Hospitals

Is a health-insurance mandate unconstitutional? MedCity Morning Read, Dec. 15, 2009

While some conservative legal scholars assert that an individual’s basic rights dictate that the government can’t tell him how to spend his money, a Wake Forest University law professor labels such arguments “unconvincing and deeply flawed.”

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Highlights of the interesting and the important from the world of health care:

Is a health insurance mandate constitutional? Wake Forest University Law Professor Mark Hall answers that question with an emphatic “No,” writing at The Health Care Blog. While conservative legal scholars argue that an individual’s basic rights dictate that the government can’t tell him how to spend his money, Hall labels such arguments “unconvincing and deeply flawed.”

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The concept of individual liberty, Hall writes, is protected by the Constitution only when “fundamental rights” are involved, and an insurance mandate is not a matter of fundamental rights. Rather, an insurance mandate is a merely a matter of economic rights, and Congress has power via the Constitution’s “Commerce Clause” to regulate just about any part of the economy. “In short, there is no fundamental right to be uninsured, and so various arguments based on the Bill of Rights fall flat,” Hall writes.

Health overhaul a “disaster” for corporate America: Count corporate chief executives among the skeptical when it comes to perceived savings from President Obama’s health overhaul. Bloomberg News spoke with more than a dozen CEOs, from companies including Verizon Communications, United Parcel Service and Safeway, and the consensus was that reform efforts will do little to curb costs to big business. The CEO of video-game maker Electronic Arts went the furthest, calling both the Senate and House health plans “disasters.”

Since U.S. companies spent $400 billion on employee health care in 2007, opinions from the leaders of these companies shouldn’t be taken lightly. Many CEOs no doubt correctly fear that continued skyrocketing health costs will put their companies at a competitive disadvantage (unless, of course, those “costs” to the rest of us are “revenues” to their companies). The mystery is why corporate America hasn’t been more vocal in demanding cost control in the health overhaul plans. Or, for that matter, why more corporations don’t publicly support a Canada-like single-payer system that would move U.S. businesses away from the responsibility of providing health coverage to their employees in the first place.

The downside of data mining: There’s a growing backlash against pharmaceutical data mining, the practice of pharma companies using physicians’ detailed prescription data to tailor sales messages to those physicians, according to a lengthy piece in the Los Angeles Times.  While Big Pharma claims the practice results in better-informed doctors, opponents fear that it allows pharma companies to unduly influence physicians’ decision-making and fuels the prescribing of new, unproven, high-cost medications. Maine, Vermont and New Hampshire have already passed laws limiting or outlawing pharmaceutical data mining and similar laws have been floated in 20 other states, the Times reports.

With the drug industry spending last year a whopping $6.5 billion on detailing, as the practice is known in the industry, that dollar figure  suggests data mining is a huge moneymaker for the industry (though a recent study disputes that). And it doesn’t stop there: The American Medical Association pulled in nearly $48 million last year from licensing data, though not all of that evidently came from detailers, according to the article. Where are the federal watchdogs in this fight? The FDA has been notably silent. If pharmaceutical data mining is indeed a boon to drug companies and a source of unnecessary expenses to patients, you can bet government regulators will take the side of those they’re actually, you know, supposed to be regulating.

Mayo says “No” to Medicare expansion: Senate Democrats’ plan to replace a government-run health plan with a so-called Medicare “buy-in” that would expand Medicare to eligible 55-year-olds might already be dead. And that’s just the way Minnesota’s influential Mayo Clinic wants it. Mayo’s President warned that Medicare expansion could cost the hospital up to $1.4 billion a year in lost revenues, taking into account Medicare losses due to “low reimbursement rates,” the Rochester Post-Bulletin reported. “To grow the public plan that is already crumbling will be bad for citizens of this country,” Mayo President John Noseworthy said.