6/8 Update: The meeting Dr. Woolhandler refers to between Single Payer advocates and Sen. Baucus took place on 6/3. Her husband and PNHP partner, Dr. David Himmelstein attended. Click here more on that meeting.
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Today, BHN hosts the Health Wonk Review, the floating web digest of health policy blog posts.
This is Boston, but we already had a baseball theme. Summer reminds me of growing up on the Jersey Shore. So, this week — the Boss-town edition. Dedicated to Danny Federici, Bruce Springsteen’s organ player. He died of melanoma last year.
Healthcare Technology News offers a post on the health industry meeting with President Obama: “What We Call Health Care Costs, They Call Income.” The group’s proposed $2 trillion in reductions in the rate of growth of health care costs. They also pledged to reduce the growth in costs by 1.5% each year for ten years. “It’s not enforceable and there are plenty of reasons to view this cynically,” HTN asks. “But is it a signal that health care reform has a real chance this year?”
Joseph Paduda at Managed Health Matters reports on a health reform meeting sponsored by pharmacy benefits company Medco. Of the dozen meetings and press conferences on health reform each week –“This was one of the better ones I’ve (remotely) attended,” he said. Why? “Because the conversation was realistic, pointed, and quickly got into the reality of health care reform – it’s about cost.” Special extra: retro anti-health reform graphic featuring Ronald Reagan.
At the Health Affairs Blog, Harold Luft proposes a risk pool as an alternative to the public plan in “Beyond The Public Plan Debate: A Pathway To Transform The Delivery System.” Luft discusses the “weaknesses of the competing visions for a public plan option.” He outlines his proposed alternative: “a publicly chartered major risk pool that eliminates the need for the problematic behaviors of private health plans while enhancing choices for providers and patients.”
Reason to Believe
Kaiser Family Foundation’s head, Drew Altman, sees big differences in opinion between experts and the public on health care.
The Health Care Renewal blog offers a post entitled From the “Era of Cyber Hospitals to an Unfinished “Pipe Dream”There, Brown University’s Dr. Roy Poses notes that testimony in the ongoing civil lawsuit against corrupt HealthSouth hospital CEO Richard Scrushy cautions against buying into innovation hype. The “digital hospital” idea HealthSouth trumpeted in 2001 is an empty building. At the trial Scrushy testified that the hospital was a “pipe dream.”
Dr. Poses digs way back and finds a lot of cheerleading for this failed digital hospital project. “We are constantly bombarded with publicity about the latest health care ‘innovations.’ We are warned, however, that any new regulation of health care corporations may dry up the pipeline of ‘innovations,’ imperiling us all. Yet how many of these “innovations” actually improve health?” he writes
Are you tough enough to play the game they play?
Maybe this was an excuse to play video games, but David Porter at the Health Disparities blog explains how researchers are using the World of Warcraft and other “virtual worlds” to study natural experiments. In this case, he talks about a virtual virus – the kind that attacks player in the game, not the computer.
For the uninitiated, this involves a using a virus-infected virtual pet to attack the enemy. Porter described it as “an excellent example of a natural experiment and how people may act during a pandemic…” He said researchers analyzed data supplied by the game developer and cites two papers one Epidemiology and another in The Lancet Infectious Diseases.
Working on a Dream
Anthony Wright presents Getting to universal… posted at Health Access WeBlog. He agrees with with the CBO that an individual mandate by itself won’t get us to universal coverage, but disagrees with other supposed barriers to that goal.
BNET Healthcare asks “Thought Leaders Propose Health Reforms, But Will They Work?” The authors of New England Journal of Medicine article favor "accountable care organizations" that would enable healthcare providers to improve quality and reduce cost growth. BNET thinks their view of physicians and the health care business is “too idealistic to offer a practical road map to reform.”
Neil Versel at Healthcare IT Blog comments on an “outrageous statement” by the CEO of Epic Systems “Vendors, this is your wake-up call”
The Big Muddy
Sam Solomon of Canadian Medicine describes a medical crisis triggered by a nuclear accident. “When nuclear nonproliferation is the problem” He describes his post as “an article about the potential consequences, both clinical and political, of the recent shutdown of the nuclear power plant in Ontario that produces about half of the world’s supply of a certain critical radioisotope used in diagnostic imaging exams.”
Mike Feehan at Insureblog contemplates the difference between medical care and health care. “In order to reach meaningful conclusions about the direction of health care reform, we need to understand the relationship of health care to wellness… We can exercise (free). We can get adequate sleep (free). We can steer clear of substance abuse of all kinds (free). We can keep a reasonable diet (free). We can always wash our hands (free). We can hold it down to 85 on the Interstate (free). We can stop smoking or never start (better than free). To a great extent we already have free health care in the U.S.”
Jason Shafrin at Healthcare Economist notes that Medicare Part D plan was supposed to provide a prescription drug benefit for those who did not have it. The Healthcare Economist reviews a paper that that asked how well the program is working. It found that after the enactment of Medicare Part D, only 7% of seniors lacked drug coverage, compared to 24% before the launch of Part D.
Glenn Laffel at Pizaazz tell us: “It’s been a long strange trip for Dendreon, the makers of Provenge a new immune therapy for prostate cancer. No one seemed to take the stuff seriously, but now the definitive trial has been completed and lo and behold, it works! No one could be happier than its shareholders.”
Find Clearing the Haze – Is Marijuana Addictive? at Brain Blogger. “America’s most popular illegal drug has remained largely a scientific mystery. It is a drug that millions of Americans have been using regularly for years, and, from a clinical perspective, it remains the least studied illicit drug of all.”
