Health Insurance, Veterinary Care, and the Not-So-Secret Benefits of Pets

By Shailin Thomas

Pet ownership is incredibly popular in the United States. There are almost 70 million companion dogs spread across 43 million American households.   This isn’t particularly surprising, given that study after study has shown that companion animals promote healthier, happier, longer lives for their owners. Despite pet popularity and prevalence, though, many pet owners don’t fully understand how expensive their four-legged family members can be — especially if they end up needing extensive veterinary care. Every year, millions of companion animals are euthanized because their owners lack the financial resources to pay for necessary veterinary services. Unlike in human medicine, pets in the hospital with readily curable ailments often go untreated for financial reasons.

How can we help people keep and care for their pets — capturing companion animal health benefits while also ensuring those pets receive the veterinary care they need? The answer might be found in the synergies between animal and human health — and the benefits they entail for health insurance providers.

The health benefits of companion animals have been extensively documented in both the scientific literature and the mainstream media. Pet owners have, inter alia, decreased risk of cardiovascular disease, decreased risk of anxiety and depression, decreased incidence of allergies, and increased immune system function. Some insurance companies even have materials for their customers promoting pet ownership because of these benefits. The health conditions ameliorated by animal companionship are often otherwise treated with doctor’s visits, medications, and other expensive interventions paid for in large part by insurance providers. In other words, pet ownership produces positive externalities on insurance providers by decreasing the amount they pay in traditional medical services for these ailments — and insurance companies have an interest in incentivizing animal companionship.

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Monthly Round-Up of What to Read on Pharma Law and Policy

By Ameet Sarpatwari and Aaron S. Kesselheim

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues relevant to current or potential future work in the Division.

Below are the abstracts/summaries for papers identified from the month of October. The selections feature topics ranging from the failure of investigational drugs in late-stage clinical development, to the impact of Medicaid expansion on health care utilization, to impact of a bundled Medicare reimbursement policy on major adverse cardiovascular events among dialysis recipients. A full posting of abstracts/summaries of these articles may be found on our website.

  1. Dafny LS, Ody CJ, Schmitt MA. Undermining Value-Based Purchasing – Lessons from the Pharmaceutical Industry. N Engl J Med. 2016 Oct. [Epub ahead of print]
  2. Doshi P. Is this trial misreported? Truth seeking in the burgeoning age of trial transparency. 2016;355:i5543.
  3. Hwang TJ, Carpenter D, Lauffenburger JC, Wang B, Franklin JM, Kesselheim AS. Failure of Investigational Drugs in Late-Stage Clinical Development and Publication of Trial Results. JAMA Intern Med. 2016 Oct. [Epub ahead of print]
  4. Kesselheim AS, Avorn J. Approving a Problematic Muscular Dystrophy Drug: Implications for FDA Policy. 2016 Oct. [Epub ahead of print]
  5. Sommers BD, Blendon RJ, Orav EJ, Epstein AM. Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance. JAMA Intern Med. 2016;176(10):1501-9.
  6. Tominaga T, Miyazaki S, Oniyama Y, Weber AD, Kondo T. The Japanese Postmarketing Adverse Event Relief System: A confluence of regulatory science, the legal system, and clinical pharmacology. Clin Pharmacol Ther. 2016 Oct. [Epub ahead of print]
  7. Wang C, Kane R, Levenson M, Kelman J, Wernecke M, Lee JY, Kozlowski S, Dekmezian C, Zhang Z, Thompson A, Smith K, Wu YT, Wei Y, Chillarige Y, Ryan Q, Worrall C, MaCurdy TE, Graham DJ. Association Between Changes in CMS Reimbursement Policy and Drug Labels for Erythrocyte-Stimulating Agents With Outcomes for Older Patients Undergoing Hemodialysis Covered by Fee-for-Service Medicare. JAMA Intern Med. 2016 Oct. [Epub ahead of print]

Monday, 11/7, HLS Health Law Workshop with Trudo Lemmens

November 7, 2016 5-7 PM
Hauser Hall, Room 104
Harvard Law School, 1575 Massachusetts Ave., Cambridge, MA

Presentation: “While Canada Ventures into Legalized Medical Assistance in Dying, What Can It Learn from the Belgian Euthanasia Experience?”

