BLOGS: Health Wonk Review

Mar 9, 2006• 10

Welcome to Health Wonk Review. Joe expected some crack about English soccer fans, but I’m all depressed since the Catalans ejected my boys with barely a whimper from the European Champions League we were supposed to win on Tuesday.

So onto the review. Every two weeks we’re putting together the best of the health care policy, business and technology posts from around the blogosphere, and the hosting will rotate too. We’re going to start with:

Politics, policy and voodoo economics

The good boys and girls at Marketplace.MD have been busy. Founder Trapier K. Michael gives credit to the free market for hospital quality information on his new blog, Hayek, MD. Evian at Free Canada tells us how "Liberal health policy" makes Alberta’s premiere want to hurl and throw a Russell-Crowe-type health policy fit. And David of Medical Liberty looks at Dr. Wennberg (of Dartmouth Atlas fame) and asks "Where’s the Patient?" in healthcare anymore…You can also check out Marketplace.MD Blog to get your daily dose of health policy blog fodder….but those of you with a liberal bent might want to be ready for a barney!

Meanwhile, in many liberal blogs the old debate about single payer
versus other approaches to universal care is getting a run out. At TPMcafe, Leif Wellington Haase wonders about
"Universal Health Care: Many Roads to Rome?" The piece argues that the
goal of universal coverage can be pursued through many means, not only through
insisting on a "single-payer only" strategy. On the same theme at SignalHealth John Rodat’s Politics After Single Payer, is a piece about single-payer proponents struggling to reconcile their shared disdain for President Bush and Republican Congressional leadership with their confidence in complete Federal control of healthcare financing in the US. John also wrote, "A Tiny Technical Issue of Constitutional Significance" about the Deficit Reduction Act of 2005. The Act had many provisions related to health care, especially Medicare and Medicaid, but John argues that the most important issue is one of legislative procedure, an inconsistency between the House and Senate passed versions of and the cavalier manner in which the political leadership ignored a fundamental rule of lawmaking in the US.

Jonathan Cohn, New Republic health care reporter and author of a forthcoming book on health care sounds the alarm about rationing — the kind that already happens here in the U.S. Don’t look now, he says, but the problem is about to get worse.

Meanwhile, at Healthy Policy young punkette Kate Steadman mulls over the potential problems of staying in an employer-based insurance framework.

There’s plenty more from Jonathan, Kate, Leif, Ezra Klein and plenty of others (including when he gets around to it your host at THCB) over at the “Drug Bill Debacle” table at TPMCafe. Those of you on the “free-market” end of the spectrum (or whatever passes for that these days) may have to gird up your loins before you venture over. I’ll leave the reader to decide whose policy is voodoo-based.

Health care is though as much about business as it is about policy:

The business of health care is business

Tony Chen of Hospital Impact comments on the supposed 5 most dangerous trends for hospitals. Could profitability problems close down 150,000 hospital beds in the next 6 years?

At Health Care Renewal, Roy Poses has a great article about Shalala and the janitors. To give it all away, the first irony is that the maintenance workers at the University of Miami medical center do not have health insurance provided by their employer. The second is that the university president, whose palatial university-supplied mansion and life-style were just written up in the New York Times Magazine, is Donna Shalala, former Secretary of Health and Human Services in the Clinton administration, a public advocate for universal health insurance. The third (and not noted except on Health Care Renewal) is that Shalala also sits on the board, and hence has fiduciary responsibility for, UnitedHealth Group, a for-profit managed care company whose stated mission includes improving access to health care.

David Williams at the Health Business Blog looks at the FDA report on the status of pharma companies’ post-marketing commitments. Although PhRMA says the report shows all is well, Public Citizen makes a solid argument for why that’s not the case.

At Managed Care Matters Health Wonk Review’s founder and guiding star Joe Paduda worries that rising health care costs are leading to increasing labor relations problems for manufacturers and service companies across the US. With premiums growing five times faster than wages, employers are trying to shift more of the financial burden onto workers. One of the better reform advocacy groups, the National Coalition for Healthcare Reform, has done an admirable job of presenting alternative solutions.

At Point of Law, insurance specialist Martin Grace of Georgia State looks at some current controversies over medical malpractice and concludes that the recent crisis is not just an artifact of the "insurance cycle", as some have contended; and that the leveling off of premiums in the past year should not be taken as a sign that our medical liability system has somehow reverted to health.

