Checking in with this week’s edition of the Health Wonk Review

The new Health Wonk Review is up with a collections of health policy blog posts. Image

This edition includes comments on a Harvard School of Public Health study on “how public and healthcare experts perceive very different reasons for Medicare’s always-impending insolvency.” Also, the latest on the effort to shut down the government in an effort to defund the affordable care act.

With the exchanges coming on line next week, it’s a good time of check in with this crowd.

Beyond the ACA,  local blogger David William takes on those who take on doctor rating programs.

Data, medicine, insurance reform and a round up of health policy blogs

1950s era analog computer

1950s-era analog computer

Health data is a theme of this edition of the Health Wonk Review because it is also the focus of the current Knight News Challenge. That contest rewards media innovation with seed money. They use the word “challenge” literally, asking for innovative responses to question: How can we harness data and information for the health of communities?

Our definitions of “health data” and “news” are broad, and range from projects in traditional newsrooms to consumer-facing technology to crunching big datasets. We’re hoping to find and accelerate projects that use data and public information in innovative ways to create strong information flows about health in our communities.

Check it out. Health care produces big, big data. Health information technology, surveillance data, electronic medical records, clinical trials, NIH databases.  Payers and providers produce endless streams of data for millions of people.  On the other end of the scale, the quantified selfers keep blood pressure, diet and exercise logs.

US-MapWhat would happen if you had to turn those logs over to your insurer? David E. Williams of the Health Business Blog notes that car insurer Progressive gathers lots of info on drivers through its Snapshot device. Then, the company lowers premiums in return for lower risk behavior. He asks “What will it look like when the same approach is applied to health insurance?” Risk assessment also serves as the basis for public policies and day-to-day individual behaviors. At Workers’ Comp Insider, Julie Ferguson looks at real versus perceived risks in her post about how “Your Daily Shower Can Kill You.”

Former VA research chief Joel Kupersmith writes on the Health Affairs blog about data, privacy and genomic research.  He considers the  challenge of balancing the benefits of widely shared genomic data with privacy concerns, in particular the re-identification of individuals.

The Healthcare Economist reports data about long-term care trends and investigates the systems in Austria, England, France, Germany and the Netherlands. For many disabled elderly individuals, a nursing home is their only option.  How do European countries take care of the long-term disabled?

CDC data suggest 200,000 Americans are needlessly dying every year from preventable heart disease, but over the last decade, that number – on an unadjusted basis – has decreased by about 12%, or that there are 28,000 fewer deaths, notes Jaan Sidorov of the Disease Management Care Blog: That being said, while the greatest jumps in saved lives are among persons of color, they still are the most vulnerable to avoidable cardiovascular conditions.  If we are really going to use this information, that insight is what tells us where the resources are really needed

                  Black men are at highest risk of dying early from heart disease and stroke
Black men are at highest risk of dying early from heart disease and stroke

Moving out of the data world, Health Care Renewal asks:  What Sorts of People are “Most Influential in Healthcare?” The post notes that Modern Healthcare answers this question with with a list of managers from hospital systems and  health care corporations — and very few doctors. The list did include the CEOs of Sutter Health and Advocate Health, two companies known for significant mismanagement of health care technology, HCR notes.

Some of the most influential  run corporations that have been cited time and again for ethical/ legal problems, and some of the corporations have paid hundreds of millions of dollars in legal settlements and sometimes pleaded guilty to criminal charges.  The list included not a single doctor in private practice, very few people with backgrounds in medical or health care academics, and a tiny number who have suggested reforms of the sort we discuss on Health Care Renewal. 

dials

On to the ACA

Anthony Wright of the Health Access Blog notes that the first ads from California’s  insurance  exchange  provide some basic information to Californians, but also “introduce some signposts and open some doors.” Health Insurance Resource Center Blog offers Maggie Mahar, who says that some pundits are claiming that young Americans will have little interest in purchasing health insurance through the ACA’s exchanges. In reality, the subsidies available to about nine million of those young people should actually make the exchanges’ comprehensive coverage attractive to them.

