Docs distrust hospitals; Americans divided over health law; Children's hospitals lose discounts on orphan drugs

News outlets report on a range of issues related to the new health law.

The Hill: "The successful implementation of the new health care reform law will hinge on physicians and hospitals working out trust issues with one another," according to a new PricewaterhouseCoopers survey. "The reform law requires increased collaboration and information sharing between physicians and hospitals, including through new accountable care organization (ACO) arrangements, to reduce costs and increase quality." But the survey found that "one in five physicians don't trust hospitals, and 60 percent of hospitals believe it will be difficult to obtain information from community physicians to improve patient care." Physicians cited competing goals, lack of transparency and underrepresentation on hospital boards as reasons for their distrust (Millman, 12/7).

HealthDay News: Meanwhile, "Americans are still deeply divided over the nation's new health care reform package, with 28 percent of adults wanting to repeal the legislation while 31 percent favor keeping all or most of the reforms. Another 29 percent aren't sure what should be done," according to a new Harris Interactive/HealthDay poll. The poll was taken three weeks after Republicans gained control of the House in the November elections. "The poll revealed an interesting paradox: Large percentages of even those people who want the law repealed are happy with many of its provisions." Support for one part of the law "is widely unpopular: the stipulation that people without health insurance buy it or face a penalty. Fifty-seven percent of the respondents oppose this and only 19 percent support it." Even among those in favor of repealing the new health care law, a significant percentage were in favor of the provisions pertaining to tax credits and pre-existing medical conditions" (Gardner, 12/6).

The Hill: "While most discussion of the new healthcare reform law has focused on insurance coverage, the law provides a 'serious platform' to improving the quality of care, Health and Human Services Secretary Kathleen Sebelius said at a health care quality forum Tuesday afternoon." Sebelius said the United States spends $700 billion a year, 30 percent of all healthcare spending, "on services that may not improve people's health." She noted that healthcare quality varies widely across the country, and the current system rewards care delivered piecemeal rather than "in a seamless, coordinated manner." The new reform law, Sebelius said, will provide "a number of tools to address healthcare quality issues, including a new $10 billion innovation center announced last month to experiment with new payment and care delivery models"  (Millman, 12/7).

The Washington Post: Sometime this month, U.S. District Court Judge Henry E. Hudson "will rule in a case filed by Virginia Attorney General Ken Cuccinelli II (R) challenging the constitutionality of the nation's sweeping health-care overhaul." Two other federal judges have ruled in favor of the law, while no judge has ruled the law unconstitutional. "Many observers think Hudson will be the first." Hudson has roots in Republican politics, and demonstrated "skeptical courtroom questioning of lawyers defending the law on behalf of President Obama this summer and fall." In July, he offered a written opinion "rejecting a motion to dismiss the suit out of hand." The Virginia lawsuit "is one of more than 15 that have been filed around the country challenging the law, including another suit filed jointly by 20 state attorneys general in Florida." If Hudson rules to strike down the law, it is likely that "the law's constitutionality will ultimately be decided by the U.S. Supreme Court"  (Helderman, 12/7).

The New York Times: "In an unintended consequence of the new health care law, drug companies have begun notifying children's hospitals around the country that they no longer qualify for large discounts on drugs used to treat rare medical conditions." That has caused prices for the "specialized 'orphan drugs,' some of which are also used to treat more common conditions," to rise. Congress had previously required drug manufacturers to provide discounts to a variety of health care providers, including children's hospitals, "But this year Congress, in revising the drug discount program as part of the new health care law, blocked these hospitals from continuing to receive price cuts on orphan drugs intended for treatment of diseases affecting fewer than 200,000 people in the United States. … Children's hospitals say the change is costing them hundreds of millions of dollars" (Pear, 12/7).