Ainos, Inc. (NASDAQ:AIMD, AIMDW), a healthcare company specializing in AI-powered point-of-care testing and therapeutics, has reported significant progress in the clinical trials of its "Ainos Flora" device, which utilizes AI Nose technology for rapid detection of infections. The device, currently being tested at four major medical centers in Taiwan, has completed 75 clinical cases, providing valuable data for the development of the next-generation product.
The Ainos Flora device is designed for non-invasive detection of bacterial, fungal, and sexually transmitted infections in women. The company announced that the AI algorithm model has shown improved accuracy by integrating more real-world data into the Ainos AI model. The use of advanced data processing techniques has enhanced the device's reliability by addressing individual and environmental variations.
Ainos is developing an upgraded version of Ainos Flora, incorporating NVIDIA (NASDAQ:NVDA) CUDA technology to expand its testing capabilities to include viral infections. The next-gen device is tailored for at-home testing, allowing users to obtain accurate results without professional medical assistance. The design and laboratory testing phase is expected to conclude in the third quarter, with clinical trials slated to begin in the fourth quarter.
Chun-Hsien (Eddy) Tsai, Chairman of the Board, President, and CEO of Ainos, highlighted the need for accessible and rapid testing solutions for vaginal health and STIs, especially given the high rate of new STI cases among young adults in the U.S. The company aims to address this need with Ainos Flora, which is positioned in a market projected to reach US$256 billion by 2028.
Ainos' commitment to innovation is evident in its portfolio of over 50 approved and pending patents, focusing on integrating AI with digital nose sensors for diagnostic tools.
Kyverna (KYTX) shares dropped 28% amid updated data for its lead CAR-T cell therapy candidate KYV-101 at a rheumatology medical meeting.
https://seekingalpha.com/news/4116261-kyverna-stock-plunges-amid-data-update-on-lead-drug
CNS Pharmaceuticals, Inc. (NASDAQ:CNSP) ("CNS" or the "Company"), a biopharmaceutical company specializing in the development of novel treatments for primary and metastatic cancers in the brain and central nervous system, today announced that John Climaco, Chief Executive Officer of CNS Pharmaceuticals will participate in a fireside chat at the Healthcare Company Showcase hosted by Alliance Global Partners on May 21, 2024 at 1:40 PM ET.
A live webcast of the event will be on the Events page of the Investors section of the Company's website (cnspharma.com).
https://finance.yahoo.com/news/cns-pharmaceuticals-present-alliance-global-123000607.html
In 2018, the Department of Health and Human Services issued a rule on hospital pricing transparency, requiring hospitals to post prices in easily accessible form. This was done under a Republican administration, and it expresses free-market ideology: If consumers have more information, they can shop around for the best price. A better-informed consumer will in turn discipline sellers, lead to more salutary competition, and restrain costs.
The rule was strengthened in 2021 to include sanctions for hospitals that failed to comply. What followed speaks volumes about the folly of attempting to use consumer market discipline in a profit-maximizing system that is opaque and manipulative by design. In practice, most people just follow the advice of their doctors and use the hospital where their doctor practices.
Suppose you are the rare outlier who would like to shop for the best deal. If you look at the website of Mass General Hospital, you will learn that an “HC BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL” will cost you $35,014.00. Even if you can decipher what that means, it’s just the beginning of determining the real price.
Posted price lists give hospitals wiggle room by noting that the actual price will vary with the length of stay and the patient’s condition. And a bill for a single procedure typically has multiple elements, from individual treatment aspects like sutures or anesthesia, to “facilities fees,” which have of late been added even to routine outpatient care, like consultations and ordinary screening.
Every procedure has a billing code. In recent years, there has been an epidemic of upcoding, in which the hospital bases the charge not just on the procedure that necessitated the current visit, but on every prior condition the patient has ever had.
Upcoding also undercuts one widely hyped reform that was supposed to restrain costs: so-called Prospective Payment Systems, which were introduced in the late 1980s. The idea is to pay hospitals a lump sum for treating a given condition rather than reimbursing each specific task. This was supposed to give hospitals an incentive to use the most cost-effective treatments rather than the most profitable ones. But with upcoding, two patients in adjoining beds can receive identical treatments, and the one with a medical history that becomes the basis for upcoding is more profitable to the hospital than the other. HHS audits hospitals to limit extreme abuses of upcoding but cannot audit every charge, and the penalties for flagrant abuses are slaps on the wrist.