Joe Paduda’s post  discusses the origins of the “idea” of the mandate while positing that repealing the law “won’t do anything to solve the underlying issues inherent in today’s health insurance system.” A post on health and higher education comes in from John Goodman’and the Health Policy Blog. In it, he compares the way the two are funded.

InsureBlog’s Bob Vineyard enthusiastically reports on a new health insurance start-up that leans heavily on transparency and features free telemedicine and generic drugs. Find out why he gets to post a picture of the Oscar Mayer Wienermobile.

Colorado Health Insurance Insider says that the idea of the ACA “ was to make sure that large employers offered good qualify coverage in order to avoid paying a fine, it appears that some large employers will opt for the fine instead.”

Finally:

datagraph

Dats graphic by Michael Schieben

Forget the Supreme Court — Can Ayn Rand torpedo the health care bill? See the Health Wonk Review for more #HCR

Every two weeks, The Health Wonk Review saves you the troubling of tracking the health policy blogosphere. It also takes all comers, which recently includes a strong libertarian voice from a blog with an ambiguous name. From the digest:

One of the most provocative entries that I received comes from the Center for Objective Health Policy (COHP), a group that reaches out to medical students while arguing that health care reform violates individual rights.

Nathan Fatal explains: “The problem with [the] assumption” that everyone has a “right to health care … is that a right to a good or service would require that somebody provide it, i.e., that somebody be forced to provide it.”

He objects to the individual mandate: “Just as one cannot kick down a neighbor’s door and hold a family hostage until all members pay a small fee toward his healthcare costs, a large number of citizens cannot properly hand the role of hostage-taker to the … government in order to exact indirect but forced payments from all fellow citizens … all such actions are the same since they violate freedom of action by initiating force against innocent people in order to provide ‘basic security’ to those who ‘need’ it.”

Much more on the site from all points on the political spectrum, including thoughts on the pending Supreme Court decision.  Hosted this week by Maggie Mahar at  her new blog home: healthinsurance.org blog

Where can you find the best of #health #policy blogs? On the new Health Wonk Review

Get the views on health reform from the right and the left over at this edition of Health Wonk Review. Take note of the Health News Review entry. That site — which critiques health news coverage — started in Minnesota but features a slew of reviewer from MGH and other Boston hospitals.

This week’s digest is hosted by the Disease Management Blog, which is also responsible for a series of goofy health policy videos, including this one:

Health Wonk Review: Wearing the Green for the St. Patrick’s Day Edition

Here in Boston, researchers have looked into that most pressing of St. Patrick’s Day health questions: Is Guinness really good for you? Red wine gets all the press, but Tufts researchers found a positive association between beer and bone density.

For this edition of the Health Wonk Review, we take a a look at the Irish Times and find that even with a national health plan, Ireland has to deal with barriers to care. One story details slow progress in the establishment of promised primary care centers, and another story, asks “Is the EU good for your health?”

So, while we refight the battle over birth control, the Irish health ministry – of the largely Catholic country — is releasing a “sexual health” app.

Back here in the new world, the great grandchildren of Irish immigrants celebrate their heritage as Linda Leu at the Health Access Blog writes about a report that “highlights the need for cultural competency and language access, to welcome all ethnicities from California (and America’s) diverse communtiies….The Importance of Equity in the Bridge to Reform: As St. Patrick’s Day celebrates Irish ethnic pride, we need to take note of the full diversity of our states and nation. As we get ready for 2014, remember the communities that will be newly served may not look (or speak) the same as those that the current system serves.” 

