Medical Device Daily Washington Editor
The incoming Obama administration is wasting no time in dealing with matters other than the economy, naming two interim chiefs for FDA and the Centers for Disease Control and Prevention. The current director of CDC, Julie Gerberding, MD, is reportedly set to leave CDC next week on inauguration day after six years at the post. Gerberding's successor is expected to be William Gimson III, the agency's chief operating officer, pending the appointment of a permanent successor.
Andrew von Eschenbach, MD, reported recently he would also step aside from his post at FDA on Jan. 20, but the announcement of his temporary replacement, Frank Torti, MD, the chief scientist at FDA, did not come until Monday. Among the proposed replacements at the FDA helm is Steve Nissen, MD, a critic of the agency from the Cleveland Clinic (Cleveland). Torti's elevation to the temporary slot over Janet Woodcock, MD, the director of the Center for Drug Evaluation and Research at FDA, hints that Woodcock is not in the running to take the permanent post.
FDA announced recently two appointments in administrative positions. According to a Jan. 12 statement, Lou Valdez will take the position of associate commissioner for international programs and Lori Davis will take over as the agency's chief information officer, a post that was unfilled for several months recently.
According to the FDA statement, Valdez will "help lead implementation of FDA's international programs at a time of significant growth and expansion of the agency" in overseas jurisdictions. Valdez is said to have served previously as the deputy director of the Office of Global Affairs at the Department of Health and Human Services.
Davis was hired at FDA as the deputy CIO in November 2007 "and has been instrumental in restructuring the Office of Information Management and [in] centralizing information technology projects and budget resources," according to FDA. Davis will henceforth also zero in on improving interoperability of the various systems in use at the centers and offices at the agency, a task made less onerous by the ongoing consolidation of operations in the agency's new campus in White Oak, Maryland.
Healthcare could get $100B of stimulus
The economic stimulus plan currently under development by the incoming Obama administration and Democrats in Congress could include as much as $100 billion for healthcare, with the bulk of the sum likely to go to states for their Medicaid liabilities.
Wire reports indicate that the Medicaid amounts may run to about $80 billion, a situation fed by falling tax receipts and rising unemployment, which always amps up demand for pubic-sector healthcare services. Much of the remaining $20 billion would go toward the $50 billion President-elect Obama has promised to plow into a healthcare modernization effort that would likely include substantial sums for electronic health records (EHRs) and e-prescribing. Some of the monies for healthcare information technology (HIT) would go toward a national coordinator for HIT standards, but whether that sum would fund a HIT data bank that would allow more or less instantaneous retrieval of medical records from anywhere in the U.S. is not clear.
The proposed sum does not likely include the Children's Health Insurance Program (CHIP), which was the object of wrangling between the White House and Congress last year. In 2007, the Bush administration proposed upping the annual budget for CHIP by 20% from $5 billion to $6 billion a year, but congressional Democrats offered a counterproposal that would have boosted CHIP spending to $15 billion a year after five years, a move widely seen as guaranteeing a veto and an opportunity to use CHIP as an issue in last year's elections.
The program was funded at $6.1 billion for the year to end in March, and part of the monies for the program were expected to come from taxes on tobacco products. The ailing economy, however, figures to shrink consumption of tobacco, hence leaving that revenue stream below projections.
Prevention not always effective
Many of the hopes of trimming the cost of healthcare in the U.S. hinge on the ability of preventive care to cut down on disease incidence and severity, but an article appearing in a recent edition of Health Affairs suggests that prevention lacks the expected power to substantially trim costs.
Louise Russell, PhD, a professor of economics at Rutgers University (New Brunswick, New Jersey), said in a recent presentation on the paper that prevention "is usually not cost saving." After analyzing hundreds of cost-effectiveness studies conducted over the past 40 years, Russell concluded that "the vast majority of programs add more to medical spending than they save," with about 80% of preventive services as culprits.
According to the online edition of Congressional Quarterly, others who appeared at the session, held Jan. 6 at the National Press Club (Washington), disagreed. Brent Pawlecki, corporate medical director for mail meter manufacturer Pitney Bowes (Stamford, Connecticut), said the company's workplace wellness program has saved the company money in its healthcare program, but the Centers for Medicare & Medicaid Services has had little luck with prevention services dealing with chronic diseases. David Bott of CMS stated at the session that of the 35 prevention programs CMS has rolled out since 1999, only seven remain in effect.