MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'costs,'. Tue, 13 Oct 2009 17:51:43 +0100 http://www.medworm.com/index.php?rid=2882972&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F12%2Fthe-proposed-framework-for-quality-accounts%2F Title: Mental health factsheet: Patient safety The Skinny: Asks for views on the DH proposals for a framework for Quality Accounts, to inform the NHS Confederation response to the DH. Key issues are: Quality Accounts will be a requirement from 2010. In the first year, NHS trusts, foundation trusts and their private/voluntary sector equivalents will provide a Quality Account. They will be introduced for the primary and community care sectors from 2011. The estimated cost for a provider to produce a Quality Account is £14k–£22K. Boards will be responsible for the accuracy and completeness of their Quality Account and for compliance with regulations and guidance. There are a number of key issues where the DH is seeking input and it is imperative that the view of the service is ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2882972 Mon, 12 Oct 2009 14:04:09 +0100 2882972 http://www.medworm.com/index.php?rid=2882978&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F12%2Fhealth-service-journal-2009-1st-october%2F Fade Fade: Recession means PCTs must make ‘hard choices’ on spending Fade Skinny: Primary care trusts will have to make some tough decisions on how to prioritise spending during the recession, according to NHS Confederation Primary Care Trust Network director David Stout. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: Costs, Current Awareness, Journals, Primary Care Trusts (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2882978 Mon, 12 Oct 2009 09:55:26 +0100 2882978 http://www.medworm.com/index.php?rid=2882985&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F12%2Farchives-of-general-psychiatry-2009-vol-66-no-10%2F content page Fade Fave: Incremental Benefit and Cost of Telephone Care Management and Telephone Psychotherapy for Depression in Primary Care Fade Skinny: Effectiveness of organized depression care programs is well established, but dissemination will depend on the balance of benefits and costs. The Objectives were to estimate the incremental benefit, incremental cost, and net benefit of 2 depression care programs. NHS Athens is required to access this article online Posted in Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Costs, Current Awareness, Depression, E-Journals, Primary Care, Telephony (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2882985 Mon, 12 Oct 2009 08:40:28 +0100 2882985 http://www.medworm.com/index.php?rid=2879387&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F9GV5LzGBeX0%2F The Senate Finance Committee’s health-overhaul bill leaves in place a planned 25% cut in Medicare payments to doctors in 2011. Congress probably won’t allow this to happen; lawmakers will likely swoop in, as they’ve done repeatedly in recent years, and block the planned cuts. But when CBO does its projections, it doesn’t take into account what Congress is likely to do — it looks only at the laws as written. That means that the much-discussed CBO estimates for the Senate Finance bill will only hold true if Congress allows the cuts in Medicare payments to doctors to go through. CBO said as much in its estimate this week, writing: The … mechanism governing Medicare’s payments to physicians has frequently been modified (either through legislation or adminis... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2879387 Fri, 09 Oct 2009 21:07:28 +0100 2879387 http://www.medworm.com/index.php?rid=2876004&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZ-JAP0f0IAI%2F A post from Kristina Peterson of WSJ’s Washington Wire blog: The inventor of the recently much-maligned MRI machine said today his creation has taken enough abuse in the national debate over how to reduce health care costs. “Naturally it annoys me,” said Raymond Damadian, who built the first magnetic resonance imaging machine prototype in 1977. “We’re saving lives the world over.” Using the machines isn’t cheap, and in the war to whittle down the price of health care, politicians have targeted diagnostic imaging machines. The Senate Finance Committee bill would reduce funding for doctors using imaging tests, though the cuts are less severe than first proposed by President Obama. MRIs use magnetic field and radio waves to help create high-resolution images of body organs and tis... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2876004 Fri, 09 Oct 2009 00:50:45 +0100 2876004 http://www.medworm.com/index.php?rid=2876021&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fymn1_XTNQfs%2F The Congressional Budget Office released a report this week that revealed that the proposed health care bill would not increase the deficit.  But is it that simple? Cato health care policy experts have examined the bill and added up the costs. Here are a few things they have found: Congress has been cooking the books: “When it comes to the health care reform debate…honest budgeting is nowhere to be seen.” Costs will only decrease if we give market forces room to breathe. How some in Congress are hiding the true costs of the health care overhaul. Healthy Competition: What’s Holding Back Health Care and How to Free It Podcast: Do You Smell the Books Congress is Cookin’? (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2876021 Thu, 08 Oct 2009 16:33:40 +0100 2876021 http://www.medworm.com/index.php?rid=2876024&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fz3uyza6fyC4%2F The CBO report that said the health care bill won’t raise deficits makes it clear that the Baucus bill’s reduction in future budget deficits comes not from controlling government spending or reducing health care costs, but because of a rapid escalation in tax revenues. The bill imposes a 40 percent excise tax on health-insurance plans that offer benefits in excess of $8,000 for an individual plan and $21,000 for a family plan. Insurers would almost certainly pass this tax on to consumers via higher premiums. As inflation pushes insurance premiums higher in coming years, more and more middle-class families would find themselves caught up in the tax. In fact, overall, the tax increases in the bill are more than double the amount of deficit reduction. This isn’t a health care effici... