H.E.L.P.! Senators start swinging on health reform

Apparently it was quite a scene on Wednesday as the Senate Committee on Health, Education, Labor and Pensions tried to begin the debate on the health care bill.

Kaiser Health News has a good round up.

Sen. John McCain, R., Ariz., interrupted the opening remarks of Sen. Christopher Dodd, D., Conn., saying the proceedings were a “joke.”


More from the NY Times.


ONC: “Meaningful use” for HIT will evolve

 A panel deciding what kind of computerized health information systems will get stimulus money was sent back to do some more homework yesterday, according to Healthcare IT News.

 Companies that make these systems and providers who use them have been waiting for a definition of the “meaningful use” requirement  so they canplan to  get in on the $20 billion in stimulus money set aside for HIT. Looks like they may have to wait a while for a precise RFP-type definition. This HIT News story was entitled “ONC goes back to the drawing board on meaningful use“: 

After a “lively discussion [on the criteria] and considerable input on meaningful use, we decided to send the workgroup back to work on another set,” David Blumenthal, MD, national coordinator for health information technology, said during a media call…. According to Tony Trenkle, director of the CMS Office of e-Health Standards and Services, CMS expects to have a proposed final rule on payment issues – including the definition of meaningful use – by the end of the year.

But Dr. John D. Halamka, CIO of CareGroup, which includes BIDMC, says on his Geek Doctor blog that:   

 After months of anticipation, the definition of Meaningful Use has arrived. 

Sort of. As he points out, the HIT Policy Committee meeting in DC did produce a framework that will help steer docs and geeks in the right direction.

 The meaningful use matrix is organized into specific meaningful use goals to be achieved by 2011, 2013, and 2015. It also lists metrics for these goals to evaluate hospital and clinician progress in meeting them.

 You can check it out here on the Health IT Policy Committee page.

Or, you can read the story that was posted later in the same HIT news, which read: “Officials outline criteria for meaningful use

 Beside Blumenthal, Bostonians at yesterday’s meeting include:


Massachusetts underinsurance model? Plus, weekly reviews.

Three things.

Boston health week in review: See my look back, posted weekly on the Mass Device website. Also, check out the rest of the site. Devices are a big part of the health industry but don’t get the same attention as pharma.

 masthead-hwrHealth Wonk Review: The latest collection of health policy blogs is up on Managed Care Matters. There, Joe Paduda directs us to video clips of the Senate debate, as well as his own piece about the miraculous transformation of VA health care.  His point – many government-run programs efficiently produce high quality products and services: the Centers for Disease Control, US Coast Guard, National Oceanic and Atmospheric Administration, Head Start, AmeriCorps, NIH, the GI BIll, and the National Weather Service. (Some would disagree on NIH.) Also, great postings on the public insurance plan debate, costs and the impact of reform on hospitals. Click here for a HWR archive.   

Massachusetts underinsurance model: Some employer plans “meet the letter but not the intent of the law,” according to a Kay Lazar story in today’s Globe:

Regulators yesterday said that reviews of scores of health plans show many cap the benefits insurers pay each year on prescription drug coverage, exclude maternity coverage for dependents, or place an annual overall dollar limit on benefits.

Jamie Katz, general counsel for the Connector Authority, which oversees the state’s health initiative…said that while rules created by the Connector require, for instance, health plans to include prescription coverage, they don’t address whether such coverage is allowed to have limits.

Also see WBUR’s post on enrollment and the anonymous response to it  about the failure of the Mass plan.  

Keeping up with Capitol Hill happenings

The full-pitched health reform battle is under way in DC.

To keep up,  I suggest checking out the Wall Street Journal‘s Health Blog, National Public Radio’s Health Blog, the Kaiser news page, Politico  and, of course, The Boston Globe.

 Find other good links to the right under Health Reform and Health News

Kennedy produces health care bill

You can read Kennedy’s actual bill here. If you’re not up to reading all 615 pages, find a few reports below. 

(For the conservative response, see this story in The American Spectator.)

This from the AP story on the Kennedy bill:

Americans would be able to buy long-term care insurance from the government for $65 a month under a provision tucked into sweeping health care legislation that senators will begin considering next week.

The 651-page bill, released Tuesday by Sen. Edward M. Kennedy, D-Mass., would revamp the way health insurance works. Insurance companies would face a slew of new government rules, dealing with everything from guaranteed coverage for people with health problems to possible limitations on profits. Taxpayers, employers and individuals would share in the cost of expanding coverage to nearly 50 million uninsured  Americans.

The story also notes, in fact, leads with this:

Americans would be able to buy long-term care insurance from the government for $65 a month under a provision tucked into sweeping health care legislation that senators will begin considering next week.

That’s a expensive item but in effect, Medicaid already pays for a lot of  nursing home patients who stay more than a year. It takes about that long for even middle class patients to “spend down” to the eligible level.

Dementia units cost $4,300 month and shared nursing home rooms cost $80,000 year, according to Met Life’s 2008 report on the cost of long tem care. The average bill at an assisted living facility – which neither Medicaid nor Medicare covers– is $2,500 to $3,300 a month.  

Also see reports on the bill from the LA Times and NPR.

Massachusetts H1N1 update

Confirmed H1N1 Influenza (swine flu) 

For current updates see the DPH site.  Also note this 6/23 Globe story. 

The only person known to have died of swine flu in Massachusetts suffered from none of the underlying medical conditions that can turn a relatively mild viral infection into a life-threatening illness, city disease trackers disclosed yesterday.

Update for June 8, 2009

Total confirmed cases to date:  940 

For more info click on the DPH site


Total Cases

































Obama pushes harder on health and the end of pain at MGH

From MGH mural


 I’m an early riser and tend to get up on Sunday and read through the Times and the Globe. Lots of health stuff, starting with a Globe story on how Obama’s going to get more involved in creating and promoting the health reform bill.


 This weekend, Organizing for America – the president’s former national campaign organization, now run through the Democratic National Committee to support his policies – kicked off a months-long effort to build ground-level support for a healthcare overhaul. At the house parties, organizers read from talking points, urging those in attendance to get involved, echoing Obama’s contention in his weekly radio and Internet address that lowering costs and improving access to quality healthcare is “a necessity we can’t postpone any longer.”

 The GlobeIdeas” section also had a piece by Mike Jay on the introduction of anesthesia, focusing on the unexpected role pain plays in health care. Also check out the letters to the editor on profits at non-profit hospitals.

 Before 1846, the vast majority of religious and medical opinion held that pain was inseparable from sensation in general, and thus from life itself. Though the idea of pain as necessary may seem primitive and brutal to us today, it lingers in certain corners of healthcare, such as obstetrics and childbirth, where epidurals and caesarean sections still carry the taint of moral opprobrium.


  The Times also had a front page storyon the Obama push.

His hope is to provide what his chief of staff, Rahm Emanuel, called “air cover” for lawmakers to adopt his priorities. It is a gamble by the White House that Mr. Obama can translate his approval ratings into legislative action.

“Obviously,” Mr. Emanuel said, “the president’s adoption of something makes it easier to vote for, because he’s — let’s be honest — popular, and the public trusts him.”

But as Mr. Obama wades into the details of the legislative debate — a process that began last week when he released a letter staking out certain specific policy positions for the first time — he will face increasingly difficult choices and risks.

Times writer Sheryl Gay Stolberg did a lot of health reporting before she covered politics.

But when I Google her, I just get tons of rants against the Times. (Sometimes the Internet and comments sections of blogs seem overrun by the mean and the clueless.)  

 The Times also ran a staff editorial on “Paying for Universal Health Coverage.”