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  • Lawmakers return to Raleigh with health policy wish lists

    Lawmakers return to Raleigh with health policy wish lists

    By Rose Hoban

    Amid the smiles, photographs, receptions and family members crowding the legislative building in Raleigh on Wednesday, lawmakers involved in the making of health care policy said they were readying their lists of priorities for the legislative biennium that began this week.

    The topmost issue on both sides of the aisle? The seemingly perennial issue of the past decade: whether North Carolina would ever join the majority of states and expand the Medicaid program to provide coverage for more than half a  million low income workers. 

    Senate leader Phil Berger (R-Eden) highlighted Medicaid expansion in an address after being elected as leader for the seventh time since 2011, saying it was one of the issues the legislature “must tackle.”

    “I support expanding Medicaid in North Carolina,” he told a capacity crowd in the Senate chamber.

    Berger spent a decade opposed to the measure, but he changed his stance in 2022. He shepherded his bill through the Senate last year, only to have it hit a dead end in the House of Representatives. 

    “We must recognize that it is not a silver bullet,” he continued. “North Carolinians are saddled with some of the highest health care costs in the country. We need to eliminate regulatory red tape and other bureaucratic barriers that impede access to care and unnecessarily increase medical costs.”

    Berger’s 2022 Medicaid expansion bill also included provisions that would 1) overhaul rules around hospital competition in North Carolina and 2) give advanced practice nurses more latitude to work independently of physicians.

    In a media gathering after the swearing-in ceremony, Berger reiterated his position. 

    “In order to get … the broad bipartisan support that we had for the Medicaid expansion bill that we had before, there have got to be some measures that address the supply side,” he told reporters. “If you’re going to give 500,000, 600,000 people an insurance card that says they have a right to have their medical care paid for, then we need to do something to hopefully open up more access to more primary care providers, more facilities where they can be treated.” 

    Old differences could reemerge, though, as members of the House and Tim Moore (R-Kings Mountain), the re-elected House speaker, talked about a “clean” Medicaid expansion bill that does not include mention of nurses or hospitals. 

    Rep. Donny Lambeth (R–Winston-Salem) acknowledged that some of Berger’s concerns will need to be addressed before the two chambers come to any agreement. House committee assignments have not been announced, but Lambeth has been a key player from the House in committees with members from both legislative chambers tackling health care issues.

    “I think we have to do the certificate of need reform,” he said, referring to the laws on hospital competition. “So my second bill will be a certificate of need bill that I’ve been working on with the industry. And I think we’ve got to get that one done in order to do expansion.

    “That was kind of the Senate feedback.”

    Mental health on many minds

    Republicans and Democrats noted the importance of addressing mental health needs across the state. 

    Lambeth said he recently attended a forum on mental health best practices with representatives Carla Cunningham (D-Charlotte), a nurse, and Wayne Sasser (R-Albemarle), a pharmacist. Lambeth said they were interested in implementing some things other states are doing.

    “I think we need more psychologists in schools, because I think we need to reach out to these kids and listen to these kids in a more proactive way,” Lambeth said. “We’ve talked about having more guidance counselors and psychologists in schools, and we’ve done a little bit of that. But I do think we need more.”

    Lambeth also would like the legislature to consider funding mental health crisis centers.

    “We’ve seen suicide rates grow exponentially in the last several years, and COVID did not help anything,” said Sen. Sydney Batch (D-Apex), who is a social worker and family law attorney. She’s been appointed to the Senate Health Care Committee. 

    Senate leader Phil Berger (R-Eden) said he’s planning on pushing for Medicaid expansion again this year, but continues to insist the measure be combined with “supply side” measures to loosen restrictions on advanced practice nurses and increase hospital competition. Credit: Rose Hoban

    “Children are sitting in hospitals for way too long not having appropriate placements,” Batch said. “We have a mental health crisis in the foster care system. And then also just within our schools every single day, we need to actually have mental health professionals seeing the children, identifying them and addressing their needs.”

    Batch filed a bill in the last session that would have given mental health providers treatment spaces in schools, prioritizing children who lack health insurance or a regular care provider.

    “My real concern is that… everybody’s talking mental health, but we just say the same redundant words over and over again,” said Rep. Donna White (R-Clayton), a nurse who has played a key role in shaping legislative health care policies. “We just don’t try to find out what’s causing the mental health issues in our young people.”

    Lists are long

    Rep. Hugh Blackwell (R-Valdese) said that during the swearing-in festivities he started jotting down on a scrap of paper a list of priorities that he wants to work on in the coming biennium. House committee assignments haven’t been announced, but Blackwell said he expects to again be appointed to health care committees. 

    Rep. Hugh Blackwell (R-Valdese) shows off the list of legislative priorities he jotted down during the swearing-in ceremonies at the legislative building on Wednesday. Credit: Rose Hoban

    At the top of that list were mental health issues, but he ticked off a number of other topics, including getting patient information at state-operated health care facilities onto electronic health records.

