February 5, 2018
Midwinter Short Takes On Some Current Health Topics
By Michael D. Shaw
We just observed Groundhog Day, and now know whether or not we are facing six more weeks of winter. Of course, a quick check of the calendar will reveal that the elapsed time between February 2nd and this year’s vernal equinox (March 20th) is 46 days (six weeks and change). February 2nd is roughly halfway between the winter solstice and the vernal equinox, and has long been a time of celebration. The Celts had Imbolc, and the Christians have Candlemas (Presentation of the Lord).
Adolescent Brain and Cognitive Development Study
This study, with the catchy acronym ABCD, is the largest long-term study of brain development and child health in the United States. Launched by NIH on September 25, 2015, the study is recruiting approximately 10,000 children, at age 9 or 10, (i.e. before they are likely to have started using drugs), conducting behavioral interviews and gathering neuroimaging, genetic, and other health data at periodic intervals until they are young adults. The subjects will be followed for approximately ten years.
As such, the goal is to determine how biology and environment interact and relate to developmental outcomes such as physical health, mental health, and life achievements.
While the original concept of the study focused on drug and alcohol abuse, the scope has expanded. Last November, the Medical University of South Carolina joined the project. Lead researchers at this facility are Lindsay Squeglia, PhD and Kevin Gray, MD. As Squeglia puts it, “We want to know how things like screen time, substance use, head injuries, hobbies, video games, how all of these things affect how the brain is developing.”
Gray emphasizes that every kid who visits a pediatrician is readily evaluated against norms for height and weight, but “We don’t have anything like that for brain development.”
I’ll go out on a limb here and say that spending 10 hours a day staring at screens may not be ideal for young brain development.
Patients Over Paperwork Initiative
Even the Center for Medicare & Medicaid Services (CMS) realizes that providers need to spend more time with their patients, and less time dealing with regulatory and administrative functions. As such, last October, CMS announced its Patients Over Paperwork initiative.
Specifically, this policy aims to:
** Increase the number of satisfied customers–clinicians, institutional providers, health plans, etc. engaged through direct and indirect outreach
** Decrease the hours and dollars clinicians and providers spend on CMS-mandated compliance
** Increase the proportion of tasks that CMS customers can do in a completely digital way
Since CMS sets the tone for the manner in which all insurers and medical plans operate, this is a welcome development.
Amazon, Berkshire Hathaway, And JP Morgan Chase Join Forces To Disrupt Healthcare
For sure, this announcement has caused a stir. Among other things, prices of various health stocks dropped.
Julius Hobson, health care lobbyist with Polsinelli in Washington, D.C. shared these thoughts:
“Health care costs have annually exceeded inflation for years. In 2015, health care was 18 percent of GDP. It should be no surprise, then, that large business corporations are combining to lower health care costs. The question is, why did it take so long? The new entity would cover about 900,000 employees worldwide. The volume alone will help cut costs. With a lesser incentive for profits, the new company can cut out middle entities, such as pharmacy benefit managers.”
“Hospitals could contract directly with the new company. Initially, the company could buy drugs at a greater volume and demand lower prices. Later, it could manufacture generic drugs as a means for reducing costs.”
All true, but as retired vascular surgeon and blogger Chuck Dinerstein has noted, the supposed dream team collaboration is “missing actual healthcare.”
“If health care was solely about financing, logistics, and value investing we would be in fat city. But the absence of any indication of who will direct the actual health care suggests that this is only a game changer for how we pay for healthcare, not, in the office, in the emergency department, or in the operating room healthcare. Perhaps that is why the insurance companies stocks fell and the hospital stocks rose.”
It’s not just about the dollars.