of Tuesday morning, more than 17,000 cases of the coronavirus had been reported in Oakland County. County health data reports that more than 1,100 people in the county have died from the virus, while over 14,000 people have recovered from it.

This article originally appeared on the Troy Patch

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COVID-19 Symptoms Often Appear in a Certain Order, Study Says

Photo credit: Joos Mind - Getty Images
Photo credit: Joos Mind – Getty Images

From Men’s Health

Researchers at the University of Southern California have found that COVID-19 symptoms often manifest in patients in a particular order. According to a scientific paper entitled ‘Modeling the Onset of COVID-19 Symptoms’, published in the Frontiers in Public Health journal, the team attempted to discern the most common order in which symptoms presented themselves. The intention was to enable healthcare professionals to more quickly distinguish cases of COVID-19 from other conditions with similar symptoms, such as flu and allergies.

What is the order of COVID-19 symptoms?

Using World Health Organization data from more than 55,000 patients in China, the research team determined that fever is most frequently the first symptom of the virus. This is followed by a cough, then aches and pains in the throat, muscles, and head, then nausea and/or vomiting. Diarrhea is the last symptom to appear.

“Our model predicts that influenza initiates with cough, whereas COVID-19 like other coronavirus-related diseases initiates with fever,” the study reads. “However, COVID-19 differs from SARS and MERS in the order of gastrointestinal symptoms. Our results support the notion that fever should be used to screen for entry into facilities as regions begin to reopen after the outbreak of Spring 2020.”

This won’t apply to everyone

While these findings may be useful in helping frontline healthcare workers distinguish new cases of coronavirus from the common cold of flu, other experts have pointed out that this order of symptoms will not be the same for each patient. Another potential flaw that has been flagged by critics of the study is the issue of recall bias; namely, patients struggling to accurately remember which of their symptoms they experienced first.

“It’s not going to be universal,” said Dr. William Schaffner, a specialist in infectious diseases at Vanderbilt University’s School of Medicine. “We know, for starters, that a number of people don’t have a fever.”

This study may provide some insight into the way in which COVID-19 symptoms present themselves in patients, but the consensus among the scientific community seems to lean towards the idea that equally close attention should be paid to other symptoms including shortness of breath, loss of taste or smell, and fatigue.

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Kemp’s Latest Order Starts At Midnight Thursday

ATLANTA, GA — Gov. Brian Kemp’s latest extension to his coronavirus executive order keeps most restrictions in place but makes two minor revisions: one for hospitality workers and another for those seeking Georgia scholarships.

One change allows restaurant and bar workers to return once they’ve been symptom-free for 24 hours following a known or suspected COVID-19 diagnosis. According to a news release from Kemp’s office, this follows guidance from the Centers for Disease Control and Prevention.

The other change allows for some SAT/ACT test score deadlines to be extended for HOPE and Zell Miller scholarships.

The changes go into effect at midnight Thursday and run through Oct. 15.

Gov. Kemp’s office announced the extended executive order on Wednesday, the same day Georgia surpassed 7,000 deaths from COVID-19, the disease caused by the new coronavirus.

GEORGIA’S CORONAVIRUS NUMBERS FOR THURSDAY, OCT. 1

Georgia Department of Public Health in Atlanta reported a total of 319,334 confirmed cases of COVID-19 at 2:50 p.m. Thursday, Oct. 1. According to the health department’s website, that includes 1,376 newly confirmed cases over the last 24 hours.

Georgia also reported 7,063 deaths so far from COVID-19, with 43 more deaths recorded in the last 24 hours. In addition, the state reported 28,668 hospitalizations — 146 more than the day before — and 5,300 admissions so far to intensive-care units.

No information is available from Georgia about how many patients have recovered.

Counties in or near metro Atlanta and other metropolitan areas continue to have the highest number of positives, with Fulton County still in the lead.