    Another one of his concerns was about staffing in health care. 

    “I think, at Broughton Hospital, for example… that we’ve got maybe over 100 beds that are not being used that could be, because we haven’t got the staffing for it,” Blackwell said. 

    Last year, leaders at the Department of Health and Human Services signaled to lawmakers that they faced significant staffing shortages across all of their divisions, including in state-operated hospitals. 

    Sen. Jim Perry (R-Kinston) also had health care workforce issues on his mind, and he mentioned the shortage of child care workers. 

    “The availability of workforce, qualified individuals to work in those facilities, [of] affordability — wages have just gone through the roof,” Perry said. “We’ve got to try to figure some things out… have a healthy workforce. Mom and Dad got to have someone taking care of the kids so they can go to work.”

    Other health care topics that topped lawmakers’ lists included:

    • Addressing mental health issues faced by foster children, a topic raised by Batch and Sen. Mike Woodard (D-Durham). Woodard said he’s concerned about how kids in foster care have difficulty accessing health care if they move from one region of the state to another — something that Batch tried to address in a bill she championed last year.
    • White said she’s ready to take another run at getting her chamber behind the SAVE Act, which would give more independence to advanced practice nurses. Last year, the bill had 75 co-sponsors in the House of Representatives, but it was never brought to the floor for a vote. “I believe that I could get that many [sponsors] this time,” White said. “I’ve not met all the freshmen and I don’t know what their views are about a lot of things, but it’s certainly a whole new group to consult with, and I’ll be doing that very shortly.”
    • Lambeth said he’d like to address some of the issues around getting other health care workers into the educational pipeline. “One is physician manpower in rural areas. Whether we do loan forgiveness or other programs, we’ve got to do something to address the shortage in some of the rural areas,” Lambeth added. “We’ve met with some community colleges. What they’re telling me is ‘We’ve got the space, we’ve got qualified applicants, we don’t have instructors, we don’t have enough money.’”
    • Abortion was mentioned by multiple lawmakers on both sides of the aisle. Woodard noted that Senate Democrats plan to file a bill codifying the constitutional protections for abortion overturned in last summer’s Supreme Court Dobbs decision. Republicans, for their part, talked about a range of possibilities for a possible bill limiting the procedure. “We’ll see what, if anything, is something that can be passed by the General Assembly and withstand a possible veto,” Berger said. 

    Wednesday was just the start of a process that will play out over the coming months and perhaps years. Many of the initiatives would take state funding, which will pit interest groups against each other — and lawmakers know how frustrating that can be. 

    “Everything requires money, and that’s why you can never do everything at once,” Perry said. “It’s not that something is or is not important, it’s just that resources are scarce.”

  • Wednesday, January 11, 2023 | Kaiser Health News

    Wednesday, January 11, 2023 | Kaiser Health News

    Following Additional Infant Fatalities, Fisher-Price tag Recalls Rock ‘n Play Sleepers, Again

    Considering that the initial recall in April 2019, about 70 more fatalities have been described, bringing the complete to 100. According to the Customer Product Basic safety Fee, eight of people fatalities took place right after the 1st remember. Extra public well being news covers opioid overdoses, gasoline stoves, social media’s impact on teen mental overall health, and much more.


    TheStreet:
    Fisher-Selling price Recollects 4.7 Million Baby Products and solutions Right after A number of Deaths

    Fisher-Rate announces of the recall of virtually 5 million of its Rock ‘n Participate in Sleepers which have been linked to about 100 deaths. Fisher-Value introduced yet another recall of its Rock ‘n Engage in Sleeper that has linked a overall of 100 fatalities, federal safety officers stated. The sleeper was 1st recalled in April 2019, the U.S. Consumer Solution Safety Commission reported in a Jan. 9 filing. The remember handles about 4.7 million products. (Lenihan, 1/10)


    NPR:
    Fisher-Selling price Re-Announces Recall Of Rock ‘n Participate in Sleeper Linked To Child Deaths

    Fisher-Price tag is reminding buyers not to use the firm’s when-preferred Rock ‘n Engage in sleepers, which ended up recalled in 2019 but have continued to guide to toddler deaths. On Monday, in conjunction with the U.S. Client Item Safety Commission, the little one item large re-declared the remember of 4.7 million of its Rock ‘n Enjoy sleepers. The Atlanta-based business Young ones2 also re-declared the 2019 recall of 694,000 of its Rocking Sleepers. (Hernandez, 1/10)

    In information about drug use, overdoses —


    Reuters:
    U.S. Food and drug administration Panel To Evaluation Emergent’s OTC Opioid Overdose Drug

    The U.S. health regulator claimed on Tuesday its advisory panel will meet on Feb. 15 to critique Emergent Biosolutions Inc’s (EBS.N) over-the-counter (OTC) nasal spray to deal with suspected opioid overdoses. Emergent is looking for the Meals and Drug Administration’s (Fda)acceptance for the prescription-absolutely free sale of Narcan, its nasal spray type of the drug naloxone. Narcan is previously cleared for the remedy of opioid overdose in the state. (1/10)


