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.

Happy holidays, your gift is medical debt forgiveness

Medical debt can easily be characterized as out of hand in the US, considering there’s more than $750B in past-due bills floating around out there. Two New Yorkers decided to buck the stereotype of being stingy and spent some time raising money to make that number just a bit smaller. So they raised $12,500… which, to be fair, is way more than I have in my checking account in any time, but is not going to help a ton of people out. Enter RIP Medical Debt, a charity started by former debt collectors (boo) who now buy medical debt portfolios en masse and forgive them (yay!) That $12,500 allowed the charity to buy $1.5M in medical debts, and gave 1,284 New Yorkers a surprise Christmas/Hanukkah/Festivus/Year-End gift. Talk about a feel-good story.

Show me the drug money

While any DTC drug commercial will likely include shots of people happily hiking and a list of side effects longer than the symptoms of the disease it’s curing, one thing you won’t see advertised is the price of the prescription. New federal policy could change that for drugs covered under Medicare and Medicaid, forcing companies to disclose list prices in TV advertisements. While most patients don’t typically pay the full price for their prescriptions, Health and Human Services Secretary Alex Azar says, “They deserve to know if the drug company has pushed their prices to abusive levels.” PhRMA says their members would be willing to include a link to a website that has pricing information in advertisements, to which Azar pretty much replied, that’s not what I meant.

Free gene tests! Get your free gene tests here!

Genes seem to play a role in causing disease, but perhaps not in the way you may think. The current thinking around genes is that one bad or missing gene isn’t going to be the sole cause of most diseases. Rather, it seems that multiple genetic factors mix together to increase risk. Dr. Sekar Kathiresan came up with a way to assess how many genes are causing those risks in a patient, called a polygenic risk score. The score could help identify ‘hidden’ at-risk patients—AKA patients at-risk for a condition that weren’t tipped off by current assessment tools. Also, Kathiresan wants to offer the assessment for free. But there’s some skepticism that an extra diagnostic tool could cause patients to seek unnecessary treatment. Still, something to keep tabs on.

Hacks that hurt

We’re used to vulnerabilities in data systems leading to massive personal data breaches (cool visualization of those here.) But there’s an even darker side to hacking that can put peoples’ lives directly at risk. We’re talking medical device hacks. Two “white-hat” (good) hackers identified vulnerabilities in pacemakers and insulin pumps which “black-hat” (bad) hackers could use to injure patients. One scenario put forth is a pacemaker being manipulated to deliver too many or too few electric shocks, which obviously could lead to negative patient outcomes. The researchers shared their findings with the device manufacturer and relevant regulatory bodies, but they say these authorities are playing down the risks. They apparently considered bringing in a pig they could kill with an app to make their point, so we should probably take them seriously.

Summary of Trump’s Drug Pricing Plan

American Patients First. Catchy title. Unless you’ve been under a rock, you’ve likely heard of President Trump’s “sweeping” drug pricing proposals. While it’s way too complicated a topic to cover in our typical article length, we’re going to provide some of the better summaries. First is a nice summary about how this could impact the drug distribution system. Second is about how PhRMA increased its lobbying by 30% in 2017. Third is how Wall St. reacted in a positive manner on Friday, signaling Wall St. isn’t scared of the Trump plan for drug makers. Our last point is how Health & Human Services (HHS) Secretary Alex Azar said pharmacy benefit managers (PBMs) are a prime target in the effort. There will be lots more to digest in the future as the plan is unraveled. As the Brits say, keep calm and carry on.