People are skeptical of giving their data to Big Tech platforms. But they trust their doctor. Clinically, the physician needs to know their entire medical history and is professionally bound by an ethic of confidentiality. Patients expect their doctor to keep the information safe. Little do they know that this data is used to raise prices on them.
The airlines have multiple possible prices for the same seat, but hospitals have a practically infinite number of possible prices for the same procedure. Indeed, compared to hospitals, airline pricing is a model of transparency and simplicity.
ONE OF THE BIGGEST FALLACIES in treating hospital prices as consumer-determined—and why public posting is no kind of solution—is that most individual patients never actually do all the paying. Hospitals typically negotiate price schedules with insurers. Depending on the relative market power of the hospital and the insurer in a given area, the same hospital will make different pricing deals with different insurers.
In Boston, where I live, the Mass General Brigham conglomerate is both the most prestigious and the most economically powerful hospital system. Though insurers attempt to “manage” care, no insurer would dare tell a subscriber, or an employer who buys insurance for employees, that they are not allowed to use Mass General Brigham. That, in turn, gives the hospital more power to negotiate relatively higher charges with the insurer.
The insurers, in turn, have also been merging, in order to maximize their market power with hospitals. The wave of mergers in the health industry has nothing to do with greater “efficiency” and everything to do with the quest for greater pricing power.
But there is one area of convergence for these behemoths fighting over price. Both the hospital and the insurer gain to the extent that they can offload costs onto patients.
For instance, if a given procedure is not covered by insurance, the “self-pay” rate is typically several times that of the hospital’s negotiated rate with the insurer. This has nothing to do with the hospital’s costs; it simply reflects the fact that the individual patient, unlike the insurer, has no bargaining power and has not negotiated a discounted rate in advance.
I encountered one of the games hospitals play when my mother had an emergency admission to Mass General Hospital after a bad fall. She was admitted and treated by specialists, and was an inpatient for three days. But she was placed in a category invented by hospitals called “admission for observation.” That misclassification, for billing purposes, technically made her an outpatient.
Under Medicare, an outpatient is responsible for a 20 percent co-pay. An inpatient is not. But why does Mass General care if Medicare saves money? Because under a Medicare policy instituted under George W. Bush’s presidency, hospitals are punished if they bill Medicare under inpatient rates when they might have charged outpatient rates. So the government created an incentive for hospitals to make patients pay more.
Shifting costs to patients is a major source of profit maximization for both hospitals and insurers. Many insurers have a variety of complex requirements for authorizing treatment. The purpose is partly legitimate—to avoid medically unnecessary care—but it has the handy side effect of tripping up patients who fail to comply with some arcane technicality.
Having written numerous pieces on health care for the Prospect and having served earlier in my career as national policy correspondent for The New England Journal of Medicine, I am more sophisticated than the average patient trying to navigate the system. But in trying to determine what I needed to do to be sure that Blue Cross would cover a pending minor surgery, it took me upwards of ten hours on the phone with Blue Cross and staffers in two doctor’s offices to avoid getting caught in a trap that would have substantially increased my costs.
Blue Cross insisted that under my PPO plan, my treatment by a specialist did not require a referral from my primary care doctor. But after I saw the specialist, Blue Cross refused to pay his bill for the initial consultation, or to authorize further procedures. On what grounds? They had not heard from my primary care doctor.
After numerous calls and emails, I finally figured it out. Blue Cross has its own terminology and I wasn’t using the right words. Blue Cross does not require a referral to a specialist; but before it will approve payment, it does require pre-authorization based on a communication from the primary care doctor on the medical condition that necessitates the treatment.
If I hadn’t figured this out, I would have been liable for the specialist’s entire bill. At best, I would have to engage in prolonged wrangling with Blue Cross after the fact. The terminology game serves as a trap to confuse the consumer of health care.