  1. Fulton County: 27,790 cases — 106 new

  2. Gwinnett County: 27,733 cases — 86 new

  3. Cobb County: 19,829 cases — 89 new

  4. DeKalb County: 18,938 cases — 79 new

  5. Hall County: 9,498 cases — 125 new

  6. Chatham County: 8,548 — 37 new

  7. Richmond County: 7,180 — 33 new

  8. Clayton County: 7,114 — 7 new

  9. Cherokee County: 6,159 — 41 new

  10. Bibb County: 6,097 — 8 new

Counties in or near metro Atlanta also continue to have the most deaths from COVID-19.

  1. Fulton County: 577 deaths — 2 new

  2. Cobb County: 427 deaths

  3. Gwinnett County: 409 deaths

  4. DeKalb County: 369 deaths — 2 new

  5. Dougherty County: 187 deaths

  6. Bibb County: 173 deaths — 2 new

  7. Muscogee County: 170 deaths

  8. Chatham County: 166 deaths — 3 new

  9. Richmond County: 164 deaths — 2 new

  10. Clayton County: 161 deaths — 1 removed

As of Thursday, Georgia has administered more than 3.2 million COVID-19 tests, with about 9 percent of those tests the less reliable ones used to detect antibodies.

For the more reliable test for the virus itself, 10.1 percent of tests came back positive. For the less reliable test for antibodies, 8.4 percent came back positive. The overall positive rate was about 10 percent.

As more Georgians were tested over the last month, the percentage of positive tests inched upward from about 8 percent to more than 10 percent. However, over the last few weeks, the percentage of positives has stabilized at

American Medical Association petitions Supreme Court to review Title X ‘gag order’

Oct. 1 (UPI) — The American Medical Association led a petition to the U.S. Supreme Court on Thursday to review a Trump administration revised rule banning federally funded family planning clinics from referring women for abortions.

The petition, filed alongside the American Civil Liberties Union, Planned Parenthood and the National Family Planning and Reproductive Health Association, calls on the court to weigh conflicting decisions in a pair of appeals courts regarding the so-called “gag rule” earlier this year.

Under the revised rule issued by the Department of Health and Human Services in 2019, the government said it would require “clear financial and physical separation” between Title X-compliant facilities and those that provide abortions or abortion referrals.

“The AMA strongly believes that our nation’s highest court must step in to remove government overreach and interference in the patient-physician relationship. Restricting the information that physicians can provide to their Title X patients blocks honest, informed conversations about health care options — an unconscionable violation that is essentially a gag rule,” AMA President Susan Bailey said in a statement.

In February, the 9th U.S. Circuit Court of Appeals upheld the rule, stating that it allows family clinics to mention abortion, but not to refer or encourage it, and that it was a “reasonable interpretation” of federal law and was not “arbitrary and capricious,” as challengers including Planned Parenthood had argued.

However, the 4th U.S. Circuit Court of Appeals blocked enforcement of the federal rule in Maryland earlier this month, saying the Trump administration’s rule revision “failed to recognize and address the ethical concerns of literally every major medical organization in the country.”

“The petitioners argue that until the Ninth CIrcuit’s erroneous decision is corrected, the administration’s gag rule is harming patient care and causing physicians and other health care professionals to violate ethical obligations by preventing Title X clinics from providing full information to patients about all of their reproductive care options,” AMA said.

The petition also comes as the Senate prepares to confirm President Donald Trump’s nomination to the Supreme Court, Amy Coney Barrett, shifting the court’s makeup to a 6-3 conservative majority following the death of Justice Ruth Bader Ginsburg.

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ACGME Issues Statement on the Executive Order on Race and Sex Stereotyping

ACGME Issues Statement on the Executive Order on Race and Sex Stereotyping

PR Newswire

CHICAGO, Sept. 30, 2020

CHICAGO, Sept. 30, 2020 /PRNewswire/ — The ACGME today issued a statement on the Presidential Executive Order on Combating Race and Sex Stereotyping. The Order, issued September 22, 2020 seemingly promotes training of employees to create an inclusive environment by avoiding race and sex stereotyping; however, that intent is subverted by defining divisive concepts in a way that turns mechanisms intended to protect into weapons of divisiveness and exclusion. The Executive Order is inconsistent with work done over the past 50 years to advance civil rights of minoritized and thereby marginalized communities in the United States and, through its mandates, risks further division and fostering a culture of enmity. This approach works against the ACGME’s mission to improve both health and health care for patients and communities and ultimately results in worsening health outcomes for those we are dedicated to serve.

