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New heart drugs come in more expensive than expected
Reuters

Two of the most anticipated new heart drugs to be launched in recent years have been priced well above analyst expectations, fuelling the debate about whether modern medicines cost too much.

Praluent, made by Sanofi and Regeneron Pharmaceuticals, and Entresto from Novartis are both treatments that represent significant advances for millions of patients at risk of serious heart problems.

But their positioning in the marketplace was always likely to be contentious since they offer more effective alternatives to very cheap, off-patent drugs.

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Can Medicare afford personalized medicine?
San Diego Union-Tribune

Personalized medicine is the future of health care, but it is not yet clear exactly what that means for Medicare.

As it reaches its 50th anniversary Thursday, the nation’s largest health program is at a critical moment. The program, which is projected to spend more than $600 billion this year, must find ways to slow its spending as personalized medicine creates an ever-greater demand for expensive new medicines and tests with price tags closer to Ferrari than Ford.

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CMS extends moratorium on new home health agencies in some cities
Modern Healthcare

The CMS has again extended a moratorium for another six months on new Medicare home healthcare agencies, subunits and ambulance suppliers in a slew of major cities across the country. It’s part of an ongoing battle against fraud, waste and abuse.The CMS relied on the experience of law enforcement and its own data analysis in deciding to impose the moratoria, according to a notice released Friday afternoon by the CMS. The extended moratoria take effect July 29 and will last for at least another six months.

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Medicare Turns 50 But Big Challenges Await
Kaiser Health News

Medicare, the federal health insurance program for the elderly and disabled, has come a long way since its creation in 1965 when nearly half of all seniors were uninsured. Now the program covers 55 million people, providing insurance to one in six Americans. With that in mind, Medicare faces a host of challenges in the decades to come. Here’s a look at some of them.

Financing – While Medicare spending growth has slowed in recent years – a trend that may continue into the future – 10,000 people a day are becoming eligible for Medicare as the trend-setting baby boomers age.

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6 Ways the Big Health Insurance Mergers Will Affect Your Coverage
Yahoo! News

Health insurance company Anthem announced Friday that it will buy rival insurer Cigna for $48.3 billion.

The deal comes just weeks after fellow health insurance providers Aetna and Humana announced their merger, concentrating health insurance providers in the U.S. to just three big companies. (UnitedHealth Group is the third.)

The latest deal will impact more than 53 million people, representing about 17 percent of the U.S. population, The New York Times reports.

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Employers warming up to private insurance exchanges
Modern Healthcare

Employers and health insurance companies showed a visible appetite for private health exchanges at a conference Thursday, building on executives’ desires nationwide to keep the growth of healthcare costs manageable.Several companies and consultants who made the switch shared their experiences at the event. But private exchanges still remain far from widespread, as some employers are reluctant to shift their workers into fixed-dollar benefit structures.Private exchanges are online health insurance marketplaces for a company’s employee base.

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Think big on healthcare finance reform
Modern Healthcare

The United States finances healthcare through a confusing hodgepodge of payment programs that send distorted signals to employers, insurers, providers and the general public. Every program—Medicare, Medicaid and the tax subsidies that support the private employer-based insurance market—is desperately in need of reform. Wouldn’t it be nice during this presidential election cycle if the candidates debated potentially beneficial changes to those different sub-systems? Don’t hold your breath.

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Uninsured Rate Remains Higher For Men
KQED Radio

Men remain less likely than women to have health insurance in the U.S., despite drops in the overall number of uninsured since the Affordable Care Act, new research shows.

In October 2013, before the health reform expansion, 21.8 percent of men were uninsured. But by March of this year, only 15.2 percent were.

Comparatively, 18.9 percent of women were uninsured two years ago, but that percentage declined to 11.2 this year.

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State health insurance markets struggle with cost challenges
Baltimore Sun

State-run health insurance markets that offer coverage under President Barack Obama’s health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states.

Hawaii’s marketplace, the latest cautionary tale, was awarded $205 million in federal startup grants. It has spent about $139 million and enrolled 8,200 customers for individual coverage in 2015.

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California health exchange to announce 2016 premium rates
Baltimore Sun

California on Monday will announce 2016 premium rates for individual health plans sold on the state’s insurance exchange, an important gauge of affordability amid growing concern that some insurers around the country are seeking double-digit price increases.

Last year, state officials declared victory when they announced premiums rose by an average of 4.2 percent, which was about half the increase the industry saw over a three-year period.

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Health Law Experiment Failed To Show Savings
Kaiser Health News

A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money, says a new government report.

The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services’ innovation center.

The Affordable Care Act created the lab and gave it $10 billion over a decade to test new ways to improve care and save money.

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5 Challenges Facing Medicaid At 50
Kaiser Health News

A “sleeper” provision when Congress created Medicare in 1965 to cover health care for seniors, Medicaid now provides coverage to nearly 1 in 4 Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

Enrollment has soared to more than 70 million people since 2014 when the Affordable Care Act began providing billions to states that chose to expand eligibility to low-income adults under age 65. Previously, the program mainly covered children, pregnant women and the disabled.