    Axios:
    Surging Opioid Overdoses Prompt Much more Americans To Carry Narcan Spray

    The worsening opioid epidemic is prompting additional folks to carry a nasal spray that reverses overdoses and turn out to be de facto very first responders in existence-or-death circumstances. Naloxone functions 5 times faster than the somewhere around 10-moment typical arrival time for EMS technicians, in accordance to a federal overdose tracker released previous month. (Moreno, 1/11)

    In other community well being information —

    On mental wellbeing matters —


    Axios:
    Social Media’s Results On Teenager Psychological Health Arrives Into Target

    Specialists are more and more warning of a relationship concerning hefty social media use and psychological wellness troubles in youngsters — a incredibly hot matter now driving significant lawsuits in opposition to tech giants. Some experts who research technology’s outcomes on youngsters say the negatives considerably outweigh any positives. (Kingson, 1/11)


    The New York Occasions:
    Prince Harry Claimed Psychedelics Helped His Grief. Here’s What To Know

    Prince Harry and Meghan Markle have been remarkably transparent about their psychological struggles. In a documentary about psychological wellbeing that he filmed with Oprah Winfrey in 2021, Harry integrated a online video of himself undergoing E.M.D.R., or eye movement desensitization and reprocessing treatment, which will help individuals with write-up-traumatic tension condition cope with triggering reminiscences. Ms. Markle has spoken candidly about dealing with depression and suicidal views. (Smith, 1/10)

  • How might traveling benefit health?

    How might traveling benefit health?

    happy older person backpacking on hiking trailShare on Pinterest
    People today who are equipped to vacation away from their local spot report remaining in better health and fitness than these who are not, a new study implies. Picture credit: Rob and Julia Campbell/Stocksy.
    • In accordance to a new survey-centered research on a population from the United Kingdom, constraints on vacation outside of one’s area place are associated with poorer self-documented health and fitness.
    • In contrast, individuals who travel absent from their dwelling area report encountering much better health and fitness.
    • One particular purpose may well be that when a particular person is not able to vacation, they also have less social interactions, which may perhaps add to loneliness.
    • The review focuses on the North of England, an location with poorer wellness results than the rest of England, and minimal transportation products and services outdoors of huge city places.

    A new, survey-primarily based study conducted by scientists at College Higher education London’s Centre for Transport Studies, in the United Kingdom, exhibits how folks really feel that vacation — and boundaries to travel — impression their wellness.

    The analyze finds that people today who facial area constraints on their capacity to travel exterior their nearby space, or to as lots of areas as they would like, report poorer wellness, while individuals who are capable to vacation absent from dwelling experience that they expertise greater well being.

    Its conclusions appear in the Journal of Transportation & Overall health.

    The researchers obtained funding from the U.K. transportation system Transport for the North for their analyze.

    The analyze outlined touring outside one’s community space as touring 15 miles, or 24 kilometers, away from property.

    The review authors analyzed responses from 2,747 inhabitants from the North of England about their health and the constraints to journey that they experience.

    This spot of England has the nation’s worst health outcomes, according to the scientists, and lots of of its parts deficiency enough transportation amenities.

    The study respondents have been asked to report their stage of settlement or disagreement with five questions, just about every of which focused on a unique vacation constraint:

    • “I vacation further than my neighborhood place much less generally than I would preferably like to” — a travel frequency constraint
    • “I vacation to much less destinations (e.g., towns or cities outdoors my regional area) than I would ideally like to” — a constraint on the amount of locations traveled
    • “I journey to spots that are nearer than the ones I would preferably like to go” — a travel length constraint
    • “I vacation by general public transport to locations I would preferably like to go by car” — a travel-by-auto constraint
    • “I travel by auto to sites I would preferably like to go by community transport” — a constraint on obtain to public transportation.

    Dependent on the study responses, the authors concluded that persons who ended up ready to travel at least 15 miles away from household, and who had been capable to travel regularly and see a lot more locations have been much more most likely to report superior wellbeing.

    The associations in between travel and condition of well being were being much more substantial in respondents aged 55 many years and in excess of.

    According to lead writer Dr. Paulo Anciaes, previous exploration has set up that the capacity to vacation can maximize access to work and instructional alternatives. He hoped to examine, for the first time, the outcome of travel on wellness.

    He told Clinical Information These days that the North of England was selected as the space of research because it lags behind the rest of the nation. “The government has, as one particular of its most important priorities, the ‘leveling up‘ of the North and other lagging areas,” he claimed.

    “The wellbeing results are continuously even worse [in the North] than in the South,” Dr. Anciaes pointed out, “and statistics and scientific tests recommend that this is largely stated by the reduced incomes. Our study tried to uncover other possible explanations. We observed that the means to travel is one of them.”

