Morning Read: Congress put ‘health’ in healthcare reform

Highlights of the important and the interesting from the world of healthcare:

Congress quietly tucked disease-prevention into healthcare reform. With little fanfare — and in spite of a rancorous and sometimes poisonous healthcare reform debate — Congress approved a set of wide-ranging public initiatives to prevent disease and encourage healthy behavior, according to the New York Times.

The initiatives to encourage people to turn from their evil ways — sedentary lifestyles, smoking, and intake of fatty, high-calorie foods — and to adopt healthier ways of living reflect a sea change in federal health programs and policy, said Sen. Max Baucus, Democrat of Montana and chairman of the Senate Finance Committee, which took a leading position in healthcare reform.

Republicans supported many of the health promotion initiatives and objected to a few, but had much bigger concerns about the overall law, the Times said. The proposals largely escaped public notice as lawmakers fought over abortion, taxes and a government-run “public option.”

Under the law, chain restaurants will have to provide nutrition information on their menus. Employers must provide “reasonable break time” for nursing mothers. Health insurance companies will soon have to cover all recommended screenings, preventive care and vaccines, without charging co-payments or deductibles. Medicare beneficiaries will get free annual physicals. Medicaid will cover drugs and counseling to help pregnant women stop smoking. And a new federal trust fund will pay for more bicycle paths, playgrounds, sidewalks and hiking trails, the Times said.

Some of the same initiatives in the Patient Protection and Affordable Care Act also will boost primary care, the American Medical Association said. However, lawmakers failed for the second time to to prevent a 21 percent cut in Medicare physician reimbursements, the AMA said.

When is a mouse a guinea pig? Mice often are test subjects for new drugs for humans. Animal models of disease help researchers understand how cancer works, and which compounds are safe and promising enough to try in people, according to the Boston Globe.

But in a work funded with a $4.2 million economic stimulus grant from the National Cancer Institute, mice are receiving treatment at the same time as humans. It is hoped that what is learned at the bedside can be integrated with results from the lab bench to speed and streamline the development of cancer drugs, the Globe reported.

The novel strategy is an attempt to ease a bottleneck that has emerged in the cancer drug pipeline because of the many drugs in development. “There are 800-plus drugs in the pharmaceutical pipeline, and … we already don’t have enough people going into clinical trials to begin with,” Cheryl Marks, associate director in the division of cancer biology at the National Cancer Institute, told the Globe. “Our traditional clinical trial structure … is simply not serving us very well.”

Hackers’ next playground: medical devices? Medical devices could be susceptible to hackers, and a thorough security analysis should be done as part of Food and Drug Administration approval, according to MedPage Today.

Premarket regulatory evaluation should include a risk-based security assessment depending on the nature of the device and the perceived threat of a security compromise, Dr. William H. Maisel of Beth Israel Deaconess Medical Center in Boston and Tadayoshi Kohno of the University of Washington in Seattle said a Perspective article in the April 1 issue of the New England Journal of Medicine.

“We think medical device security should be improved before there is a widespread incident, rather than waiting for the incident to occur and then acting,” Maisel said in an e-mail to MedPage Today. “It is very difficult to add on security after the fact.”

The authors said that in terms of security risks, medical devices are like “the drug supply of a generation ago.” They cited an intentional 1982 poisoning of Tylenol with cyanide and suggested that security concerns need to be addressed “through regulatory and scientific actions.”

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