(PRNewsfoto/ACGME)
(PRNewsfoto/ACGME)

The ACGME has sought to advance the work of diversity, equity, and inclusion and the elimination of health disparities through its programs, policies, and requirements. The goal of the ACGME is to foster a professional, equitable, respectful, and civil environment that is free from discrimination, sexual and other forms of harassment, mistreatment, abuse, or coercion of students, residents, and faculty and staff members, for the betterment of patient care through its accreditation processes.

Prohibiting institutions from providing certain types of education and training that the Executive Order deems to be promoting racial and sexual stereotypes would have devastating consequences on educating residents and fellows toward the goal of eliminating disparities in health outcomes and achieving equity within the health care profession. The Executive Order would similarly preclude residency and fellowship programs from developing curricula that reflect the needs of their communities, particularly in those of color and women, and promote inclusivity.

Read the full ACGME statement.

The ACGME is a private, non-profit, professional organization responsible for the accreditation of over 12,000 residency and fellowship programs and the approximately 865 institutions that sponsor these programs in the United States. Residency and fellowship programs educate approximately 145,000 resident and fellow physicians in 157 specialties and subspecialties. The ACGME’s mission is to improve health care and population health by assessing and advancing the quality of resident physicians’ education through accreditation.

Cision
Cision

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SOURCE Accreditation Council for Graduate Medical Education

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Alabama COVID mask order extended to Nov. 8

Update:

Alabama Gov. Kay Ivey is extending the order requiring facial coverings in public places until Nov. 8.

The governor announced the extension at a press conference today in Montgomery.

Ivey and State Health Officer Dr. Scott Harris issued the mask order effective July 16 as the state saw increasing numbers of coronavirus cases. The order was extended twice, most recently on Aug. 27, and was set to expire Friday. It is now extended through Sunday, Nov. 8.

Ivey mentioned the national election as one reason for extending the order past Nov. 3.

“I want everyone to (vote) and to be able to do it safely,” she said, adding that Alabama’s coronavirus case numbers saw consistent decline after the mask order was instituted.

The mask order requires people to wear coverings over their nostrils and mouth when within 6 feet of people from another household in indoor spaces open to the public, a vehicle operated by a transportation service, or an outdoor space where 10 or more people are gathered. Masks are not required for children 6 and younger, people with a medical disability that prevents wearing a mask, people voting, or those “actively providing or obtaining access to religious worship.”

Ivey also announced changed in policies that limited visitors to hospitals and long-care term facilities, including nursing homes.

Effective Oct. 2, nursing homes and other long-term care facilities may allow each patient or resident to be accompanied by one caregiver or visitor at a time.

Alabama currently has 154,701 COVID-19 cases, 137,564 confirmed and 17,137 probable.

Earlier:

Gov. Kay Ivey is planning a press conference today to provide an update on the state’s battle against coronavirus.

Ivey will be joined by State Health Officer Dr. Scott Harris for the 11 a.m. press conference. The press conference is being live streamed, below. The announcement comes as Alabama’s mandatory facial covering order is set to expire on Friday. Ivey has indicated she plans on extending the order.

“Yes it has, and I know a lot of folks grumbled about it and still are,” Ivey said in an interview last week when asked about people being upset over the mask requirement. “But look. It’s working. Our students and teachers are back in school. Our businesses are open. We’ve got one of the lowest unemployment rates in the country. And y’all it’s working, and so we’ve just got to keep on being strong.”

Alabama has seen a decrease in new daily cases, hospitalizations and the rate of positive tests since the order was put in place in mid-July.