Wednesday, January 17, 2018
Editorials

Editorial: Getting a grip on rising medical costs

Americans are just beginning to understand what the health care industry's secrecy costs them. New federal data about individual doctors' Medicare billing practices sheds needed light on how unintended consequences of government policies and long-held assumptions drive up the cost of medical care. Part of the solution to slowing the nation's growing health care costs is more transparency and ensuring doctors' duty to patients isn't undermined by a drug reimbursement scheme. The more consumers are aware of how choices drive costs, the better.

As the Tampa Bay Times' Jodie Tillman revealed last month, a major reason that ophthalmology ranks as the highest reimbursed specialty for Medicare is an extraordinarily expensive drug used in an in-office treatment to combat age-related macular degeneration, the leading cause of blindness in the elderly. Lucentis costs $2,000 a dose and is used in a two-year, 24-injection course of treatment. Medicare reimburses doctors based on the average cost of the drug plus 6 percent for their service.

Doctors have a less expensive option that has been confirmed by clinical trials. Avastin, which costs an average of $50 a dose, also works the same way in blocking growth of abnormal blood vessels and leakage of fluid that causes so-called "wet" macular degeneration. Combined with the doctor's fee, Medicare's cost would come in around $53. A 2011 report from the federal Office of the Inspector General estimated Medicare could save $1.4 billion if doctors switched to the lower-cost drug. But there are various policies — some of them well-meaning — that discourage Avastin's use and inflate Lucentis' cost.

First, federal law prevents Medicare from negotiating lower drug prices. That was part of the political calculus Congress made in crafting Medicare Part D, and President Barack Obama agreed to continue the ban on negotiating in order to secure the pharmaceutical industry's support for the Affordable Care Act. It is absurd that the nation's largest health care insurer cannot negotiate lower rates and save taxpayers millions.

Second, Medicare provides a financial incentive to doctors to prescribe a more expensive drug. Why aren't they paid a flat fee for administering a drug?

Third, a well-meaning federal policy requiring drug companies to seek regulatory approval for how they market drugs to doctors does not work well. Lucentis has been approved for treating "wet" macular degeneration, but Aventis, a cancer drug, has not been, even though the Food and Drug Administration has encouraged its maker to do so. But what incentive does manufacturer Genentech have to do so? It makes both drugs.

Finally, the nation's long record of inadequately regulating compounding pharmacies, where Aventis is broken into small enough doses for eye treatments, has created a prejudice against its use — particularly after a high-profile incident last year in New England where several patients died after a compounding pharmacy made a mistake. Congress has responded and there is now new regulation, but it is still unclear if it will go far enough in reducing bias against that supply chain.

The Affordable Care Act has helped millions of Americans get health coverage. But that progress could be for naught if the nation does not find a way to significantly bend the cost curve for health care and eliminate policies that encourage unnecessary spending.

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Editorial: Tighten substitute teacher rules in Hillsborough

Editorial: Tighten substitute teacher rules in Hillsborough

A substitute teacher at a Plant City elementary school berated a class of fourth graders — and then the school principal. Another compared a student to a stripper. Others were caught napping, hitting children, making sexual remarks, giving students b...
Published: 01/16/18
Editorial: Balancing the playing field for workers’ compensation

Editorial: Balancing the playing field for workers’ compensation

For the longest time, injured workers in Florida were basically at the mercy of the whims of employers to treat them fairly. A 2003 law aimed at reducing the cost of workers’ compensation coverage for businesses had the desired impact, but it also di...
Published: 01/16/18

Another voice: Why just Florida?

Cynicism has always been a part of politics, but rarely are politicians so brazen and self-serving as President Donald Trump and his interior secretary, Ryan Zinke, have been over the past week. First they announced a new offshore drilling plan that ...
Published: 01/16/18
Editorial: King’s legacy still relevant in digital age

Editorial: King’s legacy still relevant in digital age

Today’s holiday honoring the legacy of Dr. Martin Luther King Jr. couldn’t be more timely. At a moment when the nation’s civic dialogue is choking on personal and political division, it is hard to remember an earlier time when role models were role m...
Published: 01/15/18

Another voice: 38 minutes of fear in Hawaii

In 1938, Orson Welles panicked the nation with a false alarm about a Martian invasion in the radio broadcast The War of the Worlds. That was farfetched, of course. But what happened on Saturday, sadly, was not so hard to imagine — or believe.Authorit...
Published: 01/14/18
Updated: 01/16/18
Editorial: Florida’s chance to make it easier to restore civil rights

Editorial: Florida’s chance to make it easier to restore civil rights

As it has for decades, Florida stubbornly clings to an inhumane, inefficient and indefensible system of justice that permanently sentences more than 1.5 million residents to second-class citizenship. This state automatically revokes the right to vote...
Published: 01/13/18
Editorial: Speak out against Trump’s vulgar remarks

Editorial: Speak out against Trump’s vulgar remarks

President Donald Trump’s vulgar outbursts during a White House meeting on immigration are racist and indefensible no matter how he parses them. They are not presidential, they undermine U.S. foreign relations and they do not reflect America’s values....
Published: 01/12/18

Editorial: Pinellas commission stands up for accountability

The Pinellas County Commission has gotten the message that it should not be a rubber stamp. Commissioners sent a clear signal this week they will demand more accountability of local agencies by refusing to approve nominees for the board for CareerSou...
Published: 01/11/18
Updated: 01/12/18

Editorial: Progress on Tampa Bay graduation rates

Tampa Bay’s four school districts all reached a significant milestone last school year: achieving graduation rates over 80 percent. It’s believed to be the first time Pinellas, Hillsborough, Pasco and Hernando counties all surpassed that threshold, a...
Published: 01/11/18
Updated: 01/12/18

Take deal; build wall

President Donald Trump says he is optimistic a deal can be struck to shield "Dreamers," the young undocumented immigrants whose lives he put in jeopardy by stripping them of work permits and deportation protection, beginning March 5. His price, and t...
Published: 01/10/18
Updated: 01/11/18