Health Wonk Review: Stormy Weather

February 3rd, 2011 by Julie Ferguson

This dramatic satellite shot from NOAA captures the scope of the blizzard that swept across the country in the last few days. Being snowbound offered our contributing bloggers lots of time to think about all things healthcare, and in that arena, the climate is almost as stormy as the weather. The Florida judge’s ruling against the Health Care Act was much on the mind of several of our bloggers, as was the State of the Union address — both of which occurred since our last compilation. We have a lot of good submissions this week – grab a cup of cocoa to take the chill off and dig in.
Managed Care Matters – Hosting has its privileges, so we kick off this issue with a nod to the blogger who did the heavy lifting last issue, Joe Paduda. One thing we love about Joe is that he is never one to mince words, as evident in this week’s submission, Paul Ryan’s blatant hypocrisy – and the abject failure of mainstream media. Joe takes the Wisconsin representative to task, along with most of his colleagues in the GOP and the mainstream media. He finds today’s hand-wringing over healthcare related debt insincere from the same players who ignored yesterday’s elephant in the room. Also see his related post: If health reform is overturned.
The Apothecary (posted at Forbes) – Avik Roy’s post Florida v. HHS: Why Vinson’s Ruling Might Stand offers a detailed discussion of the four components of Judge Vinson’s Monday ruling, with an emphasis on why the lack of a severability clause might be the key factor in overturning the entire law.
California Healthline – With talk of rolling back the Patient Protection and Affordable Care Act dominating the news, Dan Diamond reminds us that this isn’t the first time that Congress has considered overturning a major health law. He wonders if the battle over the 1988 Medicare Catastrophic Coverage Act and its repeal 17 months later mightn’t hold some lessons for today.
Colorado Health Insurance Insider – Louise Norris suggests that any debate on healthcare should be based first and foremost on facts rather than rumors. She puts on her detective hat in considering whether a Colorado Representative’s vote was swayed by debunked info from an E-mail forward. She thinks the public debate should be informed by a higher standard and offers some clues for spotting suspect chain-mail claims
Disease Management Care Blog – Jaan Sidorov considers Atul Gawande’s recent essay The Hot Spotters and asks if targeted care management is something new? Jann says that while The New Yorker article might garner the glitteratis’ attention, the practice of identifying and reaching out to patients at risk is a standard MO in many commercial insurance plans. “What’s next, Dr. Gawande,” he asks, “discovering that there are machines that use electromagnetic radiation to take pictures of people’s insides?”
Health Affairs Blog -Tim Jost offers an analysis of Judge Vinson’s decision invalidating the Affordable Care Act, while his co-bloggers opine about the implications of the Sate of the Union speech and its aftermath: Kavita Patel on health care and the State Of The Union; Len Nichols who suggests being honest for a change, and Joe Antos with a taste of budgets to come.
Health AGEnda – In his post on the the John A. Hartford Foundation’s blog, Chris Langston poses a good question: Why are Medicare’s innovations more secret than the Joint Strike Fighter?. He champions the idea that we should be more nimble, transparent and collaborative in sharing innovations and improvements in care, particularly in terms of knowledge that we as taxpayers have already purchased.
Health Beat Blog – Maggie Mahar suggests that when it comes to electronic health records, perhaps we should walk before we run. She likens the mad stampede of EHR implementation to a market bubble with too many sellers, too many buyers, and too little information. In light of this, she tackles the question of whether Congress should defund the conversion to EHRs as some are proposing.
Health Business Blog – What makes you sad? For David Williams, it comes down to three words: US biogenerics policy. David makes the case that the debate on biogenerics misses the point: There are better, safer, faster ways to bring down the cost of biotech drugs while preserving incentives for innovation.
Health Care Renewal – Roy Poses makes a strong contribution to this week’s roundup with his post Big Door Keeps On Turning. He lists examples of health care leaders going from government to industry and then back to government again. He asks if this revolving door, with its constant interchange among corporate and government health care leaders, is a sign of how corporatist health care has become and if we can we really expect a cozy corporate leadership class with no fixed loyalty to any organization to put the care of individuals and populations ahead of their personal interests and relationships?
