Med Society: 41% percent of Massachusetts docs support single payer

The Massachusetts Medical Society is out with its annual survey of doctors. It’s full of information about the ongoing shortage of primary care docs and select specialists. No surprise. What is unexpected  is the growing support among state docs for a single-payer system — 41 percent, up from 34 percent last year.

Opinions of U.S. Health Care System
For the second year, physicians were asked their opinions on the best option for the U.S. health care 
system. While support for a single-payer system saw a 7 percent jump from last
year, 59 percent of physicians prefer other options.  The responses from the
2011 study: 23%  (versus 32% in 2010) preferred both public and private plans with a
public buy-in option for businesses and individuals

  • 15% (v. 17%) said keep the existing mix of public and private plans, but
    allow insurers to sell plans with limited benefits and high deductibles to keep
    premiums low
  • 17% (v.14%) preferred the current Affordable Care Act
  • 41% (v. 34%) preferred a single-payer national health care system
  • 4% (v. 3%) other

More from single payer advocates @ MassCare here.

The survey also asks docs about their willingness to participate in accountable care organizations and the global payment system now on the table at the State House.

Views of Massachusetts Payment Reform Initiatives
For the  first time in the workforce studies, physicians were asked about payment reform

initiatives being undertaken in the Commonwealth, specifically global payments
and accountable care organizations (ACOs). Responses to questions about both
showed many physicians to be hesitant to participate in either global payments
or ACOs.

Findings on Global Payment Systems

  • Familiarity with global payments is high, with 57 percent of physicians
    saying they were   familiar with global payments.
  • Of all respondents, 42 percent said they were likely, and 58 percent said
    they were not likely to participate in a voluntary global payment system.
  • Of those respondents who said they were familiar, 45 percent said they are
    likely to participate in a voluntary global payment system; 55 percent said they
    were not likely.
  • Primary care physicians (61.4%) are more likely to participate in a
    voluntary global payment system than specialists (32.2%). 

Findings on Accountable Care Organizations (ACO)

  • Familiarity with ACOs is high, with 58 percent of physicians saying they
    were familiar with ACOs.
  • Of all respondents, 49 percent said they were likely, and 51 percent said
    they were not likely to participate in a voluntary ACO
  • Of those who said they were familiar, 59 percent said they were likely to
    participate in a voluntary ACO, and 41 percent said they were not likely.
  • Primary care physicians (71.9%) were more likely to participate voluntarily
    in an ACO than specialists (50.2%).

NYTimes on “Small Fixes” for global health problems

The entire New York Times “Science” section is dedicated “low-cost innovations that are making a big difference”  in solving global health problems. It’s a great topic and a nice package including longer stories and sidebars on individual projects, like a biodegradable, single-use toilet called the PeePoo.  Don’t laugh. As this story and others point out, 40 percent of the world population does not have access to a toilet. The resulting water contamination leads to diarrhea. And, as the story notes,  1.5 million babies die each year from diarrheal disease.

One story profiles a local company called Diagnostics for All:

The diagnostic tests designed in Dr. (George) Whitesides’s Harvard University chemistry laboratory fit on a postage stamp and cost less than a penny.       

His secret? Paper.       

His colleagues miniaturized diagnostic tests so they could move into the field with tiny pumps and thread-thin tubes. Dr. Whitesides opted for a more novel approach, reasoning that a drop of blood or urine could wick its way through a square of filter paper without any help.       

We heard about this company at a meeting last year sponsored by the Mass Device website. Speakers at that meeting discussed how to create “a business model that helps solve the global problem of providing healthcare to the planet’s poorest people

No comment from Boston for story on the business of #children’s #hosptials #hcr #pediatrics


Kaiser Health News and McClatchy newpapers offer a big take out on the rise of the mega-childrens hospitals.

Comment from Children’s Boston: None.

From their humble origins more than a century ago, many of the nation’s biggest and best known children’s hospitals today are health care juggernauts with sprawling medical centers and suburban satellites, extensive real estate holdings and thousands of well-paid employees and millionaire CEOs. 

The billions of dollars flowing through children’s hospitals every year pay for care for tens of thousands of kids, many of them extremely sick or suffering from chronic conditions requiring a lifetime of treatment. Hospital officials say costs are high because the care is complicated and the technology expensive. In addition, the hospitals help fund research into the causes and treatment of diseases.

But the surge in spending is also helping to fuel a multibillion-dollar building boom as hospitals add towers and beds.  That in turn is spurring more spending on staff and technology, even as Washington, the states and employers grapple with budget-busting increases in health care spending. While children’s hospitals represent a small slice of the nation’s health care bill, they offer a case study of the expansive ambitions of hospital leaders and the faltering efforts of government to control spiraling costs

The 39 largest hospitals, KHN found, had accumulated $21 billion in stocks, bonds, real estate and other investments as of 2010 – more than enough to provide an entire year’s worth of medical care for free They had net assets – the equivalent of net worth for nonprofits – of $23 billion.

Children’s Hospital of Boston, arguably the nation’s best known hospital for children, listed $2.6 billion in stocks and other investments in bond filings.

Last year, the 400-bed hospital was cited as having some of the highest charges in Massachusetts in a report critical of hospital charges filed by State Attorney General Martha Coakley.  Hospital officials declined numerous requests for an interview, but noted on their website that they have lowered the rate of their increases.

Even with their tax breaks and wealth, top children’s hospitals provide relatively little charity care. On average, about 2 percent of what children’s hospitals spend is for free medical care, according to the National Association of Children’s Hospitals and Related Institutions (NACHRI), an industry group. Some of the largest and richest children’s hospitals spend less than one percent.

