The Daily Rise: Monday, March 7

Patients Fight On

Start your Monday morning off right — by reading a great story in Cure Magazine about the inspirational “Fight On” spirit of Ryan Davidson.

“Ryan Davidson was just 6 years old when he was diagnosed with brain cancer,” explains Beth Fand Incollingo, “and even though he entered clinical trial after clinical trial without ever getting free of the disease, he never felt that medicine had failed him.”

We’ve long been inspired by Ryan’s story. We’ve been very lucky to work with Ryan’s family to help share Ryan’s “Fight On” attitude towards cancer research funding and the progress we’re making. Last year, the Davidsons were part of a panel we presented at ASCO.

“He always thought it gave him a fighting chance, so he’d fight for the research to continue to give the next child a better chance and the next child after that an even better chance,” his dad, Kirby Davidson, shared with Cure Magazine.

Take the time to read the entire piece at Cure Magazine.

20 Million Signups

Morning Consult’s Mary Ellen McIntire covers President Obama’s announcement that approximately 20 million people have gained health insurance under the Affordable Care Act.

“This is the lowest rate of uninsured that we’ve seen since we started keeping these records,” the President said in a speech at an event in Milwaukee, Wisconsin. “But we know that there are millions more who are eligible for coverage, but haven’t gotten it yet. And that’s understandable.”

Obviously, it’s great that more people have health insurance. But, health insurance is a means to an end — not an end in and of itself. Our end goal is high quality care that delivers the greatest value to patients.

Many patients who have health insurance routinely experience coverage denials by their insurance companies. Life-saving necessary treatments are often rejected in favor of “fail first policies.” The president seems to have ignored this point.

“You’re getting more for what you’re paying for,” he said. “Your insurance is better than it was, even if you didn’t know it, even if you didn’t vote for me.

Better? That’s not the case for many of Americans who are paying more and getting less. Set aside the politics and debate about “Obamacare.” If we can’t acknowledge the major flaws in the current health care system – the rising costs and denial of treatments – we’re unable to fix those problems to improve care for patients.

Snagged by Paperwork

While we’re on the subject of the Affordable Care Act, we’d point back to Ricardo Alonso-Zaldivar piece on how hundreds of thousands of patients are losing their Affordable Care Act subsidies due to a paperwork nightmare. This piece continues to get publicized in news outlets across the country because it highlights the areas for improvement under the Affordable Care Act.

“Walt Whitlow was under treatment for cancer when he got an unwelcome surprise. His financial assistance under President Barack Obama’s health care law got slashed. That meant his premium quadrupled and his deductible went from $900 to $4,600.”

The numbers directly refute President Obama’s claim that “you’re getting more.”

  • 470,000 people, as of Sept 2015, had their coverage terminated because of unresolved documentation issues involving citizenship and immigration.
  • More than 1 million households had their financial assistance “adjusted” because of income discrepancies

“These problems can grow, and they can contribute to undermining consumer faith in the system, and that could lead to attrition,” Rachel Klein of Families USA, an advocacy group that supports the health law, told the Associated Press.

Lawsuit targets Medicaid Hep C Policy

The Seattle Times’ JoNel Aleccia reports on a new lawsuit that is attempting to force Washington State to expand its coverage of Hepatitis C treatments. Right now, only the sickest patients are entitled to the most effective treatments. The lawsuit, filed against Washington state’s Medicaid provider, follows a similar lawsuit filed against private insurance companies that have denied treatment to Hepatitis C patients.

“Two Medicaid patients, a 53-year-old Seattle woman and a 47-year-old Lakewood man, were prescribed the drug Harvoni to cure their hepatitis C infections,” Aleccia writes. “However, the prescriptions were denied because the drug is too expensive, according to the complaint filed in U.S. District Court in Western Washington.”

The positive news is that the two lawsuits against private insurance companies have already forced some changes. BridgeSpan revised its policy “to provide the direct-acting anti-viral drugs to all hepatitis C patients, regardless of liver-fibrosis stage,” while Group Health changed its policy to consider more treatments for patients with fibrosis scores of F2 and higher rather than F3 and higher.

Patients shouldn’t have to file class-action lawsuits in order to get life-saving treatments. Our health care system should always focus on delivering the right treatment to the right patient.

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