Highlights of the important and the interesting from the world of health care:
Mayo Clinic in Arizona stops accepting Medicare patients: In what millions of Americans no doubt hope isn’t the start of a long-term trend, one primary care clinic in Arizona that’s affiliated with Minnesota’s highly acclaimed Mayo Clinic says it will stop seeing Medicare patients. The move at Mayo’s Glendale facility will affect about 3,000 patients who will have to begin paying cash to continue seeing their doctors, Bloomberg reports. Mayo says the popular government program simply pays too little. Medicare pays about 20 percent less, on average, than private plans. System-wide Mayo says its lost $840 million in 2008 on Medicare, with $120 million of that coming at its four Arizona clinics and one hospital.
However, an expert with the Urban Institute says the problem is more a function of the primary care shortage than Medicare’s pay rates:
“Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” he said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.
Challenges to the individual mandate:Now that it looks like the health overhaul is all but assured of passing Congress, opponents are pushing to defeat the measure in another venue: the courts. Conservatives, and perhaps even some liberals, are taking aim at the individual mandate, which would require Americans who don’t get health insurance through their employers to buy it on a national exchange or face a financial penalty, the Washington Post reports. Though legal scholars differ on whether the individual mandate is constitutional, it seems certain that opponents will seek to challenge the mandate all the way up to the Supreme Court. Whether the Court accepts the case is another matter, but expect to hear plenty about the following arguments in the coming months, if not years:
Conservatives make two primary arguments against the mandate. The first is that an individual’s inactivity — in this case, the failure to buy health insurance — does not qualify as interstate commerce, and thus Congress does not have the power to regulate it under the Commerce Clause. The second is that the financial penalty the law would impose goes beyond Congress’s ability to lay and collect taxes.
Biotech M&A looking up: Count peHUB blogger and Lux Capital co-founder Peter Herbert among those expecting 2010 to be a banner year for mergers and acquisitions in the biotech sector. He cites December’sstrong M&A activity, with three key acquisitions (Acclarent, Calixa Therapeutics and Gloucester Pharmaceuticals) returning a total of around $1 billion to investors as one reason for his optimism. Herbert calls this month’s JP Morgan Healthcare Conference, which kicks off next week in San Francisco the “ultimate speed dating session,” so stay tuned to reports from the conference for hints of things to come.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Montana upholds physician-assisted suicide: While most of our minds were on New Year’s Eve celebrations, the Montana Supreme Court ruled late last week that the state’s laws do not prevent residents from seeking physician-assisted suicide. Montana becomes the third-state, following Oregon and Washington, to allow the procedure, the Associated Press reports. Before proponents of the procedure rejoice, though, it’s important to note that the court didn’t rule that the state constitution guarantees the right to assisted suicide. “Instead, it said nothing in state law or the court’s precedent indicated it was against public policy — and pointed to laws giving patients rights to make crucial decisions as a justification for legalizing the assistance,” the AP reports.
