7 days in healthcare (November 11th-17th, 2024)

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Summary

The most impactful news in health this week were, from an international point of view,

  • The analysis of Trump’s victory and its consequences for health, generally valued as negative by most analysts.
  • The new health reform law approved in Germany, although the call for elections in that country will surely at least slow down its implementation

From a national point of view, the most relevant:

  • The debate and positions on the future of MUFACE continue

Biomedicine

  • Genetic screening can reduce premature deaths by 25%, according to a study. This makes it possible to stop a quarter of deaths from common diseases, including breast cancer, diabetes and hypertension, by identifying people at risk. This will allow vulnerable groups to be offered earlier studies and treatments, according to the study published by Stanford University

Global Health

  • The global incidence of diabetes doubles, while many patients are left without treatment. Diabetics are left without treatment, while the global incidence of the disease doubles (from 7% of the population to 14% between 1990 and 2022), while many middle- and low-income countries fail to provide care and access to treatment

International health policy

  • Analysis of Trump’s victory in the American elections and its consequences on health. Given Trump’s precedent of leaving the WHO, this will possibly mean a weakening of international aid programs against certain diseases (malaria, HIV/AIDS, etc.). At home, it will surely lead to a decrease in the population covered by the ACA (Obamacare) and a tightening of reproductive rights. It is more doubtful how the negotiation of drug prices, already initiated by Biden, will evolve. The future of the NHI, the largest funding agency for biomedical research in the world, is worrying. The personality of the new Secretary of Health, Robert F Kennedy, is also worrying vaccine manufacturers and baby food manufacturers. 
  • The US view of the NHS. The New England Journal of Medicine has published an interesting article on this topic:
  • Health care reform in Germany. How to fix the problematic German health care system. The new law was approved by the lower house, the Bundestag, on October 17, 2024, and recently by the upper house, the Bundesrat. The law establishes a new system of payment for hospitals, the consideration that there are too many hospitals, and a hospital reform. Germany has a high number of hospitals, 7.7 beds per 1,000 inhabitants, compared to the EU average of 5.3. The official position is that Germany spends a lot of money on health care, for a mediocre quality. We will have to see what happens after the call for elections in Germany.

National Health Policy (Spain)

  • The continuity of MUFACE is in doubt. The continuity of MUFACE remains in limbo, after the decision of ADESLAS and ASISA not to participate in the tender and the decision of the government to call for a new tender, perhaps under new rules. It has been leaked that the government is considering that those who opt for the insurance system will not be able to return to the public system, which is a fairly radical change. It would be something similar to the German model, but in a very different context. Meanwhile, there are controversial statements by doctors linked to the system who ask the government not to renew with the insurance companies. The CSIF union activates certain mobilizations.
  • SESCAM starts a telephone service to avoid transfers to health centers.

Companies

  • International
    • New generation of anti-obesity medication. NovoNordisk provides the results of a clinical trial on a new generation of anti-obesity medications.
  • National
    • Better Care finalizes an alliance with Oracle for the management of health data.
    • The new HM Madrid Río was inaugurated, with 10,000 square metres, 40 consultation rooms, 77 beds and 10 emergency rooms.

