My sources tell me that the bloggers had fun in DC. Hopefully Dmitriy remembers to publish about Trusted.MD himself, rather than just let the press report about it 
Above the Fold
HEALTH PLANS/POLICY: Kaiser Permanente’s plan to cover all Californians
The plan is interesting in that it seems to basically contradict the AHIP plan that Halvorson was touting last week. That one called for subsidies for low income workers to buy into private health plans. This one calls for a state sponsored first dollar coverage plan in addition, plus an individual mandate plus a pay or play tax, plus two different pools for the non-poor to buy high deductible plans from (again both state sponsored). At least I think it’s what they’re saying. The major problem with this plan is that it’s so damn complicated I couldn’t figure out which special interest group was going to get the angriest, as it gets ignored by the rest of the public. It is worth noting that pay or play was turned down at the ballot box (2004) recently in this state and the version that was turned down had an exemption for small businesses. No such exception would exist under this plan. So maybe some anger (read: opposing political contributions) there…(are you watching WalMart?)
It’s also worth noting that they, like the Mass guys and everyone else look at the Medicaid and SCHIP enrollment levels, say “why don’t all those poor people just enroll in the plans that they’re already entitled to enroll in?” They seem to see that as a source of free (Federal) money. Well if they all did, then that money would actually have to come from somewhere…which is why those programs are under-enrolled to start with.
Still this is a serious effort. They’ve even done sums and everything. And we’re starting to count these policy documents by weight now, which indicates that it’s all getting somewhat serious and is picking up as a political issue.
OFF-TOPIC: Which side of the great divide is more intelligent and civilized?
Apparently Gywnny’s dissing her heritage
But the question remains: was Gwyneth Paltrow on to something when she noted (or didn’t) that “the British are much more intelligent and civilized than the Americans,” and that “people here don’t talk about work and money; they talk about interesting things at dinner”? Whether Britons are objectively cleverer and more amusing than Americans, or whether they just sound that way, is one of the deep mysteries of British life for expatriates like Ms. Paltrow, who lives in London with her husband, the British rock star Chris Martin, and their children, Apple and Moses.
Of course I have my own opinions and can legitimately talk out of both sides of my mouth on this one. But then again, I can introduce you to some extremely uncivilized and unintelligent citizens of both nations!
TECH/PHYSICIANS/INDUSTRY: Communists in press stirring up trouble
So a disgruntled reporter is stirring up trouble by daring to question the way medical advances happen in this great nation. Apparently this Joel Rutchick character is suggesting that when respected surgeon Dr. Isador Lieberman and his organization the Cleveland Clinic began pushing a new type of back surgery, we are supposed to be surprised he didn’t plaster memos about his stock options and holdings in the company that made the device all over the foreheads of his patients.
Lieberman did not tell his patients about his financial conflict of interest unless asked, the Clinic acknowledged. According to Plain Dealer research, he also did not reveal his stock holdings in numerous articles he wrote about kyphoplasty.
Bunkum! Does every computer come with a message that you’re making Bill Gates richer every time you turn it on? Of course not.
And when he (Lieberman) testified to the treatment’s benefits at a government hearing last year, he did not divulge past stock interests in Kyphon Inc. and other device makers – even when explicitly asked to disclose such holdings.
Well he was correct. He had apparently sold the last of his stock a few months before the Congressional hearing. Like any good capitalist Dr Lieberman is onto the next pony. As he told the commie rag The Plain Dealer
"I strive to be transparent in my disclosures and believe that I have disclosed my interests within the guidelines and policies of the Cleveland Clinic," Lieberman said in a written statement. He declined to be interviewed.
Who needs an interview in the face of that transparency!
Didn’t Rutchick know that unlike a bum masquerading as a reporter Dr Lieberman had been to medical school and therefore knew all about ethics? And didn’t Rutchick also know for there to be great inventions like this it’s required that not just the inventor but anyone who uses it gets rich? Otherwise what incentive would physicians have to help patients and save lives! After all who except some communist would disapprove of such a system?
When Kyphon officials took their company public in May
2002, they disclosed in a filing with the Securities and
Exchange Commission that they had offered stock options to
the eight members of their advisory board. All took them
except Dr. Joseph Lane, a New York orthopedic surgeon who
teaches at the medical school affiliated with Cornell
University. "I felt it was very awkward for me to be honest about
these things if I owned stock in the company," Lane
said last week.
Yeah, and we know what color state this Dr. Lane character is from, don’t we?! Enough said on that topic. Honestly, virtually every great medical advance absolutely requires this kind of capitalist incentive for those using them. After all, most other medical advances come about the same way. The important thing is that there’s clear evidence of an improvement.
On the SpineUniverse Web site, Lieberman, Kyphon co-founder
Reiley and three other doctors published a four-paragraph
synopsis of their initial experiences with kyphoplasty
involving 26 patients. "These results support further
use of kyphoplasty," the March 2000 summary concluded.
What possible other evidence than this initial, non-per reviewed disinterested study could be needed? None, of course! The important thing is to get the new procedure into as general use as quickly as possible for the betterment of patient care and to save lives!
Before 2004, there had been only one reported death
associated with kyphoplasty and seven with vertebroplasty.
