Health Equity & Access Weekly Roundup: September 21, 2024

Financial Inequities in Maternity Care: Lessons From the Netherlands and US

Despite the Netherlands' generally accessible maternity care, financial barriers persist for pregnant women due to high-deductible health plans (HDHPs), according to a study published in Health Affairs. The study examined the impact of a bundled payment model aimed at improving maternity care coordination and reducing costs, and found modest clinical changes but a 5% reduction in total spending per pregnancy. However, the financial burden on women remains a concern, mirroring findings from a US study where HDHPs can cause significant out-of-pocket costs, particularly when pregnancies span 2 insurance plan years, a phenomenon termed "deductible double jeopardy." These studies display the need for systemic reforms in both countries to protect pregnant women from financial harm, highlighting the broader challenge of addressing cost-sharing structures in maternity care.

Frameworks for Advancing Health Equity: Youth Behavioral Health Strategy Program

In this episode of the Managed Care Cast podcast series Frameworks for Advancing Health Equity, Chris Barton, LCSW, senior director at Horizon Blue Cross Blue Shield of New Jersey, discusses the Youth Behavioral Health Strategy program. This initiative addresses the growing mental health and substance use challenges among youth through a comprehensive approach based on 5 key pillars: prevention, early identification and intervention, whole child care, parent and support systems, and community engagement.

Abortion in the Presidential Debate: Trump Defends State Bans, Harris Vows National Protections

During the presidential debate between former President Donald Trump and Vice President Kamala Harris, moderator Linsey Davis questioned Trump on his shifting stance on abortion, highlighting his support for a 6-week abortion ban in Florida despite earlier opposing it. Trump defended his position by criticizing what he described as the "radical" abortion policies of Democrats and emphasized his role in overturning Roe v Wade, which he argued allowed states to decide on abortion rights. Harris countered by accusing Trump of misleading the public and intentionally appointing Supreme Court justices to impose restrictive abortion bans. The debate highlighted stark differences in their views on reproductive rights, with Harris emphasizing the importance of protecting women's autonomy and pledging to restore Roe v Wade if elected; Trump stated he would deny a national abortion ban in favor of autonomy among the states.

Bridging Global Treatment Gaps in Relapsed Multiple Myeloma

In an interview, Leland Metheny, MD, lead investigator for the phase 1 BAFF CAR T clinical trial, University Hospitals Seidman Cancer Center, discusses the ongoing challenges and goals in treating relapsed/refractory multiple myeloma with CAR T-cell therapies. While CAR T-cell therapies have extended progression-free survival, they are not curative, and patients eventually relapse. Metheny emphasizes the need for more effective and faster-manufactured CAR T-cell therapies, as current processes can take too long for some patients. He also highlights the broader aim of making cell therapies widely accessible, including in resource-limited regions, to ensure global equity in cancer care.

US Health Care System Ranks Last Overall Among Other High-Income Countries

The US ranked last among 11 high-income countries in health system performance, particularly in equity, access to care, and health outcomes, according to a new report by The Commonwealth Fund, titled "Mirror, Mirror 2024: A Portrait of the Failing US Health System." Despite spending the most on health care, the US faces significant issues such as high out-of-pocket costs, 26 million uninsured individuals, and severe disparities in care access. The nation ranked lowest in health outcomes, with high rates of preventable deaths and a lower-than-average life expectancy. The report suggests that the US could improve its health system by reducing financial barriers, simplifying the insurance system, investing in primary care, and addressing social determinants of health.