None of these needless complications apply when the insurer is Medicare, an island of efficient socialized medicine amid an ocean of sharks. No referrals or “pre-authorizations” are required; there is no such thing as in-network versus out-of-network. The money saved from this endless gaming and counter-gaming goes to patient care.
Medicare Advantage is a whole other story. Despite the misleading branding, Medicare Advantage plans are run by private insurers. They are a kind of HMO, related to Medicare only in the sense that if you qualify for Medicare, the government will pay premiums on your behalf to the Medicare Advantage plan.
These plans are aggressively marketed to older Americans on the premise that they offer lower-cost and better coverage. Traditional Medicare does have some deductibles and co-pays, though they can be covered if you purchase a relatively inexpensive Medigap policy. But Medicare Advantage has no co-pays, and special perks like gym memberships and wellness programs.
That’s the theory and marketing pitch. In practice, cost-shifting to patients, gaming the Medicare program, and reducing treatment are the central components of the business model.
Medicare Advantage plans often decide that a proposed treatment, test, or medication is not medically necessary. So the patient either absorbs the entire cost or goes without. Unlike traditional Medicare, the private plans also stringently limit which doctors and hospitals a patient may see. All of this makes Medicare Advantage plans highly lucrative to insurers, at the expense of patients.
In this sense, sticker prices and promises of cheaper coverage have no relationship to what the plan actually pays, or doesn’t pay, the doctor or hospital on behalf of the patient.
SURPRISE BILLING IS ANOTHER AREA where there is an endless cat-and-mouse game between insurance industry profit maximization and attempts to protect consumers. The most common sort of surprise billing comes when a patient gets treatment from a medical provider who turns out to be out-of-network, and charges an exorbitant bill.
The No Surprises Act of 2021 prohibits the most extreme forms of surprise billing. Typically, that occurs when a medical provider whom the patient did not select, such as an anesthesiologist in a surgical procedure, turns out to be outside the insurer’s approved network, and the patient is billed after the fact for the full, nondiscounted fee.
The federal government found that 16 percent of in-network hospital stays involved at least one non-network provider. The act says that hospitals and other providers must not bill patients for more than the in-network rate if it turns out that someone on the medical team was out-of-network.
But the whole concept of in-network versus out-of-network is worth a closer look. It began in the 1970s with the arguably legitimate premise that the entire team of doctors who worked for an HMO were in close communication on a patient’s comprehensive needs. This supposedly improved care and reduced costs. The patient, therefore, needed to use a specialist who was in-network.
As HMOs grew from so-called staff-model systems into networks whose only common feature was that participating doctors agreed to accept the HMO’s treatment protocols and payment schedules, providers on the “common team” treating a given patient had often never heard of each other. The point was not better communication; it was restraining the HMO’s costs and increasing its profits.
Today, in-network versus out-of-network is a pure game of gotcha. If I happen to misunderstand the complex requirements and get treatment from a doctor who is considered out-of-network by my insurance company, there is no clinical difference. The only difference is that I am stuck with a larger co-pay.
Insurers and hospitals have used the issue of which doctors are in-network to play chicken with each other, as they bargain over what the insurer will pay the hospital. In New York, UnitedHealthcare has repeatedly threatened to remove Mount Sinai Hospital and its affiliated doctors from its network of approved providers. UnitedHealth has done this because Mount Sinai was bargaining for rates more in line with what the insurer pays other New York hospital systems. Had UnitedHealth carried out its threat, tens of thousands of New Yorkers would have had to pay out-of-network charges or switch doctors.
The hospital and the insurer finally came to terms in March, but only after UnitedHealth had already classified Mount Sinai inpatients as non-network, disrupting treatment of cancer patients, among others. As part of the deal, that cynical move will be reversed. Note that this battle had nothing whatever to do with using networks to ensure quality of care. On the contrary, it degraded care. It was purely about money.
IN THE LATE 1960S, A PHYSICIAN and public-health researcher named John Wennberg began doing systematic analysis of clinically unwarranted variations in medical interventions and their costs. The results, updated annually in what became the Dartmouth Atlas of Health Care, were shocking. Wennberg’s studies, among the most widely replicated findings in health research, found that hospitals in comparable cities performed medical interventions at absurdly divergent rates and with wildly divergent costs, based not on medical necessity but on market power and profit maximization.