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2876024 Thu, 08 Oct 2009 14:55:32 +0100 2876024 http://www.medworm.com/index.php?rid=2876009&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F3-9i_KhK03s%2F There’s a new estimate out today from the drug wonks at IMS Health: U.S. prescription-drug sales are likely to rise about 5% this year over last year. That’s a big swing from the decline of 1% to 2% the company projected back in April. Why the shift? We just spoke with Murray Aitken, an IMS exec who works on the company’s forecasts. It turns out that much — but not all — of the projected increase isn’t quite as solid as the numbers suggest. Part of the shift comes from inventory fluctuations at pharamacies. At the end of last year, they were selling more drugs than they were buying, which means they were lowering their inventories — perhaps in anticipation of lower demand, Aitken said. But this year, they stocked back up. In year-over-year terms (... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2876009 Thu, 08 Oct 2009 13:22:22 +0100 2876009 http://www.medworm.com/index.php?rid=2871558&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FEeEFMVdfWyU%2F Cost is a big reason that doctors and Hospitals have been slow to adopt electronic medical records. But it’s not the only one; among other issues, some docs worry that typing information into a computer will make it harder for them to have a good conversation with the patient — to develop a rapport, to figure out what’s really going on. This morning’s USA Today describes a solution the emergency room at the University of Virginia Medical Center came up with after going nearly paperless last fall: People who follow the doctor around from patient to patient, entering information into a laptop. Sort of like a real-time version of dictation, a tried-and-true system for getting doctors’ notes into patient records. The hospital calls them scribes and docs, apparentl... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2871558 Wed, 07 Oct 2009 14:15:56 +0100 2871558 http://www.medworm.com/index.php?rid=2865632&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fi9ULU-_nNnQ%2F If there’s any way out of our current health-care morass, it’s this: In health care, more expensive care is often no better than less expensive care. We were reminded of this fact by a front-page story in this morning’s WSJ, which points out that Pennsylvania is the rare state that requires hospitals to publicly report a wide range of data — and those data show hospitals with good outcomes are often cheaper than hospitals with bad outcomes, even after you adjust for the patient mix. While Pennsylvania’s reporting requirements are unique, the core lesson here is familiar. As we noted last year, Wyoming coal companies figured out that they could save money by sending their workers to fancy facilities like the Mayo Clinic. Lower costs at better hospitals is partl... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2865632 Tue, 06 Oct 2009 12:55:44 +0100 2865632 http://www.medworm.com/index.php?rid=2862461&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIEZnfztJ_Kk%2F The story so far in Massachusetts: State implements near-universal health insurance coverage; costs rise sharply; state panel calls for replacing fee-for-service payments with fixed, per-patient payments. The latest development: Doctors’ and hospital groups have been warning state officials that ending fee for service within five years, as the panel recommended, could cause havoc in the state health-care system, the Boston Globe reports. “It can’t be forced on everyone,” the president of the Massachusetts Medical Society told the Globe. “You’ll force [doctors] out of business.” The CEO of the Massachusetts Hospital Association, who was on the panel that proposed the new payment system, called for certain protections for doctors and hospitals. She also s... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2862461 Mon, 05 Oct 2009 15:06:50 +0100 2862461 http://www.medworm.com/index.php?rid=2865610&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fpop-the-cost-bubble-unallot-medicare.html By Victor M. Sandler, MD Here’s a dirty little secret: Cutting health care costs is not that difficult, nor will it harm patients. That’s because it only involves giving up unnecessary medical care—tests and treatments patients may want but really... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2865610 Sun, 04 Oct 2009 23:00:00 +0100 2865610 http://www.medworm.com/index.php?rid=2855538&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FGUTp0IKnrC0%2F Medicare just started reimbursing doctors less for very small amounts of the cancer drug Avastin. Oddly enough, that could mean Medicare will start spending lots more money on the eye drug Lucentis. Here’s why. Lucentis and Avastin are very similar molecules. A few years back, before Lucentis was on the market, eye doctors realized that they could inject Avastin in patients’ eyes to treat macular degeneration, a condition that can lead to significant loss of vision and occurs mostly in the elderly. Avastin costs tens of thousands of dollars to treat cancer patients, but the tiny dose doctors inject into patients’ eyes costs a very small fraction of that –the specialty pharmacy chain The Apothecary Shops repackages Avastin for use in the eye and sells it to doctors ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2855538 Fri, 02 Oct 2009 13:28:54 +0100 2855538 http://www.medworm.com/index.php?rid=2855534&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F10%2F01%2Fmassachusetts-health-reform-employer-coverage-from-employees-perspective%2F As Congress and the Administration debate health care reform, it is instructive to look at the Massachusetts model, now in its third year. Health Affairs today released a study of workers in the Bay State who were interviewed in fall 2008 about their employer-sponsored health care coverage, following up on similar surveys in 2006 and 2007. Despite predictions that employers could reduce coverage or benefits under health reform, the results suggest the opposite, although premiums and out-of-pocket costs have increased for some employees in smaller companies. These findings are the latest in a series of updates on implementation of the Massachusetts reforms funded by the Blue Cross Blue Shield of Massachusetts Foundation, The Commonwealth Fund, and the Robert Wood Johnson Foundation. The res... