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BLOGS: Health Wonk Review

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HwrWelcome to Health Wonk Review. The bi-weekly round up of the great and the good in health policy wonkery around the web. Putting HWR together this week confirms that health wonks know alot about health care, but can’t follow simple instructions to save their lives. There’s a lesson in there for health care as a whole, and the lesson is that user interface design of software, insurance products, compliance regimens, or blog carnivals has to be mind-numbingly simple and foolproof.

So on with the show…

From Managed Care Matters, Joseph Paduda notes that some US employers are sending their employees to India for expensive procedures and that word is bubbling up into the mass media—more evidence that drastic times call for drastic measures. His take? The more pressure from alternative solutions like Indian surgeons, the better as it will force us to confront our mess of a health care system.  Ain’t competition great?

At Ambulatory Computing Robert J Lamberts writes that Medicare has backed off due to pressure from device manufacturers. There were cuts due for reimbursement for high priced, high end devices, but caving to pressure from the lobbyists for the device manufacturers, the current administration has backed off from this plan. This entry is a rant by a primary care doctor who faces the threat of cutbacks on reimbursements for physician visits.  "Politics as usual" threatens to undermine any attempt at real reform. His version is called Medicare Cuts Scaled Back

On the same topic at Health Care Renewal, Roy Poses says that some naively thought that CMS proposed cuts of its high reimbursement rates for high-tech procedures might make more money available for primary care, etc.  Alas, the cuts were speedily rescinded.  CMS bureaucrats could not withstand the onslaught of commentary from executives of big device manufacturers and hospitals, and surprisingly two famous left-wing senators.

At TMBN Dimitriy shares reports from two Silicon Valley conferences which hint how blogs and social media will transform health care, much like news, politics and entertainment. The AlwaysOn Stanford Summit offers an analogy with Hollywood (do not miss the War of the Worlds spoof video!). BlogHer offers a model of online community fused with a conference and an inspiration for TMBN. Finally, note how the health care blogger survey may help us find the right way to apply BlogHer ideas to health care.

What do the Grand Canyon, a Lotto ticket and the Union Jack have in common? Henry Stern from InsureBlog reports on how one nationalized health system gambles with folks’ lives.

Meanwhile Glowing appraisals of Cuba’s state-run health care system are plentiful in the health policy literature. But even if a few isolated metrics indicate something good (like a high doctor per capita figure), does it justify the whitewashing of medical apartheid? And how reliable are health data from a dictatorship, anyway? The Lucidicus Project touched on these questions.

Of course if you want to get beyond the rhetoric, perhaps you should look at some real data on the topic, as I did on this posting on Canadians grumpily waiting on waiting lists at THCB. Sadly for the anti-single payer crowd it’s just not as simple as they’d like it to be, even if most Americans can’t tell Cuba and Canada apart.

Talking about grumpy, also writing at THCB, surgeon Eric Novack is most pissed off with CMS for deciding just not to pay up for a few days….he should meet some of my clients!

Meanwhile a real full-time wonk, Michael Cannon at Cato@Liberty has not one but two interesting posts on P4P’s role in Medicare FFS (Hint: he doesn’t think it should have one). Michael also busts certain bloggers (err..me actually) for just reading the press release and not the whole report!

David Williams of The Health Business Blog writes about anesthesia-related adverse events which are four times as likely to occur when surgery starts at 4 pm compared to 9 am. Authors of the study call the results "expected." He’s not surprised either, but thinks it’s a scandal that quality varies so much based on time of day.

From MSSPNexus Blog, Rita Schwab writes that participating in the medical blogosphere has educated her about how strongly many clinicians feel about the Joint Commission on Accreditation of Healthcare Organizations. However, this post supports the premise that for all the angst and expense a survey generates, US hospital care is better than it would be without a "big brother" looking over our shoulders.

Vreni Gurd who writes the Wellness Blog says that drinking good quality water in adequate amounts is one of the foundational principles of good health.  Therefore deciding where to source your water is important.  Here are some ideas to help you make informed decisions.

