The pharmaceutical industry aggressively supported efforts to pass health care reform, even pledging to trim drug costs by $80 billion.1 In addition, it pumped millions of dollars into lobbying and ad campaigns to push the legislation to a successful conclusion, even joining with groups such as Families USA, which ironically spent years attacking drug makers in the early part of the decade.2
The recent signing of health reform legislation signals a watershed event in the delivery of health care in our country. It is the culmination of a tangled legislative battle, but it ignores 3 of the 4 pillars of health reform. In this article, I describe these pillars, and then outline where recent legislation falls short.
The sweeping health care reform bill signed into law in March will eventually provide coverage to 32 million more Americans, but the Congressional Budget Office has estimated that about 23 million will still be without health care by 2019.1 Even those with insurance may continue to have high out-of-pocket (OOP) expenses, because coverage premiums and medical services outpace household incomes.
Connecticut Attorney General Richard Blumenthal has backed a bill that will require hospitals in Connecticut to disclose publicly all adverse events that occur in their facilities. Previously, hospital errors were reported but specifics of the errors, including where they occurred, were never disclosed because of a confidentiality provision enacted in 2004 that allowed the health department to list the overall medical errors without naming a hospital.1
A group of 18 senators have proposed to reverse a policy that imposes a lifetime ban on donating blood for men who have had any gay sex since 1977. In writing to the FDA Commissioner Margaret Hamburg, the lawmakers stressed that the science has dramatically changed since the ban was established in 1983 at the emergence of the HIV/AIDS crisis.1
Thimerosal, the organomercurial compound commonly used as a preservative in vaccines, does not cause autism, ruled the so-called vaccine court, a special branch of the US Court of Federal Claims that was established to handle claims of injury caused by vaccines. In this case, a group of parents who are convinced that there is a connection between the additive and autism were told that they had failed to prove their belief.1
Three years after the FDA’s authority was broadened to allow it to require pharmaceutical manufacturers to conduct additional clinical studies or change medication labels (among other new powers), the FDA still has concerns about medication risks. Drug safety has always been an issue for the FDA, but given the recent high-profile troubles with the recalled painkiller Vioxx (rofecoxib), the contaminated blood-thinner heparin, and the sometimes fatal cardiac effects of the diabetes drug Avandia (rosiglitazone), it is clear to the FDA that it needs to have better oversight when it comes to medication safety.