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2855534 Thu, 01 Oct 2009 20:33:25 +0100 2855534 http://www.medworm.com/index.php?rid=2865612&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fby-don-kemper------should-we-incent-or-requireproviders-to-prescribepatient-decision-aids--should-we-incent-or-requireconsum.html By DON KEMPER Should we incent or require providers to prescribe patient decision aids? Should we incent or require consumers to use patient decision aids? Overtreatment is the most celebrated cause of runaway health care costs, but we shouldn’t blame... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2865612 Wed, 30 Sep 2009 23:00:00 +0100 2865612 http://www.medworm.com/index.php?rid=2846340&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FbfuABJoJzMM%2F If you think U.S. health-care spending is out of control today, just wait a decade. A (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2846340 Wed, 30 Sep 2009 17:37:32 +0100 2846340 http://www.medworm.com/index.php?rid=2846343&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZSQ2FISpNlY%2F There’s been a lot of focus – including in my column today – on the subsidies that the health-overhaul bills would provide to aid lower-income people in paying their health insurance premiums. But there’s another twist that may matter just as much to consumers: how much help those same folks will get with their out-of-pocket costs. This varies between the different bills now working their way through Congress. And as lawmakers try to crunch costs, these subsidies may be easier to trim because they’re less visible than the premium subsidies. The House bill, at least in its current incarnation, would provide credits that would rein in out-of-pocket costs for people between 133% and 350% of the federal poverty level, which is around $38,000 for an individual and about $77,000 for a fami... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2846343 Wed, 30 Sep 2009 11:50:02 +0100 2846343 http://www.medworm.com/index.php?rid=2842467&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F29%2Fhealth-service-journal-2009-10th-september%2F Fade Fade: ‘Unpopular NHS spending decisions should fall to PCTs’ Fade Skinny: Unpopular decisions about NHS spending should be made locally by primary care trusts, the Social Market Foundation said.The foundation’s health researcher Barney Gough said the McKinsey report had highlighted the scale of the challenge and some “unpalatable choices” that had to be made. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: Costs, Current Awareness, Decision Making, finance, Journals (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2842467 Tue, 29 Sep 2009 12:04:10 +0100 2842467 http://www.medworm.com/index.php?rid=2838898&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F1nZ1SshkJ3I%2F Efforts to provide universal health insurance will result in higher premiums for the young and healthy in order to subsidize the older and sicker, according to an op-ed piece in today’s WSJ. Such a move is essentially income redistribution, argue the authors Michael Leavitt, former secretary of Health and Human Services, and Al Hubbard and Keith Hennessey, who both served as past directors of the White House National Economic Council. President Obama envisions that insurers will have to cover the sick, and lifetime caps on medical costs will no longer exist. If these elements become reality, then young healthy people could have a safety net against future catastrophic health costs. But they will end up subsidizing older and sicker people, according to the authors, and many may still... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2838898 Mon, 28 Sep 2009 15:39:44 +0100 2838898 http://www.medworm.com/index.php?rid=2828153&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fby-don-kemper------should-we-incent-or-requireproviders-to-prescribepatient-decision-aids--should-we-incent-or-requireconsum.html By DON KEMPER Should we incent or require providers to prescribe patient decision aids? Should we incent or require consumers to use patient decision aids? Overtreatment is the most celebrated cause of runaway health care costs, but we shouldn’t blame... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2828153 Wed, 23 Sep 2009 23:00:00 +0100 2828153 http://www.medworm.com/index.php?rid=2823953&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FMivduSGu4d0%2F Should more troops be sent to Afghanistan? Cato’s Malou Innocent weighs in alongside the policymakers. What does the end of the missile defense system in Central Europe means for U.S.-Russian relations? Signals indicate that the market just might be on the rebound. That’s great,  but it’s important not to get ahead of ourselves, says Johan Norberg.  “We must never forget that the light at the end of the tunnel can be an approaching train.” A few thoughts on the new rise of the Taliban in Afghanistan, and what it means for Pakistan and India. Michael Cannon continues his debate in the LA Times: The dirty little secret is that “Obama-care” isn’t about reducing health care costs or making coverage more secure. It’s about robbing... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2823953 Wed, 23 Sep 2009 18:02:52 +0100 2823953 http://www.medworm.com/index.php?rid=2823929&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Freform-means-higher-costs-not-lower.html By JOE FLOWER A reader asks: "If the current bill passes are my health insurance costs likely to go up, down, or remain about the same?" If the form that I believe most likely to pass actually passes (insurance reforms,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2823929 Tue, 22 Sep 2009 23:00:00 +0100 2823929 http://www.medworm.com/index.php?rid=2823928&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fa-remedy-for-healthcare-organizations.html By PAUL LUNDY, VP, Xerox Global Services The switch to electronic health records can be a daunting task. To make the shift less painful, healthcare organizations should first consider taking control the number of documents flowing through the organization –... