Pandemic Continues

And other healthcare news.

Happy Friday! Did anyone else find this to be the absolute worst week? I did. Just one of those can’t-get-out-of bed weeks, and I don’t have a good excuse, because my life is basically fine. This person agrees, and it really might be a thing. Also, did you know the idea of that “Blue Monday” in January originated as part of a marketing campaign for British people to vacation in the Canary Islands? If that isn’t enough to justify your malaise I don’t know what is. Dumbass world we live in.

Here’s a picture of Digby, one from the archives this time. She’s in a little box, which she loves almost as much as a big box.

Little freak.

Coronavirus news

The Los Angeles Times reports on the case of a California woman who owes over $42,000 for her $1 million Covid-19 treatment. At the start of the pandemic, most of America’s health insurers made promises about waiving patients’ cost-sharing for treatment of Covid, but the Times found that 46 percent of the insurers who were part of America’s Health Insurance Plans either never promised to waive costs, or had waivers that have now expired, despite the ongoing pandemic. (Even as daily new cases are dropping from their January peak, they’re still higher than at any point since early November.) And from the start, most of these waivers didn’t include “self-funded” plans, where the employer providing the insurance pays for the costs itself—and which comprise the majority of employer-provided plans. Like everything we’re promised will help Americans with our vicious healthcare system, it’s a patchwork, insincere, avoidable, negligent thing. It hates you. Hate it back.

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The Biden administration is struggling to gather adequate data on the race and ethnicity of vaccine recipients, hampering efforts to distribute the vaccine more equitably. The administration will ship doses directly to community health centers, which provide care in low-income settings, but will start with just a million doses across the entire nation. Meanwhile, a study published in JAMA Network Open found that nursing homes with the highest proportion of non-white residents “experienced COVID-19 death counts that were 3.3-fold higher than those of facilities with the highest proportions of White residents.”

No federal agency is tracking Covid-19 outbreaks in facilities for the disabled, according to Kaiser Health News. They should start doing that, then.

A hospital in Maine where nurses are seeking to unionize vaccinated the union-busting consultants brought in by management. The consulting firm, Reliant Labor Consultants, advertises such services on their site as “avoiding a union” and “fighting a union.” Not much to say about all this except a big old Fuck You to the management at Maine Medical Center. (Check out this piece by Sarah Jaffe in The Nation on nurses’ vital unionization efforts during the pandemic, too.)

Smaller American manufacturers of N95s are struggling to sell their products, almost a year into the pandemic.

The Washington City Paper reports on working conditions for DC’s cooks during the pandemic. The cramped, hot environment makes avoiding Covid-19 hard, but workers are desperate—particularly undocumented people who didn’t qualify for any sort of help from the government, like the expanded unemployment benefits or the stimulus checks. A recent study found that in California, line cooks had the biggest increase in mortality during the pandemic—they were 60 percent more likely to due during the pandemic than before.

Non-Coronavirus news

The Biden administration is moving to reverse Medicaid work requirements, one of the cruelest policies implemented by Trump on healthcare, according to Politico—though it’s not clear how fast this will (or can) be done.

An analysis by the consulting firm Guidehouse looked at hospital price lists, posted as part of the price transparency rules that went into effect in January, and found that about 30 percent of providers weren’t complying with the rules. Just over half didn’t provide machine-readable lists, and those that did were inconsistent on format and file type—which makes it harder for interested parties, like the government, insurance companies, or experts and journalists to analyze hospital prices at scale. I wonder if that’s sort of the point!!!

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Make sure to read this story by Jake Bittle in The New Republic on LHC Group, a major home health care company that “prioritized profits at the expense of its employees and patients alike.” Home health aides employed by the company describe being pushed to work longer hours, provided lower-quality supplies, and paid less, including hours in unpaid overtime.

A study published in Environmental Research estimated that air pollution caused by fossil fuels leads to 8 million premature deaths globally each year.

A report by the RAND Corporation found that brand-name drugs cost 3.44 times more in the United States as they do in the 32 other countries studied. Interestingly, generics cost less in the US than elsewhere—only 84 percent of the average cost of other countries, and they account for 84 percent of the volume of drugs sold, too, compared to 35 percent for other countries. It’s just that our spending on brand-names, particularly biologics, is so high that it drives our average spending up by an insane amount. (And hey, maybe other countries prescribe more brand-name drugs because they don’t pay as much for them!)

Speaking of drug costs, an NBER working paper found that even small increases in co-pays for drugs lead to an increase in deaths. For each percentage point increase in cost-sharing, the study finds, “patients make 5.6% to 18.9% fewer fills” for life-saving drugs like statins and blood pressure medications. They also found that “[s]imply inspecting the number of drugs filled at year-end reveals a substantial mass of people who, when faced with higher prices, choose to fill no drugs—no matter how many drugs they were on prior to the price shock, or their individual health risks.” In other words, people will stop taking all their drugs if they cost even a little bit more (a median increase of $10.40 in the study), even if those drugs have a major health benefit. The study was conducted by comparing behavior between patients on Medicare, who must pay for a percentage of drug costs, and patients who are also eligible for Medicaid because of their low income and assets, who face almost no cost-sharing. If you would like to stay alive, you should simply spend all your money on medications until you qualify for Medicaid.

That’s it this week—see you on Tuesday. In the meantime, send me your healthcare stories at sicknotenewsletter@gmail.com.