Category: Uncategorized

Better Care Through Clinical Trials

Dec 13, 2009• 13

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By DOUGLAS BLAYNEY, MD

Amid hundreds of amendments offered in the health care reform debate, there is a non-partisan, non-controversial gem that will both help patients and speed the search for new cures to deadly diseases.

Senators Sherrod Brown [D-OH] and Kay Bailey Hutchison [R-TX] have proposed an amendment that would encourage patients with life-threatening diseases or conditions to participate in clinical trials by requiring private insurers to cover patients’ routine care. It is essential that the Senate pass this amendment as part of health care reform.

As a cancer physician, I can speak to the benefits of clinical trials in my field of oncology. Virtually every advance in cancer prevention, screening, and treatment over the last 40 years can be traced directly to clinical trials – colonoscopies; curative treatment for testicular cancer; improved survival for most pediatric cancers; chemotherapy after surgery to prevent recurrence; new personalized therapies that target specific characteristics of cancer cells; and symptom management. Thanks primarily to the knowledge gained through clinical trials, today two-thirds of cancer patients survive at least five years after diagnosis, compared with only half in the 1970s.Continue reading…

Your Money or Your Wife

Dec 11, 2009• 33

By JD Kleinke

Talk about perfect timing. Just as the last “death panel” falsettos fade into the droning no-government- takeover chorus, along come those “faceless government bureaucrats” from the U.S. Preventative Services Task Force to stop the music in the nation’s busy and profitable mammography suites.

No more breast self-exams or mammograms for low-risk women under 50; mammograms only every other year after the age of 50; nothing for any woman over 74. That was the thunderclap pronouncement from the acrobatically acronymic USPSTF, the dreaded “they” from the gub’mint that has the folks at Fox in full fulmination.Continue reading…

Program Director Healthcare IT

Dec 10, 2009

Since its inception, the New England Healthcare Institute has been committed to the identification, assessment and promotion of valuable health care technologies with the potential to improve the quality of care while reducing cost. The Fast Assessment and Adoption of Significant Technologies (FAST) initiative, conducted in partnership with the Massachusetts Technology Collaborative, has been at the core of our work to promote innovation in health care and, among others, has resulted in the identification of computerized physician order entry (CPOE) and tele-ICU programs as key elements of health information technology policy at the private, state and federal levels.

Position Summary

NEHI is seeking a Program Director – Technology with rich experience in the health care technologies to play a critical role in the continued development of NEHI’s portfolio of health care technology projects. As health care technology receives greater attention for its ability to significantly improve health care quality and lower costs as part of state and national health reform effort, the Program Director – Technology has the opportunity to catapult the promise of FAST to the national stage and brand NEHI as a national thought leader in the advancement of promising, underused innovations.

This is a full-time position and an outstanding opportunity for candidates with strong health information technology experience to work with senior leaders from all across the health care community to drive change in a fast-paced, team-oriented environment. Ideal candidates bring a blend of skills – problem solving, intellectual curiosity, collaboration – to their work at NEHI. Download job description. (PDF)

Senate Compromise on Health Care Reform: Political Genius?

Dec 10, 2009• 13

By JOE FLOWER

Democrat Roland Burris, the sudden senator who replaced Barack Obama in that august body, has now joined those who are pledging to filibuster any bill that does not have a “public option” – joining of course those, like Connecticut’s infigurable Joe Lieberman who will filibuster if it does have a “public option.” But the compromise that is brewing may turn all such pledges inside out. The compromise would allow 55 to 65-year-olds to buy into Medicare, while letting under-55s without insurance into the Federal Employee Health Benefits Plan, along with mandates to buy in, and subsidies for those who can’t afford it. If this does indeed emerge, liberal Democrats in both houses may have some trouble defining what they mean by the “public option” they are so strongly demangin. Is it a “public option” for 55-and-overs if they can buy into Medicare? Sure sounds like it – a government-run plan that people can buy into, in competition with private plans. Is it a “public option” if the federal Office of Personnel Management runs an exchange called the Federal Employee Health Benefits Plan (FEHBP) setting the rules and transparency for private plans, with subsidies and tax credits for those 54 and under who can’t afford a health plan?Sounds close, but not quite. Close enough for confusion, at least.

Convergence and the Death of the Public Option

Dec 10, 2009• 9

By TIM GREANEY

So maybe the two parties are coming together on health reform after all. Last night we learned that after days of “secret talks” among the “gang of ten” the Democrats have reached agreement to restructure their health care proposal. The changes are significant:

– ditch the already-watered-down public option plan;

– create a new insurance exchange “option” for individuals and small groups consisting of a nonprofit plan as negotiated by the Office of Personnel Management;

– expand Medicare eligibility to cover uninsured individuals aged 55-64.

