weekly blog--one for the ages
Here we go again. With Mueller gone, the political debate has shifted back to healthcare. "To Be or Not to Be" is the question of the day on Obamacare. For Medicare participants, the "To Be or Not to Be" resides in reining in escalating drug costs.
There are a number of proposals being floated on how to do so. But the gotcha in all of this is that unlike commercial plans that cap members’ out-of-pocket drug spending annually, traditional Medicare plans do not have a limit for prescription medications in its Part D drug benefit. And with the cost of specialty drugs increasing, some Medicare beneficiaries could owe thousands of dollars in out-of-pocket drug costs every year for a single drug.
In a standard Medicare drug plan, beneficiaries pay 25 percent of the price of their brand-name drugs until they reach $5,100 in out-of-pocket costs. Once patients reach that threshold, the catastrophic portion of their coverage kicks in, and their obligation drops to 5 percent.
And that never changes. The lack of a spending limit for the Medicare drug benefit sets it apart from other coverage. Under the Affordable Care Act, the maximum amount someone generally owes out-of-pocket for covered drugs and other medical care for this year is $7,900. Plans typically pay 100 percent of customers' costs after that.
“In the spring, at the end of the day, you should smell like dirt.” Margaret Atwood
"It was one of those March days when the sun shines hot and the wind blows cold: when it is summer in the light and winter in the shade." Charles Dickens
"Spring is when life's alive in everything." Christina Rossetti
"Spring is nature's way of saying, "Let's party!" Robin Williams
With the number of people living with Alzheimer's or Dementia on the rise, some new breakthroughs in their diagnosis.
To start, a pattern of inflammatory activity in circulating blood cells two days after a stroke strongly predicts the likelihood of losing substantial mental acuity one year later, investigators at the Stanford University School of Medicine report. In developed countries such as the United States, 3 out of 4 stroke patients survive for considerable periods of time. However, these survivors are at twice the normal risk for dementia over the next decade, even if their cognition was initially unimpaired by the stroke.
Meanwhile, researchers from the Duke Eye Center have shown that a new, non-invasive imaging device can see signs of Alzheimer’s disease in a matter of seconds. The researchers found that the small blood vessels in the retina at the back of the eye are altered in patients with Alzheimer’s. And they showed that they can distinguish between people with Alzheimer’s and those with only mild cognitive impairment.
Because the retina is an extension of the brain and shares many similarities with the brain, researchers believe that the deterioration in the retina may mirror the changes going on in the blood vessels in the brain, thereby offering a window into the disease process.
In the 1980s I used to work in Kendall Square (Cambridge, Mass.). At the time it was home to MIT and a growing number of technology oriented businesses and services. It was a rather sleepy, nondescript place with only a handful of places to eat lunch, and I could park for free at the building I worked in, or when full, on Memorial Drive along the Charles River.
Today, Kendall Square is a bustling tech hotspot; it’s streets now clogged with cars and people, mostly young professionals going to and from work and research laboratories housed in shiny new glass office buildings. So it should come as no surprise that a business incubator has opened in the Square seeking startup companies devoted to helping the world's aging populations, their families and care partners.
With older people in the United States representing an $8 trillion market, the Cambridge Innovation Center fits neatly into the Governor of Massachusetts' goal to position the state as a hub for innovation about aging. The first group of companies renting space at the Center are developing products ranging from sensor-equipped braces called “exoskeletons” for people with injuries or neurological conditions to smart watches that detect falls and prompt seniors to take their meds at designated times.
Similar innovation spaces are planning to open over the next two years in Providence, Philadelphia, Miami, Tokyo, and Rotterdam in the Netherlands. AARP already runs the Hatchery innovation lab in Washington, and a Cambridge holding company called Life Biosciences has launched multiple longevity startups, and other efforts are underway on the West Coast.