Author: Sally Pipes

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June 13, 2022 Innovation, Issues

Earlier this month, a group of 17 House Republicans released several ideas for modernizing the healthcare system, improving access to care, and lowering costs. One of the proposals — safeguarding expanded access to telehealth — could help achieve all three of those goals. Lawmakers would do well to relax permanently the telehealth restrictions that were temporarily waived during the pandemic. Those waivers have eliminated onerous barriers to virtual care. For example, Medicare beneficiaries no longer have to travel to a designated healthcare facility just to...

May 23, 2022 Issues, Price and Costs

Hospitals are shoring up their balance sheets on the backs of cancer patients, according to a new study published in JAMA Internal Medicine. Researchers looked at 25 of the top cancer medications distributed at 61 cancer treatment centers across the country over the course of six months. They found that the clinics charged private insurers anywhere from 118% to 634% above what it cost them to acquire the drug. It shouldn’t take a team of medical researchers to find out how much...

May 23, 2022 Coronavirus, Issues

Did the Biden administration participate in closed-door meetings with foreign officials to deal away some of America's most valuable intellectual property? It appears so. According to a letter sent by six senators to U.S. Trade Ambassador Katherine Tai on May 10, the Biden administration negotiated a proposal with the European Union, India and South Africa to suspend IP protections for COVID-19 vaccines without consulting Congress like it's supposed to. The senators condemn her for negotiating behind their backs. They're right to be incensed. Ambassador Tai's...

May 19, 2022 Issues, Price and Costs

More than eight in 10 hospitals are flouting a federal rule requiring them to publish their prices, according to a new report. That rule has been in force for over a year now. It’s long past time for hospitals to comply. The lack of transparency in the health care market is costing patients billions of dollars. Since Jan. 1, 2021, the Centers for Medicare and Medicaid Services have mandated that hospitals share how much they charge for at least 300 different “shoppable...

May 16, 2022 Coronavirus, Issues

Earlier this month, members of the World Trade Organization met to debate a proposal to waive intellectual property protections on COVID-19 vaccines. Supporters of the plan claim it's necessary to boost the supply of vaccines in developing countries and, in turn, vaccinate the world. But insufficient supply isn't holding up the global vaccination campaign. In fact, many developing countries have a surplus of vaccines. Consider South Africa, which is preparing to destroy its stockpile of expiring doses and terminate its mass vaccination program. Or take the Serum Institute of India, which shut...

May 9, 2022 Industry Trends, Issues

Nearly three in four doctors now work for a hospital, health system, or corporate entity, according to new data from Avalere. That's a 7% increase from a year ago—and an almost 20% jump since 2019. In other words, the independent physician is becoming an endangered species. The corporatization of medicine is sapping competition in the healthcare marketplace. And that's leading to higher prices for patients—and lower pay for providers. The pandemic accelerated the longstanding trend of greater consolidation in medicine. Large health systems acquired more than 36,000 physician...

April 25, 2022 Innovation, Issues

Last week, both New York and Kansas granted nurse practitioners the freedom to practice independently, without the supervision of a physician. The Empire State and the Sunflower State are now the 25th and 26th states to roll back "scope-of-practice" restrictions on NPs. This trend is worth celebrating. The shortage of primary care doctors in the United States is already at crisis levels, particularly in rural areas. Empowering NPs, physician assistants, and pharmacists to treat people independently could expand the supply of health care virtually overnight — at...

April 24, 2022 Coronavirus, Issues

The Centers for Disease Control and Prevention just recommended that seniors get a second COVID-19 booster shot. But there are plenty of people over the age of 65 — one-third, according to the latest data — who have not yet gotten their first booster. Perhaps that's because it took until the omicron variant emerged last fall for the CDC to get behind booster shots for all adults. Or maybe it's because public health officials have been peddling confusing and contradictory messaging...

April 11, 2022 Issues, Policy Proposals

In the last three months, state legislators have introduced more than 70 bills that would modify “scope-of-practice” laws—regulations that set limits on the care physician assistants, nurse practitioners, and other qualified professionals can provide to patients. It’s no wonder why. Many state lawmakers understood the benefits of temporarily relaxing these restrictions as COVID-19 strained the healthcare system. Freeing up physician assistants and nurse practitioners to provide more services made it easier for patients to access care during the pandemic. And it gave physicians more time...

April 10, 2022 Innovation, Issues

Nearly 84 million Americans live in “primary-care health professional shortage areas” — places that don’t have enough primary-care physicians to meet patient need. That includes over 7.8 million patients living here in California. Even in the face of this shortage, only 25 states grant the right of “full practice” to nurse practitioners, or NPs, who could immediately address this problem. In the remaining states, “scope-of-practice” laws prevent NPs from evaluating patients, ordering and interpreting diagnostic tests and managing treatments. States with such...

