By Sarah Arnquist

After a nearly two-year ordeal that divided Democrats and Republicans and involved two presidential vetoes, President Obama signed a bill on Wednesday to reauthorize the State Children's Health Insurance Program.

 SCHIP provides health insurance coverage to about 7 million children. This expanded bill will extend coverage to an additional 4 million children.

The WSJ Health Blog reports that doctor-owned hospitals were winners in the bill and big tobacco was a loser.

The bill will increase the national tobacco tax by 60 cents to about $1 per pack to fund the $33 billion expansion. This will please the tobacco control folks, who say the best way to reduce smoking is by increasing the price of cigarettes through taxes. It does mean, however, the expansion is funded through a declining revenue source.

By Sarah Arnquist

President Obama remains committed to comprehensive health care reform in 2009 and believes the declining economy emphasizes its urgency, a top White House official told hundreds of health policy experts Monday in Washington D.C.

“The current economic crisis has really highlighted the problems and put them under fluorescent lights," said Jeanne Lambrew, deputy director of the newly created White House Office of Health Reform.

The Academy Health conference is probably the wonkiest of meetings on the increasingly crowded health reform conference circuit. University PhDs and private sector policy analysts are here to discuss and assess the impacts of reform.

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By MONTE UYEMURA, MD

Successful healthcare reform is critical to the well-being of our nation. Who has the answers? As a rural family physician, I keep shouting in vain that they are backing the trailer up to the wrong barn. Reform proposals utilizing creative accounting keep conjuring up healthcare expenditure savings where they don’t exist, and even is we could attain this mythological information technology utopia, it will be mere cough medicine for our healthcare system’s pneumonia. It scares me to think that healthcare reform is being guided by myths.

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By Val Jones MD

Merrill Goozner
has been speculating about who will be nominated as the new Secretary
of HHS. He reviewed his most likely candidates (David Cutler or David
Blumenthal), and threw in a “dark horse” potential nominee: Ken Thorpe
(whom I’ve interviewed several times on this blog and spent time with during Obama’s inauguration ceremony).

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By John HALAMKA

Economists track changes in the money supply, personal debt, consumer
confidence, and durable goods orders. My signs of economic health are
more subtle.

1. Email volume on nights and weekends

In
good times, people eat out at restaurants. They go to concerts, plays,
and movies. They take weekend trips with the family.

In bad times, they stay at home and email.

For
the past two months, I've received an average of 100 emails between
6pm-12am and another 50 between 12am and 6am. This is double the usual
volume for those hours.

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By BOB WACHTER

A study in this week’s Archives of Internal Medicine
by Vinny Arora and colleagues found that vanishingly 
few hospitalized
patients could name any of their hospital doctors. Should we care?

I think we should. Vinny
is one of the nation’s up-and-coming researchers in the field of
hospital medicine, and a good friend. In this clever study, she and
colleagues at the University of Chicago interviewed over 2800
hospitalized patients over 15 months. Three-fourths were unable to name
even a single doctor caring for them; of those who “could” name a
doctor, the majority of names were wrong. Sobering stuff.

There
are multiple issues at play here.

At a place like the University of
Chicago Hospital, hospitalized patients on the teaching service are
cared for by gaggles of residents, students, and others who are
increasingly working in shifts and running for the exits because of
duty hours limits.

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By Sarah Arnquist

The Obama Administration has yet to announce an appointment for the director of the Centers for Medicare and Medicaid Services (CMS). We're not about to start any rumors, but the announcement must be near.  The eventual appointee will confront an unenviable number of difficult problems, including state Medicaid programs feeling squeezed by the financial crisis, a Medicare trust fund facing insolvency in a decade, and competing interests in any reform proposal the Obama team may propose.

The folks at the industry newsletter RPM Report think Mayo Clinic CEO Denis Cortese may be at the top of the list. Analyst Ramsey Baghdadi notes:

"Cortese would be an intriguing pick to lead the agency
and seemingly has every qualification to lead the growing Medicare
programs: He's an outsider, he holds a medical degree, he manages a
large health institution and he's helped to implement a number of the
most talked about health reforms at Mayo and made them work. Cortese
also chairs the Institute of Medicine Roundtable on Evidence-based
Medicine."

A Mayo spokeswoman downplayed the idea,
telling the Minneapolis Star Tribune that the executive has not been offered
the job.

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Tracey Moorhead has been head of the DMAA–Care Continuum Alliance for a couple of years, coming from the pan-healthcare industry group the Healthcare Leadership Council.

DMAA is the trade group for the disease management & population health management crowd–a crowd that has had to take it's lumps of late–including from me, but more significantly from CBO and CMS. Tracey gives DM a very vigorous defense, and is very optimistic about the future of disease management despite the doubts harbored by some members of various house committees.

It's a fun interview, and Tracey gives probably better than she got….Here's the interview

Plus quick shout-out to DMAA's Integrated care Summit on March 29-31 in Austin, TX