For the once-a-year step dancers,Gary Schwitzer at Health News Review answers questions about outcomes data on knee replacement surgeryAlso see posts on the JGIM paper on  data on  shared decision-making in prostate cancer surgery & coronary stents decisions   and an online “Daily Deal” coupon for preventive MRI scan – disease-mongering du jour

Boston’s own David Williams notes: “Profits are up at Massachusetts health plans –should you be upset? On his Health Business Blog, he writes: The Globe reports higher profits and CEO compensation at Massachusetts health plans. But profit margins are low and if anything the CEOs are underpaid.”

More of the best of recent health policy posts

At The Hospitalist Leader, Brad Flansbaum examines physician pay,fairness, and how it relates to the reinvigoration of primary care. Specialty physicians take note.”

Another post on health care providers — and their support teams – notes: “There’s been much discussion of the potential impact of health reform, aka Obamacare, on employment”  Joseph Paduda at ManagedCareMatters.com writes: “Most has referenced employers cutting jobs to avoid the mandate or save dollars for premiums.  What hasn’t received much attention are the new jobs – mostly high-paying ones- that will be created as more Americans are insured and seek coverage and care.”

Julie Ferguson of Workers’ Comp Insider asks “If you had to guess what workplace experienced most assaults by customers/patrons what would you guess? If you guessed healthcare, you would be right.” She informs us that 61% of all workplace assaults are committed by healthcare patients, according to a recent report issued by NCCI.

Two posts came in on shady practices.

Colorado Health Insurance Insider offers: Colorado AG Files Lawsuit Against Discount and Mini-Med Health Plan:  “It’s a pretty typical website for that sort of product, with lots of great-sounding claims and sample cases where members have supposedly saved thousands of dollars.  But they also have a link for people who want to “become a reseller”.  And their process of getting recruits enrolled to sell the product is what has come under the watchful eye of the Colorado AG.”

 Calling it “The latest example of misbehavior by a large health care corporation,”  Roy M. Poses at Health Care Renewal writes : Gentiva’s Odyssey Healthcare Settles Again, Signs Yet Another Corporate Integrity Agreement and gets “little more than a financial wrist slap.  The case was about allegations that a for-profit hospice enrolled patients who did not meet the regulations for federal reimbursement for hospice care.  In particular, they were alleged to be patients who really did not seem to have extremely limited life expectancies.  It is true that enrolling such patients lead the government to pay more for their care than might otherwise be the case.  But the real problem is that patients may have been denied treatments that could have improved, or even lengthened their lives. 

Two on workplace wellness:

Wellness Program Implementation at WCS Looks a Lot Like Dating” says Kat Haselkorn Corporate Wellness Insights. This post details the similarities between customer satisfaction and romantic relationships. Although wellness program implementation and dating do not seem to have much in common, we have found that the process of making a client happy mirrors the act of keeping a romantic prospect satisfied. When it comes to setting up a wellness program, we do whatever it takes!

Henry Stern, LUTCF,  at the CBC InsureBlog writes about “Health vs Common $ense, challenging “the conventional wisdom that workplace health promotion programs work.”

And two on HIT:

“Competition today in healthcare encourages care providers to hoard patient data.”  says Vince Kuraitis of the  e-CareManagement blog in a post called “Stage 2 MU Rules : The proposed Stage 2 Meaningful Use rules support moving competition in healthcare to the right bases — sharing and adding value to patient health record data.

Health Affairs offers a post by Danny McCormick, of Harvard Medical School and the Cambridge Heath Alliance, and coauthors David Bor, Stephanie Woolhandler, and David Himmelstein. The title of the post is  “The Effect Of Physicians’ Electronic Access To Tests: A Response To Farzad Mostashari

The four authors of the post are also the authors of an article in the March issue of Health Affairs. The article reported that electronic access to computerized imaging results (either the report or the actual image) by physicians was associated with a 40% -70% increase in imaging tests, including sharp increases in expensive tests like MRIs and CT scans; the findings for blood tests were similar. The article prompted a critical blog post by national health IT coordinator Farzad Mostashari.

