The Health Care Blog – Page 973 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Grim economic outlook

Sep 10, 2008• 2

By Sarah Arnquist

Congressional Budget Office Director Peter Orszag is playing a role he admittedly hates: the grim economist. The CBO released the annual summer update to its Fiscal Outlook for 2008 to 2018.

On the "Director’s Blog," Orszag explains the economic report and gives it context, including what the takeover of mortgage giants Fannie Mae and Freddie Mac means for the federal budget. The blog, in my opinion, is a great resource and worth a regular read.

Here are some bullets from the update — note health care costs nearly top the list of the nation’s fiscal concerns:

CBO estimates that the deficit for 2008 will be $407 billion higher than last year’s $161 billion. As a share of the
economy, the deficit is projected to rise to 2.9 percent of GDP this
year, up from 1.2 percent of GDP in 2007.

Over the longer term, the fiscal outlook continues to depend mostly on
the future course of health care costs as well as on the effects of a
growing elderly population. CBO estimates that federal spending on
Medicare and Medicaid will grow to 6 percent of the GDP in 2018 and 12
percent of the GDP by 2050.

23andMe punk rock partying, price cuts and on vid on D

Sep 9, 2008• 2

By Matthew Holt

23andme is having a gobbing party in NYC tonight—presumably at the Roxie. You didn’t know punk was back, did ya?

Indu will be there (sadly I had to stay chained to the computer). But there’s a little more 23andme news today in that they’ve dropped their core price to $399 and have inked a deal to get access to Ancestry.com’s database of users. Not quite an impulse purchase yet, but still getting down there.

And if you want to know what 23andme is up to, you can see Linda & Ann’s interview/demo at All things D last May. Of course you can see Linda at Health 2.0 next month, but I’m not sure we’ll be quite the pushovers Mossberg & Swisher are…at least we’ll keep them to 3.5 minutes!

I’m still trying to figure out whether the DTC genomic market is a gimmick or actually has some value (and I don’t mean value the way a VC does! I mean whether society should be spending health care dollars on genomics when we do such a shitty job treating diseases we do understand). But it’s good to see some real activity in at least postulating the concept.

Health 2.0 Road Trip Vroom! Vroom!

Sep 9, 2008• 6

By David Kibbe

Kibbemotorcycle This country is simply meant to be seen from a motorcycle. It’s big, it’s wide open, and all sorts of Health 2.0 activity is happening.

Unless, of course, you’re in downtown New York City, where you’d have to be crazy to drive anything. I kicked off the Great American Motorcycle Tour for Health 2.0 in Manhattan, in hot pursuit of the real people of Health 2.0, including Tara Parker Pope of the New York Times, and a host of folks who came to the HelloHealth opening party in Williamsburg, Brooklyn. Jay Parkinson was the master of ceremonies, but I also interview Nat Findlay of Myca and Howard Krein, MD of Organized Wisdom. Sans Honda Goldwing. So, I took the subway, did a lot of walking, and shot a lot of film.

I’m asking all the interviewees the same question: Are YOU Health 2.0? And you will be surprised at some of the answers I’m getting. Who are these people, and why are they blogging, starting medical practices with videoconference capability built in, creating new kinds of health search and knowledge engines, and generally finding new and exciting ways to use Web 2.0 technologies? The stories behind the obvious are what I’m after, in a Zen sort of way, of course.

Next stop: Chattanooga, Tennessee. And, yes, this time I’m going to be traveling by motorcycle all the way. Vroom!

Private Medicare plans face uphill battle to prove efficiency

Sep 9, 2008• 3

By Robert Laszewski

I have been struck by the optimism regarding private Medicare presented by health plan executives during the recent earnings season and the analysts failure to press them on just how their numbers will add-up to sustain the long-term viability of a private Medicare strategy.

The typical private Medicare health plan operates on a medical cost ratio in the mid-80s. Let’s assume 86% for medical costs and the remaining 14% for overhead, profit, and taxes.

Government-run Medicare operates on about 3% overhead. One can argue that many federal Medicare costs are paid for elsewhere but that is the number the private plans have to compete against. So private Medicare plans spend 14% on overhead and Medicare charges
itself 3% — that’s an 11% disadvantage for the private market right
out of the box.

The Politics of Pet Food

Sep 9, 2008

By Sarah Arnquist Petfoodpolitics

In a new book "Pet Food Politics," Marion Nestle uses last year’s pet food safety scare to highlight the importance of a sound food safety regulation system. As she puts it, “Advocacy for policies good enough to protect pets also means advocacy for policies that protect people."

The Economist reviewed the book and interviewed Nestle, a professor of nutrition, food studies, and public health at New York University. Nestle said the pet food scare can be viewed as the "Chihuahua in the coal mine" in that it serves as a warning of our national and international food safety system.

The pet or animal food systems cannot be separated from the human food system for several reasons, Nestle said. Thus, the lessons from the contaminated pet food is a lesson for us all that:"We have a food safety system in the United States that is not adequate."

Palin’s health care sense on target

Sep 8, 2008• 29

By Don Johnson Palin

Alaska’s Sarah Palin, who is running for vice president with Sen. John McCain, has better health care policy sense than Sen. Barack Obama and his running mate, Sen. Joe Biden.

Palin has pushed for less regulation of health care providers and more competition, while Obama and Biden are pushing for socialized medicine and ultimately a single-payer plan patterned after the failed systems in Canada and the U.K.

Her approach, which is described here by the Washington Post, is supported by many physicians and advocates of a pro-competition approach to health care and health insurance market reforms, and it will be opposed by executives and employees of entrenched hospitals and local health care monopolies and ologopolies who don’t want to lose business to independent clinics and specialty hospitals.

