News & Commentary

Briefly Noted May 2019

Only in relatively rare circumstances should people on warfarin also be taking aspirin, but it happens, partly because many people get into the habit of taking aspirin as a preventive measure against heart attacks and stick with it after warfarin has been prescribed. Results reported in JAMA Internal Medicine showed why the pairing should largely be avoided. The study showed increased rates of bleeding and emergency department and hospital admissions for bleeding among those taking both drugs. The study was based on data from a 6,359-person retrospective cohort study at six anticoagulation clinics in Michigan.

No wonder hospitals don’t like Medicare for all, even the milder version that would allow Americans to buy into the program. The Federation of American Hospitals and the American Hospital Association examines eight Congressional proposals put forward in 2017 that would substantially broaden Medicare. Seven of them would have made Medicare available to many more people than are currently eligible, what the analysis calls Medicare-X Choice. Medicare-X Choice would use Medicare’s network of providers in a public health plan to be offered to individuals and small business health exchanges. Allowing consumers to choose an existing private insurance or a government-run Medicare-X Choice plan could result in more than 20 million people exiting commercial plans. The exodus would cost hospitals over $800 billion over the next decade because Medicare pays hospitals about 11% below costs, according to the analysis.