Jason Shafrin writes: “Americans are a litigious culture.  The malpractice claims that make it to court, however, are not many as you may think.The Healthcare Economist explains why.

Finally, how does health care In the U.S. compare to other countries?  On the Disease Management Care Blog  Dr. Jaan Sidorov tests our knowledge of and finds: We’re not so bad after all!

So, our days of drinking black — or green  — beer are over. But, on Saturday I’ll boil up some cabbage and — sorry Walter Willett – and a hunk of  corned beef in honor of my Irish nanny and the Readys and Gradys  and Murphys who left their green shores and made their way across the sea to settle in Boston and New York.  Happy St. Patrick’s Day from BHN.

 

Reviews and Revues: Health Wonk roundup and Ig Nobels tonight

The new edition of the Health Wonk Review is out, hosted for the first time by the Health Talent Transformation page. It includes a video in honor of the UN’s new ambassador to outer space.

Such a move clearly qualifies for an Ig Nobel award, but the alien ambassador will have to wait until next year. The 2010 Igs will be announced tonight. Too late to get a ticket to this live send-up of silly science, but you can watch a live webcast or read more about it here or on the Ig website. 

Broken women put back together again

Two items of note in the local press.

In the Globe, master obit writer Bryan Marquard offers a remembrance of Angie Scardino, the Franklin women who allowed the former Globe reporter Alice Dembner to chronicle her life after a hip fracture. According to the Mayo clinic, nearly  half of all hip fractures occur in adults older than 80 years. While bone loss is a factor, most hip fractures are caused by falls.  

Mrs. Scardino, who most recently lived with her daughter in Franklin, but always thought of the house she and her late husband bought in Scotia, N.Y., as her home, died of congestive heart failure Friday at Beth Israel. She was 86.

Allowing herself to become the public face of an injury that takes the lives of so many older patients was, in many ways, uncharacteristic of Mrs. Scardino, who was so private she usually avoided trading stories with friends about the ailments of age.

Also, Rachel Zimmerman over at Commonhealth, offers a Q &A. with Dr. Roseanna Means who “started the nonprofit, Women of Means, in 1999, when she realized that help for the homeless was primarily geared toward men and overlooked the specific medical needs of women.  Earlier this month, Dr. Means was presented with a Community Health Leaders Award for her work by the Robert Wood Johnson Foundation.”  She begins with the Q:  How does a pedicure constitute medical care?

Finally, on the blogs, check out this week’s Health Wonk Review, which features another Q & A, this one with Evan Falchuk, President of the Boston-based company Best Doctors. Speaking to local consultant Dave Williams, Falchuk describes his company this way:

Evan Falchuk: We sell an employee benefit to companies that they give for free to their employees. We help people get the right diagnosis and the right treatment.  The way we do it is by collecting information from the patient, doing an interview, compiling records, having doctors analyze all the information and then consulting with experts from our Best Doctors database to figure out the right course of treatment.

This week’s HWR is brought to you by The Insure Blog.

A killer edition of Health Wonk Review

Boston is full of killer doctors. So, this is the Dr. Death edition of Health Wonk Review – the roving digest of health policy blog posts. 

  Start with Donald Berwick – Obama’s nominee to head the Medicare and Medicaid program. Republicans cast the Cambridge doc as a supporter of medical rationing.  Is evidence-based medicine the same thing as rationing? Do they ration care in the U.K.? Is Berwick the personification of the death panel? 

If so, he wouldn’t be Boston’s first killer doctor. In recent years, the local news brought us details of the alleged “Craig’s List killer” – a BU med student – as well as the “secret life” doctor. He was convicted of beating his wife  and slashing her throat after a walk in the suburban woods. Prosecutors said he was motivated by his appetite for prostitutes and phone sex. The “cross-dressing” dermatologist was convicted of fatally shooting his wife. While in jail, he was charged with but aquitted of hiring a hit man to kill a former country prosecutor. 

