Health Wonk Review - Feb. 21, 2008

Let’s start this week by paying homage to Jack Wennberg of Dartmouth Medical School, whose pioneering research has taught health wonks everywhere that more care doesn’t necessarily mean better care. Maggie Mahar at the Health Beat Blog draws attention to his work in a post entitled "Blueprint for Healthcare Reform." She also reprints a long article tracing his career, which is must reading for anyone not familiar with its arc.

Ezra Klein over at The American Prospect website asks Why Insurers Suck, and Five Way to Make Them Better. “It is actually counterproductive for insurers to compete on giving us the best care,” he writes. “It's not simply that they're not doing it, but given the structure of the marketplace, they shouldn't do it.”

For a different political slant, check out Beltway Insider Bob Laszewski’s Health Care Policy and Marketplace Review. He asks this week if Mom, Dad the Kids and Medicare – Would an Obama Presidency Energize Young Adults to Demand Entitlement Reform? . . . . Cutting it down the middle, Joe Paduda over at Managed Care Matters finds some small differences in the Clinton and Obama health care plans that matter. . . . And if you’re in the mood for a knock on consumer driven healthcare, check out David E. William’s post at the Health Business blog where he asks if consumers can really make use of the proliferating amount of data on the web about provider cost and quality.

The daisy chain in pharmaceutical manufacturing exposed via the Baxter International heparin scandal got Health Care Renewal up in arms. “Perhaps the self-appointed geniuses who manage our health care organizations need to re-think their clever business strategies of out-sourcing production to cut costs.”

Rob Cunningham on the hydra-headed Health Affairs blog rounds up the state of play on Health IT (last place in the high-tech division).

Meanwhile, a long list of heavyweights tackles the “sustainable growth rate” physician reimbursement system, which is scheduled for a 10 percent cutback come July and will occupy mucho time on the Congressional calendar as physicians and their professional societies work overtime to make sure that doesn’t happen. Paul Ginsburg, president of the Center for Studying Health System Change, suggests a more accurate relative value scale and better effectiveness research free from political interference (among his other spot-on recommendations).

The Urban Institute’s Robert Berenson (whom I had the pleasure of meeting recently and, IMHO, deserves a louder voice in the health care reform debate) offers an excellent explanation of who’s winning and who’s losing in the current system, and then concludes “payment for generalist physicians needs to increase. Payment for niche specialists can safely be reduced, perhaps with a redesigned expenditure target approach.” Amen to that.

Other offerings in the series include Mina Matin, Thomas Bodenheimer, and Kevin Grumbach on strengthening primary care and Jay Crosson of the Permanente Federation on a payment alternative. Gail Wilensky, senior fellow at Project Hope, will conclude the series, but that’s not up yet.

The Highlight Health Blog takes on the PLoS Medicine study showing that most prevention measures don’t save money for the health care system by pointing out that living healthy isn’t cost saving, but it is a cost effective way of living a longer, more productive life. But Jason Shafrin at the Healthcare Economist read that PLoS study and had a different view, while the Medical Humanities blog by Daniel Goldberg reminds us that the endless debate over health insurance reform forgets that "health and illness are primarily caused by social and economic conditions. It is these root factors that are left virtually unaddressed by acute care."

Meanwhile, Lisa Emrich at Brass and Ivory warns Big Pharma to keep its mitts off her medical records. . . .Lynch Ryan at Workers’ Comp Insider analyzes a proposed ADA Restoration Act to redress Supreme Court decisions that have undercut the definition of who’s disabled in the American Disabilities Act.

The health insurance issue is generating a lot of heat in the states, and you can get a peak at the debate in Georgia from the Insure Blog where Bob Vineyard has details on new legislative efforts to make health insurers justify their rates and a strong opinion on why they're doomed to fail. . . . The Colorado Health Insurance Insider describes how tough it is for women who’ve had infertility treatments to get or remain insured. . . .

On the incentives front, David Harlow’s HealthBlawg sounds off on payers not paying for hospital acquired infections; while the Physician Entrepreneur has some good things to say about corporate and insurance programs that offer bonuses to physicians who “raise the bar” on offering preventive care and better disease management. . . . Meanwhile, Vince Kuraitis at e-CareManagement assures us that the death of Medicare Health Support project, aimed at better chronic disease management, has not been greatly exaggerated.

And finally, Robert Jarvik of artificial heart fame drew lots of heat on the front page of the New York Times and in the blogosphere for promoting Lipitor under false pretenses. Health Care Renewal got some major media play from this post.

Posted by gooznews at February 21, 2008 12:00 AM