AVOIDING A GOVERNMENT SHUTDOWN

In a typical year, legislators find it to be extremely difficult to agree on 12 appropriations bills. The current fiscal year ends on September 30. Assuming that not all of these pieces of legislation have been signed into law by that date, a remedy exists in the form of continuing resolutions (CRs). One possibility could be to produce a CR to avoid a federal government shutdown at the end of the fiscal year (FY) on September 30. Such a short-term spending bill might, for example, extend current government funding into late November or early December.

Having left Capitol Hill for most of August, elected officials returned in September with the Senate Appropriations Committee approving spending allocations for all 12 subcommittees, along with Defense and Energy and Water Development spending bills by a party line vote of 16-15. While appropriators had planned to vote on the Labor, Health and Human Services (Labor-HHS) bill and State-Foreign Operations bills, proceedings had to be postponed because of abortion-related disputes regarding Title X grant funding. Disagreements over the topic of abortion have a long history of serving as a major impediment to reaching agreement.

The 302(b) top-line spending caps for FY 2020 were decided without input from House appropriators, who already have advanced the majority of their panel’s spending bills. Labor-HHS, which includes Education, will receive $187.7 billion, a $200 million amount that constitutes only a 1% increase over FY 2019 levels.

Regardless of party affiliation, it is quite likely that continued efforts will be made to deal with the problem of high pharmaceutical prices. The soaring cost of insulin offers a stark example of exorbitant drug pricing. More than 100 million individuals are either diabetic or pre-diabetic. Although the drug was invented in 1922, its inflated-adjusted per unit price has at least tripled between the 1990s and 2014. In the U.S., insulin costs per patient have nearly doubled from 2012 to 2016 ($2,864 vs $5,075). High prices of this nature are driving up health insurance premiums and creating unaffordable costs for patients.

Proposed solutions vary between Democrats and Republicans. House Speaker Nancy Pelosi (D-CA) is preparing to issue a plan to lower drug prices by directing the U.S. Department of Health and Human Services (HHS) Secretary to negotiate the prices of the 250 drugs that are most expensive to Medicare each year and that lack competition of at least two other generic drugs, biologics, or biosimilars. Pharmaceutical manufacturers that do not negotiate or are unable to reach an agreement with the government would face a 75% penalty of the gross sales of the drug from the previous year. Other purported features include that lower drug prices would apply to both Medicare and private insurers, and that savings resulting from the lower-priced drugs would be directed to the National Institutes of Health (NIH) for the development of new drugs and treatments. The legislation also proposes a $2,000 cap on Medicare beneficiary out-of-pocket spending starting in 2022.

Meanwhile, a more moderate alternative by Republicans has emerged from the Senate Finance Committee that would require manufacturers to issue rebates to the Medicare program if prices rise faster than inflation.

UNCERTAINTY IN RELATION TO EXISTENTIALISM

Indicates the importance of conducting more research on the topic of uncertainty, an incompletely understood phenomenon. Read More

PRESIDENT’S CORNER—ASAHP MEMBER FOCUS

Susan Hanrahan offers her thoughts on the upcoming ASAHP Annual Conference from the standpoint of speakers, a leadership panel, and the Business Meeting, along with updated information about the Association’s Institutional Profile Survey. Read More

 

HEALTH REFORM DEVELOPMENTS

Discusses questions pertaining to enactment of proposed Medicare For All Legislation. Read More

 

DEVELOPMENTS IN HIGHER EDUCATION

Summarizes finalization of stricter rules for student loan claims and trends in the ratio of the Pell Grant to total price of attendance and federal loan receipt. Read More

QUICK STAT (SHORT, TIMELY, AND TOPICAL)

  • Mortality Patterns Between States With Highest Death Rates And States With Lowest Death Rates

  • Comparing Retail Clinics With Other Sites Of Care

  • The Use Of Small-Scale, Soft Continuum Robots To Navigate In Cerebrovascular Areas

  • The Use Of “Phyjamas” In Health Care Read More

AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY

  • Hospital Concentration Index

  • Reducing Inequities In Healthy Life Expectancy

  • Investing In Interventions That Address Non-Medical, Health-Related Social Needs Read More

BALEFUL IMPACT OF WORKPLACE INCIVILITY ON HEALTH

Mentions how dissimilarity in political identity can relate to reducing the quality of interpersonal interactions and subsequent well-being of workers. Read More

 

“BURNOUT” AND EARLIER SOMATIC PHENOMENA

Refers to a possible relationship between burnout in the 21st century and neurasthenia in an earlier century. Read More

 

THE ROLE OF ACCIDENTS ON THE PATHWAY TO INJURY AND DEATH

Examines factors pertaining to death and injury of adolescents from motor vehicle accidents and adult mishaps stemming from attempts to remove an avocado pit with a knife. Read More