What Caught Our Eye (WCOE), October 27, 2017
What Caught Our Eye is our week-in-review blog series, where we recap the cancer policy articles, studies, and stories that caught our attention.

Affordable Care Act

“When Silver Costs More Than Gold: How Trump’s Actions Have Scrambled Insurance Prices”

Via New York TimesThe rates for next year’s Obamacare plans are out, and they show how President Trump’s actions have scrambled the insurance marketplace. Usually, plans known as gold have higher monthly premiums but lower out-of-pocket costs than “silver” plans, which have tended to cost less each month and have been the most popular plans.

But this month, Mr. Trump carried out a longstanding threat and ended certain subsidies for insurers. To compensate for the lost funding, insurers increased the prices of their plans — heavily in the silver category and less so in others.
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“CBO: Congress waited too long to avoid Obamacare premium increases for 2018”

Via L.A. TimesThere’s good news and bad news in the Congressional Budget Office’s analysis of the bipartisan Senate deal to save some Obamacare provisions from President Trump and his wrecking crew.

The good news is that the so-called Alexander-Murray compromise, named after its godparents, Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would accomplish its goal of reducing premiums and would even cut the federal deficit, without raising the number of Americans without health coverage.
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“Share The News (Because Trump Won’t): ACA Open Enrollment Starts Soon”

Via Forbes OpinionTrump and the GOP are doing their best to undermine the Affordable Care Act (aka Obamacare) and cause it to fail. One of their means of sabotage is by removing outreach and educational efforts, which are vital in getting people to enroll for health care.
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Policy News

“How a change in hospital policy saved thousands of lives”

Podcast from Vox.com — Sarah Kliff’s new podcast series, “The Impact” on Vox.com, examines how policy impacts lives. In this episode, she describes how two hospitals responded when children in their care died of central line infections. One examined its practices and made changes to reduce infections. The other did not.
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“Trump health official Seema Verma has a plan to slash Medicaid rolls. Here’s how”

By With a broad overhaul of Obamacare stalled in Washington, one of President Trump’s top health care leaders is drawing the outlines of sweeping changes to Medicaid that could pare enrollments and cut costs without congressional approval.

Seema Verma, director of the federal Centers for Medicare and Medicaid Services, is promising to give states an “unprecedented level of flexibility” to design their Medicaid programs as they see fit. In an appearance in Cleveland this week, she pledged to reduce scrutiny of state requests for waivers from federal rules meant to preserve access and quality standards.
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“Actually, Many New Cancer Drugs May Be Helpful And Worth Trying”

Via Forbes.comYou might have heard that many new cancer medicines offer little benefit. This month, the BMJ published a review finding that for most cancer drugs approved by the European Medicines Agency between 2009 and 2013, there was neither published evidence that they extend overall survival nor improve patients’ quality of life. In 2015, JAMA reported similar observations for oncology drugs approved by the U.S. FDA between 2008 and 2012. Both papers focused on evidence from randomized clinical trials.

Perhaps the literature fails to capture the clinical benefit of many oncology drugs. This could happen for several reasons. One is the under-appreciation that progression-free survival (PFS) can be truly helpful, permitting many people with advanced cancer to more comfortably go about their lives. Another is that randomized clinical trials (RCTs) may not be designed or statistically powered to reveal true benefits in small fractions of patients.

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Coping with Cancer

“‘No One Is Coming’: Hospice Patients Abandoned At Death’s Door”

Via Kaiser Health NewsAs her husband lay moaning in pain from the cancer riddling his body, Patricia Martin searched frantically through his medical bag, looking for a syringe.

She had already called the hospice twice, demanding liquid methadone to ease the agony of Dr. Robert Martin, 66. A family practice physician known to everyone as “Dr. Bob,” he had served this small, remote community for more than 30 years.
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“So Much Care It Hurts: Unneeded Scans, Therapy, Surgery Only Add To Patients’ Ills”

Via Kaiser Health News When Annie Dennison was diagnosed with breast cancer last year, she readily followed advice from her medical team, agreeing to harsh treatments in the hope of curing her disease. “You’re terrified out of your mind” after a diagnosis of cancer, said Dennison, 55, a retired psychologist from Orange County, Calif.

In addition to lumpectomy surgery, chemotherapy and other medications, Dennison underwent six weeks of daily radiation treatments. She agreed to the lengthy radiation regimen, she said, because she had no idea there was another option.
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