    To evaluate the effect of vacation on health and fitness, Dr. Anciaes and his co-author, Dr. Paul Metcalfe, employed a approach identified as “path analysis” that created it attainable for them to observe the direct and indirect outcomes of just one variable on an additional.

    The scientists observed that when people today were being confined in the selection of sites they could go, the absence of possibilities for social interaction was straight linked to poorer well being.

    On the other hand, constrained vacation frequency negatively affected overall health fewer straight. That is, he stated, “travel constraints are noticeably associated to social participation, and social participation is then significantly related to self-documented well being.”

    Traveling exterior one’s neighborhood place can also have a immediate result on wellbeing top quality, in that it could allow folks to access far more, and perhaps superior, health care selections than may be obtainable nearer to house.

    Way of living professional medical educator Dr. Elizabeth Pegg Frates, who was not concerned in the analyze, informed MNT:

    “It is apparent that social link is a primary human have to have. Immediately after our require for water, meals, and shelter, we have a want for belonging, or social link.”

    Dr. Frates said there is ample investigation describing the impact a deficiency of social connectedness can have on health and fitness: “Research from 1979 shown that the people today who lacked social and local community ties were being the most very likely to die in a nine-yr prospective review. With absence of social interaction typically arrives loneliness.”

    “Loneliness has been reported to be associated with coronary heart assaults, cancer, delayed most cancers restoration, development of coronary heart sickness, high blood force, and slower wound healing,” she pointed out. “Also, a current study indicates that loneliness could be linked with the improvement of sort 2 diabetic issues.”

    Dr. Frates has co-authored an report for the American Journal of Life-style Medication describing the good benefits of social connections on wellbeing.

    “The review exhibits,” claimed Dr. Anciaes, “that the likelihood to journey is important for the health of populations. The implication is that constraints to journey need to have to be eliminated.”

    He cited as these kinds of constraints an insufficient degree of transportation companies, specifically in rural parts, and the absence of services over and above the peak journey hrs of the day, or on weekends and for the duration of college vacations.

    The expense of transportation can also be an issue, as is a lack of particular security, crowded amenities, and weak accessibility for more mature and disabled travellers.

    For people who would like to be equipped to travel a lot more by car but are inhibited by the prices of owning and employing a person, Dr. Anciaes advised that relevant authorities could give “subsidies to poorer households utilizing a private automobile when they live in locations with no community transport.”

    Dr. Anciaes pointed out that increasing community transportation would also make car driving easier by cutting down the selection of cars on the street.

    Dr. Patricia L. Mokhtarian of the Faculty of Civil and Environmental Engineering at Georgia Tech was not concerned in the review, but endorsed the great importance of journey, telling MNT in no uncertain conditions that, “[f]undamentally, vacation is crucial to health and properly-currently being — if we aren’t going, we are lifeless.”

    She admitted, however, that promoting travel “presents anything of a policy/ planning dilemma,” thinking of the resulting enhanced environmental load when far more folks journey extra.

    However, said Dr. Mokhtarian, “[t]he properly-currently being added benefits are manifold. There is [a] sizable literature on the latter, together with much of my personal operate.”

  • Medicaid and Abortion Top Health Agenda for Montana Lawmakers

    Medicaid and Abortion Top Health Agenda for Montana Lawmakers

    Keely Larson

    HELENA, Mont. — Montana lawmakers stated lowering fees and increasing patient entry will be their major overall health treatment objectives for the new legislative session. But they also will have to contend with creating variations to Medicaid, a management disaster at the Montana Condition Medical center, and proposals to regulate abortion.

    Republicans, who hold a veto-evidence bulk, stated they will focus on 3 places of wellbeing treatment: transparency, prices, and individual alternatives.

    Party leaders intention to preserve “taking tiny bites that are going the ball in the appropriate way on people three significant factors,” Senate Republican spokesperson Kyle Schmauch claimed.

    Democrats, who are the minority social gathering and have to have Republican help to move their charges, determined lowering health and fitness treatment fees, shielding Medicaid coverage, and preserving reproductive liberty as their priorities.

    As the 90-day Montana session enters its 2nd 7 days, right here are some of the top wellness troubles on the agenda:

    Growing Affected individual Entry

    Increasing telehealth and building it easier for capable providers from outdoors the state to observe in Montana are two approaches Republican Gov. Greg Gianforte proposes to enhance wellbeing care accessibility, claimed spokesperson Brooke Stroyke.

    Residence Speaker Matt Regier (R-Kalispell) agreed that telehealth is essential to improving upon access. Republicans program to establish on a law passed in the 2021 session that created everlasting some of the pandemic-pushed crisis regulations that loosened restrictions on telehealth.

    Schmauch mentioned legislators will think about shelling out proposals to expand Montana’s broadband arrive at to make telehealth a feasible selection for far more people, specifically rural people.

    Other proposals meant to give rural patients with restricted accessibility to treatment additional alternatives are prepared, this sort of as letting doctors to dispense prescription medications to clients, and making it possible for pharmacists to prescribe certain medicines, Schmauch mentioned.