Wennberg died earlier this year, at 89, and his work continues. A recent summary of his findings, spanning five decades of research, reports: “Where there are more hospital beds per capita, more people will be admitted (and readmitted more frequently) than in areas where there are fewer beds per capita. Economically, it is important for hospitals to make sure that all available beds generate as much revenue as they can, since an unoccupied bed costs nearly as much to maintain as an occupied bed. Similarly, where there are more specialist physicians per capita, there are more visits and revisits.”
In other words, supply generates demand. And it gets worse. The summary adds: “Studies by Dr. Elliott Fisher et al have indicated that there is higher mortality in high-resourced, high-utilization areas than in low-resourced, low-utilization areas. One explanation for this phenomenon is that the risks associated with hospitalizations and interventions—hospital-acquired infections, medication errors and the like—outweigh the benefits.”
One of Wennberg’s most consistent findings was a crazy quilt of pricing disparities. Despite decades of supposed reforms, that pattern keeps worsening. A 2022 study of pricing for cardiovascular procedures published in JAMA Internal Medicine found: “Across hospitals, the median price ranged from $204 to $2588 for an echocardiogram and from $463 to $3230 for a stress test. The median price ranged from $2821 to $9382 for an RHC [heart catheterization], $2868 to $9203 for a coronary angiogram, $657 to $25 521 for a PCI [treating a blocked coronary artery], and $506 to $20 002 for pacemaker implantation.”
Once again, these extreme pricing disparities had nothing to do with hospital costs. The fees increased in line with the hospital’s power to do so.
THE MORE COMPLICATED THE SYSTEM GETS, the more its participants rely on middlemen to shift costs. We see this with pharmacy benefit managers and group purchasing organizations, which claim to save money on drugs and medical supplies for insurers and hospitals, but which raise costs throughout the system because of the profits they skim off the top. My Blue Cross policy uses an outside vendor to review all claims and payments, and find reasons to deny some after the fact.
One cost-containment firm called MultiPlan has attracted extensive private equity investment and a position of dominance in the practice of determining out-of-network pricing. The firm’s algorithm, Data iSight, is marketed to insurers, and recommends ways to cut reimbursements and shift costs onto patients or doctors. Sen. Amy Klobuchar (D-MN) has accused MultiPlan of being a form of algorithmic collusion, gathering payment data from across the industry and using it to inform its low reimbursement rates. “Algorithms should be used to make decisions more accurate, appropriate, and efficient, not to allow competitors to collude to make healthcare more costly for patients,” Klobuchar wrote in a letter to the Federal Trade Commission and the Justice Department.
Another middleman comes in the form of electronic medical records. These were supposed to revolutionize medical care by making it easier for doctors to access patient histories. What some would call a natural monopoly of hospital patient data was quickly taken up by Epic, a for-profit product sold by an outside vendor. But although numerous hospital systems now use Epic, doctors affiliated with one hospital typically cannot access patient records at another.
That’s because the Epic system only pretends to be mainly about providing access to computerized patient records; it’s primarily about maximizing billing. All of the upcoding I talked about earlier is facilitated through Epic. When patients are asked about their prior medical history, each keystroke can enable hospitals to add a code and raise prices. And for clinicians, it is more time-consuming than a purely clinical data system.
The more complicated the system gets, the more its participants rely on middlemen to shift costs.
Obviously, patients suffer from this in the cost of medical care. Even if they don’t feel the direct cost in co-pays and fees, they eventually have it passed through to them in higher insurance premiums as well as frazzled doctors. And that brings up another cost: how it affects the quality of care.
I see an eye doctor twice a year for a condition that requires monitoring. When my ophthalmologist retired, I was referred to a new one whose practice had been bought by the hospital. He spent about ten minutes with me, skimmed my chart, did not bother to take a history, and did a cursory examination. He had two waiting rooms, and raced between patients, almost as if he was on roller skates.
When I sent him a very polite note to express some concern, I received back a plaintive letter going into great detail about his economic situation. His net earnings were about half of what he had expected. He lived in a small apartment, and drove an old car. The only way he could make a decent living was to see what he acknowledged were too many patients. And the hospital, which took a cut of his caseload, put no limits on how many he saw.