Dmitriy, the Publisher of The Medical Blog Network has looked into the firestorm caused by New York Times article "Why Doctors So Often Get It Wrong", noting that P4P is here to stay and now even AMA is getting with the program.

At THCB your host is not surprised that we have too many inefficient doctors, but predicts an untimely demise for a certain group of health service researchers if they don’t shut up about it.

Meanwhile guesting in the same place, Brian Klepper is unimpressed by the chances of consumerism as being a savior for health care. Don’t miss the excellent and long, long comments section.

Tech and mash

Some of the best in the health care IT world are in this section:

Shahid Shah, The Healthcare IT Guy, blogs about how we should all start using RSS for health/medical alerts and data sharing. In the posting he reminded us that today’s medical devices send out alerts using push-based approaches which are usually proprietary. He encourages software vendors to start providing RSS/ATOM feeds from their applications to help get non-safety-critical data out of their health IT systems because it’s easier to use, interoperable, and a cinch to deploy.

Tim Gee at Medical Connectivity reports on the creation of a health care advisory board for portable computing device vendor OQO. The OQO “pocketable” Windows computer could be the device that overcomes limitations that have held back the adoption of other devices like PDAs and Tablet computers.

MrHISTalk features an excellent article from Nurse Janus about the hellish life of a clinician going through a major install, and subsequent un-install. And of course most of the best gossip in the hospital IT world lives at that site.

Turning his hand to tech, Dmitriy of The Medical Blog Network reports from the CalRHIO Summit III, making sense of how capable are RHIOs of truly serving the interests of consumers. What is rhetoric and what is reality? He also writes about the tough talk dished out by Craig Barrett towards the healthcare industry and why this is the leading indicator of general public’s attitude towards the industry.

Guesting on THCB, hospital IT director Roy Johnson is not exactly impressed by the “highness” of the tech in health care IT.

Rod, on the Informaticopia Blog examines the implications of an announcement by UK universities that they will be changing their user authentication system from Athens to Shibboleth over the next few years. As the UK’s National Health Service currently uses the Athens system for its 1 million + staff it is likely that they will need to go the same way.

Rod would also like to give everyone a “heads up” about the HC2006 Blog from Europe’s Healthcare Computing Conference and Exhibition (which is sort of equivalent to HIMSS) on 20-22^nd March. The blog will be an eclectic collection of news and views – as near to real time as we can get it – and offer the opportunity for those unable to attend to comment on the issues.
Meanwhile, if you are thinking of haranguing a journalist or a blogger about your company’s incredible new software product, Neil Versel’s Healthcare IT Blog tells you what not to do

Odds and ends

Last but not least are a few on unique health care issues that don’t fit so easily into other sections

Fard Johnmar at Envisioning 2.0 is currently holding a series of conversations about race and medicine with physicians, communicators, health policy experts and others. He is publishing these discussions to highlight new perspectives from a variety of people in the healthcare field about this important issue. Dr. Sally Guttmacher, a noted public health expert, is the subject of the first interview. Fard will be posting interviews on this subject for the next few weeks — at least. He is encouraging others within and without the healthcare blogosphere to contact him to be interviewed about this topic.

Guns at work – coming to a neighborhood near you? Julie Ferguson at Workers Comp Insider discusses the state-by-state push by the NRA to enact legislation that would override an employer’s policy prohibiting employees from keeping guns in their cars on company premises. Such measures have passed in a few states, but have hit a temporary roadblock in Florida. The NRA is determined to push on. The American Journal of Public Health recently published a study finding that murders are three times more likely to occur in workplaces that permit employees to carry weapons than in workplaces that prohibit all weapons.

Rita at the MSSP Nexus Blog (and no I still don’t know what that title means) is a little riled up about the practicalities and problems with board certification and credentialing as discussed in a recent JAMA article.

Meanwhile in one of my homes, away from THCB Spot-on, I’m very upset about the role of the Calvinists in our medicine cabinets. DEA employees reading this may not like what I say about them.

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Thanks to all those who contributed, especially as I had them do it in a very vicious stringent format which almost everyone kept to. It really cuts down on the hosts work, so I recommend it to future hosts. You can see what I suggested for contributors here.

In two weeks Kate Steadman will host HRW over at Healthy Policy.

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