Good morning ... The Winter Olympics are too cold for some events and some spectators, Bloomberg reports. What did we expect when we decided to have outdoor events during the Earth's unequivocally worst season?
Presidents’ budgets are not legislative documents. They’re wish lists. So it’s easy to make too much of them — there’s really no penalty for swinging for the fences, nor is there much incentive to try to craft a budget that would please a lot of people.
But with the caveat that the budget is just a statement of priorities, here’s what we can glean from the choices the Trump administration announced yesterday:
The bottom line: A lot of these proposals would need congressional approval, and that’s why a great many of them will never see the light of day. But this is a pretty good roadmap to the administration’s priorities — one that should make Medicaid advocates, including hospitals, especially nervous.
Police and medical workers treat a woman who overdosed on heroin. Photo: Spencer Platt/Getty Images
The opioid crisis has cost the U.S. $1 trillion since 2001, according to Altarum, a nonprofit health research firm. Those costs have been increasing more rapidly over the past few years, and Altarum projects they’ll grow by another $500 billion by 2020.
By the numbers:
The human cost: Roughly 64,000 people died of drug overdoses in 2016, driven by a recent surge in deaths from fentanyl, heroin and prescription opioids — making today’s addiction crisis worse than the HIV epidemic at its peak.
Between the lines: “Lost wages and productivity” can seem like a nebulous cost, but it’s a good way to think about the ripple effects of this crisis beyond the people who die from it. When 116 people per day are dying from opioid-related overdoses, at an average age of just 41, their “lost wages and productivity” are a partial measure of the hole that’s left in their families and their communities.
Or at least, nobody really hates him — which is about as much as any political appointee can hope for anymore.
Buzz: The New York Times had a long front-page story yesterday that bears out what I’ve heard, as well: Food and Drug Administration commissioner Scott Gottlieb is extremely well liked, even by some Democrats who are surprised by how much they like him.
Key quote: “I thought he was a bad pick,” Andrew Kolodny, a co-director of opioid policy research at Brandeis University, told the NYT. “But I may have been wrong.”
Opioid manufacturers have paid more than $9 million to third-party advocacy groups that then fought limits on opioid prescriptions and downplayed the risks of the drugs, according to a new report from Sen. Claire McCaskill.
The details, according to McCaskill's report:
Go deeper: An overwhelming majority of patient advocacy groups are funded at least in part by the drug or device industries, according to a study published last year in the New England Journal of Medicine.
Speaking of McCaskill, remember last fall when she demanded Envision Healthcare cough up documents and information about its controversial emergency room billing practices? Well, we are four months past her original deadline for Envision, and there are still no answers, my colleague Bob Herman reports.
What we’re hearing: McCaskill’s office and Envision are going back and forth with each other, and the hope is to put something out in a few weeks. There’s still nothing concrete, though, for those who are interested in the company’s out-of-network billing.
All you Herman-heads out there, be sure to check out Bob's "field report" video breaking down the coming changes in how insurers plan to process drug companies’ discount coupons — and how it could roil the debate over drug prices.
Go deeper: Read Bob’s coverage of the coupon controversy.
What we're watching this week: It's all budget, all the time. HHS secretary Alex Azar will be up on Capitol Hill Wednesday and Thursday to testify in defense of the administration's budget.
Get in touch: As always, I welcome your tips, feedback and questions: firstname.lastname@example.org.