Friday News Dump: Wonkbites

by Karan Chhabra

Happy Friday!

  1. Thanks Uncle Sam! A provision of Obamacare requires members of Congress and their staffs to enroll in federal health exchanges to get their health insurance, but it’d been unclear if they’d have to pay for plans themselves or if they’d be eligible for government subsidies. No longer—the feds have announced an exception, stating that they’re allowed to get employer contributions to their plans. Since the employer (the federal government) is the same piggy bank that’d be giving out subsidies, I can’t really tell the difference (apart from income cutoffs, of course).
  2. Double-dipping? The third report by the Government Accountability Office on physician self-referral (i.e., sending patients to facilities where doctors have a financial stake) provides yet more evidence of its perverse economics. This time it’s about IMRT (an advanced radiotherapy technique) for prostate cancer. While doctors without financial interests in the procedure actually performed less of it in recent years, doctors with financial interests performed substantially more. I’m not one to decry more expensive care if it’s more effective than prior options, but the decline of IMRT among non-self-referrers in this case tells all. The American Society for Radiation Oncology is in fact supporting legislation to close the loophole on radiotherapy.
  3. Can I have your numbers? Electronic health tracking is evolving from a novelty to a legitimate source of health data, with Partners HealthCare’s move to let patients upload personal measurements directly into the system’s electronic health record. Though the article doesn’t delve into it, it’s worth noting that this sort of telemedicine has been hampered by a lack of reimbursement for interpreting the reams of data it generates. But as a successful (so far) Pioneer ACO, Partners may be the exception to that rule, since the Shared Savings Program is supposed to incentivize robust at-home prevention.
  4. This little piggie went to the bathroom Pumping livestock full of antibiotics is probably bad. Urinary tract infections (UTIs) are definitely bad. UTIs with resistant bugs are ugly. A researcher at George Washington University thinks they might be related, based on past cases of resistant bugs in livestock spreading to humans. Perhaps the most fascinating part of this connection is that even if the rate of meat-to-human spread is very low, UTIs are so common that this research seems to have a good shot at picking something up. This phenomenon is not exclusive to UTIs—we could be getting other types of infections from meat too—but UTIs are the subject of this research because they’re so common and easy to study.
  5. (Med)Schoolhouse Rock… …er, rap. As many of us get back to school for the fall, check out this video by med students at the University of Maryland. Actually, check out all their videos. Preferably not in class.

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Karan is a student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.

Follow him on Twitter @KRChhabra or subscribe to the blog.

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