What does the Democrats’ “public option ultralight” compromise have in common with Republicans’ alternative universe? Well, consider the latter’s proposal to open interstate competition for all health insurers–a move they promise will immediately lower health care costs. Besides being shameless attempts to offer simple solutions to complex problems, the two proposals are guilty of the same fundamental misunderstanding of health insurance. Simply put, they both ignore a critical economic truth of health insurance today: insurers require a provider network of hospitals and doctors or must have market leverage in order to negotiate for lower provider prices and for controls on excessive volume.

Pelosi’s Hidden Tort Bomb — an Alternative View

Dec 8, 2009• 17

by Charles Silver & David A. Hyman

We once thought Democrats would accept tort reform to win Republicans’ support for national health care legislation. Now, however, Democrats have dispensed with bipartisanship. Perhaps they think they can ram health care legislation through without any Republican backing. Perhaps the price required to obtain even a few Republican votes was too high. Perhaps Democrats received too much pressure from the trial bar. Whatever the reason, neither the bill passed by the House nor the bill pending in the Senate contains any of the tort reform provisions Republicans want. To the contrary, the House health care bill is anti-tort reform.

Not only does it reject the entire slate of lawsuit restrictions Representative John Boehner put forward in the Republican alternative to the Democrats’ bill; it contains a provision that will reward states for scrapping damages caps and other tort reforms many already have in place. This provision flew beneath the radar during the House debate, but the editorial board of the Wall Street Journal condemned it after the vote took place. Describing the provision as a “hidden Pelosi tort bomb ,” the Journal editors predicted that “[i]f it passes in anything like its current form, we are going to be cleaning up the mess for decades to come.”

Most predictions that the sky will fall are wrong. This one is wrong as well.

Genetic Testing, Fact or Fiction: You Be the Judge

Dec 8, 2009• 11

By MICHAEL MILLENSON

Which of these two events is fact and which is fiction?

Organizations representing employers and health plans call for a moratorium on implementation of the Genetic Information Nondiscrimination Act, asserting that the new rules could have a “significant and adverse impact…on wellness and prevention efforts” in the workplace.

One of the largest companies in America begins matchmaking its employees based on their genetic compatability, hoping to save on the health insurance bills associated with imperfectly bred children.

Answer: No. 1 is a Dec. 2 press release from the Disease Management Association of America. No. 2 is a description of the Dec. 8 episode of the ABC-TV comedy, “Better Off Ted.”

Coincidence? You be the judge.

2009: A Year of Surprises and Change for the EHR Technology Market

Dec 6, 2009• 21

By DAVID C. KIBBE and BRIAN KLEPPER

2009 began with a bang for legacy Electronic Health Record (EHR) vendors, promising strong sales and windfall profits on the heels of stimulus package incentive bonuses initially worth more than $19 billion to doctors and hospitals. But things changed dramatically along the way.

Here ten surprises and notable events that have impacted the EHR market:

Payment for Meaningful Use of EHR technology, not for the software and hardware itself.

The idea that using EHR technologies ought to produce improvements in quality of care, better communication with patients, enhanced safety, and better public health reporting — and that these outcomes ought to be monitored and providers held accountable for their achievement — was itself a surprising innovation in 2009. It has to be counted among the best 10 health care ideas to come out of government in the past generation.Continue reading…

Health Journos Protest FDA Interview Rules

Dec 4, 2009• 4

By MERRILL GOOZNER

The Association of Health Care Journalists, the Society of Professional Journalists and 9 other scribbler groups have asked the Food and Drug Administration to lift its requirement that agency officials first get permission from the public relations office before speaking with reporters. The demand came in a letter sent to Principal Deputy Commissioner Joshua Sharfstein, who is running the FDA's Transparency Task Force.

Good idea. In fact, it should be extended to every government agency.

Why Wait Four Years?

Dec 2, 2009• 81

By PAUL LEVY

I was struck during President Obama’s health care speech before Congress several months ago that the reforms he advocates would not go into effect for four years, until 2014. This timetable, too, is written into both the House and Senate versions.

Why the delay? It is hard for me to imagine, even given the federal rulemaking process, that it should take four years to establish an insurance exchange from which people can buy coverage. This is the exchange that would eliminate the nasty practices of insurance companies: Denying coverage because of pre-existing conditions; limiting annual or lifetime payments; and rescission of policies. It is hard for me to imagine, too, why it should take four years to fully deliver targeted subsidies to lower income people so they can afford insurance.

As noted by Princeton Professor Paul Starr in an article in the New York Times earlier this week: “By comparison, when Medicare was enacted in 1965, it went into effect the next year.”

This leaves me with a bad feeling. It looks like the Obama team does not want implementation of the health care bill to take place during their first term. Why? Perhaps they know that the cost of the plan is higher than they are saying. Or maybe they know that the options available to consumers will be less attractive than currently portrayed.