Globe: How Mitt Romney came around to Massachusetts style health reform

The Globe has a loooong piece today just for those who don’t cringe at the word ” wonk” and like terms with the suffix -care.

The story tells the tale of how, six years ago, then Massachusetts Governor Mitt Romney came to the same conclusion as the Heritage Foundation — the individual mandate is a compromise approach health care reform.

While Romney still supports the concept, conservatives don’t. The mandate, the story reports… has become the rallying cry for conservatives who reject the national plan, pressed by President Obama, as statist anathema.

Some of these critics maintain that Romney must disavow the Bay State health reform to have any chance of winning the Republican presidential nomination in 2012.

He will not.

“Overall, it was a positive approach,’’ Romney said in a Globe interview for this story. “I’m proud of the fact we took on a real tough problem and moved the ball forward.

Are fears of Alzheimer’s overblown?

Margaret Morganroth Gullette’s op-ed in last week’s NYTimes dared to suggest that our fears about Alzheimer’s
may be overblown.  The Brandeis-based writer said:

 The mere whiff of perceived memory loss can have terrible consequences in an insecure economy in which midlife workers are
regularly (and illegally) laid off on account of their age. This epidemic of anxiety around memory loss is so strong that many older adults seek help for the kind of day-to-day forgetfulness that once was considered normal …Greater public awareness of Alzheimer’s, far from reducing the ignorance and stigma around  the disease, has increased it.

Today’s letters to the editor included several outraged responses

Having witnessed the disease firsthand, I can truly say there is something worse than death…I truly hope that Margaret
Morganroth Gullette and those she loves never experience the disease as my family has. I implore her not to use her public platform to minimize the horror that is Alzheimer’s.

But, Douglas Powell, described as the author “The Aging Intellect” and a psychology instructor at the Harvard Medical
School, came to her defense

Studies that followed up mildly impaired elders for three to five years found that a large minority remained stable and about 14 percent returned to normal. No one yet knows why.

Hospital cost and insurance premium comparison data up

With rising co-pays, consumers can literally save thousands of dollars by comparing prices at different hospitals. Here’s the state makes it a little easier.

The report examines the prices paid by private health plans for commercially insured members in three service categories: inpatient hospital care, outpatient hospital care, and physician and other professional services. In each category, a sample of high-volume health care services was selected to maximize comparability across providers.

Heart attack? It will cost you $19,000 at UMass Medical and less than $10 at South Shore Hospital.

Hip replacement? $21K at Mt. Auburn in Cambridge and $27 across the river at the Brigham, which has a much nicer lobby.

The second half of the reports compares the list price to the amount Medicaid pays –  rates that hospitals routinely say don’t cover theirs costs. Still, be aware that these are hospital prices, not costs. In other words, this is the sticker price, not the actual cost of delivering the service. So, theses numbers don’t reflect the actual differential.

Comparing health plans can be a little trickier, but the state is also offering data comparing premiums. Here are a few of the highlights:

From 2007 to 2009, private group health insurance premiums in Massachusetts increased roughly 5 to 10 percent annually, when adjusted for benefits. This comparesto consumer price index (CPI-U) increases(for all goods and services) averaging 1.7 percent annually over the same time period nationwide and 2.0 percent in the Northeast.

On average, the level of benefits covered by private group health insurance has declined and member cost-sharing has increased.

 - Deductibles and copayments generally increased from 2007 to 2009. For example, in the small group sector, the inpatient copayment in the most popular HMO plan increased from $500 to $1,000.

– Among small groups, average benefits decreased 3.6 percent from 2007 to 2008 and 6.6 percent from 2008 to 2009.

Do you get what you pay for? BHN is about to start posting links to different data bases so you can do a little research. Got something to say?  The state plans to hold hearings at the end of the month.

Connected Chucks: Wired sneakers help Dot’ kids stay fit

A new state reports says what the Globe told us a few years back — patients pay a premium as some hospitals.

So, at least Partner’s is spreading a little of that cash around.  This  program encourages kids to be active  by installing chips in their sneakers. The chips send datae of a “Step Meter”  which then sends the kids messages that say things — Turn off that )*(&^%4 video games… you only walked ten feet today.

Not really. “The Step Meter contains milestones, such as “you’ve walked the Boston Marathon”, or “number of average steps taking in a soccer game”.  More here and in the video below.

Study: Increase in older women attempting suicide via drug overdose

Massachusetts and several other New England state participate in a federal project called the Drug Abuse Warning Network (DAWN), “a public health surveillance system that monitors drug-related hospital emergency department (ED) visits and drug-related deaths to track the impact of drug use, misuse, and abuse in the U.S.”

The HHS project just released number that found the number of women over the age of 50 attempting suicide via drugs rose 49 percent between 2005 and 2009. The study concludes that The increase reflects the increase in
the number of women in that age group, not an increase in visits.

But, it appears that demographicd don’t explain the entire increase: :23.8 ED visits per 100,000 population in 2005  v. 32.3 visits per 100,000 population in 2009.

This from the study:

The mental and physical health needs of women vary across the life span, and older womenrepresent one of the Nation’s fastest growing populations.4 Problems such as pain and sleepdisorders can lead to increased use of prescription drugs to treat theseconditions. Also, older women may experience depression because of health
changes or other negative life events. Expanded research on women’s agingissues and the potential use of these drugs as a method of, or influence on, suicide attempts is critical
.

More on the study and Boston specific trends in drug-related ED visits here.

“Cell phone use while performing cardiopulmonary bypass” #cardiology

Not quite like a trip to the ATM during surgery, but…

Not really Boston related, but stumbled on it and thought you should know.

From the journal Perfusion.

2010 survey on cell phone use while performing
cardiopulmonary bypass. Smith T, Darling E, Searles B.

