Medical Monopolies

A free public service for a better community

Feb 28, 2024

A Good Day To Advocate for Better Healthcare

If there are subjects you’d like to see or improvements made, please let me know using the comment button below. Private equity’s impact in healthcare is on the docket.

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February is Heart Month

Heart disease is the leading cause of death in the United States. The Centers for Disease Control and Prevention estimates that 1 in 5 deaths is attributed to the condition.

Five things to do to lower your risk (Washington Post). The advice is from Dr. Leana Wen, professor in the School of Public Health at Georgetown University.

Manage your underlying medical conditions. High blood pressure, diabetes, high cholesterol and obesity are all major risk factors for heart disease. A meta-analysis of 48 clinical trials found that every five-point drop in systolic blood pressure can cut the risk of cardiovascular events by 10 percent.

Reduce substance use. Smoking elevates the risk of heart attacks by increasing plaque buildup, damaging blood vessels and worsening cholesterol. That includes smoking and exposure to second hand smoke, alcohol and even marijuana (daily marijuana use with a 34 percent increased risk of developing heart failure).

Exercise. A large study involving 30 years of medical records from 100,000 adults found that people who followed the CDC’s recommendation for at least 150 weekly minutes (or a little more than 20 minutes a day) of moderate or high-intensity exercise had a 31 percent decrease in cardiovascular mortality.

What you eat matters. Reduce salt and fats intake and be on the look out for ultra processed food since each daily serving of ultra-processed food increased the risk of cardiovascular death by 9 percent, according to a 2021 study in the Journal of the American College of Cardiology.

Aim for at least seven hours of sleep. The American Heart Association recently added sleep to its key behaviors that people can adopt to improve cardiovascular health. This change was based on decades of data: Those who slept less than seven hours a night had higher chances of developing diabetes, hypertension and obesity. Studies have also demonstrated links between sleep irregularity and coronary artery abnormalities.

Advances in Diagnostics - Esophageal Cancer

A vitamin-sized diagnostic could be the future of esophageal cancer prevention. Cancer of the esophagus — the muscular tube that moves food from the mouth into the stomach — has just a 20% five-year survival rate. Yet there are no standard or routine screening tests for the disease, according to the National Cancer Institute (NCI). Lucid Diagnostics, a New York-based biotech company, is looking to change that with its newly developed test, which only requires taking a single, pill-sized diagnostic. (Reference)

Private Equity Update

We’ve written about how Anesthesia Partners moves into a community and buys up existing anesthesia practices and jacks up the price. This is typical behavior as you build a monopoly.

In 2012 U.S. Anesthesia Partners (USAP) first opened in Texas and spread to nine other states growing by acquiring the largest anesthesiology firm in a city and then adding other nearby practices.

A Washington Post story in June into USAPs business in Colorado showed that this was exactly how they operated. It is worth noting that USAP has issued more than $1.3 billion in dividends to its shareholders.

It now will give up exclusive contracts at five hospitals to settle allegations by the Colorado attorney general’s office that it engaged in anti-competitive practices and drove prices up 30 percent over other firms according to the Washington Post. U.S. Anesthesia Partners will also revise employment contracts that previously hindered its physicians from working at other practices. The company and its private equity founder, Welsh, Carson, Anderson & Stowe, continue to deny any unlawful conduct.

The FTC still has a suit against them ongoing. That legal action was filed against USAP and its private-equity founder, Welsh, Carson, Anderson & Stowe. The case represents one of the strongest moves by regulators to address complaints that the large doctor practices being built by financial firms are boosting U.S. medical prices.

We’ve mentioned before that when private equity and medicine meet, it is the patient who suffers.

UnitedHealth Monopoly?

The Justice Department has launched an antitrust investigation into UnitedHealth, owner of the biggest U.S. health insurer, a leading manager of drug benefits and a sprawling network of doctor groups. The investigators have in recent weeks been interviewing healthcare-industry representatives in sectors where UnitedHealth competes, including doctor groups, according to people with knowledge of the meetings.

Medicaid Update South Dakota

South Dakota recently expanded Medicaid to include those whose income is up to 1.38 times the Federal Poverty Limit. That’s good and as we have seen this generally has little to no effect on states budgets because the federal government picks up a large share of the cost and economically, more people needing services increases the tax revenue. The Commonwealth Fund has a good analysis on the subject.

Republicans in South Dakota have put an issue on the ballot this fall to demand that those who receive Medicaid under the expansion and can work, must work to receive the health insurance. Here is an AP story on the subject.

First, the unemployment rate in South Dakota is 2%. So most everyone who can work, is working. Second, we have seen this stunt in Georgia where a work requirement was added to expand Medicaid and instead of hundreds of thousands being enrolled, they added 2300. Here is the article I wrote about Georgia. The truth is that demanding this type of requirement feeds on the false narrative that people who are poor are cheating the system and is just a way to deny health insurance to so many who need it and cannot afford it.

ACTION In South Dakota

I encourage you to vote down the measure that would add a work requirement to receive Medicaid.

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.