March 24, 2022 Policy Proposals

Last week, the U.S. Senate Finance Committee held a hearing, "Prescription Drug Price Inflation: An Urgent Need to Lower Drug Prices in Medicare." It's rare to see so many falsehoods in so few words. The idea that drug-price inflation is especially bad or that it poses some sort of threat to our health system is at best confused — and at worst dishonest. The hearing was largely intended to give Senate Democrats a forum to grandstand with calls for price controls on prescription drugs. That such...

March 18, 2022 Coronavirus, Issues

The federal public health emergency prompted by the COVID-19 pandemic is set to expire in mid-April. Some states have already let their own emergency declarations lapse. It's about time. COVID-19 is no longer the crisis it was back in 2020. Living in a permanent state of emergency is unsustainable. But that doesn't mean we should go back to the pre-pandemic status quo. Many of the reforms enacted during the state of emergency — especially those that liberalized the healthcare labor market — deserve to...

March 8, 2022 Issues, Price and Costs

Late last month, the Federal Trade Commission announced it would seek public comments on the ways pharmacy benefit managers distort the prices of prescription drugs. PBMs deserve the scrutiny, as they're to blame for much of the rise in prescription drug costs. Insurers hire PBMs to negotiate drug prices with manufacturers and determine which medicines end up on a plan's formulary. To guarantee their drug has a spot on the list, pharmaceutical firms routinely offer these gatekeepers deep discounts on medications. Savings on...

February 28, 2022 Blog

To say that Americans are anxiously awaiting the end of the COVID-19 pandemic would be an understatement. But for patients who have enjoyed the ease of attending doctor's appointments virtually, a return to the way things were pre-pandemic might be bittersweet. That's because onerous restrictions on telemedicine, which lawmakers relaxed when COVID-19 hit, could be reinstated once officials declare the public health emergency over. Fortunately, Congress may not let that happen. Several pieces of legislation are pending that would permanently loosen restrictions on telehealth...

February 22, 2022 Blog, Policy Proposals

It’s budget season in Sacramento. Governor Gavin Newsom’s spending proposal is the largest in the Golden State’s history. There’s no shortage of expensive and misguided policies in his budget. Chief among them is his push to expand Medi-Cal, the state’s Medicaid program, to cover all undocumented immigrants. Doing so would make Medi-Cal worse for its legacy beneficiaries and nudge the state closer to the government-run, single-payer system that is the long-term goal of Newsom and his progressive allies. The governor proposes spending...

February 10, 2022 Issues, Price and Costs

Last week, President Joe Biden announced the re-launch of his "Cancer Moonshot" initiative, a project he created in 2016 while serving as Vice President in the Obama administration. The ambitious effort aims to "end cancer as we know it today" by, among other things, halving the death rate from the disease by 2047. That goal is laudable. It will also be impossible to achieve if the president continues to make prescription drug price controls a top administration priority. The only way to spur the...

February 9, 2022 Blog

Imagine a visit to the local farmer’s market. When you’re about to pay the farmer for some fruit, a man in a suit and sunglasses interrupts the exchange and offers to negotiate a discount with the farmer. Cool, right? Not so fast. The man in the suit didn’t tell you who the discount was for. He gets the fruit for less, to be sure, but sells it on to you for the original price. He keeps the difference between his purchase price...

February 7, 2022 Blog, Industry Trends

Upon facing declining revenue prospects, physicians are shuttering their private, independent practices to partner up with larger hospitals that have near-monopolies on care in the regions they serve. This trend is depressing news for most Americans. Further concentration of market power in these health systems ultimately results in less personalized care and higher overall costs for patients. The effect of the decrease in independent medical practice Medicare physician’s pay has increased by 11% over the past 20 years. The overhead costs of operating an independent medical...

January 10, 2022 Blog

On Jan. 1, the Centers for Medicare and Medicaid Services increased fines for hospitals that have not complied with a rule enacted at the beginning of last year mandating they be transparent about their prices. As of December, more than half of hospitals were still flouting the rule. Patients deserve better. Transparent prices can help them make more informed decisions about their care — and drive down health costs. The 2021 CMS rule ordered hospitals to reveal their prices for 300 "shoppable services," ranging from...

January 3, 2022 Blog, Policy Proposals

Imagine you’re walking the aisles of your local supermarket, on the hunt for your favorite cereal. You usually purchase the generic version, since it tastes nearly the same and is much cheaper than the name-brand version. But today, you notice that the price of the name-brand cereal is just a few cents more expensive than the generic version. You remember that Congress just passed a law capping the price of name-brand cereal. Now, with the prices almost equal, you decide to purchase...