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BLOGS: Grand Rounds up at Medpundit, and here next week

Whoops. If you’re looking for the December 28th, Grand Rounds please click HERE.

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Grand Rounds is up at the ever-wonderful Medpundit’s site. OK I rag on Syd a lot, but she’s a great blogger in addition to having a real job. I just wish that her no-nonsense views on medicine transfered over to her views on politics, but I’d be happy to have her as my physician (but no, I’m not moving to Ohio!)

Meanwhile, next week Grand Rounds will be here at THCB. It’s a best of the YEAR 2005 edition, so send me you favorite post from the year. Email to matthewATmatthewholtDOTnet

 

POLICY: Tax health care benefits, go on I dare ya!

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Hat tip to Ezra, who clearly wasn’t partying enough this weekend and read the NY Times on Sunday. In it there’s a rational argument that me, Fuchs, Enthoven and Eric Novack all agree with: get rid of the tax deductibility of health benefits.

Next year, the federal government expects to provide about $130 billion for Americans to buy health insurance. The amount is substantial: it is equivalent to about 11 percent of all federal income tax revenue and more than a fifth of federal spending on Medicare and Medicaid. And it is growing fast: the bill is expected to surpass $180 billion in 2010.

Of course, this was recently proposed  by the same panel that suggested getting rid of tax deductibility of mortgages, and immediately disowned by the politicians who set up said panel.  But linking this to the issue of the uninsured and showing that it’s unbelievably regressive on those people who buy their own insurance and don’t get the tax break can’t be a bad meme for us wonks to pursue.

THCB: New feeds live!

After much tinkering and grumbling, THCB’s crack tech staff has set up new RSS feeds filtered by content category. This means you can now get Health Care Blog posts on specific topics delivered to your trusty RSS reader without having to look at everything. There are now individual feeds for pharma and technology. More categories will be added soon. 

BLOGS: Grand Rounds coming here for an end of year special

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I have finally been suckered into offered to host Grand Rounds, and will be doing so in the week between Christmas and New Year on Tuesday 27th December. And it’s likely that’s all I’ll be doing that week over here.

So to make it special I’m putting out a request for your best post of 2005–-the whole year. Please think about it and get it to me by the end of next week, that’s Friday 23rd.

POLICY: Ignorance is not bliss

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Young punk Kate Steadman has a very interesting post about the uninsured over at Health Policy

The current display of ignorance was on the subject of being uninsured. The woman I talked with didn’t really understand what it meant to be uninsured until her housekeeper had a health problem and couldn’t get seen by a doctor.

Look down in the comments for a combination of ignorance and desperation, and you’ll see why this will end up the political topic of the next two decades, as I said in my Spot-on piece last week.

And a big Hat-tip to Derek Lowe who’s doing Grand Rounds this week.

POLICY: Another balanced debate–what did you expect from the WSJ editorial pages?

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So in this online "debate" about consumer health care called Consumer Choice: Can It Cure The Nation’s Health-Care Ills? the WSJ editorial page shows its lack of bias by having two HSA advocates, and one very tired liberal debunking them.  And Reischauer obviously couldn’t type as fast as the other two.

And no one mentioned the 80/20 rule, nor the RAND experiment that showed that needed care was forgone as often as un-needed care. And despite the fact that the two HSA loonies claim that we do not apparently ration by price, we have a huge rate of bankruptcies caused by medical bills, and huge numbers of the poor are unable to afford reccomended care or have trouble paying for care compared to poor people in other countries. But why bother using actual data published in peer reviewed journals when you can wax poetic telling lies about South Africa while ignoring what’s going on in Singapore. But it’s a "debate" so why sweat the small stuff?

TCHB: Jobs and requested people

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I’m getting an increasing number of people calling me looking for senior and not so senior health care consulting, strategy and marketing types. Not that I’ve figured out how to get in the middle of this or make any money out of it yet, but if you are looking and want to send me a little synopsis, go ahead. (I will of course treat any emails with the fullest confidentiality). Extra points for senior consultants who want to head to the East Coast, and health plan marketing types interested in the south and Texas.

Let me know….

QUALITY: We spend how much on the NIH and how much on AHQR?

This is far, far too true.

Spending less money on better drugs and more on getting existing therapies to patients would save more lives. That’s the conclusion of a study published by a Virginia Commonwealth University family medicine and public health physician."For every dollar Congress gives the National Institutes of Health to develop blockbuster treatments, it spends only one penny to ensure that Americans actually receive them," said Steven Woolf, professor and director of research in VCU’s Department of Family Medicine and a member of the National Academy of Sciences’ Institute of Medicine. "This reflects, in part, a misperception that the improved drugs, procedures and the like will improve health outcomes, and that does not happen," he said.To illustrate, Woolf used a theoretical disease that claims 100,000 lives a year. If a drug is available that reduces the mortality rate from that disease by 20 percent, it has the potential to save 20,000 lives each year, he said. But if only 60 percent of eligible patients receive the drug, only 12,000 deaths will be averted. So closing the gap in care by making it available to 100 percent of eligible patients would save 8,000 additional lives, Woolf said.But to save the same number of lives by making a better drug and without closing the gap in care, i.e., delivering the better drug to only 60 percent of eligible patients, the drug’s lowering of mortality would have to be increased from 20 percent to 33 percent, he noted. Calling this the "break-even point," Woolf said that is an unrealistic goal for many treatments. In fact, the study showed that the billions invested in statins and anti-clotting drugs failed to reach the break-even point.

And we know that this is not just theoretical.

THCB: Wussies–Tough? Try not drinking for a month

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Apparently it’s to difficult to give up drinking for a month.  As many of my friends will tell you I drink my fair share of alcohol, but I’ve managed it quite a few times. The LA Times reports how difficult it was for a group of fit people to give it up for a month. 

For moderate social drinkers, hopping on the wagon for a month shouldn’t have been that daunting of a task. Not just any moderate social drinkers, but a handful of men and women who are exceptionally fit, as in training-for-a-marathon fit. These are people used to discipline and healthy lifestyles, people who can get through a rigorous boot camp class without hurling. Yet some found that wagon trip much more uncomfortable than they thought, and didn’t even last a month. Some didn’t even make it a week.

Well they must have been a particularly weak-willed bunch. This year for two separate months (March and October) I’ve given up drinking and meat, and sugar and carbs) in order to lose weight. Of the four food groups I quit — yes I basically ate fish and vegetables — sugar is by far the hardest to give up.  Thank god for Splenda. Booze is easy to do for a month, and I’m always happy to fall off the wagon at the end of it. Whether the odd month every few years is going to help my well-exercised liver in the long run, I doubt.

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