Carol Krishner who’s still Driving in Traffic, tells us about a new senate bill (S 3719) introduced by Tom Harkin (D-IA) that would amend the Public Health Act and Rehabilitation Act of 1973 to establish a competitive grant program to support activities that would improve the health and wellness of individuals with disabilities.

At Drug Channels, Adam Fein has been busy..and he has a PhD too! He says that the Democrats are making Part D “reform” into a major theme of the 2006 elections, and wonders what effects direct negotiations between HHS and manufacturers would have on the pharmaceutical supply chain? Meanwhile the British fake Lipitor scandal continues to expand after an additional recall was announced. Adam wonders what can we learn from the European situation that can shed light on the misguided attempts to allow importation into the US? I think that we can all figure out his answers from his use of adjectives.

Finally people today are larger in stature and live longer than their ancestors. William Marcus Newberry, from Fixin Healthcare, tells us that most of this is the result of public health with sanitation, clean water, better nutrition and immunization, and antibiotics for life-threatening infections. Analysis reveals that conditions during pregnancy and the initial two years of life have a profound impact upon health status in middle and old age. The public would be well served if health policy was based upon these observations.

Meanwhile Fard Johnmar of Envision Solutions and Dmitriy Kruglyak of The Medical Blog Network have launched the first global survey of health care bloggers. It is open to all bloggers that spend at least 30% of their time blogging about health care-related subjects. The survey will run until September 29, 2006. Please go take it.

Next HWR is on August 24 at a to be disclosed location–check the HWR site for details or to volunteer. The one after that is at InsureBlog and the one beyond that at The Century Foundation.

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  4. Sorry for the confusion… UI normally takes a few iterations to really get right. Mea maxima culpa.
    We have an email discussion between former hosts underway and will be deciding on the fixes shortly.

  6. No, actually the new linking system was a total bust hence my shitty comments at the start as NO ONE followed the instructions at all apart from Prof Stern and Dimitiry and even they got it wrong.
    I’m in separate communications with Dimitriy about that.
    I very nearly had a sense of humor failiure in the middle of the whole thing, but decided to go through with and fixed it. But it took 2 hours rather than the 5 minutes it should take.

  7. John,
    The only conspiracy we have (and proud of it) is to elevate the stature of healthcare blogging community.
    We are long way from being as influential as our political comrades (look at Connecticut US Senate race!), but with steps like this survey, conference, etc we are on the way.
    30% was picked as a cutoff to focus *THIS* survey on habits or *regular* healthcare bloggers so we could first understand the trends in this segment.
    My opinion is that the “long tail” of medblogosphere is as important (due to its size) but that would be another study sometime later.
    Onwards!

  10. Fard:
    Ah well, that makes more sense then.
    I’d been afraid it was some sort of vast conspiracy to redefine blogging to favor full time bloggers.

  11. Matthew:
    Thanks so much for developing a great edition of The Health Wonk Review and for highlighting the survey.
    John:
    Thanks for your question and interest in the survey. As you noted, we are asking bloggers that spend at least 30% of their blogging time on healthcare. To make it even clearer, this means that at least 30% of your posts should be healthcare focused. Based on your comment, you certainly qualify for the survey.
    We are only referring to blogging time, not the percentage of your overall time you spend blogging.
    I hope this answers your question and please consider taking the survey!
    Best,
    Fard Johnmar

  12. Matthew:
    Thanks so much for developing a great edition of The Health Wonk Review and for highlighting the survey.
    John:
    Thanks for your question and interest in the survey. As you noted, we are asking bloggers that spend at least 30% of their blogging time on healthcare. To make it even clearer, this means that at least 30% of your posts should be healthcare focused. Based on your comment, you certainly qualify for the survey.
    We are only referring to blogging time, not the percentage of your overall time you spend blogging.
    I hope this answers your question and please consider taking the survey!
    Best,
    Fard Johnmar

  13. Dimitry:
    On same days, I spend 28% of my time blogging about health care related subjects. On others, I spend about 14.8% of my time. Does that make me a blogger?
    Also, are you calculating the percentage of my time on a 24 hour basis? Or on personal hours per day available for blogging and other noble pursuits basis?
    This “30 percent of your time to be considered a blogger” is an interesting concept. I wonder how many bloggers would qualify …