Since this is my first time hosting the Health Wonk Review, I really didn’t know what to expect. I have to say that I’ve learned a lot while poring over the insight and wisdom of my fellow bloggers. Fortunately, this week’s entries fell into neat categories:
- In-Store Clinics
- Problems — U.S. & World Health Systems
- Solutions — U.S. & World Health Systems
- Cats, Dogs and Kangaroos
Just in case that last category, doesn’t look too familiar, let’s revisit the whole point of the Health Wonk Review:
Health Wonk Review is a biweekly compendium of the best of the health policy blogs. More than two dozen health policy, infrastructure, insurance, technology, and managed care bloggers participate…
There were a few entries that didn’t “quite” meet this definition, and I’ve included some of the best in the last category.
To get your blood flowing right from the start, Dr. Roy Poses and Henry Stern are on opposite sides of the spectrum on in-store clinics.
My biggest concern is that these clinics may fail to provide good care to some of their patients, particularly patients who have more serious problems masquerading as or accompanying one of the limited ailments which the clinics claim to handle….I am afraid that the people touting in-store clinics and similar business-think based fads are too preoccupied with the brilliance of their business models to appreciate how the health care context may make the model unworkable.
The idea is to move away from traditional (and expensive) delivery models for routine care, and toward more economical, cost-effective ones….It’s not clear why such delivery systems would be “controversial,” except to those who have a vested interest in the older model.
Isn’t America great?
Maggie Mahar at the Health Beat blog asks about Health Care Spending: The Basics; How Much Do We Spend on Physicians Services? Could We Spend Less? She observes that while the percentage of our nation’s $2.1 trillion health care bill has increased slightly from 19.4% to about 22%
…not all physicians are prospering… A committee dominated by specialists updates the fees Medicare pays physicians on a regular basis. Not surprisingly, specialists are paid considerably more than generalists.
Brian Klepper writing at Matthew Holt’s The Health Care Blog describes Four Big Trends, #2 of which relates to relates to Medicare’s release of data about physicians. He calls the trend “Consumer Checkbook v HHS”, referencing consumer advocacy organization Consumers’ Checkbook winning a Freedom of Information lawsuit against the US Department of Health and Human Services (HHS).
The Checkbook case is a watershed moment for physician transparency. Until now, despite all the calls from supposed “market-advocates” for informed consumerism in health care, the public has had no way to really tell how a doctor compares to his/her peers in terms of resource consumption or results. If the data were released, evaluated and publicly reported, one important part of health care could begin working like a competitive market.
Targeting fellow physicians, Dr. Jose DeJesus at the Physician Entrepreneur puts a positive spin on consumer ratings of physicians. In Physician Rating System Supported by Governor Cuomo he suggests that “you can use these reviews as a barometer for the way your practice is perceived by your patients. Take the time to peruse them and implement changes as you see fit.”
At HealthBlawg attorney David Harlow offers perspectives about how to stay out of jail by not sharing money inappropriately with physicians. In Gainsharing: implications of the latest OIG advisories, he elucidates that the Office of Inspector General’s latest gainsharing advisories are more of the same: virtually identical to the first eight. To those who say “just add a safe harbor and stop the case-by-case review” he responds “why focus a reg on such a narrow slice of P4P?”
For those that just want the nuts and bolts about YOUR doctor, Sagar Satapathy at NOEDb (Nursing Online Education Database) writes about 12 Tools to Do a Background Check On Your Doctor. She also recommends the “Consumers Checkbook Guide to Doctors.”
At Neil Versel’s Healthcare IT Blog, journalist Neil mulls over the pros and cons of attending the upcoming HIMSS conference — an event which attracts over 20,000 people. In My HIMSS wish list he notes that his personal focus is going to be on physician practices rather than hospitals — “applications like web-based patient portals, electronic medical records, telemedicine, clinical decision support and mobile systems”.
We know Neil takes his job seriously. He concludes: “Last year, I wore a pedometer and clocked at least 12 miles during the conference.”
Problems — U.S. & World Health Systems
Daniel Goldberg at the Medical Humanities Blog writes On Preventable Death. He cites a new study released in Health Affairs which found that out of 19 industrialized nations, the U.S. ranked “dead” last in preventable deaths:
IMO one of the primary factors is that the U.S. does not allocate adequate resources to preventive medicine and public health….there is excellent evidence that such interventions are likely to have a much greater effect on population health than acute care interventions.