Since then, the numbers have changed dramatically. From 2004
through September, 16 deaths involving kyphoplasty were
reported to the FDA versus three vertebroplasty-related
fatalities. Experts agree that vertebroplasty is used more
frequently than kyphoplasty, although the gap has closed in
recent years. “These sorts of complications are extremely rare,” said
Julie Tracy, a Kyphon vice president. “These are procedures
that are very safe and do a lot of good for these patients.”In a study published two years ago, researchers at the Johns
Hopkins Hospital in Baltimore also concluded that
kyphoplasty was more closely associated with serious
complications than vertebroplasty. Lieberman led the rebuttal for kyphoplasty proponents,
challenging the methodology of the study and completeness of
the data. However, those deaths and other complications underscore a
fundamental flaw of kyphoplasty: the risk of subjecting an
elderly patient to trauma and a general anesthetic, said Dr.
Kieran Murphy, one of the authors of the Hopkins study.
Murphy has disclosed that he receives royalties from one of
several manufacturers of the equipment used in
vertebroplasties.
Exactly, it’s clear that the naysayers are paid off by the communists. And at least we know that the insurance industry and the government are getting better value for money from the new procedure.
Murphy and other critics of kyphoplasty say hospitals need
the fees from general anesthesia and admission to recover
the costs of the equipment used in the procedure. That
equipment averages $3,500 to treat a single fracture,
according to Kyphon; vertebroplasty kits generally cost $500
to $600. Costs vary, but all told, vertebroplasty was found
to be $6,000 cheaper for each fracture treated, according to
a research report.
Well obviously those insurers must think it’s a better deal! Who could imagine insurers or Medicare just paying more for a new procedure without careful vetting it. After all they’re the end payer aren’t they? And they’re really strict about containing costs, as anyone paying insurance premiums knows! And if they weren’t so tough on containing costs for consumers and taxpayers, then why would we have a national clinical cost-benefit analysis center researching all these new treatments and being "transparent" about which ones cost what?
Answer me that, you Cleveland commie reporter, eh!
The only slightly disquieting aspect of this whole article is that the procedure concerned was invented in France. I know it’s a free market and all that, next time I hope that a red-blooded American like Dr. Lieberman could have been a little more patriotic. We don’t want those people with nice new backs only able to run backwards, do we?
TECH/PHYSICIANS:Vimo–building business by doing good (or vice versa)
Vimo is donating $1 for every doctor rating posted to the Vimo site during the month of December.
INTERNATIONAL: This is why we have trial lawyers
Man changes sex, parents sue hospital
A couple whose only son underwent a sex change operation has sued a hospital for compensation and to have the surgery reversed because their “family line” was broken, a Chinese newspaper reported.The Yancheng Evening News said the parents and relatives of a person whose name the newspaper gave as Xie Xiaoxin also became violent and occupied a ward at the hospital for 11 days in September in an attempt to get US$3.6 million in compensation and their son’s gender changed again.
I guess there’s also some issues around who exactly gets to consent to "informed" consent!
THCB: Not today
Dealing with the recent computer crash has made me grumpy, and limited time for writing today. There’ll be something somewhat cynical up in the morning.
BLOGS/TECH: And if you didn’t understand Web2.0 before..
…you definitely will after you watch this!
PHYSICIANS: Barry Bonds and the AMA’s still got management where they want them
The irony is quite staggering. On the same day that Barry Bonds gets the San Francisco Giants to bid against themselves–appalling the local baseball columnists–and give him $16m for one season in his tarnished chase of Hank Aaron, the Congress after a lot of high falooting talk, cancels the fee cut for Medicare Part B and gives a tiny P4P boost. Obviously like Bonds and the Giants management, the AMA still has Congress where it wants it — even though Bond’s numbers for the last two years have not exactly been worth $6m a year let alone $16m, and the cost to Medicare of Part B physician services has gone up despite previous fee cuts, while all the wonks agree that access to physicians for Medicare patients is not a problem (or at least not one affected by across the board fee increases or decreases).
Still let’s not look to baseball teams or Congress for rational decisions, especially with other people’s money. And I won’t even comment on the potential abolition of the limit to which people can put tax-free money in HSAs, other than to note that as they can be used for any spending after age 65 Congress may have just created the biggest tax avoidance scheme of all time!
THCB: Err…comptuer failure
Not much here today. Yesterday my computer started telling me that it had problems with some files in the registry, and after running the reccomended chkdsk utility (which took 2 hours), at the subsequent restart it kept on crashing and restarting without ever booting up (and no safe mode didn’t work, nor did anything else). After hours on the phone with Toshiba and on web searching out every possibility, I ended up doing a failed “recover”, noticed that it was wiping my data, and literally pulled the plug. This is the page that should work, but as Borat says “is no so good for meee!” I’m pretty well backed up other than one big piece and a few days email — I hope–and should be largely OK.
Now I have the hard drive in a bag and need to go buy a new computer. Something I was thinking of holding off on unitl Vista appeared. I guess I’m in the market for a Vista ready one. If you knew the project I was working on at the moment you’d find this all a little ironic.
By the way, I didnt know this but the Apple Macs automatically move your old computer data to your new one. For a PC you need a separate program. And if you only have a damaged hard drive, I guess that won’t work!
