News & Commentary
Fifty percent of patients admitted to intensive care units (ICUs) are either too well or too sick to derive any benefits from the costly care they would get, according to a research letter in the Dec. 27, 2016, issue of JAMA Internal Medicine.

Comes a new twist in the recent uproar about how pharmaceutical companies are spiking costs for variations of medicines that have been around for decades.

Sexual Health
Jan Greene
Women’s health advocates are concerned about health coverage guarantees that could disappear as Republicans in Congress and the White House go about dismantling Obamacare. These include everything from contraceptive coverage to breast cancer screenings to equity in the premiums women pay for insurance.

Officials at Harvard Pilgrim Health Care believe that they’ve responded to the soaring cost of drugs with tools already familiar to stakeholders: paying based on outcomes (for Enbrel), and paying based on value (for Forteo).

But that might change since the pharmaceutical industry itself is beginning to examine this disconnect, according to STAT.

Sexual Health
Robert Calandra
New York State’s Target Case Management (TCM) program was created in 1990 by to help people with mental health and substance abuse issues stay engaged in their care. It’s been very successful for people with HIV as well. Can it be expanded for other chronic conditions?

In an effort to calm the nerves of wary health plans who are unsure about whether to participate in ACA exchanges in 2018, the Trump administration asked a federal court to delay a ruling about ACA subsidies, the Wall Street Journal reports.

As President Trump weighs nominees to head the FDA who mostly agree that the agency’s approval process must be accelerated, the head of the pharmaceutical industry’s most powerful lobbying group responded, in effect: Now hold on there, Mr. President!

Legislation & Regulation
Richard Mark Kirkner
Texas is the petri dish of sorts for the anti-Planned Parenthood movement. Efforts to restrict Planned Parenthood funding there date back to 2011, when the legislature directed the state’s Medicaid waiver program, the Women’s Health Program, to exclude Planned Parenthood affiliates from its funding.

The ACA mandates that health care benefit packages sold to individuals and small groups look like plans offered in a typical employer-sponsored package and “those are still pretty generous.” That’s Timothy Jost, an emeritus professor at Washington and Lee University Law School, explaining to Kaiser Health News why GOP officials are considering watering down the 10 essential benefits that the ACA says must be covered. Republicans do not have the 60 votes needed to repeal and replace, as of this writing, but they do have the necessary majority needed to change existing law.

UnitedHealth Group owns the biggest share of the Medicare Advantage market (21%), according to the Kaiser Family Foundation.

News & Commentary
Don’t discard the Cadillac tax even if other large chunks of the ACA are tossed, urges a joint report by two think tanks. Fixing some flaws in this excise tax, scheduled to take effect in 2020, will help control health care spending and provide revenue.
Viewpoint
Michael Schlosser, MD
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Felix Lee, MD
There are some success stories. Lowe’s pioneering flat-rate deal with the Cleveland Clinic for heart surgery has shown both cost savings and quality improvement. Other large employers, notably Walmart and PepsiCo, have followed suit, signing contracts with self-described, single-hospital “centers of excellence” for a handful of elective procedures.
Sexual Health
Susan Ladika
Not too long ago, rates for sexually transmitted diseases (STDs) in the United States were at historic lows. Now they are at record highs, and many experts fear they will continue to climb because of meager funding of public health clinics and diminished sex education in schools.
Sexual Health
Joseph Burns
Men’s health care changed dramatically after the FDA approved Pfizer’s blue, diamond-shaped Viagra. Suddenly men were interested in seeing their doctors if for only one reason. Now, with restrictions on what some call a lifestyle drug, other health problems go uncharted.
Sexual Health
Jan Greene
Some see a big market for medications for low libido in women. But sales of Addyi have been slow. Has a normal experience been unnecessarily medicalized? One of many factors in the debate is whether women’s sexual response tends to be more spontaneous or responsive.