 (Note that doctors can also play a role in preventing violence against women.)  

But, in Boston’s most notorious medical murder, the victim was doctor. In 1849, Boston Brahman Dr. George Parkman tried to collect a debt from a chemist co-worker and ended up dead. The killer chemist dismembered the body and hid it behind a wall at what was then Harvard Medical School. 

Not to make light of murder –but, could any of this been driven by sleep deprivation? What if the members of the rationing panel are tired ? Maggie Mahar of  The Health Beat blog looked at a survey released this week which found most people think residents work reasonable hours. She writes: 

Most patients have no idea that the residents caring for them may be coming to the end of a 30-hour shift.  Sleep deprivation impairs a resident’s judgment and this can lead to errors that harm and even kill patients. Residents themselves have been killed after falling asleep at the wheel while attempting drive home following a 30 -hour shift.  In 2006, the Institute of Medicine recommended capping shifts at 16 hours. The Accreditation Council on Graduate Medical Education (ACGME), the group that oversees resident’ training. The ACGME has been reviewing IOM’s recommendations and is expected to release its ruling later this month. For hospitals, residents represent cheap labor. For patients, an exhausted resident represents a threat to patient safety. 

Brad Wright at Wright on Health comments as well, in a post entitled Debating the Physician Work Week

Dartmouth Atlas 

Gooz News – and many others — commented on The New York Times story on the limitations of the Dartmouth Atlas  in both a review and a weekly roundup

Regional variation in Medicare spending is one indicator of gross overutilization. Something is happening when a hospital in McAllen, Texas does twice as many knee implants per Medicare beneficiary as a hospital in Baton Rouge, Louisiana. (An earlier version of this post compared McAllen to Rochester, MN, which actually has a slightly higher rate of knee implants per 1,000 Medicare enrollees.) 

But that by itself tells us nothing about why that overutilization occurs. 

(McAllen Texas, was the subject of Atul Gawande’s much touted New Yorker piece on cost and practice pattern variations.) 

Avik Roy at The Apothecary says “…(T)he debate about the ins and outs of the Dartmouth Atlas is not merely a statistical one. It is about something more fundamental: Can government do a better job of managing medicine than doctors and hospitals can, or should the doctor-patient relationship remain sovereign? There is plenty of waste in medical care today, but the Dartmouth Atlas demonstrates that government is the problem, not the solution.” 

To catch up on the blog spew on the Dartmouth data see Kaiser Health News. 

Oil Spill 

Jon Coppelman of Workers Comp Insider looks at the BP oil spill and sees another potential disaster looming for the health of recovery workers.  

North Grove St. site of Parkman murder

Aging 

Eric Widera presents Rethinking Prisoner Release Policies from a Geriatrics Perspective posted at GeriPal - A Geriatrics and Palliative Care Blog, calling it “a short little piece on why geriatric prisoner release policies need to be reexamined and reworked.” 

Canada  

Henry Stern, LUTCF, CBC presents No More Free Lunch posted at InsureBlog, saying, “Summary: Just as ObamaCare heats up here, our Friends to the North are looking to bail on their own nationalized health care system.” 

HIT  

Shahid N. Shah presents How to commercialize your healthcare IT and media products posted at The Healthcare IT Guy, saying, “Shahid gives advice from his recent talk at The National Institutes of Health Commercialization Program (NIH-CAP) to this year’s class of SBIR/STTR grantees about how to commercialize their Healthcare IT, Media, and Training products.” 

VA Care     

Jason Shafrin presents Non-VA VA Care posted at Healthcare Economist, saying, “The VA is held up as a model of integrated, government-run medical care. Even the VA, however, sometimes has to purchase medical services from outside vendors. The Healthcare Economist explores why this is the case.” 

Today, No. Grove St. leads to Mass General. Note street sign.

