Hospitals' emergency dilemma

Excess pandemic deaths | Tuesday, July 12, 2022

Open in app View in browser   Presented By PhRMA   Axios Vitals By Adriel Bettelheim · Jul 12, 2022 Good morning, Vitals readers. I'm filling in for Tina. Today's newsletter is 880 words, a 3-minute read. One interesting thing to start the day: Amazon is quietly developing vaccines for breast and skin cancer in partnership with the Seattle-based Fred Hutchinson Cancer Center, Insider reports.     1 big thing: Hospitals' emergency dilemma Illustration: Aïda Amer/Axios   A decades-old law designed to keep hospitals from turning away uninsured patients is becoming a focal point in the post-Roe abortion debate. What's happening: The Biden administration on Monday issued new guidance stating that health providers who perform abortions in emergency situations are protected under federal law regardless of what bans are in place in their states, Axios' Oriana Gonzalez reports. Why it matters: Treating a pregnancy-related medical emergency, or transferring a patient to another facility, could run afoul of state laws that ban or severely limit abortion and make the providers subject to prosecution. Some of the laws allow exceptions for medical emergencies. But providers have faced questions determining what qualifies as an emergency — and how state laws intersect with the federal Emergency Medical Treatment and Labor Act (EMTALA). What they're saying: "Today, in no uncertain terms, we are reinforcing that we expect providers to continue offering these services, and that federal law preempts state abortion bans when needed for emergency care," Health and Human Services Secretary Xavier Becerra said in a statement. Go deeper: Hospitals routinely see patients with life-threatening conditions such as ectopic pregnancies and preeclampsia that require a rapid response. Many existing and anticipated state bans make abortion illegal, even in situations that would constitute an emergency under EMTALA, said Mary Ellen Palowitch, a senior managing director at Dentons. Concerns about how state laws could put providers in a legal bind intensified after a Texas woman who went to a hospital in April was arrested and charged with murder for an alleged "self-induced abortion." The charge was later dropped. Go deeper.     2. "Excess" pandemic deaths linked to uninsured Illustration: Aïda Amer/Axios   States with high uninsured rates saw more "excess deaths" during the pandemic that weren't attributed to the virus but stemmed from reasons like meager care in overwhelmed hospitals, the White House Council of Economic Advisers writes in a new issue brief. Why it matters: It's the latest evidence concluding the pandemic indirectly killed millions of people because of its effect on health systems and society in general. Findings: The CEA estimated a 10 percentage point increase in the pre-pandemic uninsured rate was associated with a 4.8 percentage point increase in excess mortality. Excess mortality differed significantly across states between March 2020 and March 2022, from a low of 5.7% in Hawaii to a high of 27.4% in Arizona. Uninsured people experience generally poorer health, which could make them more vulnerable to severe illness. Flashback: The CDC has estimated that excess deaths between the weeks ending March 7, 2020, and March 5, 2022, totaled 1.1 million, or 15% more than the 958,864 official death toll from COVID-19 over that period. Yes, but: There were other factors influencing excess deaths, such as regional vaccination rates and individual behaviors, such as masking and social distancing.     3. Deaths fall with lower barriers to hepatitis drugs Illustration: Sarah Grillo/Axios   Treating intravenous drug users with hepatitis drugs at the community level significantly drove down liver disease and deaths over more than a decade, Axios' Arielle Dreher writes off research in the Annals of Internal Medicine. Why it matters: Injection drug use and sharing needles are the primary ways hepatitis C spreads. The study is the first to show how increasing access to treatment for the most at-risk individuals can drive down disease levels nationwide. Details: The study followed more than 1,300 patients in Baltimore with chronic hepatitis-C from 2006 to 2019, using data from the ALIVE study, which followed adults with a history of injecting drugs. The proportion of participants with detectable hepatitis C dropped from 100% to 48% over the 13-year time frame. The big picture: Hepatitis-C cases have increased each year since 2013, according to the CDC, and federal health agencies have been working to drive down infections nationwide to 35,000 by 2025. By 2030, HHS wants to eliminate all viral hepatitis as a public health threat. Community access to treatment will help move toward this goal, the study authors write.     A message from PhRMA What's fueling inflation?     Not prescription drugs — and the presidential administration's economic data proves it. The proof: Overall inflation surged by 8.6% since May 2021 while prices for medicines grew less than 2%, even before factoring in the discounts insurers receive. Find out more.     4. FDA to consider 1st OTC birth control pill HRA Pharma on Monday sought FDA approval to sell the first birth control pill that would be available over-the-counter rather than via prescription, Axios' Ivana Saric writes. Why it matters: The company's bid comes just weeks after the Supreme Court overturned Roe v. Wade and, in the process, put contraception access back into the spotlight. State of play: FDA approval could come sometime next year and would only apply to HRA Pharma's pill, Opill, per AP. Another pill manufacturer, Cadence Health, aims to get closer to submitting an application to the FDA to move its birth control pill to over-the-counter in the coming year as well, the New York Times reported. The big picture: Last month, the American Medical Association called on the FDA to make birth control pills available over-the-counter to Americans, without an age restriction. In late June, the Biden administration put insurers on notice, reminding them of their obligation to cover at least one form of contraception at no cost to members under the Affordable Care Act.     5. Catch up quick 📞 One in six calls to the National Suicide Prevention Lifeline end without reaching a counselor, per the Wall Street Journal. (WSJ, subscription) The CDC's outdated tools make it unable to quickly and accurately track the spread of COVID-19 through air travel, a watchdog report concluded. (GAO) 👓 California's health insurance program for low-income people relies on prisoners to make cheaper eyeglasses. Why that's shortsighted. (Kaiser Health News)     A message from PhRMA The real root of inflation     Some policymakers are blaming the cost of prescription medicines for the rise of inflation to build support for harmful policies. What you need to know: Medication affordability is key, but the fact is that prescription drugs are not fueling inflation. Learn what drives up costs for patients.   Why stop here? Let's go Pro. 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