Health News Review Blog – Gary Schwitzer enlists the help of Harry Demonaco, director of the Mass. General Hospital’s Innovation Support Center in turning a critical eye on health screening advice issued by Prevention magazine, which advised readers, “If you haven’t had these cutting-edge screenings, put this magazine down and call your doctor. Now.” This is cited as another bad example of screening madness in US health care journalism, which promotes and fosters screening outside the boundaries of the best evidence.
Healthcare Economist – Jason Shafrin informs us that home health services are among the fastest growing services that Medicare provides. In thinking of reform to control this rise in spending, he turns to MedPAC’s 2011 Home Health Reform Recommendations.
Healthcare Technology News – Rich Elmore and Paul Tuten discuss the launch of pilot projects enabling secure direct messages among healthcare stakeholders in their post about Direct Project implementations taking flight. They offer project details and note that this is a very big deal, as reflected in the related briefing by David Blumenthal (National Coordinator for Health IT), Aneesh Chopra (US CTO) and Glen Tullman (CEO Allscripts) among other federal and industry participants.
healthyimagination – In December, scientists and healthcare professionals shared groundbreaking research an NIH symposium focused on health disparities. Lisa Cappelloni shares some of the novel approaches aimed at eliminating health inequities in her post Advancing Minority Health: New Minds, New Methods.
The Hospitalist Leader – Bradley Flansbaum offers A Hospitalist’s Lament, a thoughtful essay on the issue of end of life care and advance directives. In the light of controversies like death panels and care rationing, he states that our country may be at least a decade or two away from having a sophisticated discussion on this subject. He illustrates the complexity of the surrounding issues through an intriguing exercise conducted with his colleagues.
Improving Population Health – David Kindig is another contributor who listened closely to the State of the Union address, and asks if one could find any mention of population health, public health, or prevention in the speech. While he didn’t hear those phrases directly, he was heartened by the speech addressing two major drivers of health — education and jobs.
The Incidental Economist – Austin Frakt says that cost shifting is not well understood and has become a political football. He sheds light on the topic in the first of a series of posts: Hospital cost shifting: Brief history and possible future.
Insure Blog – As the oft-quoted Andy Warhol line goes, we will all have our 15 minutes of fame. But in the world of insurance, fame may be measured in cents rather than minutes, if Hank Stern’s post about Ceridian’s 2-cent Moment is any measure. In this case, the company made headlines when a cancer patient was denied coverage over a 2 cent shortchange. Or was there more to this story than the headlines? Hank digs a little deeper and offers his two cents on the matter. (Oh, and kudos to Hank & crew for Insure Blog’s 6 year blogiversary – quite the landmark!)
John Goodman’s Health Policy Blog – In his post The Case For Health Insurance, John states that everyone should have access to health insurance, and notes that real insurance involves a pooling of risks. “The insurer must make sure each new entrant to the pool pays a premium that reflects the expected costs that entrant brings to the pool. Otherwise, the insurer won’t be able to pay claims. The business of insurance is the business of pricing and managing risk.”
The Notwithstanding Blog – Genomic medicine, end-of-life care, and rationing are three “hot” areas of medicine and health policy in which much stock is given to the opinion of bioethicists. Our blogger at the Notwithstanding Blog (written by a first-year medical student) says that he has a bad feeling in observing the near-uniformity with which the bioethics establishment has opposed medical advancement and patient empowerment, and uses the lens of public-choice analysis to argue that the deference shown to their prescriptions is at least partially misplaced.
Pizaazz – In his post about how early career physicians use Facebook, Glenn Laffel reviews a study that should give some comfort to those who worry that physicians will misuse the social networking site by failing to protect patients’ protected health information.
Workers Comp Insider – In the niche area of occupational illnesses and injuries, Jon Coppelman demonstrates that some villains contributing to skyrocketing health care costs might lie entirely outside the delivery system. He examines the curious spike in carpal tunnel injuries reported by guards at an Illinois correctional facility in his post John T. Dibble’s Sympathetic Ear.
That wraps up this issue! Next up to bat: Louise Norris at Colorado Long Term Care Insider on February 16!

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