    Medicaid

    Eleven Montana nursing residences declared closures in 2022, with officers citing staffing shortages and lower Medicaid reimbursement rates as the major motives for the industry’s ongoing struggles.

    Lawmakers will discussion boosting reimbursement rates for nursing households and numerous other forms of overall health vendors soon after a state-commissioned review observed they had been way too low to address the price of treatment.

    “Increasing supplier prices at the study’s advisable level will be certain a potent health and fitness care workforce and should be a precedence for this legislature,” reported Heather O’Loughlin, govt director of the Montana Price range and Coverage Centre, a nonprofit firm that analyzes the point out funds, taxes, and economic system.

    Gianforte’s spending plan proposal contains reimbursement level raises that slide short of what the examine recommends. A bill by Rep. Mary Caferro (D-Helena) would foundation supplier prices on the study’s results.

    Federal principles dictated that any person enrolled in Medicaid could not be dropped from the system all through the community health and fitness emergency. But the omnibus spending bill lately passed by Congress allows states to commence reviewing the eligibility of their beneficiaries in April, and thousands and thousands of men and women throughout the U.S. are at risk of shedding coverage as a consequence.

    “That will have an inherent end result of getting rid of people who skilled for Medicaid but because of this method getting so intricate, they’ll drop it,” Caferro explained.

    Caferro stated she ideas to introduce legislation that restores 12-month steady eligibility for grown ups enrolled in Montana Medicaid. The evaluate is probable to be opposed by legislative Republicans and Gianforte, who co-signed a letter to President Joe Biden in December indicating the general public wellbeing emergency experienced artificially expanded the Medicaid populace.

    Montana Point out Healthcare facility

    The Montana Condition Healthcare facility dropped its federal accreditation immediately after a spate of injuries and fatalities, earning administration of the psychiatric healthcare facility and the availability of behavioral health and fitness products and services a leading priority of the session.

    Stroyke mentioned Gianforte’s two-12 months budget plan, which is a starting off stage for legislative finances writers, includes $300 million for the condition healthcare facility and for growing accessibility to intense behavioral health and fitness treatment throughout the point out.

    Legislators are taking into consideration actions that would shift care for some individuals from the state-operate clinic to community-centered wellbeing expert services. Regier explained shifting additional public wellness companies from point out establishments to community suppliers would decrease some pressure on amenities like the Montana Condition Clinic.

    Abortion

    Lawmakers from equally functions have submitted extra than a dozen monthly bill draft requests working with abortion. A person from Regier would limit the sort of abortions that can be carried out in the point out, and, at the other conclusion of the discussion, a proposal by Sen. Ryan Lynch (D-Butte) would codify abortion obtain in state regulation. The Gianforte administration also not too long ago proposed an administrative rule that would make it far more tricky for women to have an abortion paid for by Medicaid.

    But the Republican the greater part is limited from enacting a sweeping abortion ban in the wake of the U.S. Supreme Court’s 2022 choice to overturn Roe v. Wade. Which is mainly because a 1999 Montana Supreme Court ruling decided the point out constitution’s proper-to-privacy safety covers abortion obtain. The state is trying to get to overturn that precedent just after a decide blocked 3 anti-abortion laws passed by the 2021 legislature.

    Clinic Oversight

    Lawmakers also will think about proposals to maximize oversight of the way nonprofit hospitals report community positive aspects.

    State overall health officers have desired to established standards for the charitable contributions those people hospitals make in exchange for their tax-exempt standing. A KHN investigation discovered that Montana’s nonprofit hospitals put in about 8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of their full once-a-year costs on charity gains in 2019, which is underneath the countrywide typical.

    Keely Larson is the KHN fellow for the UM Legislative Information Company, a partnership of the University of Montana University of Journalism, the Montana Newspaper Association, and Kaiser Wellbeing Information. Larson is a graduate university student in environmental and natural resources journalism at the College of Montana.

    KHN (Kaiser Health and fitness News) is a national newsroom that creates in-depth journalism about overall health issues. Collectively with Policy Evaluation and Polling, KHN is a person of the a few main running packages at KFF (Kaiser Loved ones Foundation). KFF is an endowed nonprofit firm giving details on overall health concerns to the country.

    USE OUR Information

    This tale can be republished for absolutely free (aspects).

  • Health News Roundup: Thailand introduced new entry regulations as China reopens border; China reports three COVID deaths for Jan 8 and more

    Health News Roundup: Thailand introduced new entry regulations as China reopens border; China reports three COVID deaths for Jan 8 and more

    Next is a summary of current overall health information briefs.

