Genome editing and the AMA “Code of Medical Ethics”

An international team of researchers recently published, in the journal Nature, their study using genome editing to correct a heterozygous mutation in human preimplantation embryos using a technique called CRISPR-Cas9. This bench research, while far from bedside use, raises questions about the medical ethics of what could be considered “genetic engineering.” The AMA “Code of Medical Ethics” has guidance for physicians conducting research in this area.

My latest at AMA Wire. Read the whole shebang.

Senate should reject ACA repeal, replace bills

Ahead of a planned vote in the Senate on Tuesday, AMA Executive Vice President and CEO James L. Madara, MD, made it clear that neither of the bills senators may consider contain the necessary elements to earn the support of America’s physicians.

“We urge the Senate to reject efforts to repeal or replace the Affordable Care Act,” Dr. Madara wrote in a letter to Senate leaders, asking that they “work instead toward improvements that will increase access to affordable, quality health care coverage for all Americans.” He noted further that “recent revisions do not correct core elements that will lead to millions of Americans losing health insurance coverage with a resulting decline in both health status and outcomes.”

My latest at AMA Wire. Read the whole shebang.

Jeff Bezos’ charitable drive and the “Code of Medical Ethics”

When billionaire Jeff Bezos—the founder of Amazon.com Inc.—recently posted to Twitter seeking suggestions on how to make the best charitable use of his vast holdings, he was met with a wealth of responses almost as impressive as his estimated $80 billion fortune. Nearly 50,000 responses have poured in so far.

For physicians seeking to do good through charity, the AMA “Code of Medical Ethics” has guidance for them to keep in mind when soliciting contributions from their patients.

My latest at AMA Wire. Read the whole shebang.

9 battleground states show health reform’s high stakes

Lora Wilkerson does not have to look far to see the potential effect of the Senate’s ongoing efforts to overhaul the nation’s health system. The Charleston, West Virginia, woman needs only peer into the bright eyes of her 3-year-old granddaughter, Ellie.

The girl was diagnosed at 18 months old with rhabdomyosarcoma, a rare cancer that mostly affects children. Wilkerson said Ellie is still alive because of the Medicaid coverage and patient protections available under the current health care law, provisions that the latest version of the Senate’s Better Care Reconciliation Act of 2017 (BCRA) would overturn.

“Ellie would have died,” Wilkerson said at a press event held Thursday in Charleston, West Virginia. “Ellie survives, but continues to have nerve damage in her hands and feet.” The girl receives physical, occupational and speech therapy on a weekly basis.

Little Ellie is just one of more than 180,000 West Virginians now covered by Medicaid expansion under the Affordable Care Act (ACA). Their coverage is threatened by the BCRA provision that would phase out the enhanced rate at which the federal government funds Medicaid expansion between 2021 and 2023. Expanded Medicaid makes coverage available to people who earn too much to qualify for the traditional Medicaid program but earn less than 138 percent of the federal poverty line (that is $28,180 for a family of three in West Virginia).

My latest at AMA Wire. Read the whole shebang.

Revised Senate bill fails to address core AMA concerns

A revised draft of the Senate’s Better Care Reconciliation Act of 2017 (BCRA) was released Thursday, and new spending and coverage estimates from the Congressional Budget Office are expected to be released Monday.

In a statement, AMA President David O. Barbe, MD, MHA, said “the revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage.” Added funding to address the opioid epidemic “is a positive step,” he said, but “those suffering from substance-use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion.”

My latest at AMA Wire. Read the whole shebang.

Recently …

It has been a hectic time, and so I have let slip on my usual practice of blogging links to my new bylined stories at AMA Wire. Here is a round-up of what was posted in June:

More to come, as always.

Individual market endangered by uncertainty over subsidies

Health insurers in most states have until June 21 or sooner to decide whether they will participate in the federally facilitated marketplace exchanges in 2018. In several states, that deadline has already passed without any certainty regarding the future of vital federal funding that helps millions of Americans shoulder the burden of deductibles and co-pays.

Billions of dollars in cost-sharing reductions (CSR) that go to an estimated 7 million patients could be affected unless Congress moves quickly to eliminate “the single most destabilizing factor causing double-digit premium increases for 2018,” according to a group of organizations representing America’s physicians, hospitals, businesses, employers and health insurers.

The lede. The whole shebang.

Anthem-Cigna merger threatens innovation, appeals court finds

The U.S. Court of Appeals for the District of Columbia has upheld a lower-court ruling blocking a proposed $54-billion mega-merger between health insurance giants Anthem and Cigna. The appeals court agreed with the trial court’s ruling that this merger would harm patients because it would likely stifle competition and choice, eliminate the existing head-to-head competition between the two insurers, reduce the number of national carriers from four to three, raise premiums, and diminish quality and innovation.

My lede. The whole shebang.

Flawed AHCA passes House despite outcry from physicians, patients

The U.S. House of Representatives today passed an amended version of the American Health Care Act without an official estimate of the bill’s costs or its impact on the insurance coverage that more than 20 million people have gained in recent years. The 217–213 vote came after a deal that was struck early this week to capture wavering Congressmen added $8 billion in funding over five years to provide assistance to individuals who may be subject to increased premiums because of a pre-existing condition.

My latest. The whole shebang.

Critical treatment gap seen in effort to stem opioid epidemic

Confronted by the gravity of an opioid epidemic that contributes to the deaths of 91 Americans daily, the nation’s physicians are making much greater use of state prescription drug-monitoring programs, reducing opioid prescriptions, and increasing prescriptions for the life-saving antidote naloxone. Tens of thousands of physicians nationwide are now certified to provide office-based medication-assisted treatment for opioid-use disorders, yet there remains a treatment gap that leaves too many patients who want help unable to get it.

My lede. The whole shebang.

New changes don’t fix AHCA shortcomings, threaten key protections

The most recent effort to broaden support for the American Health Care Act, which comes in the form of an amendment proposed by New Jersey Rep. Tom MacArthur, does not address the most serious flaws in the bill and would also undermine critical health insurance consumer protections. For these reasons, the AMA “remains opposed to passage of this legislation,” the Association’s CEO and Executive Vice President, James L. Madara, MD, said today in a letter to House Republican and Democratic leaders.

My lede. The whole shebang.