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Ronald Reagan’s lasting healthcare legacy: How ’80s deficit spending and conservative ideologies reshaped the healthcare debate
salon.com

The election of Ronald Reagan to the presidency in 1980 furthered the ascendance of conservatism in national politics. The Reagan administration sought to cut taxes, privatize the welfare state, and constrain federal expenditures on domestic programs, all while increasing military spending. Even as the number of uninsured Americans climbed significantly, the administration had no interest in proposals for universal health insurance.  It looked at Medicare, as many in Congress did, primarily as a budgetary problem and a potential source of fiscal savings. Nor was the primary concern with system-wide medical spending. That broader focus gave way to a narrower emphasis on how to contain federal spending on Medicare and Medicaid in the context of rising budget deficits. Meanwhile, conservatives promoted pro-competitive healthcare policies that relied on market incentives, consumer choice, and competition between private plans to restrain spending on medical care.

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California Judge Throws Out Lawsuit On Medically Assisted Suicide
National Public Radio

Three terminally ill patients lost a court battle in California Friday over whether they should have the right to request and take lethal medication to hasten their deaths.

San Diego Superior Court Judge Gregory Pollack said he would dismiss the case, adding that the issues were beyond his role as a judge to decide and should instead be put to the California state legislature or voters to establish new law.

Plaintiffs vowed to appeal the ruling.

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Terminally ill woman’s assisted-suicide suit likely to be tossed
San Francisco Chronicle

Christy O’Donnell may not get the death she had hoped for — one that right-to-die advocates say she deserves.

A California judge on Friday indicated that he will probably dismiss her end-of-life lawsuit and said he would issue his decision Monday.

“You’re asking this court to make new law,” San Diego Superior Court Judge Gregory Pollack said during a hearing Friday.

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Advocates For Physician-Assisted Suicide Dealt Setback
capital public radio

A San Diego County Superior Court judge today dismissed a case asserting state law and the California constitution allow for physician-assisted suicide. The suit was filed by two California women with terminal cancer. The plaintiffs in the case say they will appeal the ruling.

In his dismissal the judge said it’s up to the state Legislature or voters to change the law, not the courts.

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Could one-two punch of generics for breast cancer be more powerful than wonder drug tamoxifen?
Washington Post

First marketed in the 1960s as a fertility drug, tamoxifen has been hailed as a miracle drug for its ability to prevent and treat breast cancer, and despite decades of research scientists have not been able to find anything comparable — until now.

In a study published in The Lancet on Thursday, researchers found that a class of inexpensive, existing generic called aromatase inhibitors, which suppress hormones, reduce recurrence rates by 30 percent as compared with tamoxifen.  That confirmed what researchers had believed for several years. But a separate finding about the effect of the drug on death risk was a surprise.

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Teva buys Allergan’s generic drug unit for $40.5B
USA Today

Teva Pharmaceutical Industries said Monday it has agreed to buy Allergan’s generic drug unit for about $40.5 billion.

Based in Jerusalem, Teva is one of the world’s largest generic drug manufacturers, and the stock-and-cash deal will help boost its pipeline, supply chain and global revenue sources, the company said.

Allergan, best known for making Botox, will receive $33.75 billion in cash and shares of Teva valued Monday at $6.75 billion. Approved by the boards of both companies, the deal is expected to close in the first quarter of 2016.

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NNU wins rights to unionize at Kaiser’s L.A. Medical Center
Modern Healthcare

National Nurses United and the affiliated California Nurses Association say they’ve won the rights to unionize nurses at Kaiser Permanente’s flagship hospital in Los Angeles, months after it called for a strike at the hospital despite not representing its nurses. NNU won the vote Thursday at Los Angeles Medical Center by nearly 70% with 696 votes, beating out the San Dimas-based United Nurses Associations of California-Union of Health Care Professionals, which received 305 votes, according to NNU.

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Supervisors to hear hospital authority plan
Bakersfield Californian

Kern County supervisors will get a first glance at the inner workings of the proposed Kern County Hospital Authority on Tuesday.

The current plan is to transfer control of Kern Medical Center from the Board of Supervisors to an authority by June 2016.

The action starts on Tuesday.

Hospital CEO Russell Judd will update the board on the powers the authority will assume, how it will be governed and the next steps needed to launch the effort.

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Plan for mental hospital in Templeton would fill a void in county
San Luis Obispo Tribune

No one — or more specifically, no one who’s weighed in — disagrees that San Luis Obispo County needs more beds for patients with mental illness. The county Psychiatric Health Facility near the former General Hospital has only 16 beds, which is far fewer than the 136 recommended for our county under California Hospital Association guidelines.

Former San Luis Obispo Mayor Melanie Billig and her husband, Dr. Harvey Billig, are proposing to help fill the gap with a private, 91-bed behavioral health facility in Templeton. The hospital would serve children, adolescents, adults — including veterans — and the elderly.

 

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