    &#13

    Thailand launched new entry rules as China reopens border

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    Thailand will have to have global tourists to display evidence they are fully vaccinated for COVID ahead of flying to Thailand, in accordance to the country’s aviation regulator, as it prepares for much more tourists just after China reopened its border on Sunday. The Civil Aviation Authority of Thailand (CAAT) explained in a assertion on Saturday that starting early Monday, all overseas arrivals sta

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    China stories a few COVID deaths for Jan 8

    &#13

    China described 3 new COVID-19 deaths for Jan. 8, as opposed with two fatalities a working day earlier, the Chinese Center for Illness Control and Avoidance explained on Monday. The formal death toll now stands at 5,272.

    &#13

    rting early on Monday will have to verify they are vaccinated or present a letter certifying that they have recovered from COVID inside 6 months.

    &#13

    SK Bioscience main states unlikely China will supply vaccines from it – FT

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    SK Bioscience Co Ltd main executive Jaeyong Ahn reported in a Economic Situations interview that it is not likely that the vaccine maker can provide COVID-19 vaccines to China amid its the latest outbreak thanks to Beijing’s “nationwide delight”. Ahn claimed that it was “unrealistic” to supply COVID vaccines to China, as the state insists on applying its possess, the newspaper quoted him as saying.

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    China states talks to incorporate Paxlovid in its well being insurance policy drug checklist are unsuccessful

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    China will not include Pfizer Inc’s Paxlovid in an update to its checklist of medicines covered by basic clinical insurance strategies as the U.S. agency quoted a high price for the COVID-19 drug, China’s Healthcare Safety Administration (NHSA) stated on Sunday. The COVID-19 antiviral drug is at present protected by the country’s wide health care insurance policy scheme below non permanent steps the regulator launched in March past calendar year as outbreaks rose.

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    ‘Life is shifting forward’: China declares new COVID section

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    China braced for a “new period” in its battle towards COVID-19 on Monday and economic marketplaces strengthened immediately after Beijing dropped pandemic border controls in the hottest easing of curbs that has permit the virus free on its 1.4 billion populace. Sunday’s reopening is one of the last ways in China’s dismantling of its “zero-COVID” regime, which commenced last thirty day period just after historic protests from curbs that retained the virus at bay for three a long time but prompted popular mental agony and severe harm to the world’s second-greatest overall economy.

    &#13

    Eisai, Biogen get U.S. Food and drug administration approval for Alzheimer’s drug, apply for entire approval

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    The U.S. Foods and Drug Administration on Friday authorized the Alzheimer’s drug lecanemab formulated by Eisai Co Ltd and Biogen Inc for individuals in the earliest phases of the head-wasting disease. Eisai and Biogen stated on Saturday the Japanese drugmaker had utilized for entire Food and drug administration acceptance of the drug.

    (With inputs from businesses.)

  • Podcast: No Health Care News Shortage in 2023

    Podcast: No Health Care News Shortage in 2023

    00;00;08;27 – 00;00;19;24
    Kathleen Haddad
    Hello and welcome to another episode of “Health Affairs This Week”, the podcast where Health Affairs editors go beyond the headlines to explore the health policy news of the week. I’m Kathleen Haddad.

    00;00;20;17 – 00;00;21;20
    Chris Fleming
    And I’m Chris Fleming.

    00;00;21;29 – 00;00;49;00
    Kathleen Haddad
    So, Chris, last episode, we recapped the major developments of last year. But one last piece of health policy news broke after our last show. The 1.7 trillion omnibus spending bill that was enacted right before Christmas. It not only kept government open but contained important health policy advancements. Before we get rolling on that discussion, though, there were two news items of the past week that received scant attention.

    00;00;49;16 – 00;01;07;16
    Kathleen Haddad
    First, the FDA announced that misoprostol could be sold in pharmacies. That’s the abortion pill, and it can be prescribed via telemedicine appointments. Previously, the drug could only be given at a doctor’s office, which was an inconvenience and that made it inaccessible for many women.

    00;01;08;01 – 00;01;11;01
    Chris Fleming
    And Kathleen, what’s what’s the second news item that you mentioned?

    00;01;11;21 – 00;01;38;14
    Kathleen Haddad
    Chris, there’s a new COVID variant amongst us. Yeah, it’s called XBB.1.5. Dr. Zeke Emanuel, a former White House COVID policy adviser, says this this new variant comprises about 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of current infections, which seem to be rising or are expected to rise after the effects of the holidays show in the data.

    00;01;39;05 – 00;01;47;26
    Chris Fleming
    Oh, well, it seems kind of redundant to say this with any sentence that it contains the word new variant and COVID, but that really doesn’t sound like good news, Kathleen.

    00;01;48;14 – 00;02;08;25
    Kathleen Haddad
    Well, medical experts say it’s the most infectious variant yet. And that will be interesting just to see how it plays out and how much strain it puts on the hospital system. But Chris, let’s move on to the huge government funding law enacted just before Christmas. It’s hard to know where to start in dissecting this massive law, but what can you tell us?