Sarah Palin’s limited health care record staunchly free market

Sep 8, 2008

By Robert Laszewski

Republican vice-presidential candidate Sarah Palin has very little
on her health care policy resume from her short time in office as
Alaska’s Governor but what she does have fits right in with Senator
McCain’s strategy to use the market more effectively in bringing down
America’s health care costs and improving access to the system.

Her health care efforts have focused on two things in Alaska:

Eliminating the 1970s era strategy of requiring providers to
file Certificate of Need (CON) applications before being able to build
more health care facilities.

Providing consumers with more information.

Continue reading "Sarah Palin’s limited health care record staunchly free market."

Where does Sarah Palin stand on children’s health coverage?

By Jocelyn Guyer

The entire country now has heard about how Sarah Palin and her
husband knew in advance that their son, Trig Palin, would be born with
Down Syndrome. The Palins also must have known that they would have
health insurance and the financial resources needed to pay for the
extensive medical care Trig is likely to need throughout his life.

Here is 3-year old Emily Demko, another child with Down Syndrome, who lives with her
family in Ohio. The family has given permission to share this photo of their beautiful daughter and the story (details here) of their trials securing health coverage for Emily. As of this spring, Emily was uninsured. Due to her Down Syndrome,
the family could not find a private insurer willing to offer them
affordable coverage for Emily. If the Bush Administration had not shut
down Ohio’s efforts to expand its State Children’s Health Insurance
Program (SCHIP), Emily would have been able to continue to secure
decent, affordable public coverage. But the Bush Administration in
August of 2007 issued a controversial ban on coverage of children in moderate-income families and twice vetoed bills to reauthorize and expand the SCHIP program.

Continue reading "Where does Sarah Palin stand on children’s health coverage?

Emily’s mom responds to comments

I would like to introduce myself as the mother of the child portrayed in the story above. I can assure you, it is NOT a B.S. story, and our income is several thousand less than $75k per year. As a matter of fact, we were less than $200 away from Medicaid eligability! I live in southeast Ohio, where the median income is less than $42K per year. Also, my daughter has no option of private health care, since she has a genetic condition. The group plan I was part of when she was born did not want to continue full coverage on her because the medical bills were so extensive. we ARE a working class income family, we both work hard to provide, yet we have NO ACCESS to health care for our daughter. Her medical bills would astound you, sir. I pay what I can every month, and pray that I can continue giving her the best medical care I can. I am sure that Gov Palin will never see a $100 bill for 20 min of speech therapy, or a $22,000 bill for a 6 day hospital stay. Neither will her grandchild. They will always be covered, and we as taxpayers would foot that bill if she were to be elected. How is that not an upeer middle class person bilking the federal government?

Rising health benefits costs slowing

Sep 8, 2008• 2

By Jane Sarasohn-Kahn

Health benefit costs will increase in 2009 by just under 6 percent. This would be a slightly slower rate compared with the past several years, according to Mercer, the benefits consulting firm that calculated health cost growth of about 6 percent each year since 2005.

Mercer’s finding that health benefits costs are slowing down next year echoes the same message previously delivered by Aon, and covered here in Health Populi in August. However, Aon projected nearly 10 percent health cost growth.

Mercer forecasts that 5.7 percent would be the lowest increase in more than 10 years.

Around the Web in 60 Seconds (Or Less)

Sep 8, 2008• 1

By Sarah Arnquist

ELECTION 2008: Stateline.org has a useful Web tool to compare synopsis of McCain and Obama’s stance
on issues ranging from health care to abortion to the environment. Despite the fact both candidates barely mentioned health care reform at their respective party’s conventions, Stateline says health care remains a top issue.

More election coverage: The New York Times on Sunday examined what Republican VP nominee Sarah Palin’s really may do for children with disabilities in office given her record, and on Monday the Times zeroed in on her motherhood, including the fact that she was "leaking amniotic fluid" while giving a speech in Texas to support building a natural gas pipeline through Alaska.

WSJ Health blog reports on Sen. Chuck Grassley’s persistent pressure on nonprofit hospitals, demanding to know why they deserve their tax breaks.

The FDA has published online medications currently under investigation for possible safety concerns, the Associated Press reported. The list includes 20 medications and their possible side-effects or warning signs. Examples of drugs on the list are Heparin for possible "Anaphylactic-type reactions" and Seroquel for "overdose due to sample pack labeling confusion."

Single-patient hospital rooms don’t obviate need for attitude shifts on safety and quality

Sep 8, 2008

By Paul Levy

JAMA published an article Aug. 27 by Toronto doctors Michael Detsky and Edward Etchells called "Single-Patient Rooms for Safe Patient-Centered Hospitals." Abstract here. (As usual, JAMA does not allow free access to public policy articles. When will they start to do that, I wonder?)

Here’s the summary:

Clinicians should advocate for single-patient rooms in any new hospital construction, expansion, renovation, or redesign. Single-patient rooms are permanent physical features that potentially could improve safety and patient satisfaction without the need for ongoing staff training, audits, or reminders. Money spent on capital costs to improve patient care may be more efficient than money spent on changing hospital culture and the behavior and attitude of health professionals. It is not necessary to wait 50 years for existing hospital structures to deteriorate before the full potential of single-patient rooms can be realized.

I do not disagree about the attributes of single-patient rooms, in terms of infection control, patient satisfaction, and optimal use of rooms for a diverse mix of patients. Also, they are strongly recommended in guidelines of the American Institute of Architects. I believe they will result in higher capital costs (and therefore higher annual carrying costs), but I do not think it likely that they will generate savings or efficiencies commensurate with those capital costs. In other words, they may not have a good rate of return, in strict financial terms, but they clearly will be the standard for new construction and renovations.