Headlines: March 1, 2011
by Meg Larkin
First, in policy news, State Governors are asking for more flexibility in complying with Federal Medicaid requirements. While both Democratic and Republican governors agreed that there should be more freedom for States to change eligibility rules and Medicaid program requirements, the meeting of the National Governors Association revealed sharp differences in how much flexibility the States should be given. Leaders of the NGA have formed a bipartisan committee to determine what kinds of changes should be requested of Federal health officials by the states. However, it is unclear whether a consensus will be able to be reached given sharp partisan differences over the shape of the Medicaid program and its role in the national health reform bill passed last year. According to the Washington Post, “The law will, starting in 2014, lead to an expansion of Medicaid to an anticipated 20 million people with somewhat higher incomes, with the federal government paying for the new recipients for several years.” The Federal law also limits the ability of States to restrict who can join their Medicaid programs, which is a particularly contentious issue this year given the fact that Medicaid is a large component of many state budgets.
In other policy news, the United Network for Organ Sharing has proposed new kidney transplant guidelines that would favor younger recipients. The new policy would replace the current one, which allocates available organs on a first-come, first-served basis. UNOS hopes that the new scheme will better match the life expectancy for the transplant recipient with the functional life of the donated kidney. According to the New York Times, “Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies. The remaining 80 percent of patients would be put into a pool from which [UNOS] would try to ensure that the age difference between kidney donors and recipients is no more than 15 years.” It remains to be seen whether the latest effort to reform the organ donation system will be accepted by both patients and lawmakers.
In public health news, researchers have found that air pollution significantly contributes to heart attack risk. A study published last week in The Lancet found that air pollution accounts for almost 12 percent of heart attacks worldwide. While the additional risk posed to each individual by air pollution was small, the community risk was substantial. According to the Boston Globe, “The Lancet study found that traffic exposure accounted for the highest percentage of heart attacks — more than 7 percent — followed by extreme physical exertion, excess alcohol use, coffee, and a depressed mood.” Dr. Andrea Baccarelli, of the Harvard School of Public Health suggested that air pollution may contribute to heart attack risk by promoting inflammation or increasing blood clotting, and advised at risk individuals, including the obese and the elderly, to take precautions to minimize the likelihood of a heart attack.
Finally, in business news, Medtronic has ended its contract with the Group Purchasing Organization (GPO) Novation, LLC. Medtronic terminated five contracts with Novation, citing expected cost savings as its reason. The move has been characterized as “bold” in a market where providers frequently band together into GPOs in order to attempt to obtain greater leverage in negotiating prices with device manufacturers. According to the Wall St. Journal, “The contract cancellations highlight a long-running dispute between GPOs and the devices industry about whether GPOs add value or are middlemen that add costs, particularly fees that device makers pay GPOs to reach customers. In this case, Medtronic said it believes the move will ultimately take costs out of the health-care system.” It is unclear at this point whether the termination of the Novation contracts will lead to similar action by other device makers or by Medtronic against other GPOs.
Meg Larkin is a third year law student at Boston University. Please feel free to email her with any questions, comments, suggestions or concerns.