Jason Shafrin The New America Foundation’s New Health Dialogue blog offers three posts on the revised and updated edition of Phil Longman’s “Best Care Anywhere” book on the VA. This one looks at “Longman’s ideas on how the rest of the health care system may be able to adapt some of the VA’s innovations and create a version of accountable care.” 

 “Patient engagement”  

Chris Langston presents Sailing the Ship of Health Care posted at The John A. Hartford Foundation blog, Health AGEnda, on “patient engagement in health care, focusing on a team-based approach to care management and the respective roles of each ‘team member.’” 

Insurance and Payment Reform  

David Williams writes about Mental health parity: a three-stage path to equality posted at Health Business Blog. “Implementation of mental health parity may lead to the increased use of evidence based medicine for utilization management. But it’s a 3-step process” 

The Colorado Health Insurance Insider says: Continuous Coverage Does Not Eliminate Underwriting  

 If the co-director for health policy at the Center on Budget and Policy Prioritieisn’t clear about how medical underwriting and the individual health insurance market work, it’s no wonder that people in general find the subject a bit confusing. 

National Center for Policy Analysis president  John Goodman  blogs “Do We need an Individual Mandate?”  Goodman explains why he thinks mandating health insurance coverage creates more problems than it solves. 

Dr. Parkman's remains

California Health Line wonders why small businesses aren’t embracing reform.

Austin Frakt  writes about  The Decline Of Employer-Sponsored Coverage Under Health Reform: Good, Bad Or Ugly? at The Incidental Economist, saying, “One of the latest criticisms of the new health overhaul law is that it will encourage employers to stop offering health insurance. In fact, it will. And that’s not a bad thing.” 

Anthony Wright, Health Access California presents Real choices… posted at Health Access WeBlog: California is moving forward on state legislation to implement reform, not just to set up exchanges, but on standardizing benefits in the whole individual market to allow for real apples-to-apples comparison and choice.” 

The Disease Management Care blog looks at “some recent developments involving that darling of health reformists everywhere, the “Patient Centered Medical Home”  and concludes” The issue remains unsettled. “ 

 In contrast to the Obama Administration’s confidence that the PCMH is a bedrock of “bending the curve” there is a report from the American Academy of Family Physicians that shows how difficult it can be to install it and how little impact it has on clinical outcomes and patient satisfaction.  On the other hand, Blue Cross Blue Shield of Michigan is making it look easy and they have a press release saying they saved beaucoup money.  Which is it?  Stay tuned…….. 
 

Current site of HMS

Bradley Flansbaum comments on physician salary and workforce issues in a post entitled  The Spend We Don’t Have, Part II at The Hospitalist Leader

Drug Channels explains the dispute between Walgreens and CVS/Caremark  in “The WAG-CVS Brouhaha: What’s Really Going On” 

From Health Care Renewal : RUC Off – the New England Journal Once Again Fails to Mention the Unmentionable:“A major article in the most prestigious US medical journal noted how Medicare’s payments to physicians have tilted in favor of procedures and against cognitive medicine, including primary care.  Yet the article failed to mention the key role of the RUC (RBRVS Update Committee), the obscure, opaque AMA committee that de facto controls the payment system, without public input from any other group or individuals.”

 Etc. 

Boston Health News promises to move away from the macabre next time. (The last edition featured East Cambridge’s famous Halloween decorations.) 

Violence is a serious issue. And surprisingly, the health care system doesn’t always deal very well with death and dying. 

But we’ve spared you the obvious sports theme of choking Bruins, trailing Celtics and sort-of surging Sox. 

Finally, for local science news, check out the revived Nature Network Boston. We’re still updating the home page. Your BHN  host, Tinker Ready,  is now in charge of bringing the briefly dormant blog there back to life. Today’s edition: The stem cell rap.

You’ll find similar sites for local scientists in London and NY. 

  Wonk on.

Can a computer save you from an extra x-ray?

Two news round ups today.

