Category: Uncategorized

War on terror becomes a war on the desperate

Jul 14, 2008• 3

By Matthew Holt

I don’t go off topic on THCB much these days, but I do so after reading about the arrests of illegal immigrants at a meat-packing plant in Iowa and the treatment of those arrested.

The “war on drugs” was ramped up in 1986 after a basketball star allegedly died from a cocaine overdose and has since been perverted into a budget-busting bonanza, going largely after marijuana users who are doing little harm to themselves or anyone else. But they are still being arrested in their hundreds of thousands, and contributing massively to the budgets of law enforcement and prisons nationwide.

It was entirely predictable that the same thing would happen to the “war on terror.” In order to justify the huge and growing budget of the Department of Homeland Security’s biggest agency, the Immigration and Customs Enforcement (ICE), illiterate illegal immigrants who are doing nothing more than trying to support their families are now being charged and jailed for laughable offenses using legislation put on the books to stop terrorists. The “war on terror” is now taking on the vital stronghold of rural Guatemala, via Postville, Iowa. The aim is clearly to justify ICE’s budget by pretending that illegal immigrants are serious criminals.

Just in case you thought the callous indifference of this Administration couldn’t get much worse, you should read the whole account from the interpreter who was at the court cases at Postville, Iowa. Hundreds of immigrants are being jailed for up to 5 months — at your and my expense — on the insistence of the DOJ and the ICE.

Here’s the whole account from interpreter Erik Camayd-Freixas, and I urge you to read it.

Around the Web in 60 Seconds (Or Less)

Jul 14, 2008

WASH POST: Pioneering heart surgeon, Michael E. DeBakey, 99, dies.

WASH POST: AMA apologizes for historical racism.

NY TIMES: Docs Medicare payment problem persists.

NY TIMES: The hilarities and health benefits of dancing.

WSJ: Lessons from Massachusetts health reform.

WSJ: Medicare auditors recover $700 million in overpayments.

AP: Can rising gas prices save lives?

WASH POST: Japanese dying from too much work.

CANADIAN MEDICINE: Advanced Access scheduling causes headaches.

People with high-deductible plans make riskier decisions

Jul 14, 2008• 5

By Jane Sarasohn-Kahn

Healthaffairs People enrolled in high-deductible health plans tend to make more risky health
decisions than those enrolled in lower-deductible plans, according to a study published in the July/August issue of Health Affairs.

In Do Consumer-Directed Health Plans Drive Change In Enrollees’ Health Care Behavior? the authors find the answer is, "yes," probably.

Enrollees in the high-deductible CDHP were more likely to forgo medical care to save money.

My Health Direct

Jul 14, 2008• 3

Nearly two years ago Jay Mason called me telling me about his plan to create an appointment system whereby hospitals in Wisconsin could re-route their Medicaid patients to community and safety-net clinics. He told me that not only would it relieve ED overcrowding but that it would also allow providers to more efficiently deliver pro-bono care. I didn’t exactly rate highly his chances of success in creating a calendar referral system for Medicaid and uninsured patients, but I suggested that he check in with me when it was up and running. Here’s Jay on what My Health Direct is doing now, and it indeed sounds encouraging. Matthew Holt

By Jay Mason Jay_mason

The problems of emergency department overcrowding and increased bad debt affect nearly every urban acute care hospital in the country. Patients who seek care at an ED are four times more likely to be covered under Medicaid or twice as likely to be uninsured than their privately insured counterparts.

In 2006, several hospitals sought a new approach to address some of their most entrenched challenges – overcrowded emergency departments, increasing levels of uncompensated care, and an ongoing imperative to maximize use of its clinical resources. They soon gravitated to a web-based solution called My Health Direct, which was created by start-up Global Health Direct for use in settings with a highly disproportionate share of the Medicaid and uninsured population.

The personal tragedies behind the patient safety movement

Jul 14, 2008

By THCB Staff Millenson_2

Regular THCB contributor Michael Millenson wrote last week at the Health Affairs blog about the sad stories which emerged during a recent meeting of providers and patients who call themselves Consumers Advancing Patient Safety (CAPS). You can read it here.

Marketplace: Aloha, THCB

Jul 14, 2008

Maui AgeWave, a company working to expand the use of digital telehealth technologies to help people age in place, is in the early planning stages of a Maui Connected Care System ("MCCS") conference. If any of THCB readers would like to get involved as a speaker, new product exhibitor, sponsor, or attendee, we’re eager to hear from you.