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2823928 Tue, 22 Sep 2009 23:00:00 +0100 2823928 http://www.medworm.com/index.php?rid=2823948&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FKwlzYfixMTI%2F Health-overhaul advocates turned out across the country today at rallies targeted against insurance companies and promoting a public insurance alternative as part of health legislation. MoveOn.org, Health Care for America Now and labor unions said they organized about 150 gatherings, which followed last month’s raucous town-hall meetings focused on the health overhaul. Today’s protesters took aimat the insurance industry for standing in the way of real health-care change, which many of the demonstrators think should include a government-run health plan. Private insurers have agreed to some concessions –- including taking all comers, regardless of health status –- but oppose a public plan, saying it could disrupt coverage for insured Americans. The Health Blog caught up with the ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2823948 Tue, 22 Sep 2009 20:55:29 +0100 2823948 http://www.medworm.com/index.php?rid=2814392&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FA5rw9LJGQQ4%2F Here’s a question from Newt Gingrich on the op-ed page of the WSJ: What’s the big deal with spending 17% of our GDP on health care? The former speaker of the House and founder of the Center for Health Transformation calls the concern over this number and about spending too much on health care “arbitrary.” After all, he says, the system led to great innovation in the health-care space. The “new bureaucracies” and reduced payments to various medical professionals and industry stakeholders that have been proposed as part of an overhaul to reduce health-care spending will destroy this innovation. He agrees that some basic health reform is necessary — though he doesn’t say what or how — but that it should be achieved through “maximizin... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2814392 Mon, 21 Sep 2009 12:58:31 +0100 2814392 http://www.medworm.com/index.php?rid=2803902&cid=t_255373_87_f&fid=36941&url=http%3A%2F%2Fwww.mazecordblood.com%2Fblog%2F%3Fp%3D270 Expectant parents often wonder when they need to decide if they are going to bank their baby’s cord blood and when they need to register with a cord blood bank.  While you can decide anytime during your pregnancy, we recommend beginning your research early in your second trimester.  You want to have time to examine your options and not feel rushed. You should be able to gather information packets, make any phone calls, check out some unbiased sources and maybe even talk to your pregnant friends and your health care provider. In addition, if you wait until the last minute to register, your cord blood bank may need to charge a rush fee to ensure that your cord blood collection kit makes it to you before the arrival of your baby.  Since even scheduled babies sometimes arrive early, y... Cord Blood News blogs http://www.medworm.com/rss/comments.php?id=2803902 Thu, 17 Sep 2009 16:01:08 +0100 2803902 http://www.medworm.com/index.php?rid=2803870&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FY9B4x_Y_izQ%2F After Brianna Rice, a 17-year-old in the Chicago area, was diagnosed in February with a digestive disorder called celiac disease, her insurer went through the teen’s health history and canceled her coverage that started in November. The reason? There were reports of dizziness, elevated cholesterol, fatigue and cough in her file, according to the Chicago Tribune. “The coverage you applied for would not have been issued for Brianna if we had known this medical history at the time of application,” according to a letter the insurance company, American Community Mutual Insurance, sent the family in May. Insurers say the practice, known as rescission, is necessary to culling out those who have lied about their histories and whose costly care could raise premiums for everyone. ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2803870 Thu, 17 Sep 2009 14:18:14 +0100 2803870 http://www.medworm.com/index.php?rid=2800327&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F16%2Fhigh-quality-low-cost-care-an-interview-with-gundersen-lutheran-ceo-jeff-thompson%2F Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in America.” The conference was organized by four nationally noted health care improvement experts: Don Berwick, Elliott Fisher, Atul Gawande, and Mark McClellan. But that is only part of what has grabbed national headlines for this community that borders on the Mississippi River in Northwest Wisconsin.  La Crosse has become embroiled in a national controversy over end-of-life planning that has swirled around the health-care reform debate.�... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2800327 Wed, 16 Sep 2009 17:42:47 +0100 2800327 http://www.medworm.com/index.php?rid=2800334&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPWJfM68nFWk%2F The value of health insurance in the national discussion on health care is often considered a given. But for some, when they actually crunch the numbers, the value of insurance relative to other spending priorities isn’t so clear. For instance, in Massachusetts where state-mandated coverage has resulted in all but 3% of Bay State residents obtaining coverage or pay a fine, some 68,000 chose to pay the fine in 2007, according to today’s WSJ. Another 76,000 were exempted from coverage requirements. The uninsured in Massachusetts tend to be younger, male and relatively healthy, the WSJ says. In deciding whether to subject themselves to the fine, which was $1,068 last year, some seem to be deciding that the value of coverage is less than what they will pay in premiums for themselv... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2800334 Wed, 16 Sep 2009 13:07:04 +0100 2800334 http://www.medworm.com/index.php?rid=2796380&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FdPLzAlPELq4%2F Americans with job-based insurance can expect to pay more for less next year. Hit by the recession and rising health-care costs, employers are cutting a larger chunk than usual out of their health-care budgets, new national surveys show. In 2010, nearly two-thirds of employers plan to shift more of the cost of care to workers and their families through higher premiums contributions, deductibles and copayments. One out of five companies plans to cut out higher-cost health plan options in favor of less generous coverage, according to the preliminary findings from a survey by the consulting firm Mercer LLC. These finding are echoed in a new survey by Watson Wyatt Worldwide, a consulting firm. Encouraging workers to stay healthy and kicking people who aren’t eligible for coverage off the... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2796380 Tue, 15 Sep 2009 16:58:24 +0100 2796380 http://www.medworm.com/index.php?rid=2796354&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F15%2Fjournal-of-public-health-2009-vol-31-no-3%2F This article looks at a study which presents a method for estimating the health and economic burden of alcohol consumption to the NHS. (Print subscription held at Fade Library) Posted in Journals Tagged: Alcohol Abuse, Costs, Public Health (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2796354 Tue, 15 Sep 2009 15:02:01 +0100 2796354 http://www.medworm.com/index.php?rid=2796383&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F00M0f7pNmAs%2F Senate Finance Committee Chairman Max Baucus is expected to formally introduce the committee’s long-awaited health reform bill on Wednesday, according to the WSJ, but questions linger from both Democrats and Republicans about the proposal. One worry is about the affordability of insurance, which Americans would be required to buy by 2013. They could be asked to spend as much as 13% of their income on insurance under the proposed bill. Sen. Ron Wyden, a Democrat, said that “additional steps are going to have to be taken to make coverage more affordable. That’s a real hit on middle-class families.” Michael Tanner of the libertarian Cato Institute told the Washington Post, “We’re talking about the equivalent of a middle-class tax increase. Yes, they’r... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2796383 Tue, 15 Sep 2009 12:39:56 +0100 2796383 http://www.medworm.com/index.php?rid=2796365&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fcommentology-improving-cost-containment.html Stephen J. Motew writes: Surgical specialists practice under a slightly more regimented reimbursement model predominantly due to the global period payment for surgical procedures. The total care of the surgical patient for any procedure, including pre-op evaluation, the procedure itself,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2796365 Mon, 14 Sep 2009 23:00:00 +0100 2796365 http://www.medworm.com/index.php?rid=2796377&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F14%2Fgrading-the-presidents-health-care-speech%2F After decades of teaching, I view everything around me as a final exam and assign it letter grades. Naturally, I graded President Barack Obama’s speech as well. The overall grade is A–, a highly respectable grade at Princeton, although there is variation around this overall average for the different themes in the speech. The elegance and force of the delivery deserved a clear A, and one slouching toward an A+. I do not grade it A+ mainly because our Dean frowns at throwing around A-plusses lightly. The president does, however, deserve a clear A+ for reminding Americans so clearly and forcefully of the moral dimension of health reform, assisted in that task by the late Senator Ted Kennedy’s eloquent farewell letter. One may disagree with these two gentlemen’s policies, but one shoul... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2796377 Mon, 14 Sep 2009 21:49:16 +0100 2796377 http://www.medworm.com/index.php?rid=2793131&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F-wrWFOhv_nM%2F If you ever needed an reminder of how the American health-care system spends a lot of money on patients for poorer outcomes than other countries, you need read no further than an example in the New York Times this morning that describes how a limit on Medicare coverage can boomerang. The scenario: Medicare’s three-year limit on payment for anti-organ-rejection drugs led to a woman needing a second kidney transplant, because she couldn’t afford to the medicine that would have allowed her to keep her first transplanted kidney in healthy, working condition. The cost of anti-rejection drugs for the patient? $1,000 to $3,000 a month. Cost of the second transplant? $125,000. The average Medicare expenditure per kidney transplant patient care is $17,000 yearly, while it’s $71,0... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2793131 Mon, 14 Sep 2009 13:13:44 +0100 2793131 http://www.medworm.com/index.php?rid=2785895&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F10%2Fbringing-health-care-reform-back-into-a-health-insurance-reform-bill%2F The president’s speech to Congress struck important political notes.  It also included three tantalizing opportunities for adding some aspects of health care reform to what was becoming simply health insurance reform.  Delaying Implementation of the Exchange The most obvious new, and possibly controversial, point in the speech was the four-year delay in implementing the Insurance Exchange.  This will definitely help the budget figures by pushing costs further out into the future, but it has substantive implications as well.   The Exchange will be a central aspect of the new proposal.   It may appear to be similar to what is done by some health benefits departments of large employers.  It will, however, face a far more complex task than say, the Office of Personnel Management in a... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2785895 Thu, 10 Sep 2009 22:22:49 +0100 2785895 http://www.medworm.com/index.php?rid=2782009&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F_aDhKlAPaIM%2F The other day, Sarah Palin cited my work in an oped for the Wall Street Journal.  