The abuse of medical professionals is especially extreme in the area of mental health. Each insurance company has its own protocols, its own payment scales, and systems for clawing back payments if its consultants can find some excuse. Too many clinicians find the system too much of a hassle with too much personal risk, and decide not to take insurance at all. Their patients are typically rich people who can afford to pay out of pocket, while far needier people, both economically and clinically, struggle to find someone who will treat them.
NEEDLESS TO SAY, NONE OF THIS GAMING and counter-gaming around prices operates in national health systems, either in the comprehensive systems of socialized medicine on the British model, or the tightly regulated systems of true nonprofit insurers and hospitals on the German model.
In the British National Health Service, there are no prices for procedures at all. Each hospital in the system is given a global budget to serve a population of patients. The hospital allocates its budget as efficiently as it can. Doctors are salaried, based on the size and age of their patient panel. Specialists are also salaried.
We’ve seen global budget reforms attempted in the U.S., but only on a limited scale. The entire system of insurers here is parasitic on the provision of actual health care, and the industry of middlemen is a parasite on top of a parasite. Each hapless attempt at price reform only creates new openings for gaming and more opportunities for middlemen.
The fact that universal socialized systems have no counterpart to the U.S. system of price manipulation, with all of the money spent on administration and gaming, goes a long way toward explaining why the U.S. spends upwards of 17 percent of GDP on health care and the typical OECD country spends about 11 percent.
That difference—6 percent of GDP—is about $1.5 trillion a year. Just imagine what else we might do with $1.5 trillion a year. The only solution is to get rid of prices entirely by treating health care as the social good that it is.
Robert Kuttner is co-founder and co-editor of The American Prospect, and professor at Brandeis University’s Heller School.
https://prospect.org/economy/2024-06-13-fantasyland-general/
Democrats saw what happened in Europe last week, and they can read the polls. The Biden administration’s policy of mass illegal immigration is hugely unpopular, and after nearly four feckless years, the Democrats are finally going to pay a price. So this morning’s New York Times email suggests that it is time to change course.
The Times begins by acknowledging that current levels of immigration (legal and illegal) are more or less unprecedented:
The first thing to understand is how unusual the modern migration boom has been. In nearly every large Western country, the foreign-born share of the population has risen sharply since 1990. It’s not clear whether immigration has ever previously risen so quickly in so many different countries.
A chart follows. In the U.S., the foreign-born share had risen from 9% to 15% as of 2020–no doubt it has risen further since then–and that assumes that all of the illegals are being counted.
The Times claims, briefly, that the unprecedented wave of immigration has had benefits. But it goes on to acknowledge some of the negative effects:
But the boom has also had downsides. More labor competition can obviously hurt the workers who already live in a country. Governments have strained to provide social services to the arrivals. And the rise in immigration has been so rapid that many citizens feel uncomfortable with the associated societal changes. Historically, major immigration increases tend to spark political backlashes.
Given that those concerns are obviously valid, what follows is jarring:
For years, mainstream Western politicians, from the center-right to the center-left to the left, have dismissed voters’ concerns about immigration. Some politicians describe it as a free lunch, with only economic benefits and no costs. They portray worries about immigration — worries shared by millions of people of different races, especially those with lower incomes — as inherently ignorant or xenophobic. Some politicians claim that governments are helpless to control their borders.
So wait: is the Times admitting that the majority who don’t like illegal immigration aren’t racists after all? Can we look forward to some corrections and an apology?
The Times says that the left’s refusal to turn off the illegal immigration spigot has driven the popularity of conservative (“right wing”) parties, which is true. But, the Times says, it is time for a change. It harkens back to the dim past of the Obama administration:
It wasn’t so long ago that the political left and center took a different approach to immigration.
They treated it as a complex issue that required moderation. President Barack Obama and Senator Bernie Sanders both fell into this category. They were part of a progressive tradition dating to labor and civil rights leaders who celebrated immigrants — but also supported tough border security, believing that unchecked immigration could destabilize society and increase inequality.
We conservatives have been pointing out that history for a long time.
