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A clinic in Minnesota is routinely dropping patients with high-deductible health plans who aren’t paying their bills, the Star Tribune reports. "For the most part, these are college-educated and middle-class folks," Dr. Rochelle Taube told the Tribune. "We send them a letter and say unfortunately, we’re not able to care for you." Some clinics and doctors’ offices that aren’t dropping patients have had to exert more effort or new approaches to getting paid, "such as swiping a credit card at check-in just like at a hotel."

Sicker patients are better off getting bypass surgery than medicated coronary stents, according to the Wall Street Journal. Boston Scientific funded the study using its own stents. It’s the first head-to-head study of its kind, but hopefully not the last if analysts’ predictions are accurate that the failure to show stents as the obvious treatment of choice for complicated heart patients will lead to a drop in sales. The BSX stock price increased 1 percent Tuesday.

In 2006, U.S. pharmaceutical companies spent about $5 billion on consumer marketing campaigns, but the Washington Post reports a Harvard Medical School study in the British Medical Journal found the spending may have less impact on consumer behavior than previously assumed.

Also in BMJ, a review of Britain’s National Health Services records shows that patients undergoing a hip or knee joint replacement using the new resurfacing technique are more than three times as likely to need a replacement than if the joint were fully replaced and cemented. The study tracked more than 150 000 people who underwent a hip or knee replacement between April 2003 and September 2006. To learn more about the U.S. failure to track the safety of joint replacements, read this New York Times article.

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I thought the article on HDHP may be from Massachusetts as that would be the only way many people there could afford the mandatory insurance. But it seems the problem is all over. Another conservative myth that more insurance choices will give us better healthcare access.