Helping make the health care system work for you

Lawmakers renew push to block surprise medical bills

urbanbohemian via Flickr Creative Commons

Even when patients make concerted efforts to see doctors covered by their insurance plans at in-network facilities, they run the risk of unknowingly being treated by other out-of-network providers during that visit. A new state bill would protect people from paying hefty surprise medical bills stemming from such out-of-network charges.

The proposal, AB 72, says that when consumers are unknowingly treated by out-of-network radiologists, anesthesiologists or other providers, they would only pay what they would for doctors within their insurance network. These payments would also count towards their out-of-pocket maximums.

The legislation comes on the heels of an effort last year, AB 533, that was also intended to curb surprise out-of-network bills. That bill would have made consumers responsible only for in-network rates. Insurance companies would then have been required to reimburse the out-of-network doctors at the rate they would get from Medicare.

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A financial case for expanding access to costly hepatitis C drugs

The newly approved Harvoni tablets bring several advances to the fight against hepatitis C, but they also have a steep price tag, reported at $1,125 for a single dose.

/Gilead Sciences

The newly approved Harvoni tablets bring several advances to the fight against hepatitis C, but they also have a steep price tag, reported at $1,125 for a single dose.

When the very expensive - and very effective - hepatitis C medications hit the market more than two years ago, private health insurers limited prescriptions to the very sickest people.

Two new analyses now say that approach is shortsighted. Researchers, writing in the American Journal of Managed Care, argue that treating people during earlier stages of the disease has long-term health and economic benefits.

"Unfortunately, the conventional wisdom is, if there's an expensive drug, the way to ration it is to treat people who are sickest," says Darius Lakdawalla, a health economist and professor at the USC Schaeffer Center for Health Policy and Economics. "But it turns out that's kind of backwards from where the value really lies."

Lakdawalla and other researchers find that expanding hepatitis C treatment benefits private insurers in the long-term; by paying for the drug now, they avoid paying for costly complications from hepatitis C, like liver transplants, down the road. Curing patients' hepatitis C infections and avoiding future liver transplants has another benefit, they write: It frees up liver transplants for other people who need them.

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Stressed out? Comfort food might actually help

MIKI Yoshihito via Flickr Creative Commons

Do you snack when you're stressed? Do you crave comfort foods when you're sad?

We've likely all eaten our feelings at some point.

But does this actually make us feel better? What does science have to say about it?

Research into stress and comfort eating is still in its early stages, but recent studies have shown that eating comfort food can lower your stress levels. At the same time, it's unclear whether it can improve your mood.

Feeling stressed?

Eating before or after a stressful event might tamp down your stress levels, according to research by Janet Tomiyama, director of the UCLA Dieting, Stress and Health Laboratory.

She says there is a strong body of research showing that when rats are continually put in stressful situations and given access to comfort foods – which in their case could be Oreo cookies or Crisco mixed with sugar – that "the comfort eating over time actually dampens down their physical stress responses." The researchers could make that conclusion because the rats generated less of the hormone they produce in response to stress.

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Can transparency drive down drug prices?

Painkiller

arbyreed/Flickr Creative Commons

Two bills moving through the state legislature would require more transparency around prescription drug costs.

One bill, SB 1010, would obligate drug manufacturers to notify health plans if they were going to increase the wholesale cost of a drug by at least 10 percent during any 12-month period and justify those increases.

Another bill, AB 2463, would require insurance plans to inform consumers how much they will pay for a drug and how much their health plan paid for the drug.

The bills come at a time when one in four Americans has trouble affording prescription medications, according to the Kaiser Family Foundation. This begs the question: Can sharing this information help lead to lower drug costs for consumers?

I got three perspectives on whether price transparency could make a dent in what people pay for their drugs.

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You can now get birth control from your pharmacist in California

birth control pills

Photo by Phoney Nickle via Flickr Creative Commons

Attention California women: You can now get birth control pills directly from the pharmacist at your local drugstore, without a prescription from your doctor.

The state Board of Pharmacy Friday adopted regulations that authorize pharmacists to dispense hormonal contraceptives that you administer yourself, including pills, shots, vaginal rings and skin patches. The change is in a 2013 state law, but it couldn't take effect until the pharmacy board sorted out the regulations. (You can also get contraceptives from pharmacists in Oregon, Washington State and Washington, D.C.)

The goal is to increase women's access to birth control and reduce unplanned pregnancies.

Here's what it means for you:

Who is eligible to get birth control at a pharmacy?

There is no age restriction on who can get hormonal contraceptives from a pharmacist.

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