    00;02;09;19 – 00;02;36;23
    Chris Fleming
    Well, Kathleen, as you know, and you referred to earlier, we’ve developed this habit of ending our congressional sessions with these very large, catch-all bills at the end of the session. And, you know, I’d say that this is a crazy way to run a railroad if I wasn’t watching the as we record today on January 5th, the House trying to choose a speaker and going through multiple ballots for the first time in a century.

    00;02;37;15 – 00;03;19;16
    Chris Fleming
    But anyway, these these omnibus bills, as they’re referred to, they’re always chock full of pretty much everything and then certainly chock full of important health policy provisions. And this year was no exception. One example, physicians were facing a reduction in Medicare payment of, I think, 8.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} for 2023. And needless to say, they weren’t particularly happy about that. The omnibus eliminated a big chunk of that impending cut — that made physicians happier –but it still left a 2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} cut for this year, for this year, for 2023, plus another 3.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} cut scheduled for next year for 2024.

    00;03;19;16 – 00;03;28;24
    Chris Fleming
    And that, needless to say, made physicians less happy. But the nature of these huge bills is that, you know, you tend to get half a loaf, you know, rather than the whole loaf.

    00;03;29;17 – 00;03;32;27
    Kathleen Haddad
    So, Chris, what about the value based payment?

    00;03;33;06 – 00;03;54;02
    Chris Fleming
    Right. So Congress, there was a value-based care bonus for physicians who participate in alternative payment arrangement. That would not…before the omnibus that would not have been available next year. Congress did make it available, but they reduced it. Used to be 5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. They cut it down to 3.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}.

    00;03;55;04 – 00;03;57;16
    Kathleen Haddad
    So what’s in the law on the hospital side, Chris?

    00;03;58;09 – 00;04;28;14
    Chris Fleming
    Ah, well, the omnibus. One of the things the omnibus did is it extended through 2025 two programs that help out rural hospitals that were scheduled to expire this year. The programs are the low-volume hospital program, which helps hospitals with a small number of Medicare patients. And on the other end, the Medicare Dependent Hospital program. And that’s a program that helps hospitals where the Medicare share of total patients is high.

    00;04;29;13 – 00;05;10;10
    Chris Fleming
    Would also, the omnibus also does extend for two years some telehealth flexibilities that were introduced during the pandemic through CMS waivers. These relax the site restrictions the the restrictions on the geographic sites that telehealth can be used for. And also it provide some flexibility regarding the use of audio only telehealth. We tend to think of video and high tech when we talk about telehealth, but turned out, maybe surprisingly to some, that audio-only because some people just don’t have access to broadband.

    00;05;10;10 – 00;05;38;02
    Chris Fleming
    And for other reasons, audio-only became very important during the pandemic. Many had hoped that that that these would be these would be extended permanently. But, you know, obviously, two years, in the view of many is better than nothing. And back to the half a loaf theme from earlier now. And I also should add very quickly that the omnibus also extended something called the Hospital Home program, and that’s something that was important during the pandemic.

    00;05;38;02 – 00;05;47;06
    Chris Fleming
    It allows hospitals to treat more acute care patients at home through mechanisms like remote patient monitoring, telehealth and in-person care.

    00;05;47;16 – 00;06;01;01
    Kathleen Haddad
    Right. And I think what the Health Affairs journal, we’ve published a number of articles on that topic. Let’s go move forward to the Medicaid related provisions. What do you know about that?

    00;06;01;09 – 00;06;31;08
    Chris Fleming
    Yeah, there’s there was some really important stuff that, you know, raising will raise some challenges, but there’s some the omnibus attempted to to meet that challenge by including some some safeguards as well. Let’s back up a little bit in the Families First back, I think in 2020, early in the COVID pandemic, in the Families First Act, Congress gave states this bump in Medicaid funding, I think 6.2 percentage points.

    00;06;31;08 – 00;07;00;08
    Chris Fleming
    But to get that money, states had to to to do follow what are called, “maintenance of effort” requirements, which meant that they had to suspend Medicaid eligibility redeterminations during the public health emergency. And that was declared by the federal government in connection with COVID. So once someone was on Medicaid, you couldn’t go through and do the sort of the normal process that states do of checking whether they were still eligible.

    00;07;00;18 – 00;07;22;06
    Chris Fleming
    So this is a big deal because, you know, during the pandemic, the that was a big deal because that Medicaid program grew. It grew like 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. And the program had, you know, really it was a really huge kind of pillar for folks trying to weather the pandemic who might have lost their jobs and would have lost health insurance.

    00;07;22;28 – 00;07;44;14
    Chris Fleming
    So the emergency that this was tied to, the public health emergency, is still in effect. But the omnibus actually ended this maintenance of effort requirement, and that ends as of April of this year, April 2023. And that means that states at that point will be able to return to normal eligibility redeterminations.

    00;07;44;21 – 00;07;50;22
    Kathleen Haddad
    Chris, what are the protections against immediate disenrollment for Medicaid enrollees?