First, check out the latest edition of the Health Wonk Review, hosted by Boston’s own David Williams at  The Health Business Blog.  As he reports: It’s a wonderful day in the wonkerhood, with so much health care policy fodder to chomp on. Let’s jump right in.

Also, here’s some local news of note:

Kaiser Health News and NPR report on an MGH study about HIT doing its job.

A funny thing happens when a computer challenges orders for medical scans that aren’t likely to help diagnose patients: Doctors often drop the test requests.

This morning’s Globe gives us this disturbing news:

At least 200 emergency medical technicians and paramedics in Massachusetts and New Hampshire have been practicing without legitimate certification, paying for fake credentials, rather than receiving medical training, state public health officials said.

 The Boston Review rounds up some of the usual and unusual suspects for a debate on industry influence on medicine.

 They start with pharma critic and former NEJM editor Marcia Angell, the run several responses:

Some of Angell’s respondents share her concerns and extend them to other areas of medical practice—including nursing and the identification of novel diseases. But not everyone agrees. Emma D’Arcy thinks that patients, newly empowered by modern information and communications technology, can make sensible judgments about treatments and drugs. And Thomas Stossel, writing separately, rejects the entire framework of analysis. For Stossel, results (what he calls “value”) are the only significant measure in assessing the nexus of academia and industry. The results that matter are longer lives of higher quality with less pain. And measured by these standards, the nexus looks pretty good.

Finally, here’s a little advance news — Tinker Ready is now the “Hub Leader” for Nature Network Boston

 The site comes via the Nature family of peer-reviewed research journals. She’ll be blogging and tweeting for this networking site for scientists, entrepreneurs, policymakers and others interested in the life sciences. Once they work the bugs out of the home page, we’ll have a more formal announcement.  In the meantime, feel free to browse and/or join up.

State nixes health insurance rate hikes plus reform in review

 

The Globe reports that the state is rejecting health insurance rate hikes for the first time.

Making good on Governor Deval Patrick’s promise to reject health insurance rate hikes deemed excessive, the state Division of Insurance this morning turned down 235 of 274 increases proposed by Massachusetts health insurers for small businesses and individuals.

The ruling, stemming from emergency regulations the governor unveiled in February, marks the first time state government in Massachusetts has used its authority to deny health premium increases

More from the Boston Business Journal

 

 Catch up here on the Caritas sale and conversion to a for-profit company.

 Globe

Cerberus, known for its $7.4 billion buyout of Chrysler LLC in 2007, is acquiring a hospital chain that has struggled in a medical marketplace dominated by large teaching hospitals such as Massachusetts General Hospital, which has links to Harvard Medical School. Turning the system around and making a profit for investors will be a challenge, said Stuart Altman, professor of national health policy at Brandeis University in Waltham, Massachusetts.

“The buyout firm isn’t walking into an easy situation,” said Altman. Massachusetts is also contemplating tighter financial regulation of hospitals, which could be a “wild card” for a new buyer, Altman said.

And catch up on the arrival of health reform with  Health Wonk Review, hosted this week by Health Technology News.

 His compilation of the latest from the policy blogs features an array of  flying pigs.

 Health care has never been so center stage and so enmeshed with policy and politics.  It took 100 years, starting with Teddy Roosevelt’s 1912 presidential campaign. Seven presidents tried including two Republicans and five Democrats. 
Who won? Patients won’t be denied coverage for pre-existing conditions (eventually) and are no longer subject to lifetime caps.  Physicians will benefit from the coverage expansion and increasing fees for Medicare primary care. Government trims the rate of growth of the deficit. Small business gets a tax break. Students can stay on their parent’s plans until age 26. Seniors see the close of the Medicare prescription drug doughnut hole.  And hospitals receive payments for more of the care delivered. 

Not all of the “winners” improve access/health/costs:  Pharma doesn’t have to negotiate for drug prices. Payers will still find reasons to deny care and are permitted medical loss ratios of 80-85%.  

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