Breast Cancer Action (BCA) is challenging the legality of patenting human “breast cancer genes.” BCA is joining the American Civil Liberties Union in suing Myriad Genetics (a private biotechnology company based in Utah), that currently holds the patent on the two human genes known as BRCA1 and BRCA2.
The BRCA1 and BRCA2 genes are present in every human. However, people with certain genetic mutations on these genes are at an increased risk of developing breast and ovarian cancer. Myriad holds exclusive rights to these genes and their mutations and to the research performed on them. Testing for the BRCA1 and BRCA2 mutations can only be performed at Myriad labs and currently costs over $3,000.
Since 1998, when BRCA1 & 2 were first patented, BCA has maintained that the patenting of human genes interferes with patients’ access to genetic testing and medical care.
“The time has finally arrived for the courts to decide who owns our genes,” said Barbara Brenner, executive director of Breast Cancer Action.
Health care shoppers looking for the best deal should remember the little lagniappe that came with the state insurance plan: The “My Health Care Options” page. This simple database allows patients to compare hospitals on costs and quality. So, if you get to choose between two hospitals, you can opt for a four-star angioplasty, c-section or gall bladder operation. (Watch those co-pays; they can add up.)
But an article posted last week on the Health Affairs website suggests that hospitals themselves don’t always get what they pay for. The researchers looked at how much hospitals spend on care , not how much they bill patients. It was written by the practice-pattern variation watchers at Dartmouth and Amitabh Chandraof Harvard’s Kennedy School
Numerous studies in the United States have examined theassociation between quality and spending at the regional level.In this paper we evaluate this relationship at the level ofindividual hospitals, which are a more natural unit of analysisfor reporting on and improving accountability. For all of thequality indicators studied, the association with spending iseither nil or negative. The absence of positive correlationssuggests that some institutions achieve exemplary performanceon quality measures in settings that feature lower intensityof care. This finding highlights the need for reporting informationon both quality and spending.
Coming up this week: BHN hosts the Health Wonk Review, the floating digest of highlights from health bloggers near and far. My job – spare you from an avalanche of people who think they can use it to sell bogus diets, supplements and nursing degrees.
Here’s what Marcia Angell would have said about the single payer approach if she had been invited to the Senate Finance Committee health reform meeting this week. Via the Globe.
The reform proposals advocated by President Obama are meant to increase coverage for the uninsured. That is certainly a worthwhile goal, but the problem is that they leave the present profit-driven and highly inflationary system essentially unchanged, and simply pour more money into it – an unsustainable situation. That is what is happening in Massachusetts, where we have nearly universal health insurance, but costs are growing so rapidly that its long-term prospects are poor without cutting benefits and greatly increasing co-payments.
Also, you’ll find my week in review on the MassDevice site. There you will find reports like this one:
Massachusetts Medicaid fraud: Two ways to rip off the poor
The Globe reported this week that a Brookline couple worth $2 million pleaded guilty to fraud and larceny charges after collecting Medicaid benefits for five family members. Joseph and Jila Youshaei reported $475 in income per week and Medicaid paid for the family’s medical bills from 1999 to 2005.
“The United States and 16 states have joined in two whistleblower suits filed in the District of Massachusetts against the drug manufacturer, Wyeth, alleging that the company knowingly failed to give the government the same discounts it provided to private purchasers of its drugs, as required by laws governing the Medicaid program.”
And, when it comes to BPA, the FDA has a little problem with objectivity, according to a report in the Milwaukee Journal Sentinal.
First to Boston. The Globereports that a Harvard prof was inspired to do a new study on the suspect by-product of some plastics when she saw her student drinking out of bottles.
Led by Jenny Carwile, a Harvard School of Public Health doctoral student, 77 Harvard students in the study drank all cold beverages from stainless steel bottles for a week to wash BPA out of their bodies and minimize exposure. Most BPA is flushed from people’s bodies within a matter of hours. During that week, the students gave urine samples.
Then the students were given two refillable polycarbonate bottles made with BPA to drink all cold beverages from for one week. Urine samples taken over that week showed the students’ BPA levels spiked the second week to levels normally found in the general population.
On the FDA end of this story, TheJournal Sentinal says it has emails that “show how government regulators relied on the trade association to do much of their work for them. The FDA relied on two studies – both paid for by chemical makers – to form the framework of its draft review declaring BPA to be safe.”
The scientific evidence supporting the safety of bisphenol A has been repeatedly and comprehensively examined by government and scientific bodies worldwide. In every case, these assessments support the conclusion that bisphenol A is not a risk to human health at the extremely low levels to which people might be exposed.
The Council states the current thinking of regulators — now we know why. The environmentalists say the evidence of harm is clear – BPA has to go.
For that point of view, see The Alliance for a Healthy Tomorrow : “A broad coalition in Massachusetts working to pass laws and policies that prevent harm to our health from toxic chemicals.” Here’s why they think the Harvard study is important.
Well, it has been thought that BPA is mostly a danger when heated, but this study shows that BPA also leaches out of polycarbonate plastic when cooled. This is particularly relevant to the adult population that drinks mostly cold beverages in polycarbonate containers, while it is mostly polycarbonate baby bottles that contain warm liquids.
Here, Maryland doctor Ross Martin finds true harmonization. He also comes up with rhymes for two Boston heavies — Obama HIT man David Blumenthal and John Halamka, the CIO at Beth Isreal Deaconess Medical Center.
Dr. Blumenthal, Won’t you give me a call/
So I can work at the ONC (Office of the National Coordinator of HIT)…
We’ll work for Jon Halamka / As for lunch we’ll always comp ya.