So when the Democratic National Committee savaged her for it, ABCNews.com asked me for comment.  Here’s an excerpt from George Stephanopoulos’ blog: “Instead of poll-driven ’solutions,’ let’s talk about real health-care reform: market-oriented, patient-centered, and result-driven,” wrote Palin. “As the Cato Institute’s Michael Cannon and others have argued, such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each years in wasteful spending; a... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2782009 Thu, 10 Sep 2009 14:57:47 +0100 2782009 http://www.medworm.com/index.php?rid=2782000&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F09%2Fbending-the-cost-curve-do-we-have-the-will%2F The need to “bend the curve” of rising health care costs is certain. Less certain is the nation’s political will to take on that difficult task. That conundrum emerged today at a Washington, D.C. briefing sponsored by Health Affairs. The briefing, held to launch the journal’s Sept-Oct issue, a thematic volume titled “Bending The Cost Curve,” featured several authors from the issue. This is the first of several reports on the event that will be posted on the Health Affairs Blog. The lead article in the new Health Affairs issue, by Michael Chernew of Harvard and coauthors, vividly lays out the consequences of not restraining health care cost growth. If health care costs continue to grow at a rate of 2 percentage points higher than real per capita gross domestic product over the n... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2782000 Wed, 09 Sep 2009 22:29:53 +0100 2782000 http://www.medworm.com/index.php?rid=2778381&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F09%2Fbending-the-cost-curve-new-health-affairs-issue-and-briefing%2F If the growth rate in U.S. health care spending continues at current levels, a vastly greater share of personal income and economic resources will be devoted to health care, according to a new analysis in the September/October issue of Health Affairs. And even if that growth rate could be slowed sharply — to a pace of just 1 percentage point faster than annual per capita growth in the gross domestic product — more than half of any increase in personal income would still go to health care over the next 75 years. The new Sept-Oct Health Affairs issue is a thematic volume on bending the curve of rising health spending. The issue will be discussed at a Washington D.C. briefing at 8:30 am ET on Wednesday Sept. 9. A live Webcast of the briefing and an archived version will be available... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2778381 Wed, 09 Sep 2009 10:44:58 +0100 2778381 http://www.medworm.com/index.php?rid=2774593&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F07%2Ffact-or-fiction-advance-care-planning-in-health-reform%2F Patients with serious or advanced illnesses would be given more control over their care by language in health reform legislation passed by three House committees that would pay physicians, nurse practitioners, and other providers for counseling Medicare beneficiaries about advance planning for future care decisions. That was the unanimous opinion expressed by three respected geriatricians at a August 20 conference intended to clarify several issues at the heart of the current health reform debate. The conference, Fact vs. Fiction: Key Issues in Health Reform, was sponsored by Health Affairs. The participants in the panel dealing with end of life issues were Christine Cassel, MD, President, American Board of Internal Medicine; Diane E. Meier, MD, Director, Center to Advance Palliative Care,... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2774593 Mon, 07 Sep 2009 20:12:05 +0100 2774593 http://www.medworm.com/index.php?rid=2765975&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fgetting-rid-of-friction-in-health-care-.html By FLETCHER LANCE Friction occurs when an object moving through space encounters resistance, slows down and has its forward energy diverted. In the world of health care, friction is a term that has become synonymous with paperwork. Today, the U.S.... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2765975 Thu, 03 Sep 2009 23:00:00 +0100 2765975 http://www.medworm.com/index.php?rid=2761832&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F03%2Fhealth-affairs-briefing-bending-the-cost-curve-in-health-spending%2F For decades, the United States and other nations have sought to tame the long-term growth of health spending.  Even as resources devoted to health care grow, they remain poorly distributed, and much of the health care purchased is of questionable value.  As the Obama Administration and Congress tackle health reform, expanding health coverage to millions of uninsured Americans while simultaneously “bending the cost curve” are co-equal goals.   The September-October 2009 edition of Health Affairs, titled “Bending the Cost Curve,” delves deeply into this issue. The journal will bring together key administration officials, lawmakers, and leading health policy experts, including Aetna Chairman and CEO Ronald A. Williams and Commonwealth Fund President Karen Davis, to discuss it at a... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2761832 Thu, 03 Sep 2009 15:17:07 +0100 2761832 http://www.medworm.com/index.php?rid=2761838&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIctLuyy8N8A%2F A couple stories in the news this morning about pay for health-care executives: The top 20 execs at a big public hospital in Miami will volunteer for a 4%-5% pay cut and drop their car and executive allowances, the Miami Herald reports. The cuts at Jackson Health System come as the local county commission, which oversees the hospital and its affiliated clinics, is questioning executive pay at the hospital. Jackson, which serves as Miami’s key safety-net hospital, projects a loss of $133 million this year unless there’s some cost cutting, the Herald says. Executive pay at nonprofit health insurers and hospitals in Massachusetts is getting a close look from the state’s attorney general, the Boston Globe reports. Last year, the AG questioned the $16.4 million lump-sum retire... