Later On

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Archive for the ‘Healthcare’ Category

The problem with US healthcare is that it’s too expensive, not that people use too much

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Sarah Kliff of Vox has a (good) email newsletter. This is from the most recent:

Check out the latest episode of What the Health, where I join Julie Rovner of Kaiser Health News, Alice Ollstein of Talking Points Memo, and Joanne Kenen of Politico to talk through this week’s latest health care news.

A quick programming note: VoxCare will be taking a week-long break over the Thanksgiving holiday. We’ll be back in your inboxes on Monday, November 27. Have a fantastic holiday! 


Earlier this week, we learned of the death of famed health economist Uwe Reinhardt. The Princeton professor was 80 years old.

Reinhardt’s influence on American health policy is hard to overstate. Aaron Frakt wrote a wonderful remembrance at the Incidental Economist, and the New York Times also has an obituary that speaks to Reinhardt’s constant curiosity, his personal warmth, and the great joy he always took in trying to understand the maddening, baffling inner-workings of the American health care system.

I wanted to take today’s VoxCare to tell you about a Reinhardt paper I think anyone interested in health policy ought to read. It fundamentally shaped how I think about the biggest problems in American health care — and the right solutions to fix them.

The paper is called “It’s the prices, stupid!” It is co-authored with Gerald Anderson, Peter Hussey, and Varduhi Petrosyan.

The thrust of the argument is this: America does not have an overuse problem when it comes to medicine. We do not go to the doctor more than people in other countries — we actually go to the doctor a little bit less.

The reason that American health care is so expensive is that, each time Americans do go to the doctor, we pay outlandishly high prices. We’re not consuming lots and lots of health care. We’re just paying higher price tags.

This is a fundamental fact about American health care that often gets lost in our debate. We have a lot of discussions about “waste” in American health care or “overuse” in our fee-for-service system.

One poll of 627 doctors, published in JAMA Internal Medicine, found that 42 percent of physicians thought their own patients were receiving too much medical care. “You’re getting too much health care,” a headline in the Atlantic bluntly declared.

Most of the policy interventions we see from Congress or statehouses target the volume of health care in America. They try to tamp down on unnecessary scans, procedures, or prescriptions as a way to ratchet down American health care spending.

But as Reinhardt and his co-authors argue in this paper, those policy interventions don’t get at the fundamental problem of the American health care system: our prices. Reducing the number of MRI scans in the United States, for example, won’t change the fact that an MRI in the United States costs an average of $1,119 — but $503 in Switzerland and $215 in Australia.

Here is how Reinhardt described the situation in a 2013 blog post for the New York Times:

Traditionally, the theory driving discussions on the high cost of health care in the United States has been that there is enormous waste in the system, taking the form of excess utilization of care. From that theory it follows that methods of controlling the growth of health spending should focus on ways to reduce the use of unnecessary or only marginally beneficial health care.

Largely overlooked in these discussions has been the elephant in the room: the extraordinarily high prices Americans pay for health care. However, as a group of us noted in a paper in 2004, “It’s the Prices, Stupid,” it is higher health spending coupled with lower — not higher — use of health services that adds up to much higher prices in the United States than in any other member nation of the Organization for Economic Cooperation and Development. Aside from a few high-tech services, Americans actually use less health care and rely on fewer real health-care resources than do residents of other industrialized countries.

Reinhardt’s relentless focus on American health care prices has shaped my own reporting. It’s made me question the policy interventions that tackle the volume of health care, and how far they can really take the United States to better controlling our health care costs.

What Uwe Reinhardt taught me about American health care is exactly the title of his paper: It’s the prices, stupid. And that has shaped what I decide to report on. It is why I tackle projects that try to bring more transparency to American health care pricing, and the reason I think it’s important to tell the stories of the medical bills my readers send me.

These aren’t one-off, sad stories. These are, as Reinhardt rightfully spent his career arguing, small windows into the systematic way the American health system charges sky-high prices.

I’m so glad I had the chance to interview Reinhardt as a health reporter and learn from his work. This 2004 paper remains just as relevant to explaining American health care now as it was at the time of publication — and I highly recommend taking the time to read it.