There are some signs that the center-left and center-right are returning to this approach and becoming more respectful of public opinion:
* Biden, after loosening border rules early in his presidency and watching migration soar, has reversed himself.
The paper goes on to describe trends toward greater restrictions in the United Kingdom, the European Union, Greece, Japan and South Korea. But of course the Times’s real concern is the Democratic Party and the November election. The point of this recitation is to signal approval by the Left of Biden’s insincere reversal on the border, and to encourage Biden to keep it up.
But I think it is much too late for that to matter.
https://www.powerlineblog.com/archives/2024/06/the-times-backpedals-on-immigration.php
The 2023 Nashville Covenant School murders understandably received massive news coverage when they occurred. The fight over obtaining the murderer’s diary also received news attention. But when “nearly four dozen pages” of the murderer’s diary were finally released last week, the mainstream media completely ignored it. It turns out that behind the scenes, the FBI had fought hard against the diary’s release. Some Covenant School parents also opposed releasing the diary because it would force families to re-live the nightmare. The Tennessee Star’s parent company, Star News Digital Media, successfully filed two lawsuits to obtain the diary.
Five days after the release of the diary, with the exception of the New York Post, which is a national news outlet, the news coverage was limited to seven other conservative outlets such as The Daily Wire and Newsbusters.
The school murderer was transgender, and her diary reveals a suicidal left-winger who hated whites. The FBI expressed concern that the release of the diary from a transgender person could lead the public “to dismiss the attacker as mentally ill,” which would “further permeate the false narrative that the majority of attackers are mentally ill.” It worried that the diary could “potentially inflam[e] the public.”
The FBI worried that releasing the diary could have “unintended consequences for the segment of the population more vulnerable or open to conspiracy theories, which will undoubtedly abound.” Self-professed “experts,” the FBI fears, will “proffer their perspectives” in the press.
But there is a lot of important information in the diary. As is very typical of mass public shooters, the murderer was suicidal: “A terrible feeling to know I am nothing of the gender I was born of. I am the most unhappy boy alive. I wish to be dead.” She was also on the anti-anxiety drug Buspirone, whose potential side effects include “abnormal dreams, outbursts of anger, tremors, and physical weakness.”
The FBI worries that the diary will help create a link in people’s minds between mass murderers and mental illness, but suicidal people presumably have some mental health problems. Nor should the link be particularly surprising given that the Crime Prevention Research Center shows that 51% of mass public shooters in the last 25 years were actually seeing mental health care professionals before their attacks. That is 2.5 times the rate in the general public.
The FBI acknowledged that Americans want to “understand what led to such tragic events.” But the FBI argued these statements “seldom provide the answers” and the diaries and manifestos were “often misleading.” Yet the national media appears completely uninterested in why these murderers pick the targets they do and how their motivation to get media coverage is important in understanding how to stop these attacks.
The diary showed that the murderer had picked the Covenant School because it was a soft, unprotected target. Even if the national media ignored these comments, the Metro Nashville Police Chief John Drake, who had access to the diary, said on the day of the attack, “There was another location that was mentioned, but because of a threat assessment by the suspect of too much security, they decided not to.” A couple of days later, Nashville Council member Robert Swope stated that the murderer “looked at” two other Nashville public schools before deciding “the security was too great to do what she wanted to do.”
While the FBI worries that many of “the offenders themselves do not fully grasp or comprehend” what they are writing, there is a logic to attacking facilities assumed to be gun-free zones, like the Covenant School, and trying to maximize the amount of media coverage that they receive. The FBI may not want to acknowledge this, and the media may not want to cover these points, but we see it consistently in these attacks.
The mass murderer wanted to get attention for the difficulties facing transgender individuals. She compared trans individuals to other groups in a way that indicates she clearly believed that transgender people didn’t have the same rights: “Disabled have rights, civil races have rights, LGBTQ have rights, gun owners have rights.” But referring to the life of transgender people, she declared: “… with no rights, anyone’s country is a s***** dictatorship.”
The news media and the FBI under the Biden administration are attempting to control the information available to Americans about a mentally troubled woman who identified as a man. The Biden administration is free to argue against linking transgender issues to mental illness or mass murder, but censoring the information is not the right approach.
