CBS 60 minutes has an amazing story about a patient given a $1 million heart transplant at Stanford–who was a prisoner.  The decision to pay for the transplant was made by the state prison system because it feared being sued by the patient’s estate. Too many lawyers? Apparently it’s part of the 8th Amendment. Has the prisoner got the same rights as anyone else or more?  Would an uninsured patient get the same care? Unlikely, according to Dr. Lawrence Schneiderman, a medical ethicist at the University of California at San Diego, interviewed in the show, you may need to show that you have $150,000 in cash if you don’t have insurance. And the prisoner in question? He wasn’t a model patients and died shortly after the transplant. You can make up your own mind about this one, but it brings up all kinds of issues, and goes to show that health care is incredibly complex.

Kaiser Family Foundation and AHA’s HRET have just released their annual employer benefits survey.  Premiums paid by employers are up nearly 14% and employers are shifting costs onto workers. Employers are also more and more interested in providing employees with high deductible plans — the kind the employees in the survey in my previous post say that they don’t want! 9% of employees have them now and a further 11% are "very likely" to end up with them soon. You can get to the full report index here (if you’re a real wonk!).  But the message is, as Bob Leitman at Harris has been saying for years; "pay more, get less!"

If you don’t already, go now and sign up for Jeanne Scott’s newsletter on health care inside the beltway at her new site, right click on http://www.health-politics.com. Now you’ve done that let me tell you a bit about her.  She just retired from over 10 years at CIS, then NDC and is the best source of knowledge on HIPAA, politics inside the beltway and anything touching health care policy. You get the dirty sausage-making aspect of politics from Jeanne, but you also get highly considered and understandable background, and logical opinions on what’s likely to happen when push comes to shove.  All that and an endless supply of lawyer jokes!  Now she’s officically independent, I’m hoping that her newsletters will get even more "explicit", but they weren’t exactly quiet before. Plus go read her explanation of what’s going on in the House versus Senate Medicare Drug debate/bill settlement feud (so I don’t have to repeat it all when I write about it!)

My favorite Jeanne line comes from a few years back.  I had her as a speaker at an IFTF meeting, and she talked very amusingly in great detail about the then new HIPPA transaction laws.  One client asked her why HCFA (now CM3/CMS) had set the fines for HIPAA violations so low.  Quick as a flash she replied – "That’s all they can afford!"