A cray-cray day for the ACA

A Federal District Court judge ruled on Friday night that the Affordable Care Act, AKA Obamacare, is unconstitutional. Our first question is, who is hearing massive court cases on a Friday night? Go out, jeez. The law affects everything from enshrining protections for patients with preexisting conditions, to the massive Medicaid expansions many states have opted for since the law’s passage in 2010 (in infographic form here.) With provisions that wide-reaching, a repeal would “throw the individual insurance market and the whole health care system into complete chaos,” according to SVP Larry Levitt at Kaiser Family Foundation. The American Hospital Association and the American Medical Association have both spoken out against the ruling, which the White House has said will not take effect until a decision has been reached at the Supreme Court. Keep an eye on this one, folks.

Physicians switch to working in tech, fitness

Two stories about physicians getting snapped up by non-traditional employers caught our attention this week. First is this story about tech companies like Apple, Amazon, and Alphabet attracting doctors to give direction on their respective ventures into healthcare. Apple in particular is looking to improve products like their Apple Watch, which they’ve been loading up with increasingly more precise biometric sensors. But if you’re a doc who wants to get away from traditional healthcare without having to work on fancy gadgets, there’s a second option: open a CrossFit gym. The high-intensity workout program has been hosting networking/training events for physicians as part of its CrossFit Health program, which seems to have a bone to pick with the current healthcare landscape if their site banner is anything to go off of.

Missed the midterms?

If you somehow didn’t know that US midterm elections were last week… can you recommend the rock you’ve been sleeping under? I could use some rest. Here are some election stories InsightCity readers will find interesting: Healthcare was on voters’ minds more than any other issue, as shown by exit polls and money spent on advertising. Antivax PACs funded candidates to retaliate against politicians who push vaccination requirements in their districts. Former Celgene head Bob Hugin lost to incumbent Bob Menedez in the battle of the Bobs New Jersey’s senate race. Idaho, Nebraska, and Utah voters decided to expand Medicaid in their states, while Montana voters said ‘no, thanks.’ Michigan and Missouri waved a green flag for recreational and medical marijuana, respectively. Need more? You can find a more detailed healthcare-related election round-up here (just without InsightCity’s signature snark.)

Those kooky millennials

According to a recent national/US poll of 1,200 randomly selected adults conducted by the Kaiser Family Foundation for the Washington Post, 45% of 18- to 29-year-olds (millennials) had no primary-care provider. According to the Post’s article “Many young adults are turning to fast-growing alternatives: retail clinics carved out of drugstores or big box retail outlets, free-standing urgent care centers that tout evening and weekend hours, and online telemedicine sites that offer virtual visits without having to leave home” and they are doing so because, for millennials, convenience is prized in almost every aspect of their lives. We get it, but you know what’s not convenient? Children, and more than 17 million US millennials are now mothers. How millennials consume healthcare will have a major impact on the US system, so stay tuned and stay up-to-date on millennial slang. Word.

A merger “O.K.” with little delay

Cigna and Express Scripts have received their parents’ the Justice Department’s blessing to go ahead with their wedding merger. The health insurer and pharmacy benefit manager say they’re a good fit for each other since they’ll be able to share information about their customers’ medical expenses that will help them manage patient health better. But the announcement has got to sting a bit for CVS Health and Aetna, who have been waiting on DOJ approval for their merger since before the Cigna-Express Scripts deal was announced. Visual/meme representation of that here. You’ve gotta think that Amazon’s ever-threatening encroachment into the healthcare industry is driving some of these vertical mergers between health insurers and PBMs.

Not playing by your own rules

The well-known oncology researcher José Baselga has resigned his position as Chief Medical Officer at Memorial Sloan Kettering after an NYT/ProPublica investigation showed he failed to disclose millions in payments from pharma and healthcare companies in dozens of his research articles. The payments themselves aren’t at issue, it’s the fact that he didn’t make his ties explicitly known. Which is kinda funny since those financial reporting rules were set by the American Association for Cancer Research while he was president of the group. Critics say Baselga’s fall illustrates the bigger problem of the revolving door between academic research and industry, as well as a general laziness towards enforcing ethical standards from the academic community. Expect a rush of researchers who ‘forgot’ to include their financial ties in previous papers to quietly go add those in.

UK says “yes” to more taxes

Wait what? Yep, this refreshing portrait of self-awareness is brought to you by a recent survey of 1,000 adults across Britain. You might recall from a previous InsightCity article, the UK faces some serious shortfalls in providing for an aging population, not the least of which is a potential GP shortage. The Institute for Fiscal Studies (IFS) and the Health Foundation published a report in which they outline these pressures. Back to the survey. The data show 77% support or strongly support an increase in UK spending on public healthcare by 4% a year over the next 15 years and 82% support a ~4% spending hike for social care. This translates into each UK household “contributing” around £2,000. We’re not sure that figure was disclosed to the survey respondents when they were indicating their “support” for the increase in spending, so there’s that.

Shulkin is shuck off

The Secretary for the US Department of Veteran Affairs has been fired. Or resigned. That seems to be a point of contention. Aaaaanyway, David Shulkin is best known for taking charge of the department in 2015 after a scandal that exposed false record-keeping and wait times of over 115 days for veterans to get an initial primary care appointment. More recently he’s been pushing for the use of private health care in the VA system for routine things like getting hearing aids. But while he’s a fan of private-sector coordination he’s really against full on privatization, at least according to his NYT editorial published after his elective/non-elective dismissal. President Donald Trump has nominated White House head physician Ronny Jackson to take Shulkin’s place at the head of the VA’s 370,000 employees.