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2761838 Thu, 03 Sep 2009 13:12:42 +0100 2761838 http://www.medworm.com/index.php?rid=2761839&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FTkHHhTu8f_E%2F Doctors’ decisions to order unneeded and expensive tests out of fear of being sued cost the health-care system a lot of money, an issue that President Obama and others have talked about in the debate on health reform. But how much so-called defensive medicine are physicians actually practicing? No one actually knows because it’s so hard to measure. Spending on medical malpractice litigation comes to about $30 billion a year, or just over 1% of our health-care spending, according to the WSJ. But costs from defensive medicine, say some experts in the field, are a lot more. That’s disputed by some others: Taylor Lincoln, a research director at consumer-advocacy group Public Citizen, told the WSJ that worries about defensive medicine are “fear-mongering” about th... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2761839 Thu, 03 Sep 2009 12:48:59 +0100 2761839 http://www.medworm.com/index.php?rid=2757725&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FK1XwmUH6gaw%2F There’s been much interest in the blogosphere recently over spiraling college costs. Niraj Chokshi kicked things off at the Atlantic, and the discussion was picked up by Andrew Sullivan and Ezra Klein, among others. We’ll be hosting a debate on the causes of and solutions to this problem at Cato on the 6th of October, but in the meantime, it’s worth noting what the blogosphere has thus far overlooked: the epic productivity collapse in k-12 schooling over the past 40 years. As I noted in Investors’ Business Daily last month, k-12 spending has risen by a factor of 2.3 since 1969, while achievement at the end of high-school is flat. The scary details can be found here. If public school productivity had merely stayed where it was in 1970, instead of collapsing as it did... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2757725 Wed, 02 Sep 2009 17:21:35 +0100 2757725 http://www.medworm.com/index.php?rid=2757722&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FEyn90rCbTOQ%2F Boston Scientific showed that its $30,000 devices that slow heart deterioration, called cardiac resynchronization therapy defibrillators, produced clinical benefit in a 1,820-patient clinical trial, according to results published in today’s New England Journal of Medicine. The company announced in June that the study, known as MADIT-CRT, demonstrated that the resynchronizers reduced hospitalizations, but these complete results showed the devices were even more effective than earlier reported, according to the WSJ. But an accompanying editorial in today’s NEJM asks whether expanded CRT use in patients with heart failure is cost effective. Mariell Jessup of the University of Pennsylvania School of Medicine, points out that despite evidence that patients with certain types of hear... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2757722 Tue, 01 Sep 2009 19:21:42 +0100 2757722 http://www.medworm.com/index.php?rid=2751892&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FfXPv63hvYxQ%2F Here are a couple items about health reform this morning: Preventive services for diabetics will reduce health-care costs over the long haul but probably won’t be cost saving, according to a study due out today in Health Affairs. The Washington Post notes that most costs will be recouped at the tail end of care, when complications typically arise and care is more expensive, according to the study findings. About 75% of the overall costs of the services will be recouped over a 25-year period. Only people who enter the program as young adults — ages 24 to 30 — would wind up saving the health-care system any money, according to the calculations. The Congressional Budget Office’s estimates for the cost of preventive services, which found that “for most preventive ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2751892 Tue, 01 Sep 2009 13:32:51 +0100 2751892 http://www.medworm.com/index.php?rid=2751931&cid=t_255373_97_f&fid=35606&url=http%3A%2F%2Fwww.theangriestpharmacist.com%2F2009%2F09%2F01%2Fwhat-a-putz%2F Yup…sure would hate to see that… To be completely honest, while I have my issues with them, Medicare and Medicaid are well-run programs. They allow their money to be spent all helter-skelter, they are the most efficient programs in the entire government. The overhead of CMS is abysmal compared to your other big players like BCBS, Paid, Anthem, and Caremark. I’m not sure why the post office is always busy. I’m not sure why the DMV is slow as hell — these are subcontracted out anyway, so blaming the government is stupid. It’s like blaming Dr.Reddy’s for having to wait too long for your Glimepiride in my pharmacy. You can see the video or the original comments in its entirety here. In all honesty, it was probably just a slip of the tongue. But, callin... The Angriest Pharmacist blogs http://www.medworm.com/rss/comments.php?id=2751931 Tue, 01 Sep 2009 05:23:16 +0100 2751931 http://www.medworm.com/index.php?rid=2820623&cid=t_255373_167_f&fid=37833&url=http%3A%2F%2Fnutrition.edublogs.org%2F2009%2F08%2F31%2Fnew-study-on-obesity-healthcare%2F More than a decade ago, in 1998, the medical costs due to obesity were estimated to be as high as $78.5 billion.  