Tuesday, December 18, 2018
Thursday, October 11, 2018
Flue Shot Time!
The Centers for Disease Control and Prevention (CDC) is once again recommending FluMist Quadrivalent for vaccination against common influenza virus strains.1 The intranasal live attenuated influenza vaccine (LAIV) protects against four flu viruses: an influenza A (H1N1) virus, an influenza A (H3N2) virus, and two influenza B viruses.2
During the last two flu seasons FluMist was not recommended, because prior studies indicated it was not as consistently effective as the injectable inactivated influenza vaccine (IIV). But new analysis shows that while the injectable is more effective against H1N1 when compared with FluMist, they are equally effective against H3N2 and the two influenza B viruses. And with child influenza-related deaths at an all-time high last year, the CDC hopes that having FluMist as an option may boost vaccination rates.3 This is echoed by the American Academy of Pediatrics who, although recommend the injectable as the primary choice for vaccination, agree that it offers an alternative option for those who would not otherwise be vaccinated.4
For treatment of influenza cases, a new antiviral is in review by the Food and Drug Administration (FDA), with an expected decision date of December 24, 2018.5 Baloxavir marboxil, developed by Roche and Shionogi and recently approved in Japan, is for treatment of influenza infection in people 12 years old and older. It is given orally as a one-time dose, and kills influenza A and B viruses within 24 hours. The antiviral reduces the time span until the patient stops shedding the virus – with great potential to limit the spread of influenza.
Wednesday, October 10, 2018
Pumpkin Dragon Sushi Good to Eat
Whether you love it or hate it, there is no denying it’s Pumpkin Spice Latte season. But that’s not where the pumpkin party needs to end. There are plenty of places in the Denver area serving up dishes and drinks that incorporate the fall favorite. Here are some to try:
Pumpkin pie, a sweet fall classic, is on 12 @ Madison‘s menu. This personal-sized pie is served with bourbon-praline sauce, pecan crumble and soft cream. ($9) 12 @ Madison, 1160 Madison St, Denver. 720-216-0190; 12atmadison.com
Pumpkin sushi may be proof that pumpkin can go in just about anything. Sushi Rama, Chef Jeff Osaka’s conveyor belt sushi restaurants, will be rolling out The Pumpkin Dragon Roll, a sushi roll made with Japanese pumpkin tempura, marinated kelp and topped with avocado and a honey glaze. Sushi Rama; sushi-rama.com; RiNo, 2615 Larimer St, Denver. 720-476-4643 DTC, 4960 S Newport St, Denver. 720-667-1195 Lone Tree, 10012 Commons Street, Bldg C, Unit 106, Lone Tree, 303-537-5250
Breckenridge Brewery‘s Nitro Pumpkin Spice Latte is on tap and ready to be paired in the Farmhouse Restaurant. Additionally, Avery Brewing‘s Rumpkin, a “monstrous pumpkin ale,” is available through October in the tap room and brewery. Farmhouse Restaurant at Breckenridge Brewery, 2990 Brewery Lane, Littleton. 303-803-1380; breckbrew.com. Avery Brewing, 4910 Nautilus Ct, Boulder. 303-440-4324; averybrewing.com
Pumpkin Spice Lattes, Pumpkin Harvest Grande Griddlecakes, Pumpkin Creme Muffin and Pumpkin Pie Cheesecake will be available at Mimi’s Cafe locations through Nov. 11 in celebration of the flavors of fall. Mimi’s Cafe, various locations, mimiscafe.com
In celebration of National Pumpkin Day October 26, Cured, Boulder’s gourmet market and cheese shop, will be serving a pumpkin grilled cheese made with a variety of Cured’s signature hand-picked cheeses and house-made pumpkin butter. Cured, 1825 Pearl St., Boulder, 720-389-8096; curedboulder.com
Premiums for 2019 Health Care Colorado
Friday, September 28, 2018
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Saturday, September 8, 2018
Stable costs may shift 'Obamacare' politics
Stable costs may shift 'Obamacare' politics
WASHINGTON • After two years of double-digit premium hikes, millions of people covered under the Affordable Care Act will see only modest increases next year, according to an exclusive analysis that highlights the changing politics of health care heading into the midterm elections.
The consulting firm Avalere Health and The Associated Press crunched available state data, finding that “Obamacare’s” health insurance marketplaces seem to be stabilizing. Customers in some states will get price cuts. And the exodus of insurers from the program has halted, even reversed somewhat, with more consumer choices for 2019.
The steady outlook means the health care law won’t be an easy target for Republicans this year, an election issue that’s worked well for them since 2010. But Democrats may also be looking for new talking points. They can’t exactly argue that the Trump administration has wrecked the ACA, so they’re saying that popular provisions like protections for people with pre-existing conditions are still threatened.
The analysis found a 3.3 percent average increase in proposed or approved premiums across 47 states and Washington, D.C., for next year. This year the average increase nationally was about 30 percent. The average total premium for an individual covered under the health law is now close to $600 a month before subsidies.
