Category: Uncategorized

A Second City Warning to Obama

Jul 8, 2009• 8

By MICHAEL MILLENSON

Millenson For all those Obama-ites confident that they won’t make the same
mistakes pushing health care reform that the Clinton administration
did, might I suggest a trip back home?

Just a few minutes into the Second City comedy troupe’s latest show, America: All Better!,
the usual japes about the Jesus-like hopes projected onto our 44th
president gave way to a quick bit about health care reform. A doctor
was telling a woman that her diagnosis gave her only three months to
live. When she pleaded for help, he told her that the good news was
that Obama’s health reform plan meant she was scheduled for her next
visit just six months from now.

Bad news for Obama — the audience laughed.

Conventional wisdom says that the shopworn distortions and
deceptions that killed health care reform in the past have lost their
sting due to combination of middle-class economic worries and soothing
on-message reassurances. Perhaps. But comedy works only when it
connects with real anxieties. The fact that Second City comics in the
heart of Chicago are successfully playing to GOP-fueled fears of
rationing should raise a bright red warning flag at the White House.

Meaningful Use vs. Meaningless Adoption of Electronic Health Records

Jul 7, 2009• 9

By RICK WEINHAUS MD

Dr. David Blumenthal, the new National Coordinator for Health Information Technology, has stressed that the goal of the ARRA/HITECH initiative is to improve patient care, not to mindlessly adopt health information technology. In this regard, he wrote that many CCHIT-certified EHRs “are neither user-friendly no designed to meet HITECH’s ambitious goal of improving quality and efficiency in the health care system.”

It is therefore disconcerting that the Association of Medical Directors of Information Technology (AMDIS) just weighed in on the issue of meaningful use with their letter to Dr. Blumenthal, recommending that the new national HIT Policy Committee use the 2008 CCHIT certification criteria to determine which hospitals and physicians get HITECH incentive dollars.Continue reading…

The Tri-Committee Health Reform Bill: Implications for Children

Jul 6, 2009• 7

By JOCELYN GUYER

A little more than two weeks ago the three major committees in the
House with jurisdiction over health reform put out a draft legislative
proposal, known as "The Tri-Committee bill." We've now read the 852-page document
a few times, and think it would make giant strides in providing access
to coverage to millions more people and transforming the country's
health care delivery system. Of particular note for kids, it includes:

Major expansions in access to affordable coverage for their parents and other adults. (Click here for just a few of the articles showing a clear link between how children fare and the health and stability of their parents.);

Continued coverage of children through Medicaid with its strong, child-specific benefit package;

Increases in Medicaid reimbursement rates; and

A
guarantee that no child born in a U.S. hospital leaves without
insurance. (For more details on these and other provisions, see our Fact Sheet on the Tri-Committee bill.)

HELP! IS THE CBO GETTING SUCKERED?

Jul 6, 2009• 8

By ROGER COLLIER

In a comment on my previous post on
the Senate Health, Education, Labor, and Pensions reform bill, tcoyote
explained some of the political thinking behind what seem like totally
spurious cost projections. While I can readily accept tcoyote’s explanation
of the pols’ efforts to ignore reality, I’m still politically innocent
enough to want to know what the HELP bill might really cost. So I spent
some time looking at the Congressional Budget Office report on the bill.

Here are a few things I noticed:

The “ten-year projection”
starts in 2010, although the bill does not require insurance exchanges
to be implemented until 2014. The result is that the projection includes
only six years of reform (plus a lengthy transition period), NOT ten
years.

The CBO projections
include a $58 billion “credit” for the impact of the HELP bill’s
proposed new long-term care program (the so-called CLASS Act). However,
the “credit” accounts for the difference between premiums and benefits
over the 2010-2019 period on a cash basis only. If conventional accrual
accounting were used, CLASS would show a net cost for the period.

No Country for Old Men

Jul 6, 2009• 58

By JEFF GOLDSMITH

As we enter summer, the health reform process is moving into its Newtonian phase: irresistible forces meeting immovable objects. In both health cost and access, the trend is not our friend. There is ample evidence not only of intolerable inequities, but also intolerable waste and inappropriate use of expensive clinical tools. President Obama embodies the need for change. He has assembled a very talented and politically savvy crew of helpers. He confronts the sternest test of any Presidency, fixing a poorly tuned and fragmented health system that is, by itself, larger than either the French or British economy.