Another item in the newsletter suggests that the overcharging is done deliberately:

“Health Giant Sutter Destroys Evidence In Crucial Antitrust Case Over High Prices”: “Sutter Health intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in a lawsuit that accuses the giant Northern California health system of abusing its market power and charging inflated prices, according to a state judge.” —Chad Terhune, Kaiser Health News

Written by LeisureGuy

17 November 2017 at 3:39 pm

VA Delays Key Agent Orange Decisions

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Charles Ornstein reports in ProPublica. The blurb:

Since March 2016, the U.S. Department of Veterans Affairs has been weighing whether to expand Agent Orange benefits to Vietnam vets with bladder cancer and hypothyroidism, as well as other ailments. It keeps missing its own deadlines to act.

The article begins:

Days after he was sworn in as Veterans Affairs secretary this year, Dr. David Shulkin held a digital town hall meeting to take veterans’ questions.

A veteran named Jack posed a question of paramount importance to many Vietnam veterans: Would the U.S. Department of Veterans Affairs expand the list of diseases that are presumed to be linked to Agent Orange, a toxic herbicide used to kill forests during the Vietnam War?

“We’re getting very close to being able to give you a final answer on that,” Shulkin said on Feb. 24, adding that he was weeks away from being presented with the data he needed to make a decision. “I’m anxious to get it so that we can begin to get answers to people like Jack, because it’s been too long that they’ve been waiting to get those answers.”

Yet more than eight months later — and after his department promised a decision by Nov. 1 — the VA essentially punted, issuing a statement late Wednesday saying it would “further explore” the issue and pushing its decision to some undisclosed point in the future.

The VA said the department would now work with others in the Trump administration to conduct a legal and regulatory review of conditions for awarding disability compensation to eligible veterans.

Many veterans said they thought that was exactly the review that has been ongoing since March 2016, when the National Academy of Medicine, then known as the Institute of Medicine, said there is now evidence to suggest that Agent Orange exposure may be linked to bladder cancer and hypothyroidism. The National Academy also confirmed, as previous experts have said, that there is some evidence of an association with hypertension, stroke and various neurological ailments similar to Parkinson’s Disease.

In the past, the VA has found enough evidence to link 14 health conditions, including various cancers, to Agent Orange, which the U.S. military sprayed by the millions of gallons in Vietnam.

The Agent Orange Act of 1991 had required that the VA secretary take action on National Academy recommendations within 60 days of receiving a report; the law expired in 2015.

“Son of a gun,” said Dick Pirozzolo, 73, when he was informed of the VA’s decision to delay. Pirozzolo served as an information officer in the Air Force in Vietnam and has had bladder cancer and a thyroid condition called Graves’ disease. “That sucks.”

Pirozzolo said he applied for benefits based on his bladder cancer — and was denied. He is in the process of seeking benefits for his thyroid. “It’s frustrating,” he said. “The politicians all talk a good game about the VA, but then when it comes down to making a decision, they drag their heels.”

Carla Dean’s husband, James T. Dean Jr., died of bladder cancer last year at age 72, six days after his birthday. His application and appeals for VA benefits have been denied. Dean said she feels “gobsmacked” by the VA’s actions this week, especially because her husband died feeling relieved that he and his wife had helped persuade the National Academy of the link between his disease and Agent Orange exposure.

“My husband gave 11 1/2 years of his life to the United States Army willingly, 19 months in Vietnam, heavy combat,” Dean said. “Never in a million years did he dream basically that his government betrayed him.”

ProPublica and The Virginian-Pilot have profiled the efforts of vets with bladder cancer to secure benefits. . .

Continue reading.

The US government seems increasingly paralyzed and enfeebled.

Written by LeisureGuy

6 November 2017 at 3:53 pm

Veterans Groups Push for Medical Marijuana to Treat PTSD

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For treating PTSD and pain veterans groups understandably prefer marijuana (non-addictive, no deaths from using it) to opioids (highly addictive, overdose deaths increasingly common). However, ideology (not science) puts up significant barriers to a rational solution. Reggie Ugwu reports in the NY Times:

Among critics of the federal prohibition of marijuana — a diverse and bipartisan group that includes both criminal justice reform advocates and Big Alcohol — the American Legion and its allies stand out.

For more than a year, the stalwart veterans group has been working to reframe the debate as a question of not only moral and economic imperatives, but also patriotic ones, arguing that access to medical marijuana could ease suffering and reduce suicide rates among soldiers who return from the horrors of war.

“We’ve got young men and women with PTSD and traumatic brain injuries coming to us and saying that cannabis works,” Joe Plenzler, a spokesman for the group, which was established after World War I and has over two million members, said by telephone Wednesday.