For next year, premiums are expected either to drop or increase by less than 10 percent in 41 states with about 9 million customers. Twelve of those states are expected to see a drop in average premiums, with New Jersey joining that list on Friday. In six other states, plus Washington, D.C., premiums are projected to rise between 10 percent and 18 percent.
Insurers also are starting to come back. Nineteen states will either see new insurers enter or current ones expand into more areas. There are no bare counties lacking a willing insurer.
Even so, Chris Sloan, an Avalere director, says, “This is still a market that’s unaffordable for many people who aren’t eligible for subsidies.”
Nearly 9 in 10 ACA customers get subsidies based on income, shielding most from premium increases. But people with higher incomes, who don’t qualify for financial aid, have dropped out in droves.
It’s too early to say if the ACA’s turnabout will be fleeting or more permanent. Either way, next year’s numbers are at odds with the political rhetoric around the ACA, still heated even after President Trump and congressional Republicans failed to repeal the law last year.
Trump regularly calls “Obamacare” a “disaster” and declares it “dead.” The GOP tax-cut bill repealed the ACA requirement that Americans have health insurance or risk fines, effective next year. But other key elements remain, including subsidies and protection for people with pre-existing conditions.
The moderating market “takes the issue away from Republican candidates” in the midterm elections, said Mark Hall, a health law and policy expert at Wake Forest University in North Carolina.
To calculate premium changes, Avalere and AP used proposed overall individual marketplace rate filings for 33 states and D.C., and final rates for 14 states that have already approved them. Data was not available for Massachusetts, Maryland and Alabama. The average rate change calculations include both on-exchange and off-exchange plans that comply with ACA requirements. The government isn’t expected to release final national figures until later this fall.
Friday, September 7, 2018
Colorado governor candidates see dangers in each other's health proposals
Health care ranks among the top issues in Colorado’s race for governor. But to hear the campaigns and their allies describe it, voters in November will be choosing between competing health “scare” policies.
Both candidates say it’s a top priority to expand Coloradans’ access to health care and control costs. But Republican Walker Stapleton and his supporters warn that Democrat Jared Polis’ plans will impoverish the state and its residents, while the Polis camp argues that Coloradans will lose coverage and financial protections under Stapleton’s proposals.
Nine years after a Democratic Congress — including five-term U.S. Rep. Polis — passed the Affordable Care Act, and a year after the Republican Congress failed to repeal it but managed to abolish its individual mandate for insurance coverage, the landmark legislation known as Obamacare remains a political hot potato.
While the two candidates differ sharply on issues related to the ACA, from Colorado’s individual insurance exchange to expanded Medicaid coverage, both are also banking on getting waivers from the federal government to implement some of their more ambitious plans.
According to a public opinion survey conducted this year by the University of Colorado’s American Politics Research Lab, Coloradans consider health care the most important national priority, and fully half of the state’s residents surveyed said they support a “single payer” health care system “in which all Americans would get their health insurance from one government plan that is financed by taxes.”
Asked before the June primary to name the issues that helped determine which gubernatorial candidate to support, unaffiliated voters said education was most important, followed by health care.
Polling, however, also shows Republican voters aren’t nearly as concerned about health care as Democrats and unaffiliated voters are, and the two parties’ nominees have approached the topic differently on the campaign trail.
Just after Polis picked his running mate, former state Rep. Dianne Primavera — a four-time cancer survivor and then-CEO of Susan G. Komen Colorado, a nonprofit that raises funds for breast-cancer programs — the Democratic ticket embarked on a tour of the Western Slope devoted to discussions about health care.
Meanwhile, Stapleton’s running mate is state Rep. Lang Sias, an Arvada lawmaker who passed a bipartisan bill last session requiring more transparency on costs and customer rights from free-standing emergency rooms. He sits on the House Public Health Committee and Health Exchange Legislative Oversight Committee.
But Stapleton introduced Sias, a former Navy “top gun” pilot, in front of a fighter jet at a Denver museum.
“Health care is a human right,” Polis said in a 15-second ad that aired during the Democratic primary. “I supported ‘Medicare for All’ for more than a decade, because it will help Coloradans pay less for health care, and that’s who we should be fighting for.”
Polis described how he would implement his policies as governor in opinion pieces published this year in the Aspen Times.
“With the absence of leadership coming from Washington, we need to think outside the box and lead the charge ourselves to bring universal health coverage to Colorado,” he wrote in one.
“I’m running for governor because it’s time for us to translate the core value that health care is a human right into public policy. It’s not only the right thing to do, but the most cost-effective way to reform health care in the long term.”
Polis has outlined an array of approaches, including a proposal to band together with other Western states to establish a “universal, single-payer option,” as well as plans to attack the high cost of health care in rural Colorado, soaring prescription prices and the opioid epidemic.
Stapleton, a two-term state treasurer, wants you to know one thing, for sure, about his health care plan: “My plan won’t bankrupt the state,” he said in a meeting room in Greenwood Village after opening a Republican campaign office on a recent Saturday afternoon.
