SC Certificate of Need reform coming, but what areas might be left out?
Plus: Politifact rates Sen. Sanders statement as "half-true" and we laugh at picking about health plan
Good morning and happy Friday. This is the Friday Pulse Check from Fulcrum Strategies and FLATLINING.net. Read on to hear why we picked Robert F. Kennedy, Jr. as the first topic on Pulse Check on the Candidates and to laugh about the absurd complexity of picking a health plan.
In the news:
Ron Howrigon speaks to KARE 11 about UHC’s denial and appeal process
KARE 11 in Minneapolis, Minnesota published a report this week that followed up on ProPublica’s March investigation into UnitedHealthcare’s denial practices. The patient in the story was receiving care at the Mayo Clinic when UHC (UNH 0.00) decided to declare the treatment “not medically necessary.” ProPublica and KARE 11 obtained phone call recordings of UHC executives laughing about the denial. It’s chilling. Our own Ron Howrigon sat down for an interview with the reporter and he explained why denials are so difficult to appeal. Watch the story on KARE11.com.
Every time Ron or someone else from FLATLINING.net or Fulcrum Strategies is interviewed or appears in the media, we tell you. But you have to subscribe.
Do Americans pay ten times what non-Americans pay for drugs? Sometimes.
KFF Health News and Politifact evaluated a statement that Senator Bernie Sander (I-Vermont) made this weekend on CNN’s State of the Union, a statement he has repeated hundreds of times before. Politifact rated the statement as “half-true,” because it is true that drug costs in the US are higher than anywhere else in the world (Ron and I have explained why on the FLATLINING Podcast) but it is not true that they are ten times more expensive. The only drug that Politifact found where this was the case was insulin and that was only when they didn’t consider discounts or insurance benefits. Read more from KFF Health News.
Watch: Senator Bernie Sanders (I-VT) predicts the PBM reform will pass the Senate.
South Carolina’s Certificate of Need reform may leave rural areas behind
A report from the Post and Courrier in Charleston, South Carolina warning that recent Certificate of Need reform, which goes into effect on July 1, will follow the trends of other states and see rural areas left out. The bill was signed into law by Governor Henry McMaster (R) on May 17. New surgery centers and facilities will be allowed to open up this summer, but hospitals will not be allowed to add new beds until January 1, 2027. This differs from North Carolina’s recent CoN reform which only removed the requirement for counties with more than 100,000 residents. Read more from Becker’s Hospital Review.
Other articles of interest:
This factor can have a big impact on cardiac recoveries - American Heart Association
Mark Cuban adds five Pfizer drugs to his low-cost, online pharmacy - Becker’s Hospital Review
Five reasons PBMs operate group purchasing organizations - Drug Channels
Justice Gorsuch: COVID-19 brought about “the greatest intrusions on civil liberties in the peacetime history” of the USA - Reason
Can you cram your weekly step goal into the weekend? - InsideHook
California Watch: Medi-Cal may see a boost in reimbursement - The Press Democrat
HIPAA Violation of the Week: End of public health emergency means end of HIPAA enforcement discretion for telehealth - The National Law Review
Robert F. Kennedy, Jr. in his own words
This week, we aired the first episode in our Pulse Check on the Candidates Series on the FLATLINING Podcast. In some ways he is both the most interesting and least interesting of the candidates.
He might be most interesting because of his vocal opposition to COVID-19 vaccines, childhood vaccinations, and the use of fluoride in water purification. He refuses to back down and insist that his interlocutors prove a negative on those issues. He has name recognition being part of the Kennedy family. His father was assassinated while running for president and his uncle was assassinated while he was president.
He might be the least interesting since he doesn’t have a very good chance of winning because he is mounting a primary challenge to a sitting president. The Democratic party has announced there will be no primary debates in the 2024 election cycle and they are going to do everything possible to make sure that President Biden is the only Democratic candidate on the ballot. Whether this is the right or wrong approach to primaries is a discussion for another time.
It is for all of these reasons that I selected him as the first subject for Pulse Check on the Candidates. RFK is a niche candidate. He is the type of candidate that will excite progressives who are disappointed in President Biden’s record on uber progressive policies and at the same time he will excite conservatives disappointed with “medical establishment” following the COVID-19 pandemic.
To him, I’ll give the same credit that I give to Senator Bernie Sanders: he is consistent and believes in what he is saying. I think what he says about childhood vaccinations and COVID-19 is obnoxious in the face of the evidence, but he honestly believes them and isn’t trying to conform to the political times.
While it might be easy to laugh and brush off comments like “childhood vaccines cause autism and food allergies” as fringe parts of his platform and put all our weight on his bonafide progressive policies on the environment and corporate interests, we have to remember that all statements have consequences.
In my analysis on a potential Kennedy administration, I came to the conclusion that he will attempt to fill high-level, medical roles with people who ally with him and his organization, the Children’s Health Defense. That means vaccine skeptics and deniers running the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration. That is not a situation that I and likely many Americans (especially physicians) will want.
That is RFK’s healthcare policy until he says otherwise. His campaign website talks about needing holistic healthcare and creating a wellness society. That sounds a lot like Dr. Joseph Mercola if you ask me.
That is why we are taking a close look at the candidates on the FLATLINING Podcast. We are working to break down the proposals and platforms to have a good understanding of what it means for physicians and patients.
Be on the lookout for the next edition of Pulse Check on the Candidates. With the field growing by the week (two more candidates joined this week), we will have plenty to talk about. Please subscribe to the FLATLINING Podcast if you haven’t already and be sure to share with your friends and colleagues as well.
Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible.
This week in our Ukraine section, we invite you to read about the World Health Organization member states who have condemned the health impacts triggered by Russia’s invasion into that country. Read more in The New Indian Express.
Let’s end with something lighter than everything else above. As many college seniors graduate this month and begin to enter the workforce, they will (almost certainly) be required to pick a health plan from their employer. I’m sure that all of our readers have been confused by some of the options presented to us at some point (even those of us who work in this business) and I wanted to share a video that helps us laugh at that situation.
Have a good weekend,