To request a copy of the paper in preparation for the workshop, please contact Jennifer Minnich at jminnich@law.harvard.edu.

Trudo Lemmens is Professor and Scholl Chair in Health Law and Policy at the University of Toronto Faculty of Law. He holds cross appointments in the Faculty of Medicine, and the Joint Centre for Bioethics. Since joining the Faculty of Law, he has been a member of the School of Social Science of the Institute for Advanced Study in Princeton, a visiting fellow of the Royal Flemish Academy of Belgium for Science and the Arts, a visiting professor at the K.U.Leuven and the University of Otago (New Zealand), a Plumer Visiting Fellow at Oxford’s St. Anne’s College, and an academic visitor at the Faculty of Law and the HeLEX Center for Health, Law and Emerging Technologies at the University of Oxford.

Lemmens holds a Licentiate of Laws (LL.Lic.) from the KU Leuven (Belgium) and both a Master of Laws (LLM, specialization bioethics) and Doctorate of Civil Law (DCL) from McGill University. His research sits at the interface of law, ethics, and professional governance. Currently, his research focuses on the complex interaction between law, other governance tools, and ethical norms and values in the context of health care, biomedical research, health product development, and knowledge production.

Lemmens’ publications include the co-authored book Reading the Future? Legal and Ethical Challenges of Predictive Genetic Testing, the co-edited volume Law and Ethics in Biomedical Research: Regulation, Conflict of Interest, and Liability, as well as numerous chapters and articles in national and international law, policy, science, medicine and bioethics journals. He is currently a member of the Advisory Committee on Health Research of the Pan American Health Organization and of the Board of the Ontario Mental Health Foundation.

Legal Levers for Health Equity through Housing: A New Research Project

Health equity in housing can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health and social services, and quality of health and social services based on a person’s dwelling or neighborhood.

Lack of housing access, poor housing conditions, and income or racial segregation all have been shown empirically to cause negative health outcomes. Law has a pervasive role in housing, and has for a long time. Law was instrumental in creating and maintaining segregation through mechanisms like red-lining, restrictive covenants and zoning. The Civil Rights movement brought an end to explicitly discriminatory policies, and new finance and inclusionary zoning policies helped create millions of units of affordable housing, but we still have a long way to go. As Matthew Desmond’s work shows, drastic improvements are needed in how governments enforce housing codes and balance the rights of landlords and tenants. The bottom line is that too many of our people have trouble affording decent housing in neighborhoods with the amenities for healthy living, and too many of our neighborhoods are still segregated.

Our team at the Center for Public Health Law Research has been selected as a research hub in the Robert Wood Johnson Foundation’s Policies for Action Program. For the next 20 months, we will be using empirical research and legal scholarship to analyze the housing crisis through the lens of law. We know that law shapes environments and behaviors, so we are searching for the links between laws, their intended and unintended effects on the housing market, and the health outcomes that follow. We will be bringing a focus on law and its mechanisms to a field rich in policy research. Our aim is to investigate how law influences health equity in housing, and offer recommendations about how it can be a lever for greater equity. We hope to engage the community of non-profits, advocacy groups, policy think-tanks, and social scientists who are working on identifying problems and finding solutions, as well as the community of legal scholars and litigators working on housing issues. In our recommendations we plan on both identifying steps to incrementally advance housing equity through existing law, and envisioning creative changes to the legal framework itself.

We are excited to engage the housing policy and the law community in a discussion about legal levers for health equity through housing. We also look forward to sharing our work with you as we go, here and on the Policies for Action website. Please stay tuned!

If you are interested in continuing this discussion please reach out to Abraham Gutman at Abraham.gutman@temple.edu