    00;07;51;10 – 00;08;13;29
    Chris Fleming
    Right, and that’s that’s an important question, because the worry is, you know, that it won’t just be people who are actually, who’ve who’ve become ineligible that would lose their eligibility would be pushed off the rolls. It might be people who were still eligible, but they’re you know, communications issues, getting in touch with many Medicaid beneficiaries, there are bureaucratic errors.

    00;08;14;09 – 00;08;50;16
    Chris Fleming
    So, you know, the omnibus tries to deal with that. It has this instead of just eliminating that 6.2 percentage point bump in Medicaid payment entirely, it has a transitional phase where the payment is still there for the rest of 2023, but goes away in stages. And to get that money, states do have to agree to some safeguards. So, for instance, if they try to mail…reach a Medicaid enrollee by mail and don’t get a response, they just can’t kick him off the roll– him or her– off the rolls.

    00;08;50;29 – 00;09;15;12
    Chris Fleming
    They need to try to reach the person at least one other way. Joan Alker on the “Say Ahhh!” blog and many of her colleagues at Georgetown, they do a great job of covering these safeguards and the omnibus in general. They note also, for instance, importantly, that, you know, there are some some pro-coverage elements involved as well. So states will end up covering children continuously

    00;09;15;12 – 00;09;35;09
    Chris Fleming
    now for 12 months in Medicaid and CHIP as a result of the omnibus, regardless of changed circumstances. And the omnibus also extends the overall CHIP funding with some important policies, such as express lane eligibility for two years. And I think now through the end of fiscal year 2029.

    00;09;35;09 – 00;10;10;21
    Kathleen Haddad
    I think HHS estimates that 15 million people could could lose Medicaid coverage and that maybe half of them or almost half are are eligible, even though they might get notices or be dropped. So these protections are important. I wanted also to note that Medicaid can now extend post-natal coverage from two months to 12 months. That’s a permanent provision. Now, I think currently 27 states do that.

    00;10;11;07 – 00;10;40;19
    Kathleen Haddad
    And so that is something that’s important for post-natal health and mental health. I wanted also to mention, Chris, that the omnibus provides a lot of funding for mental health programs and changes in Medicare mental health coverage. Previously, Medicare didn’t pay for counseling provided by marriage and family therapists or licensed mental health counselors. Now, Medicare will pay for that under the law.

    00;10;41;02 – 00;11;19;28
    Kathleen Haddad
    And to address the mental health workforce shortage, the law funds 200 new residency slots with half reserved for training psychiatrists. The 988 emergency mental health line colloquially only known as the Suicide Hotline, received $400 million in increased funding to address the opioid crisis. The law now allows doctors to prescribe buprenorphine without a special waiver from the DEA. The drug used to treat its use to treat opioid use disorders, and advocates say it is simply not being used widely enough.

    00;11;19;28 – 00;11;26;13
    Kathleen Haddad
    So this provision is aimed at increasing the use of appropriate use of buprenorphine.

    00;11;26;26 – 00;11;46;25
    Chris Fleming
    And now let’s bring it back to the public health arena where we started this this session. One of the things about the omnibus that’s interesting from a health policy point of view is it requires, I believe, Senate confirmation of the CDC director, right? That that sounds like it’ll be a non-contentious confirmation hearing.

    00;11;47;26 – 00;12;17;16
    Kathleen Haddad
    Right, Chris. So currently the CDC director appointment does not require Senate confirmation as do other agency heads. But beginning in January of 2025, confirmation will be required. And the interesting part of this is that it was a bipartisan bill or effort that put this provision in sponsored by Patty Murray and Richard Burr. I it’s going to be interesting to see how it plays out.

    00;12;18;00 – 00;12;33;10
    Kathleen Haddad
    Their purpose, legislative intent, there was to cope with another pandemic more easily than we did this one. But like you say, it’ll be interesting to see if that’s that’s really the case.

    00;12;33;10 – 00;12;45;08
    Chris Fleming
    Well, I think, you know, there’s much more to be said about the omnibus and the other news that you started us out with. But I think we’re we’re pretty much running out of time today, so I think we may have to end it there.

    00;12;46;00 – 00;13;22;01
    Kathleen Haddad
    As you say, Chris, the omnibus is chock full of health policy provisions, including many we haven’t been able to get to. I also want to remind listeners that next week, on January 11th, we’ll be restarting our “Health Affairs Pathways” podcast series, which is our fellowship program. Next week we begin with Michael Shen who is a physician. He talks about how Medicare payment and Medicaid payment to hospitals doesn’t fund everything they need funded in order to do their jobs.

    00;13;22;14 – 00;13;44;15
    Kathleen Haddad
    The podcast is terrific. I suggest you listen if you want to understand anything about payment to hospitals in our disjointed health care system. This is where to learn it. But thanks for your knowledge, Chris, and Happy New Year and thanks to our listeners. Be sure to subscribe to “Health Affairs This Week” wherever you get your podcasts.

    00;13;45;02 – 00;13;55;27
    Chris Fleming
    Thanks, Kathleen. It was it was fun, as always.