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

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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.





How Do You Get People Who Can Afford it to Buy Health Insurance?

21 01 2008

Do you scare the dickens out of them? I’d like to meet the creative team behind this commercial brought to the people of Ontario, Canada by their Workplace Safety and Insurance Board. (this video is definitely not for sensitive viewers, although you might just see it on TV if you’re channel surfing in Ontario)





Dispatches from the Field – January 21, 2008

21 01 2008

For Every Vice, There’s a Price
As part of an ongoing effort to curb the runaway cost of providing health benefits, a small but growing number of companies are charging workers for habits like smoking, overeating and failing to exercise.
http://money.cnn.com/2008/01/15/pf/102902056.moneymag/index.htm?postversion=2008011510

The Truth About Mandatory Health Insurance
WSJ Op-Ed – typically hard nosed WSJ editorial about getting people coverage, but some good points about catastrophic vs. comprehensive insurance for young people.
http://online.wsj.com/article/SB119941501118966929.html

A Health-Insurance Solution
The Health Care Choice Act would allow residents in one state to buy health insurance that is available in and regulated by another state.
http://online.wsj.com/article/SB119742880091722751.html?mod=sphere_ts

Employers Tell Workers To Get Healthy or Pay Up
In an effort to motivate workers to kick unhealthy habits, U.S. companies are hitting them where it hurts: in their wallets.
http://online.wsj.com/article/SB119674051866712859.html?mod=sphere_ts





The Nation’s Health Dollar

7 01 2008

dollars1.jpg

“Physician and Clinical Services” includes offices of physicians, outpatient care centers, and medical and diagnostic laboratories. “Other Spending” includes dentist services, other professional services, home health, durable medical products, over-the-counter medicines and sundries, public health, other personal health care, research, and structures and equipment. Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group.





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





Who Is Involved in the IT Selection Process at Your Health Care Facility?

4 12 2007

Forty-two percent of nurses spend four or more hours a day using IT, but just 15% of staff nurses and 27% of nurse managers are involved in the IT selection process at their facilities, according to a survey of nurses by CDW Healthcare.

Survey results

Results are based on a July 2007 online survey of 1,028 nurses from a variety of health care settings.

 For complete story, click here.