Mr. Plenzler said that veterans had turned to medical marijuana as an alternative to so-called “zombie drugs,” including opioids and antidepressants, that they said adversely affected their mood and personality, up to and including thoughts of suicide. In studies, cannabis has been shown to help alleviate chronic pain and reduce muscle spasms in multiple sclerosis patients.

In 2016, the American Legion petitioned the government to relax federal restrictions on marijuana in two ways. The group asked Congress to remove the drug from the list of Schedule 1 narcotics — a class that includes heroin, LSD and other drugs that have “no accepted medical use” and a high potential for abuse — and reclassify it in a lower schedule. It also called on the Drug Enforcement Administration to license more privately funded growers to focus on medical research.

Because marijuana is a Schedule 1 drug, there is surprisingly little rigorous research into its medical applications, as researchers have found themselves stymied by regulatory hurdles at federal health and drug agencies and short on a supply of federally approved product.

The classification also means that veterans — many of whom rely on the federal Veterans Affairs Department for their health care — cannot get coverage for medical marijuana, even in the 29 states that have legalized it.

On Thursday, The American Legion published a phone survey of over 800 veterans and veteran caregivers in which 92 percent of respondents said they supported research into medical cannabis for the purpose of treating mental or physical conditions. Eighty-two percent said they wanted cannabis as a federally legal treatment option.

“Even in the states where it’s legal, there’s still the stigma associated with the federal ban,” said Louis Celli, the group’s national director of veterans affairs and rehabilitation. He noted that soldiers were regularly subjected to urinalysis and told to stay away from the drug. “It puts veterans in a very difficult position.”

Though a Quinnipiac University poll released in April found that a record 94 percent of all Americans supported doctor-prescribed medical marijuana usage, veterans advocating research have run into the same roadblock as pro-cannabis activists around the country: the Justice Department.

President Trump campaigned in support of medical marijuana and said that recreational usage should be a “state-by-state” issue. But his attorney general, Jeff Sessions, has been an outspoken critic of legalizing the drug for any purpose. Veterans groups draw a straight line from obstacles to medical marijuana research to the doorstep of Mr. Sessions.

“He is putting politics, antiquated policies and his own personal opinion ahead of the health needs of veterans in this country,” said Nick Etten, executive director of Veterans Cannabis Project, referring to Mr. Sessions.

A representative for the Justice Department declined to comment, but Mr. Sessions said during an oversight hearing with the Senate Judiciary Committee last month that he was considering expanding the supply of research-grade marijuana.

Veterans groups say the fastest and most effective way to help veterans get access to treatment is to simply reschedule the drug. That would automatically lift the most onerous barriers to research and allow V.A. health care providers to immediately prescribe marijuana in states where it is legal.

But getting the necessary legislation through a fractious, conservative congress may still be a pipe dream. . .

Continue reading.

Written by LeisureGuy

4 November 2017 at 8:51 am

Obamacare/Affordable Care Act open enrollment starts today and ends December 15: Move fast

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I just received an email from Vox:

Obamacare’s sign-up period starts today.

The 9 million Americans who purchase coverage through the health law’s marketplaces have from now until December 15 to pick their 2018 coverage. For those buying coverage — or just interested observers — here are the five things you need to know about this open enrollment period.

1) Open enrollment is short this year — 45 days instead of 90. Over the past few years, the Obamacare open enrollment period typically ran from November 1 through January 31. That gave enrollees about three months to pick a plan. Many would wait up until that late January deadline to sign up. That will not work this year. The enrollment period now ends on December 15, which means that shoppers will have to move quicker to sign up for coverage this time around.

2) Premiums for some Obamacare plans are spiking by double digits. The cost of mid-level silver plans is rising a lot this year, on average 37 percent, according to Health and Human Services estimates. Most of that rate hike is due to the Trump administration’s decision not to pay cost-sharing reduction subsidies. I wrote more about this in yesterday’s VoxCare, but essentially insurers jacked up premiums to offset the loss of this other funding source. This means that the sticker price of silver plans often looks a lot higher this year. But…

3) There are some great deals to be had on bronze and gold plans. In many states, health plans made their biggest premium increases in their silver plans. This is important because (again, this builds on yesterday’s newsletter) the size of the premium tax credit is tethered to the price of the silver plans. More expensive silver plans mean bigger premium tax credits. And Obamacare enrollees can take those credits to buy a less generous plan (called a bronze plan) for a really cheap price, maybe even free.