Biomedicine

Global Health

International health policy

  • USA
    • There are many published reactions to Trump’s victory in the USA and its impact on health, in general, very negative:
      • More mortality and more illness, according to Science. Trump had already decided to leave the WHO, in 2020, which never happened due to the year of transition period and the arrival of Biden. But now he will not have that limitation, which is why it is foreseeable that the global agenda against malaria, HIV/AIDS, and other diseases will be abandoned, as well as being an obstacle to the WHO Pandemic Treaty. This will mean “more mortality and more illness,” according to Ilona Kickbush, a global expert. The only guarantee is Trump’s unpredictability (https://www.science.org/content/article/more-mortality-more-illness-global-health-community-braces-impact-u-s-election)
      • Millions at risk of losing health insurance under Trump, according to NBC News. Subsidies to purchase insurance under the Affordable Care Act (Obamacare) will expire at the end of 2025. If they are not renewed, health coverage will be unaffordable for many Americans (https://www.nbcnews.com/health/health-news/millions-risk-losing-health-insurance-trumps-victory-rcna179146)
      • The impact of Trump’s election is analyzed by Health Affairs. This magazine analyzes the possible actions around: Affordable Care Act (ACA, Obamacare), with Biden a record number of enrollees had been achieved, it is not known whether with Trump the ACA will be totally rejected or weakened; Medicaid, although during the campaign there was talk of protecting Medicare, nothing was said about Medicaid; Reproductive Health; Health Equity; and the Medicare Drug Price Negotiation Program, a negotiation that has already concluded its first phase and will be implemented in 2026. The attitude of the new administration is not known, but there will likely be at least a delay in the application of this law (https://www.healthaffairs.org/content/forefront/impact-election-health-policy-and-courts)
      • What will Trump’s victory mean for the health system, according to JAMA. This journal analyzes possible changes in three areas: Price Transparency; Drug Prices; and, Reforms in the Affordable Care Act (Obamacare) (https://jamanetwork.com/journals/jama-health-forum/fullarticle/2825024)
    • Trump’s victory also worries the scientific community
      • Scientists must be united against Trump, according to Nature. This journal hopes that the new Trump presidency will not repeat the mistakes of the first, which implies respecting the scientific consensus when making regulations on public health, environmental issues, artificial intelligence and others (https://www.nature.com/articles/d41586-024-03648-z)
      • Trump’s victory and the NIH. The question is whether the new president and the Republican-dominated Congress will introduce major changes to the NIH, the largest biomedical research agency in the world, with a budget of 47 billion dollars (https://www.science.org/content/article/trump-won-nih-major-shake)
    • The appointment of anti-vaccine Robert F Kennedy generates special concern
    • First case of serious mpox in the USA, in California (https://www.nytimes.com/2024/11/16/health/mpox-california.html)
  • United Kingdom and the National Health Service
    • A view of the NHS from the USA, an article from the New England Journal of Medicine. Very interesting article, it begins by highlighting the three differences of the NHS with the American system: 1. A culture of public control and ownership; 2. A commitment to equity and access; and, 3. Weak funding. Among the lessons: 1. Underfunding can wreck any system; 2. The NHS has all the risks and benefits of centralised management; 3. A backlash from professionalism, discontent with certain reforms; and 4. A vulnerability of primary care (https://www.nejm.org/doi/full/10.1056/NEJMhpr2407495)
    • Why the NHS has a productivity problem. Pressures to fix the productivity problem in the NHS are greater after the budget increases. Lord Darzi’s report says that while resources have increased by 20% in the last 5 years, the number of patients treated has barely grown by 3%. Health Secretary Wes Streeting said last Wednesday that a kind of ranking of hospitals by productivity will be made and that managers who fail will be fired (https://www.ft.com/content/0dc04f38-249e-4ae0-af96-62e35e813259)
  • Germany
    • How to fix Germany’s troubled healthcare system. The new law was approved by the lower house, the Bundestag, on October 17, 2024 and recently by the upper house, the Bundesrat. The law establishes a new system of payment to hospitals, the consideration that there are too many hospitals and a hospital reform. (https://www.dw.com/en/how-to-fix-germanys-ailing-health-care-system/a-69236520)
    • Germany’s recipes for avoiding bankruptcy in hospitals: closing health centres and reforming emergency departments. The government is proposing the largest hospital reform in 20 years to contain spending and improve healthcare. “Not a single country in Western Europe has a worse life expectancy than us,” said the health minister, a doctor by profession. Germany has a high number of hospitals, 7.7 beds per 1,000 inhabitants, compared to the EU average of 5.3. The official position is that Germany spends a lot of money on healthcare, for mediocre quality (https://elpais.com/internacional/2024-11-11/germany-recipes-to-avoid-hospital-bankruptcy-cerrar-centros-de-salud-y-reformar-las-urgencias.html)

National health policy

Companies