Helen Darling of the National Business Group on Health wrote in to comment on the thread on Robert Laszewski's post on the realities behind  the Obama health plan. ("For the Obama administration health care reform will require cost containment.")

We have known for many years that we have a wasteful health care system full of overuse, misuse and underuse. The system is not getting better and people are less healthy than ever. It is exciting and inspiring that we have political leaders  who are willing to fight the tough and thankless battles that they will have to fight to get us on the right track as a nation. While there will be plenty of specifics to make everyone unhappy about one element or another, can't we all pull together to have a much better, more effective and affordable health care system for the good of the country?

In the thread on MEDecision CEO David St. Clair's post over the brewing battle over privacy in Washington "Consumers Need All the Facts in the Privacy Debate" Inchoate but Earnest writes:

"At present "healthcare privacy" is a wraith, a boogeyman, & like most boogeymen, it is foisted upon the innocent by people, by institutions, that would retain power over them. The unknown deserves respect, but rarely fear …"

On the same topic Glen Marshall writes —

"As someone who is directly involved with healthcare privacy and security — in HL7, HITSP, and CCHIT — it's very clear that we already have the technology standards and processes necessary to enforce privacy policies. We don't need more technology. We need what we have defined to be widely implemented.

One key problem is the lack of coherent policies. We have a crazy quilt of overlapping and sometimes conflicting rules among the states and too-vague Federal policies. The policy constructs for healthcare consumer data-disclosure consents are immature. We need to correct the regulatory policy logjam. Then we will have better privacy for all."

Meanwhile, Robert Quinn chimed in on the thread on the relative effectiveness of comparative effectiveness research inspired by Robert Laszewski's post on cost containment

"I worked as a regional Medicare medical director from 2004-2008. While
I am in favor of comparative effectiveness research, obviously, most of
those commenting on it, anywhere, have little data on how much money is
"saveable" through this route. Specific technology issues – like
whether a CT, MRI or PET scan is better for staging pancreatic cancer –
are NOT necessarily a major part of US health care costs. I suspect
(and would love to see a data wonk document) how much is actually the
softer decisions – e.g. should Patient X may be admitted to a
likely-$200K ICU stay against long odds, and similar high cost but
diffused decisions."

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