Many Maine residents, for example, qualify to buy these bronze plans with a zero-dollar premium, the Portland Press-Herald reports.

Shoppers can also go in the opposite direction: use their new big tax credit to buy a more generous gold plan at a lower out-of-pocket price.

4) It is really, really, really important to shop for coverage this year! The prices for Obamacare insurance this year are, well, just weird. Sometimes plans with low deductibles cost more than plans high deductibles. There are a decent number of free health insurance plans out there for people who receive financial assistance paying their premiums. And there are some really expensive plans out there, too.

All of this makes it so important for Obamacare enrollees to shop for coverage. There are a lot of cases out across the country where enrollees could save hundreds or thousands of dollars by switching health insurance. There is the opportunity, in many cases, for enrollees to get a better plan for a cheaper price. This year more than ever, it is crucial that enrollees compare their options.

If you need a bit of help, the New York Times has put together a great guide to how different Obamacare enrollees in different situations can best shop for coverage. Check it out here.

5) There is enrollment help out there — just less of it. The Trump administration made steep cuts to Obamacare outreach. Funding for in-person assistance fell 72 percent this year, and some groups closed up shop entirely.

Still, there is help out there. Get America Covered offers a tool that lets Obamacare enrollees search by zip code to see the closest Obamacare navigators and even make online appointments.

Those groups are scrambling to provide assistance in this shorter enrollment period, so it’s better to get an appointment early rather than wait till the last minute.

Are you an Obamacare enrollee who has questions about this year’s sign-up period? Covered Florida will be dropping into our Facebook group to help provide guidance. If you’re an Obamacare enrollee, you can join the group here.

Written by LeisureGuy

1 November 2017 at 12:27 pm

Glasses Are Cool. Why Aren’t Hearing Aids?

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Full disclosure: I use hearing aids. A few years ago, The Eldest (who works in public health) pointed out an article to me on the effects of hearing loss. As this study found, “Hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults.” That certainly got my attention. I immediately had a hearing test and bought the hearing aids prescribed, which I continue to use. And I also wear glasses.

Jennifer Finney Boylan writes in the NY Times:

If I do my job right, this column might actually change your life. More important, it might change the lives of the people you love.

But first, I need to talk about Elton John’s glasses. It was my first concert. Philadelphia Spectrum, 1972. Elton opened up with “Tiny Dancer” on solo piano. Later, during “I Think I’m Going to Kill Myself,” a character named Legs Larry Smith came out and tap danced.

But none of that is what I remember best. What has stayed with me all these years has been those stylish glasses. Spotlights flooding the stage twinkled off his rims.

Back then, I wore glasses, too. Until that moment, I had never thought of them as a fashion statement. I just thought of them as a way of existing in the world.

But of course glasses were, and are, a fashion statement. Eyewear practically defines certain people’s style. Teddy Roosevelt and his pince-nez. Iris Apfel and her signature circular specs. Mr. Peanut, rocking a monocle. In my 20s I knew a girl with perfect eyesight who even had a pair of clear glasses designed for her. “So that I look hot,” she explained, “when I take them off.”

Why, I wonder, is it that devices to keep you from being blind are celebrated as fashion, but devices to keep you from being deaf are embarrassing and uncool? Why is it that the biggest compliment someone can give you about your hearing aids is “I can hardly see them”?

Hearing loss is endemic, and not just for older people. Almost one in four Americans between the ages of 20 and 69 who think they have good hearing actually have some hearing impairment. Among those in their 50s, 4.5 million people have some hearing loss. How many wear devices that would enable them to better hear the world? Less than 5 percent.

Wearing hearing aids can change your life in an instant — not to mention that of the people you love, whose actual voices you may have been unable to hear. But we don’t get help. Because coverage by insurance carriers is inconsistent. Because we don’t know where or how to get our hearing tested. Because we’re afraid of what others might think. Because hearing loss is uncool.

This needs to change. Start with insurance: Hearing aids can be expensive, but employers need to know that people who can’t hear can’t do their jobs well. Education matters, too: People who thought it was dumb for Donald Trump to look directly at the sunduring the solar eclipse might think nothing of slapping on a pair of headphones and cranking their music to 11.

