An article called West ‘on verge of medical crisis’ on how health care is all screwed up in the UK conservative newspaper The Daily Telegraph has this rather interesting subheader.

Western nations are on the brink of a crisis in medical services, according to the man credited with curbing the rise in health care spending in America.

Given that health care costs in America have been rising fast for the last 40 years apart from a brief period in the mid-1990s, I was very keen to find out who this hidden genius was. I initially suspected that Mark McClellan would be a little surprised to find out what the Torygraph thinks he’s responsible for! But reading down in the article, it appears that the boaster is McClellan himself.

Dr McClellan has taken a leaf from the Altman book. After years in which the Medicare budget exceeded projections, he managed to keep drug spending 40 per cent below projections. This "unprecedented" improvement followed moves to encourage patients to take generic rather than brand-name prescription drugs. The key was information, giving patients the wherewithal to see for themselves that generic drugs were as effective as their pricey counterparts, he told the meeting. Dr McClellan has taken a leaf from the Altman book. After years in which the Medicare budget exceeded projections, he managed to keep drug spending 40 per cent below projections. This "unprecedented" improvement followed moves to encourage patients to take generic rather than brand-name prescription drugs. The key was information, giving patients the wherewithal to see for themselves that generic drugs were as effective as their pricey counterparts, he told the meeting.

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Mary Kay Henry is an Executive Vice President of the SEIU, the nation’s largest health care
union where she’s the head of the union’s Health Systems Division. The SEIU has been very active in health care generally, not least in their “alliance” with Wal-Mart and others on national reform. But there are other issues too that they care about. Here’s another issue that concerns her and probably given where we’re going we should all be concerned about them. What about fair share for the poorest care givers—home care aides?

Seventy-three-year-old Evelyn Coke worked for 20 years as a home care attendant for the elderly for sometimes as many as 24 hours a day, four days a week,. She occasionally even slept overnight at her clients’ homes so she could be there for them if they needed her. Unfortunately, because of the “companionship exemption” under the Fair Labor Standards Act, she rarely ever received overtime pay for the extended hours she put in. Today Evelyn stands alone as the sole plaintiff awaiting a Supreme Court decision. How the justices rule on Long Island Care at Home Ltd v. Coke might mean larger paychecks, overtime coverage, and ultimately a reduction in high turnover, which could go a long way to reducing shortages in one of the nation’s fastest growing occupations — home care workers.

As SEIU continues promoting new health care solutions, we must
remember the contributions of health care industry workers — especially
in the midst of a looming “care gap” and an aging elderly population
expected to grow 40% by 2030. This “care gap” is present in nursing
homes, assisted living facilities, and home and community-based care
across the country. As the number of elderly Americans increases
dramatically, the long-term care industry is not keeping pace. We are
barreling toward a crisis, and it is going to take some innovative
thinking and some radically different ways of doing things to avert
what could be a disaster for a generation of Baby Boomers who will all
too soon hit their “golden years.”

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I have another of my occasional pieces up at the Guardian’s Comment is Free site, trying to make sense of American health care for an international audience. I take aim at how the cautious nature of the main Democratic front-runners health care proposals doesn’t match their fiery rhetoric — Comment is free: The cautious approach.

Even though Iraq seems to have sucked all the oxygen out of American
political life at the moment – even Cindy Sheehan has given up and gone
home – healthcare does remain the largest domestic issue.

Several weeks have passed since the Democratic candidates for
president had a debate about healthcare. It’s interesting that despite
an attempt by probable Republican candidate Fred Thompson to take on
documentary filmmaker Michael Moore over the topic, none of the front
runners on the Republican side have made much mention of healthcare at
all. This is doubly curious as one of them, former Massachusetts
Governor Mitt Romney, left office having at least partially helped
make his state the most advanced healthcare reform " laboratory" of
them all. But apparently among the conservatives and evangelicals who
dominate the Republican primaries, the issue of universal healthcare is
not seen as a great vote-getter – a worldview the Republicans might
come to regret.  Continue.