Our good friend Bob Laszewski is host of this edition of Health Wonk Review, which consistently displays a collection of the best, most insightful health care writing around the Web. Maggie Mahar and yours truly are represented from THCB. Drop by Health Policy and Marketplace Review for Bob’s thumbnail sketches of each column. Indulge yourself for a half hour and read them all. It reminds you how dedicated and superbly thoughtful our colleagues are.
Matthew Holt
Leveraging The Doctor As A Trusted Authority – Brian Klepper
I was on the phone with my good friend Bill
Bestermann MD yesterday. Dr. B, a preventive cardiologist who is
passionate about the underlying mechanics of cardiovascular disease and
the horrific toll the American diet and lack of exercise is taking on
everyday people, lives in spectacularly beautiful, rural Kingsport TN.
He told me he was driving through town, channel surfing on his radio,
and he happened upon the station that broadcasts information for the
local schools. They were announcing the menu in the school cafeterias.
He said it was appalling. "Honeybuns and processed foods. It was all
the stuff I tell my patients to avoid."
POLICY: Self-employed, and going it alone
If you want to understand why an individual mandate in a community rated state won’t work without both significant reforms to the insurance systems and a whole new range of taxes and subsidies, read this experience of a healthy mid-20s writer in New Jersey who’s self-employed, and going it alone. Of course if she was living in California, she’d be able to buy a much cheaper policy–but then no sick person in California can get individual insurance.
Perhaps enough of this and it will dawn on people that we need a single pool funded by ability to pay….
On a side-note, any idiot can see that a single pool guaranteed universal system would help solo freelancers and small business people. And of course the NFIB leads the charge against it.
POLITICS: Just Saying No to crass politicization
Yeah, I know it’s not likely that anyone will pay attention given the season, but I do feel that there are enough cases with which to bash insurers which are legitimate that John Edwards didn’t have to start politicizing one in which not only was the insurer’s argument pretty good, but about which a government-sponsored universal system would also have to make the same choices. So I’m up over at Spot-on about Just Saying No.
To separate himself from the Democratic front-runners former Sen. John Edwards has spent the last few days laying into insurance company, Cigna, for its failure to immediately approve a liver transplant for California teenager, Nataline Sarkisyan. That action, says Edwards, in concession speech after concession speech, is emblematic not just of the health care system’s break-down but of a failure of the current American political system.
Edwards like most Democrats wants a single payer health system and his plan is the closest of the three front-runners to providing one. But his advocacy of Natalie Sarkisyan’s case raise a question no one else seems to be asking.
On Practical Reforms – Brian Klepper
Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others.
Over at Health Care Policy and Marketplace Review, Bob Laszewski asks an important, practical but vexing question for universal coverage advocates: Can you really mandate people to buy health insurance?
POLICY: Ian Morrison–to be thrown out by the Paisley Fabianists club
In a great article called The Fallacy of Excellence my old boss and friend Ian Morrison explains what we intuitively know. people don’t understand that more care is not better care. This is going to lead to lots of political problems as we get to righting the Wennberg-illuminated wrongs.
On the other hand, Ian’s lifetime membership in the Paisley Fabian Society will probably be revoked when they find out he’s been watching the Republican candidates debate…..
INTERNATIONAL: Those damn froggies beat us again
Here’s one international comparison I’d missed when it originally. The US has fallen to last place amongst 24 developed nations in an index of preventable death–one presumably cooked up by a Marxist cell masquerading behind a front organization called the London School of Hygiene and Tropical Medicine and funded by that cabal of Trotskyites known as the Commonwealth Fund. We’ve fallen four places since last time and are now even behind the Brits & the Irish—who I’ve always thought encouraged preventable death.
What’s happened is that every other nation showed significantly better measures relatively quickly (over a 5 year period to the early 2000s) and the US didn’t improve much at all.Who came top? Yes, those darn French again.
And their President is shagging a super-model. It makes me long for the days of JFK and Marilyn Monroe.
POLICY: It’s official–2 Trillion Dollars
For everyone who’s been going on about our (adopt Dr Evil voice) 2 Trillion Dollar health care industry, it’s now official. The 2006 data is out and we’re at 16% of GDP, $2.1 trillion and $7,000 and change per head. Growth, somewhere at the bottom of the trough, is around 6.5%. That’s nominal not real of course, but it’s still way over the economy’s growth rate, and that gap will grow if/when a recession hits.
The major change of course was the introduction in 2006 of Medicare Part D which mean that drug spending increased at over 8.5%. But then again, they’re telling us that Part D was less than originally projected. Although I bet you no one in CMS (or now out of it) will tell you what really was originally projected, and in fact which of the many revised projections the $41 Billion costs of Part D was really below!
And of course assuming that cost increases were stable in 2007, we’re actually already at 2.1 trillion + 6%, or 22.35 trillion!
PODCAST: Interview with Michael O’Neil GetWellNetwork
This podcast I did with Michael O’Neil who is the founder of GetWellNetwork. Michael had an episode of cancer relatively early in his adult life and although he was the recipient of great medical care from one of our nation’s leading academic medical centers, he was also very upset about the quality of the in-room patient experience. The result is a new system of using the TV to improve patient care in hospitals. You can hear much more in the interview.
On a technical note: this interview was conducted in the middle of a significant California winter storm, so there will be occasional tricky patch. Thanks for your patience and thanks to Michael too for his.
POLITICS: More on the Presidential plan comparison
Long time THCB friend Steve Beller tells me this:
We’ve created a Comparative Analysis of Presidential Health Care Plans, which analyzes much of the details of Susan Blumenthal’s and Kaisers’ work in order to identify top candidates based on voters’ wants and needs. We’ve taken a unique approach in which the complex details are distilled into categories of strategies that simplify comparisons between the candidates, and we’ve included comments on the key factors (with several quotes from Maggie Mahar’s blog and input from Barry Carol). It then groups the candidates on whether they propose universal healthcare, and it ranks them by the amount of attention they give to quality improvement and cost control. Then it matches the candidates to 18 types of consumers, which take into account their current insurance and health situation, their income level, and their support of good care for all.
Here’s the link.
Take a look and feel free of course to give your comments to Steve over on his blog or here.
Meanwhile as major bloggers are dropping like flies from the stress, (get soon well Om!), I feel good about the fact that I took the weekend off to go snow-boarding in some of the best powder the Sierras has seen in a while. And that’ll be all from me today!