Commonhealth on new books re: reform, medical decisions #hcr #hcr2

WBUR’s Commonhealth offers two item linked to new books. The Q & A with Dr.Pamela Hartzband and her husband Jerome Groopman comes with the publication of  Your Medical Mind: How to Decide What Is Right for You.

And, HSPH prof John McDonough offers these thoughts from his new book Inside National Health Reform. “The law is already starting to make dramatic changes in the delivery of  health care in the US to emphasize quality and improve efficiency.”

Children’s Boston: Preschool flu shots cut ER vistis

The study compared 2-4 year olds in Montreal to kids at Children’s in Boston

Canadian Medical Journal

The divergence in influenza rates among children in the US and Canadian
sample populations after institution of the US policy to vaccinate children two
to four years of age is evidence that the recommendation of the US Advisory
Committee on Immunization Practices resulted in a reduction in
influenza-related morbidity in the target group and may have indirectly
affected other pediatric age groups. Provincial adoption of the 2010
recommendation of teh National Advisory Committee on Immunization in Canada to
vaccinate childen two to four years of age might positively affect influenza
morbidity in Canada

NYT: A federal government recommendation to give preschoolers the flu
has resulted in a large decrease in emergency room visits

among 2- to 4-year-olds, new research has found. And there were benefits for
older children as well.

Dr. John Brownstein @ Children’s

Public Health Surveillance Systems: Dr. Brownstein and his colleagues work on the
development of advanced, informatics-based, real-time surveillance systems that
monitor population health from a variety of health information sources ranging
from formal clinical data to informal rumor-based surveillance

Essay contest: Cost awareness in medicine

Doc-run group seeks scribes:  


Costs of Care, a physician-run nonprofit based in Boston, has launched its second
annual national healthcare essay contest, with the goal of expanding the public
discourse on the role of doctors, nurses, and other care providers in
controlling healthcare costs. 

BOSTON, MA (PRWEB) SEPTEMBER 12, 2011—Last year Costs of Care ( launched an innovative essay contest that elucidated the importance of price transparency in everyday
medicine by gathering more than 100personal stories  from patients, nurses, and doctors across the nation. This year, Costs of Care is looking for more stories, and will award prizes for anecdotes about the importance of price transparency as well as solution-oriented stories that
illustrate ways to reduce harmful healthcare spending and save patients’ money

As the economy struggles to recover, the spiraling costs of healthcare in the
United States have become a contentious political focal point without an
obvious solution. Traditionally, health care providers have been reluctant to
discuss their own role in healthcare spending. However according to Neel Shah,
M.D., Executive Director at Costs of Care, “Ultimately, no amount of
regulating, reorganizing, or otherwise reforming the healthcare system will
successfully contain costs unless healthcare providers are invested in fixing
the problem.”

To help mobilize healthcare providers to examine their own role in spending, Costs
of Care is launching an essay contest that will collect and widely
disseminate stories from the frontlines of medicine. Costs of Care will award
$4000 in prizes to top submissions. Two $1000 prizes will be reserved for
patients, and two $1000 prizes will be reserved for care providers. Preference
will be given to stories that best demonstrate the importance of cost-awareness
in medicine. Examples may include a time a patient tried to find out what a
test or treatment would cost but was unable to do so, a time that caring for a
patient generated an unexpectedly a high medical bill, or a time a patient and
care provider figured out a way to save money while still delivering high-value

To help select the winning entries, Costs of Care has partnered with five health
luminaries who will serve as judges:

  • Peter Orzsag, former Director of the White
    House Office of Management and Budget
  • Dr. C. Everett Koop, former United States Surgeon
  • Hon. Jennifer Granholm, former Governor of Michigan
  • Dr. Susan Love, women’s health and cancer
    research advocate
  • Dr. Alan Garber, health economist and Harvard
    University Provost

Anyone looking to learn more about the successful entries from last year’s contest can
find our more at

All submissions will be due on November 15th, 2011. Finalists will be announced on
December 15th, 2011 and the $1,000 prize winners will be announced on January 15th, 2012. All qualifying submissions will be published biweekly at
during the 2012 calendar year, and will be made available to the media. 

The  contest is sponsored in part by through the generosity of Blue Cross Blue
Shield of Massachusetts and Harvard Pilgrim Health Plan.


About Costs of Care

Costs of Care is a nonprofit  organization that gives patients and healthcare workers the information they  need to deflate medical bills, while expanding the national discourse on the
role of care providers in responsible resource stewardship. Costs of Care was
founded by a resident physician based at Harvard Medical School who noticed
that even the best physicians sometimes overlook something critical—the bill.

Full contest details are available at

#Science in the news and wonks on the web #health #boston

Check out this week’s Health Wonk Review, hosted by Boston’s own David Williams at the Health Business blog. The digest of blog posts offers opinion, reporting, and more on ACOs, HIT, NBC, the PPACA, ALEC, CMS and the GDP. Your typical discussion of health policy — an acronym fest

Then, check out Science in the News, a great series of talks organized by Harvard Med School students. They start next week:

9/21 – Mind-Machine Interface: Computers and the Wired Brain

9/28 – How to Spot a Virus: The Origins of an Immune Response

10/5 – Toward the Final Frontier of Manned Space Flight

10/12 – Beneath the Surface: The Present and Future of Our Oceans

10/19 – Are we Programmed to Age?

10/28 – The Evolution of the Universe: Building Earth From Cosmic Soup

11/2 – Obesity: How Science Approaches Weighty Matters

11/9 – Species Interactions: More Than the Sum of Their Parts

11/16 – 30 Years with AIDS: Where it Came From and Why It’s Still With Us