Jason Shafrin at Healthcare Economist comments on another Health Affairs article in his post Seven Country Health Care Survey. He references timely statistics that 1/3 of Americans believe that we need to “rebuild completely” our health care system, a higher proportion than in any of the other countries; people in The Netherlands were the most satisfied, with only 9% of respondents supporting the need to rebuild completely. He suggests that
“it seems that Americans are not happy with the quality of care they receive. One reason, is that Americans are paying more for their health care. We pay more as a society, but probably more importantly for these ratings, Americans pay more out-of-pocket when they do fall ill.”
Louise Norris at Colorado Health Insurance Insider writes a movie review in Breaking News – A Sicko Review. “If Moore’s movie has caused people who didn’t understand how health care works in other countries to question our own system, then I consider it a success. We can’t fight for something that we don’t understand.” (See what happens when you have all that fresh air and mountains in your back yard to distract you! Next week’s review — Gone With the Wind).
Solutions — U.S. & World Health Systems
In a posting that opened my eyes, Joe Paduda at Managed Care Matters asks Why don’t the GOP candidates want universal coverage? First he references statistics documenting that a majority of registered Republicans favor universal coverage. He argues that “the failure to grasp the universal coverage plank looks to be a missed opportunity” and concludes that “the GOP’s candidates are out of touch with the electorate”.
…in the total amount of money spent it is actually the cheapest plan, it’s just that money comes from the government and your taxes, rather than being paid to an insurance company …Personally, if I have to pay $500 more taxes a month, but don’t have to send Aetna $1,000 a month, I’m feeling mighty far ahead.
In the category of beware of what you ask for because you might just get it, Sam Solomon at Canadian Medicine points to an unintended consequence of universal healthcare. Is universal healthcare an illegal, dangerous monopoly? One Ontario lawsuit argues ‘yes’. Concluding that this is relatively uncharted territory in Canadian jurisprudence, he explains that the plaintiff’s
…lawyers insist Ontario’s universal healthcare system is putting citizens’ lives in danger. (OHIP provides universal healthcare insurance; OHIP has a monopoly over healthcare insurance; monopolies are detrimental to the public good; ergo OHIP is detrimental to the public good.
Newcomer Dr. Jaan Sidorov at Disease Management Care Blog addresses Prospects for Health Reform and Disease Management. Similar to the issue of Health IT, DM is one of those rare initiatives that gets support from both sides of the aisle:
…it’s remarkable how much apparent agreement there is across the political spectrum on the need to develop “programs” for persons with chronic illness. While the details have yet to be worked out and then there is the matter of Congressional buy-in, it seems that no health care reform proposal will be complete without some type of “disease management” in it.
Anthony Wright of Health Access California discusses state health care reform measures in Massachusetts and California. His essay — More on Massachusetts, and comparing to California…. — is a quick update summarizing a longer report that compares and contrasts the reform that passed in Massachusetts in 2006, and the pending proposal in California. The post cites a “top ten” of major differences, suggesting that California’s effort would go far beyond the Bay State.
David Williams at MedTripInfo wonders Are HSAs ideally suited for medical tourism? Not really.
It seems like a no-brainer: patients in consumer directed health plans –which combine a Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA) with a high-deductible PPO – should be early adopters of medical tourism…. (however) in a traditional CDHP, the patient is indifferent to the cost once their HSA balance is exceeded. There’s often literally no difference in out-of-pocket costs for a $7,000 surgery and a $60,000 surgery. That’s why CDHPs have been such a failure in curbing surgical and major medical costs.
Cats, Dogs and Kangaroos
Not even HWR is immune from spam. Here are a few of the submissions that didn’t “quite” make the list:
- Kangaroo Meat – Good For You AND the Environment
- How to Overcome Procrastination in 8 Easy Steps
- Hyperhidrosis Treatment Advice and Options
- Why Your Gym Membership May Be Wasting You Over 2 Hours A Week
- Signs of a Yeast Infection during Pregnancy, and Penile Yeast Infection Remedy (there goes the PG-13 rating….)
“Are these real?” you ask. I couldn’t make this stuff up. If you have a complaint about my leaving out any of these entries, click here.
Sharpen your pencils…the next issue of HWR will be hosted by David Williams at the Health Business Blog. The deadline for submissions is February 6, 9 AM EST. Write David at firstname.lastname@example.org or submit through the Blog Carnival form.
On behalf of all my fellow wonkers, thank you for allowing us to indulge you with our pontifications!
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Tags: business model, conference, disease management, eHealth, health plan, health reform, HIMSS, hospital, Medicare, P4P, population health, telemedicine