The first thing you can do is to get your hearing tested; this is helpful even if you don’t think you have hearing loss, so that you have a baseline reference. There are several free tests online, sponsored by PhonakMiracle-Ear, Beltone and others. They aren’t as good as the ones a doctor can give you, but it’s a start.

About 90 percent of hearing loss is “sensorineural,” usually caused by damage to hair cells in the inner ear. Sometimes it’s the result of exposure to loud sounds (like concerts at the Spectrum). That’s the kind of hearing loss I have; my inability to hear high-pitched sounds means that understanding a conversation in a crowded restaurant can be a challenge.

New technology enables wearers to focus their hearing on the person in front of them while canceling out all sound behind. You can control just how much of the world you want to amplify or cancel out by using a free app on your mobile device. And it looks good — I recently wore such a device at a party where, for the first time in years, I heard everything that everyone was saying. It completely changed the way I experienced the world.

When I first learned that I had serious hearing loss (after a lifetime of playing in super-loud bands), I called my wife on the phone, and as I told her of my diagnosis I started to cry. “I’m so sorry you have to be married to someone like me,” I sobbed. . .

Continue reading.

Written by LeisureGuy

1 November 2017 at 12:05 pm

What’s killing America’s new mothers?

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Annalisa Merelli writes in Quartz:

Elizabeth “Liz” Logelin was a young, fit woman with a promising career in operations management at Disney. On March 24, 2008, after a complicated pregnancy that saw her bedridden for nearly two months (three weeks of which were in the hospital), she delivered her daughter Madeline (Maddie) through an emergency cesarean section. Two and a half months early, Maddie was healthy, if tiny. Twenty seven hours after the delivery, Liz was finally cleared to hold her firstborn. Her husband Matt Logelin already was, he teased her, several diaper changes ahead of her. She got up from the bed, ready to make her way to the nursery, and stopped in front of the mirror. “My hair looks like shit,” she said, of her long tresses. She laughed, Matt laughed, the nurses laughed. He thought her hair looked great.

She walked towards the wheelchair that was going to take her to the nursery, and suddenly didn’t feel well. “I feel lightheaded,” she complained. Moments later, at age 30, Liz was dead.

The cause was a pulmonary embolism—a blood clot that travelled from her leg to her lungs, and killed her instantaneously.

Though she had a family history of blood clots, suggesting a genetic predisposition, and her risk was increased by the prolonged bed rest and the subsequent c-section surgery, to Matt’s knowledge Liz wasn’t given anticoagulant medications, or advised to exercise to help stimulate her blood flow. Everyone’s attention, hers included, was turned elsewhere, to baby Maddie—so precious, so perfect.

There’s an assumption that death from childbirth is just not something that happens—not in America, or at the very least not in Matt and Liz’s America. “We were very healthy people living in Southern California, with great jobs; [Liz] was very healthy—she didn’t smoke, she barely drank,” Matt says. “We thought we were untouchable,” he adds ruefully.

But dying of childbirth, Matt would learn in the worst possible way, did happen in America. Even to women as young and healthy as Liz, with access to good medical care, and the wherewithal to understand and follow up on their doctor’s advice.

On that May day, she joined one of the US’s most shameful statistics. With an estimated 26.4 deaths for every 100,000 live births in 2015, America has the highest maternal mortality rate of all industrialized countries—by several times over. In Canada, the rate is 7.3; in Western Europe, the average is 7.2, with many countries including Italy, Norway, Sweden, and Austria showing rates around 4. More women die of childbirth-related causes in the US than they do in Iran (20.8), Lebanon (15.3), Turkey (15.8), Puerto Rico (15.1), China (17.7), and many more.

While most of the world has drastically reduced maternal mortality in the past three decades, the US is one of just a handful of countrieswhere the problem worsened, and significantly.

Between 700 and 1,200 women die from complications related to pregnancy or childbirth every year in the US. Fifty times that number—about 50,000 in all—narrowly escape death, while another 100,000 women a year fall gravely ill during or following a pregnancy.

The dire state of US data collection on maternal health and mortality is also distressing. Until the early 1990s, death certificates did not note if a woman was pregnant or had recently given birth when she died. It took until 2017 for all US states to add that check box to their death certificates. Calculating the number of near-deaths and severe illnesses related to pregnancy is still guesswork. There is no standard or official method of tracking, and cases are not routinely documented. In other words, data collection about maternal health and mortality is a complete mess. Even gathering reliable data for this story was difficult. Quartz was forced to turn to state data where there was a lack of national data, and to supplement gaps of any data with anecdotal evidence. If the US does not know it faces a crisis, how can it reverse the tide, and prevent the needless death of the next Liz Logelin?