SUNY Upstate Medical
University in Syracuse, NY, USA.

Abstract

Cell phone use in the U.S. has increased dramatically over the past decade and text
messaging among adults is now mainstream. In professions such as perfusion,
where clinical vigilance is essential to patient care, the potential
distraction of cell phones may be especially problematic. However, the extent
of this as an issue is currently unknown. Therefore, the purpose of this study
was to (1) determine the frequency of cell phone use in the perfusion community,
and (2) to identify concerns and opinions among perfusionists regarding cell
phone use. In October 2010, a link to a 19-question survey (surveymonkey.com)
was posted on the AmSECT (PerfList) and Perfusion.com (PerfMail) forums. There
were 439 respondents. Demographic distribution is as follows; Chief
Perfusionist (30.5%), Staff Perfusionist (62.0%), and Other (7.5%), with age
ranges of 20-30 years (14.2%), 30-40 years (26.5%), 40-50 years (26.7%), 50-60
years (26.7%), >60 years (5.9%). The use of a cell phone during the
performance of cardiopulmonary bypass (CPB) was reported by 55.6% of
perfusionists. Sending text messages while performing CPB was acknowledged by
49.2%, with clear generational differences detected when cross-referenced with
age groups. For smart phone features, perfusionists report having accessed
e-mail (21%), used the internet (15.1%), or have checked/posted on social
networking sites (3.1%) while performing CPB. Safety concerns were expressed by
78.3% who believe that cell phones can introduce a potentially significant
safety risk to patients. Speaking on a cell phone and text messaging during CPB
are regarded as “always an unsafe practice” by 42.3% and 51.7% of
respondents, respectively. Personal distraction by cell phone use that
negatively affected performance was admitted by 7.3%, whereas witnessing
another perfusionist distracted with phone/text while on CPB was acknowledged
by 33.7% of respondents. This survey suggests that the majority of
perfusionists believe cell phones raise significant safety issues while
operating the heart-lung machine. However, the majority also have used a cell
phone while performing this activity. There are clear generational differences
in opinions on the role and/or appropriateness of cell phones during bypass.
There is a need to further study this issue and, perhaps, to establish
consensus on the use of various communication modes within the perfusion
community.

HSPH video w/ AG Eric Holder: Violence as a ublichealth issue

NYTimes on Mass plan, single-payer in Vermont

The lead tells the tale of Dr. Deb Richter whom moved  from New York to Vermont with a mission.

She wanted Vermont to become the first state to adopt a single-payer health care system, run and paid for by the government, with every resident eligible for a uniform benefit package….

Twelve years later, Dr. Richter will watch Gov. Peter Shumlin, a Democrat, sign a bill on Thursday that sets Vermont on a path toward a single-payer system — the nation’s first such experiment — thanks in no small part to her persistence. …

As in all states, the cost of health care has increased sharply in Vermont in recent years. It has doubled here over the last decade to roughly $5 billion a year, taking a particular toll on small businesses and the middle class. All 620,000 of the state’s residents would be eligible for coverage under the new system, which proponents say would be cheaper over all than the current patchwork of insurers. A five-member board appointed by the governor is to determine payment rates for doctors, what benefits to cover and other details.       

But much remains to be worked out — so much that even under the most optimistic projections the plan might not take effect until 2017. Most significantly, Mr. Shumlin still has to figure out how much it will cost and how to pay for it, possibly through a new payroll tax. Whether he will still be in charge by 2017 is among the complicating factors.     

Also  in the Times, this editorial on the Mass Plan:

From yesterday’s paper:

Despite all of the bashing by conservative commentators and politicians — and the predictions of doom for national health care reform — the program he signed into law as governor has been a success. The real lesson from Massachusetts is that health care reform can work, and the national law should work as well or even better

Here’s a sample of some of the comments:

Of course, it works. I got laid off three years ago. Unemployment covered 80% of my cobra payments. When my unemployment benefits ran out, I enrolled through the Commonwealth Connector Program. It is not cheap, $400 a month. However, it covers almost everything with only one grant deductible. If I were in a different state than MA, with all of my “preexisting conditions”, I would have paid around $1800 which would have meant no insurance for me. I am grateful to MA for providing an option that is cheaper than a monthly Cobra payment (which was $650 a month)!

————-

Sure, you can get insured in Massachusetts. You have to. But what is the point of insurance if you’re assigned a PCP at a free clinic 15 miles from your house and you can’t get an appointment for three months for a physical? Good luck if there’s something actually wrong with you, because no one will take your “insurance.”

—————

Single payer is the way to go, for me at least. Not so Obama with his Republican streak and his non-challenging manner.

—————

It may or may not work,the problem is that I really don’t care.As a small business owner you are trying to put your hand in my pocket.Those are my profits that I worked for.I have no desire to pay for health insurance for my employees.Heck,I don’t even like having to pay the minimum wage.I have no shortage of applicants,despite the lack of insurance.We have no shortage of people in this world,what is the harm in just letting them go?Lock the E.R. Room doors and be done with them.

Want some H-bomb with that coffee? And then some.

Check out Nature Network Boston for a rant on the way some covered the  Harvard coffee study. The H bomb comment refers to the authority Harvard authors give studies, for better or worse. 

Over at Science News Daily, where they pretty much reprint press releases, you can find reports on several local studies: 

Orphans and chromosomes

Face masks, TB and guinea pigs 

Dairy and heart disease.

 

Games for Health Conference back in town

We love the idea of this conference. We’re not wild about the $599 per admission fee. 

The 7th Annual Games for Health Conference is gearing up! On May 18-19 join hundreds of game developers, health professionals, and leading researchers to discover, brainstorm, and debate how videogame and videogames technologies can work to improve health & healthcare.

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