We’re going for a high quality "Aloha" experience for our attendees. Besides having fun on Maui, we’ll be looking for help mapping a "Maui Connected Care" model, which participants will have a chance to help design in workshops and implement after the conference with their products and services. In this sense, the conference may be viewed as a unique "have fun, meet interesting people and produce something timely and useful" conference experience for everyone who attends. Equally important, designing, implementing, and tracking costs/benefits/health outcomes of this MCCS is intended to serve as a validating model which can be replicated across Hawaii and elsewhere.

Anyone with experience designing and implementing RHIO, H.I.E, EHR and EMR concepts should be interested in helping us sponsor and inform this conference. Likewise, we strongly encourage companies to attend who believe they can empower people to age-in- place with their innovative home care devices. We will, of course, also be inviting key stakeholders and health care executives across Hawaii to attend.

Quite frankly, we’re hoping that this conference will enable Maui AgeWave LLC to meet and enter into strategic alliances with attendees whose expertise, services and products will enable us to create the MCCS we describe here.

For details, contact Peter Durkson.

Comparative What? Translating Policy Lingo into Something Meaningful

Jul 11, 2008• 13

By SARAH ARNQUIST

Barack Obama’s health reform proposal includes creating a center for comparative effectiveness research.

John McCain also has expressed support for this research.

And the American College of Physicians would like patients and doctors to use comparative effectiveness information when making health decisions.

What the heck are they talking about?

Policymakers, pundits and journalists have begun throwing around the term “comparative effectiveness” as if people know what it means.

I haven’t seen a formal survey, but I’m confident that the general public does not understand the concept behind this jargon nor the reasons why a national center might be needed to compare different medical treatments and procedures to find out what is most effective for different patients.

The first step to helping people understand these issues is to stop using the term comparative effectiveness. Using insider terms like this will ensure the public never engages in the issue and never buys into it. And public buy-in is important — crucial actually — says Gail Wilensky, the term’s mother of sorts.

How patients get the best care

Jul 11, 2008• 3

By Susannah Fox Epatients

What are the social and psychological factors that affect how people are treated — or
even their health outcomes? This question has popped up in my reading and in my work quite a bit this week, and so I wanted to share what I have learned from three leading thinkers: Peggy Orenstein, Dr. Jeffrey Lin, and Dr. M. Chris Gibbons.

Ted Kennedy Shows Up to Vote; McCain Absent

Jul 10, 2008• 7

By MAGGIE MAHAR

When Ted Kennedy came onto the Senate floor, his colleagues cheered.

He was there to vote on the bill that would prevent a 10.6 percent cut to physicians who treat Medicare patients.

Just before Congress broke for the July 4 holiday, the bill missed the 60 votes needed to pass by just one vote.

Today, Kennedy, who is battling a brain tumor, brought that vote to the Senate floor. “Aye,” the 76-year-old Kennedy said, grinning and making a thumbs-up gesture as he registered his vote.

Meanwhile, it appeared that Republican members of the Senate had been released to vote as they wished after it became apparent that the 60-vote threshold would be met. Pressure from seniors, the AARP, and the AMA had been mounting on members who voted against the bill June 26.

The Problem with Medicare Advantage

Jul 10, 2008• 16

By MAGGIE MAHAR

Everyone understands why Congress was so reluctant to cut physicians’ fees. Reimbursements for primary care physicians are very low—so low that 30 percent of Medicare recipients who are looking for a new medical home can’t find one. Cut fees, and fewer doctors will take Medicare patients. The AMA, seniors and the AARP are all up-in-arms. Few politicians like to disappoint this trio.

But why are so many Congressmen willing to cut Medicare Advantage? After all, one out of five seniors is in the program: Won’t they be upset?

The truth is that, as many seniors have discovered, Medicare Advantage fee-for-service (the plan Congress has now voted to phase out by 2011) is not turning out to be an advantage for them.

Here is what David Fillman, an International Vice President of the American Federation of State, County and Municipal Employees (AFSCME), which represents some 1.4 million workers, had to say about MA’s fee-for-service insurance when he testified before Congress in January:

“Insurance companies have targeted our employers for the hard sell, including offers to pass through some of the federal subsidies to state and local governments.”