Quartz probes the sorry state of US maternal data in a separate story.

The lack of proper documentation of maternal health is about more than data collection though, and speaks volumes about what little thought or consideration has been given to expectant and new mothers in the US. It’s hard to avoid the inference that they’re not considered important enough to merit focused attention. It’s certainly representative of a bigger problem, that women in the US are not getting the medical attention they need. It’s as though the US is rendering its mothers invisible.

“It’s the biggest catastrophe that we have in medicine to have young mothers die of preventable causes,” says Elliot Main, the medical director of the California Maternal Quality Care Collaborative (CMQCC).

Determining exactly why so many American mothers are dying of, or suffering through, pregnancy is a gargantuan public-health puzzle. Through the course of reporting this story, it quickly became apparent that there is no single reason, but instead a complex brew of factors that, together, point to deep-rooted, systemic problems that run through the entire social and health care system of the country. Gender, class, race—and across all, a fragmented, mainly private health system—conspire to work against maternal health. In many ways, it’s a litmus test of the health of health care in the US. . .

Continue reading. There’s more.

Written by LeisureGuy

30 October 2017 at 4:22 pm

Trump’s opioids declaration was missing one key thing: money

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Ella Nilsen reports in Vox:

President Donald Trump declared America’s opioid crisis a public health emergency on Thursday, after sending mixed signals on the issue for the past three months. But there’s one big thing missing: money.

Trump won’t direct any new federal money to the opioid crisis, per administration officials. The declaration will free up the federal Public Health Emergency Fund to be used to fight the drug epidemic, but Congress hasn’t replenished the fund in years. There’s just $57,000 left in it — and public health experts say that a serious response to the addiction crisis would cost $183 billion over the next decade.

For public health officials, doctors and treatment advocates on the ground in states hardest hit by the epidemic, the federal government – under both the Obama and Trump administrations – has been slow to respond to America’s deadliest drug crisis, which killed a record 64,000 Americans last year.

Trump’s Thursday declaration, though encouraging, wasn’t the decisive action that many were looking for.

“I think it was a step forward but it wasn’t the big step, because it does not bring new money,” said Tym Rourke, chairman of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery and a longtime treatment advocate in the state. New Hampshire has the second highest rate of fatal drug overdoses in the nation, behind West Virginia.

“There are unmet needs right now that this declaration, while welcome, does not address,” Rourke said. “If we don’t get additional resources on the ground, there is only so much positive impact we can have.”

In West Virginia, where the death toll from heroin, fentanyl and prescription opioids is the worst in the United States, public health officials say they want help from the federal government matching the scale of the devastation they see every day.

“People are dying out here,” said Michael Brumage, executive director of the Kanawha Charleston Health Department in Charleston, West Virginia, in a recent interview. “We are having a Vietnam in America every single year from overdoses. If this is a war, why would we not apply the resources as we could?”

Brumage said he believes there’s a disconnect between government officials in Washington D.C. and people who are seeing the toll of the drug crisis play out every day in America’s communities.

“When you’re sitting in a position of power and you’re removed from the day to day misery of this epidemic, I believe it’s easy to dismiss,” Brumage said. “I think at an intellectual level they see the numbers of deaths from overdoses, but they’re abstractions because they’re figures on a piece of paper.”

“The public health hurricane of our generation”

Hard-hit states like New Hampshire and West Virginia have already had mixed experiences with the government’s response to the opioid crisis: they’ve gotten much less help than states with lower death rates.

The 21st Century Cures Act, passed last year, included $1 billion to be dispersed among states for drug treatment. The bill’s intent was for more federal money to go to states with the highest per capita drug death rates.

But after the bill was signed into law by President Obama, the Substance Abuse and Mental Health Services Administration changed the funding formula to take into account states with the biggest overall numbers of overdose deaths.

That meant more populous states like California, Florida and Texas got the most money, even though their per capita death rates were much lower. New Hampshire, with the second-highest death rate in the nation, received about $6.2 million over two years. Texas, with the fourth-lowest per capita rate for drug fatalities in the US, received $27.4 million. . .

Continue reading.

Written by LeisureGuy

28 October 2017 at 12:19 pm

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