Washington Post’s “Salon” Disaster and Health Care Reform

Jul 6, 2009• 5

By CRAIG STOLTZ

As a former citizen of the Washington Post newsroom, the recent disaster about the newspaper’s “salon” project is heartbreaking and embarrassing.

I won’t belabor the issues many others have so thoroughly covered, including today’s “apology” by publisher Katharine Weymouth, which feels a bit short of fulsome.

Instead I want to point out something that’s gotten lost in the media frenzy: That
the topic of the first “salon” [sorry, I find I have to use quotes when
referring to that] was to have been health care reform.

As an independent journalist [among other things] and participant in
the “health 2.0″ movement, I find this particularly distressing.

The fact that Weymouth and her team identified health care reform as
the first ripe target for a scheme to bring together “the powerful
few”: CEOs/lobbyists, “Congressional and Administration officials” and
Washington Post health care reporting and editorial staff” demonstrates
the peril faced by the group with the biggest stake in health care
reform.

I refer, of course, to patients.

A Declaration of Health Independence

Jul 6, 2009• 8

By DONALD W. KEMPER

Donkemper When in the course of human events, it becomes necessary for individuals to dissolve their professional bands of medical dependency and to assume among their obligations the primary responsibility for their own health to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of humankind require that they should declare the causes which impel them to seek Health Independence.

We hold these truths to be self-evident, that all people are created equal, that they are endowed by their Creator with certain inalienable Rights, that among these are the freedom to direct ones own Life, to provide for ones own Health and to die with dignity—that to assist in providing such rights when otherwise unattainable, health professions are instituted among people, deriving their roles solely from the consent of the people they serve—

Broad Agreement that Worker’s Comp Program for War Zone Workers Needs Fixing

Jul 4, 2009• 6

By T. CHRISTIAN MILLER

Brink-contractor-475px-latimes

Congressional hearings generally follow a script. Lawmakers publicly
vent their outrage, administration officials offer plausible defenses,
and the outcome is inconclusive. But this month's airing of complaints
about the government's system for taking care of civilian workers
injured or killed while on the job in Iraq and Afghanistan was notable
for its unanimity.

Republicans and Democrats, Obama administration officials, private
insurance companies and injured contractors all agreed that there are
serious flaws in the Defense Base Act, [1]
a 70-year-old law that requires federal contractors to purchase special
workers' compensation insurance for employees working in war zones.

The Labor Department, which oversees the system, acknowledged that
it had failed to consistently provide for the needs of the injured.
Insurance carriers complained that tight deadlines and paperwork
requirements were outmoded for the complexities of a war zone. Injured
civilians recounted long, painful battles to get prosthetic legs,
prescription eyeglasses and other basic medical needs.

Creative thinking about the CER agenda

Jul 3, 2009• 6

By JOSHUA SEIDMAN

This week the Institute of Medicine (IOM) released its list of the top 100 topics that should be addressed in comparative effectiveness research (CER) now — thanks to $1.1 billion in the American Recovery & Reinvestment Act
— that the federal government actually has the resources to do
substantial CER. IOM has prioritized the list by creating four
quartiles, noting that the first quartile is the highest priority
group, etc.

In order for the federal government to make good use of the huge pot of CER money, there are at least five things that they need to do to ensure its value and actually change care delivery.
I’m all for trying to find out whether me-too drugs add any significant
value. However, the greatest opportunities for implementing delivery
system change that improves care effectiveness and efficiency relate to
innovations in how care is organized and delivered, and how insights
are communicated to the broad range of health care actors — most
notably consumers.

That’s why I was heartened by the IOM’s top 100 list — though
certainly I’d move a few up a quartile or two. The list has many
projects that fit my priorities, including a strong emphasis on CER to
reduce health disparities.

Drug Suspected in Michael Jackson Death Subject of Recall

Jul 3, 2009• 5

By SHERI FINK

Results of Michael Jackson’s toxicology tests have not yet been released, but suspicions have centered on the powerful anesthetic and sedative drug propofol, also known by the brand name Diprivan. It was reportedly found in Jackson’s house, and a nurse who worked with him said he begged for propofol to help him sleep.

Now, some lots of propofol are being recalled for contamination.

Last night, the Centers for Disease Control and the Food and Drug
Administration advised clinicians immediately to stop using propofol
from two lots found to be tainted with elevated levels of endotoxin, a
toxin made by bacteria. Regulators said Teva Pharmaceuticals, the
manufacturer, had begun a voluntary recall of the lots.