Stapleton has been short on specifics when it comes to his prescriptions for health care. A page devoted to health care issues appeared on his campaign website only in the last week. But his campaign and his supporters have pounded a steady drumbeat about Polis’ plan, calling it radical and pointing to a recent national study that found the federal government could spend $32 trillion over 10 years to implement a single-payer plan.
“Tell Jared Polis we can’t afford his government takeover of health care,” says a pro-Stapleton ad from State Solutions, an arm of the Republican Governors Association.
“Walker is committed to instituting reforms that will actually fix our health care system and bring about real relief to Coloradans that can’t afford the out-of-control costs of Obamacare,” Stapleton campaign spokesman Jerrod Dobkin said in a recent statement.
Republicans have attempted to tie Polis to Amendment 69, a ballot measure he opposed, which would have established a single-payer health care system in Colorado but was defeated by voters nearly 4 to 1 in 2016. Stapleton co-chaired the opposition group to that proposal, called “ColoradoCare,” with former Democratic Gov. Bill Ritter.
Stapleton describes Polis’ plan as potentially more expensive to taxpayers than the projected $25 billion cost for the failed ColoradoCare proposal.
“He’s promising universal coverage to people,” Stapleton told Colorado Politics. “It’s responsible, if you’re making that promise, to explain to people how you plan to pay for it.”
It’s important to note there’s a distinction between universal coverage — something nearly every industrialized country except the United States guarantees its residents — and a single-payer system, like the “Medicare for All” legislation Polis is sponsoring in Congress. While Polis supports both, his campaign points out that there are plenty of ways to approach universal coverage for Coloradans without implementing a single-payer system at the state or federal level.
“If we don’t set a goal, it’s impossible to get to where we want to go,” Polis is known for saying — and his campaign maintains that his push for universal coverage could develop in different ways but will have to lower costs in order to move ahead.
Here’s how Polis says his proposed multistate health consortium could work: Once in office, Polis plans to meet with governors from Western states — possibly including Washington, Montana, Nevada, Oregon and New Mexico — and develop a framework for how they could provide health care at a lower cost by expanding the risk pool to include all their residents, as well as increase purchasing power for medicine and other services.
The states might also come up with other programs like reinsurance for rural areas, expanded mobile health clinics, fixed-price reimbursement to Medicaid providers, and common consumer rules and transparency requirements for prescription drugs.
After what could be a couple of years to put together the plan, the states would submit waiver applications under Obamacare to the federal government, taking advantage of flexibility built into the law.
Although it could take years to put in place, the plan could result in a regional single-payer system, or it could turn into the kind of robust public option that Polis and other Democrats have been lobbying for, bringing more competition to the health insurance market while bringing down costs for participants.
In the meantime, Polis is contemplating a legislative agenda that includes encouraging more physical activity among schoolchildren, allowing municipalities to raise their tobacco taxes, implementing paid family and medical leave policies, and permanently funding the Long-Acting Reversible Contraception program, which significantly reduced teen pregnancy and abortion rates as a pilot program.
Along with encouraging broadband development to make some medical technologies more available throughout the state, Polis is proposing a range of solutions to bring more affordable health care to rural and mountain areas, where it’s as expensive and scarce as anywhere in the country.
“I’ve been calling on Colorado for years to redefine its geographic rating system to reduce the expenses facing mountain area families, and I’m prepared to solve this issue as governor,” he said.
Stapleton’s health care plan is built from a blueprint of if’s:
• If the Legislature would support major reforms, meaning if both chambers have a Republican majority.
• If Republicans in Washington turn over Obamacare to the states.
• If Colorado’s health exchange proves otherwise unworkable.
• If federal block grants, vouchers and waivers allow the governor to unilaterally dictate care for the medically needy.
• If he can find private partners to fill the gaps at a better price than the way care is delivered now.
• If, politically, he can get away with turning away Medicaid recipients at emergency rooms, instead directing them to community clinics that could provide the service more cheaply.
Stapleton calls his plan a “managed model” for Medicaid, which provides care for more than 1.3 million Coloradans.
“It means actively managing what is going on with the expansion of Medicaid so we can deliver on the promises we’ve made, so we don’t wind up with 64 counties with one choice of health care (insurance) provider seeing double-digit increases, and people are paying more for their insurance than they are their mortgages,” he said.
Although he said in earlier interviews that he wants to reduce the number of Coloradans on Medicaid, Stapleton told Colorado Politics that he isn’t looking to kick off people who got Medicaid coverage during the Obamacare expansion — about 400,000 people.
A July report on the expansion showed Denver County added 72,947 people to Medicaid, and El Paso County was next, with an additional 63,294 recipients. That helped drop the state’s uninsured rate from 15.8 percent in 2011 to 6.5 percent in 2017, according to the same report from the Department of Health Care Policy and Financing.
Medicaid is a $10 billion enterprise in Colorado that is critical to public health and the health care industry, the way Democrats engineered it under Obamacare. Republicans have tried to deconstruct it through court cases, the tax code and President Donald Trump’s executive orders.
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