Dispatches from the Field, 2/25/08

26 02 2008

For better or worse, these are the kinds of hard discussions we have to have as we look at our options for the ailing healthcare system:

Prevention is Good Medicine, but it’s Not a Fiscal Panacea
Prevention saves lives; it is the right thing to do. But prevention does not save money

http://blogs.usatoday.com/oped/2008/02/prevention-is-g.html

One of my favorite economists is Dean Baker. His “Beat the Press” Column tackles the ignorance and hidden agendas in economics. As you can imagine, there’s a lot of material when the issue is the economics of healthcare!

When it Comes to Health Care the NYT Is Protectionist

Just yesterday the NYT editorial board was complaining about the threat of protectionism in discussing Senator Obama and Clinton’s trade policies. Today, the editorial board discusses Medicare’s financial problems and never once mentions the extent to which this is caused by protectionism.

The basic point is very simple. Every other wealthy country provides high quality health care at a far lower price than in the United States. If we want to lower cost then an obvious way would be to try to take advantage of these lower cost systems. It is easy to develop mechanisms that would allow for Medicare beneficiaries to take advantage of lower cost systems.

The argument for the gains from trade in medical services is exactly the same as the argument for gains from trade in cars and clothes (we can even use the same graph, we just have to relabel the axis), except the benefits are likely to be much larger in the case of medical care. It is inconsistent for the NYT to be so committed to eliminating trade barriers in manufactured goods but willing to tolerate much costly barriers to trade in medical services.

http://www.prospect.org/csnc/blogs/beat_the_press_archive?month=02&year=2008&base_name=when_it_comes_to_health_care_t

In the interest of full disclosure, it should be noted that I am working on the Austin health insurance program mentioned in this article.

Texas Urban Areas Work to Bring Three-Share Programs to the Working Uninsured

HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that five Texas urban areas — Austin, Dallas, El Paso, Galveston and Houston — have made various levels of progress toward forming health benefit pools
authorized last year by the Texas legislature. According to the latest Texas Health Plan Analysis, these three-share health benefits programs are designed to provide coverage access to small businesses who feel they have been priced out of the healthcare market.

http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/02-26-2008/0004762435&EDATE=

This is shaping up to be a disappointment. The new office created by the FDA “will not get the ultimate power to sign off on label changes or recommendations to remove a drug from the market.”

FDA Unveils Plan to Boost Oversight of Drugs Once They Are on Market

The Food and Drug Administration unveiled a new effort to bolster its oversight of drugs after they’re on the market, in the agency’s latest response to years of criticism about its handling of medication safety issues.

http://online.wsj.com/article/SB120405750657094407.html?mod=wsjagent





An Oldie But a Goodie: Escape Fire

27 01 2008

Here’s a link to a personal review I wrote for Don Berwick’s Escape Fire: Designs for the Future of Health Care. If you haven’t read it, I highly recommend it for setting the context and the mission.





Dispatches from the Field – January 2, 2008

2 01 2008

Hospitals Slow in Heart Cases, Research Finds

In nearly a third of cases of sudden cardiac arrest in the hospital, the staff takes too long to respond, increasing the risk of brain damage and death, a new study finds.

Researchers estimate that the delays contribute to thousands of deaths a year in the United States.

http://www.nytimes.com/2008/01/03/health/research/03heart.html?ex=1357016400&en=3d9a627e28ec54c9&ei=5088&partner=rssnyt&emc=rss

Fewer Small Firms Offer Health Insurance

Fewer small employers offered health insurance this year, despite the widespread availability of new, lower-cost high-deductible insurance plans, a survey released today by benefit firm Mercer shows.

Advocates of the high-deductible plans touted them as one solution to the growing number of uninsured, expecting the plans to appeal to small employers, who would continue to offer health insurance as a result.

“That’s not happening,” says Blaine Bos, a Mercer partner and one of the study authors. “In fact, the reverse is happening.”

http://www.usatoday.com/money/industries/insurance/2007-11-19-health-insure_N.htm

 

Students Face Health Issues Without Insurance After College

Patrick Rastelli ’08 had hoped to take a year off after graduating from Brown this spring. But after some thought, Rastelli decided to travel last summer instead, and when he graduates, he wants to get a job as quickly as possible. He’s not seeking prestige or money, but rather something most college students take for granted: health insurance.

http://media.www.browndailyherald.com/media/storage/paper472/news/2007/10/29/CampusNews/Graduating.To.The.Ranks.Of.The.Uninsured-3061887.shtml

Report Links Higher Rates of Uninsured and Suicide

The higher the percentage of residents in a state who say they can’t afford health care, the greater the prevalence of serious depression and the higher the suicide rate in that state, suggests a report released to USA TODAY.

http://www.usatoday.com/news/health/2007-11-28-healthcare-suicide_N.htm





Dispatches from the Field – November 21, 2007

21 11 2007

Interest in Wellness Programs Grows: Survey

More employers are providing financial incentives designed to drive employee participation in wellness efforts, a survey shows.

http://www.businessinsurance.com/cgi-bin/news.pl?newsId=11554

Employers Shift Focus to Prevent Obesity

The seven most common chronic diseases — six of which can be caused or worsened by obesity — are costing employers $1.1 trillion in lost productivity, a recent study says.

http://seattletimes.nwsource.com/html/health/2003997221_webobesity06.html

Program Quantifies Costs of Chronic Conditions

It’s no secret that chronic medical problems, such as high blood pressure and low back pain, can mean time off the job. What’s hard to quantify, is how much that absenteeism can cost a company. Until now.

http://www.bizjournals.com/pittsburgh/stories/2007/11/05/story2.html?b=1194238800^1544416

Consultant: Prepare for PHRs

Patients will demand personal health records, so health care organizations should be preparing technology and privacy models now, a consultant specializing in emerging technologies says.

http://www.healthdatamanagement.com/news/personal_health_records_PHRs_privacy_security25179-1.html

Drugstore Clinics Spread, and Scrutiny Grows

“We’ve got big problems in health care, and this is not the answer,” said Dr. Rick Kellerman, president of the American Academy of Family Physicians. “They are a response, they are a niche market and an economic opportunity, but we still have an underlying primary care crisis in this country.”

Patients, however, have flocked to the clinics, according to a new industry group, the Convenient Care Association.

http://www.nytimes.com/2007/08/23/nyregion/23clinic.html?pagewanted=1&ei=5070&en=0b7cd9bcc251d519&ex=1188792000





Dispatches from the Field – August 13, 2007

13 08 2007

Meet the Consumer-Directed HMO

It took a while for a managed care company to combine a consumer-directed plan with a traditional HMO. Health Net of California, taking advantage of the strengths of California’s managed care market, is launching a hybrid product called OptimizerHMO that “provides tools to help [members] make better health care decisions and incentives for demonstrating healthy behaviors,” says Stephen Lynch, president of Health Net.

http://www.managedcaremag.com/archives/0707/0707.news_meetconsumer.html

Health IT Businesses See Rise in Private Equity Investments
Health IT businesses are attracting investors and buyers from private equity firms, a sign that the industry is rife with growth and opportunity, Modern Healthcare reports.

http://modernhealthcare.com/apps/pbcs.dll/article?AID=/20070803/FREE/308030001&SearchID=73289151525029

U.S. Trails 41 Other Countries in Life Expectancy Rates

Life expectancy in the U.S. has reached its highest point ever, but it is exceeded by the rates in 41 other countries, the AP/Arizona Daily Star reports.

http://www.californiahealthline.org/articles/2007/8/13/US-Trails-41-Other-Countries-in-Life-Expectancy-Rates.aspx