In a recent study, published in the July issue of Health Affairs the authors of the study now estimate the annual healthcare cost of obesity in the US now may be as high as $147 billion dollars a year. The government-sponsored study was conducted by researchers at RTI International, the Agency for Healthcare Research and Quality, and the US Centers for Disease Control and Prevention (CDC). Key findings from the study on Annual Medical Spending Attributable To Obesity: Payer- And Service-Specific Estimates were summarized in the article on Medical News Today. Lead author  Dr Eric Finkelstein and colleagues found: In 1998 the medical costs of obesity in the US were estimated a... Nutrition and Wellness Biology 50 blogs http://www.medworm.com/rss/comments.php?id=2820623 Mon, 31 Aug 2009 18:39:15 +0100 2820623 http://www.medworm.com/index.php?rid=2744058&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FRbJxW9Z-O08%2F Deep into Congress’s August recess, here is some of the latest on health care reform: Claims that health reform will be disastrous for businesses and government are wrong, writes Gary Locke, the U.S. secretary of commerce in an op-ed in the WSJ. Making his case for reform, Locke says that climbing health care costs already cost American businesses jobs and revenue, as well as entrepreneurship, and that isn’t sustainable. “In the short term, health-care costs pose a major problem for companies and their employees,” writes Locke. “In the medium and long-term, these costs pose serious challenges to our economy.” Health insurers wonder how they’ve become the villains in the reform debate, according to the New York Times. Some reasons that employees at ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2744058 Fri, 28 Aug 2009 14:26:50 +0100 2744058 http://www.medworm.com/index.php?rid=2741363&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FgX08JAMvr5o%2F Hospitals have pledged accept more than $150 billion in pay cuts over the next decade. But a big hospital trade group says hospitals could receive an additional $171 billion over the next decade in reimbursements for the newly insured, more than making up for those reductions, Bloomberg reports. The American Hospital Association says the figure was estimated for members of Congress and state hospital associations several months ago. One analyst told Bloomberg that the assessment is “consistent with reality.” On July 8, the AHA put out a statement, along with the Catholic Health Association of the United States and the Federation of American Hospitals, stating that hospitals will “do our part to get virtually every American covered.” But, the statement warned, &#82... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2741363 Thu, 27 Aug 2009 15:18:57 +0100 2741363 http://www.medworm.com/index.php?rid=2741486&cid=t_255373_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F001614.html My post yesterday about the coming changes to the AWP pricing formula for drugs included the statement Understandably, the pharmacies, both independents and chains, are asking the big PBMs to change their contracts to account for the change by reimbursing... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=2741486 Wed, 26 Aug 2009 23:00:00 +0100 2741486 http://www.medworm.com/index.php?rid=2733663&cid=t_255373_72_f&fid=38877&url=http%3A%2F%2Fwww.laseroffers.com%2F2009%2F08%2Fquick-guide-to-laser-skin-resurfacing%2F Still horrified by laser blasting of facial wrinkles followed by months of redness? This is so 90s! New generation of aesthetic lasers is safer and more selective in treating just what the doctors says you need: wrinkles, age spots, broken capillaries, saggy skin, etc. The result? Faster healing, so you can get back in makeup and [...]Post from: Aesthetic Laser OffersQuick Guide to Laser Skin Resurfacing With Costs and Expectations (Source: Aesthetic Lasers) Aesthetic Lasers blogs http://www.medworm.com/rss/comments.php?id=2733663 Tue, 25 Aug 2009 19:46:19 +0100 2733663 http://www.medworm.com/index.php?rid=2734024&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FpLttgreO4TU%2F The Obama administration updated its economic forecast in its mid-session budget review this morning (read the WSJ story here and a post by budget director Peter Orszag here). Costs associated with health care, it says, are at the center of the government’s financial woes. In its own words: The Federal Government’s long-term fiscal shortfall is driven primarily by escalating health care costs. If health care costs continue to grow at their historical rates, Medicare and Medicaid will double as a share of spending on Federal programs within the next 30 years. These growth rates are simply unsustainable and are why slowing the growth in health care costs is the single most important step we can take to put the Nation on firm fiscal footing. For example, slowing the rate of healt... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2734024 Tue, 25 Aug 2009 16:05:49 +0100 2734024 http://www.medworm.com/index.php?rid=2730053&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPNo4WlHnSX0%2F Is it time to roll back the clock? House calls by primary care physicians may be a money saver in some cases, according to the Los Angeles Times. One main benefit of this strategy, which we’ve written about before here and here, is that closely monitoring these patients can reduce expensive hospital admissions. The LA Times details the experience of a team of docs in Richmond, Va., who visit about 275 patients — most with multiple medical conditions — once a month. Visits to these home-bound patients can turn up everything from a typical urinary tract infection to an emergency situation that requires an ambulance. But even if it may save money in the long-run, the up-front costs are expensive: Medicare pays for about half the program’s $1 million price tag, and the... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2730053 Tue, 25 Aug 2009 13:40:35 +0100 2730053 http://www.medworm.com/index.php?rid=2727251&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FHZoHBSKW-sM%2F The Massachusetts Legislature and the U.S. Congress are considering changes in the way health plans pay health care providers - in the commercial market (Massachusetts) and in Medicare (the federal government). Although details differ, the common element is that plans would pay an Accountable Care Organization (ACO) composed of hospitals, physicians, and related providers a “global” payment rather than fee-for-service payments. The underlying assumption is that an ACO will be able to lower costs and improve quality. While there is much to be said in favor of integrated service systems and tying payment to performance, if the ACO model is imposed without care the result could in fact be higher costs with little accountability. Why? A few considerations: Most hospitals and physicians do ... HPHC blogs http://www.medworm.com/rss/comments.php?id=2727251 Mon, 24 Aug 2009 13:21:40 +0100 2727251 http://www.medworm.com/index.php?rid=2716031&cid=t_255373_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2Fm2OxMxrsz6Y%2F We’re hearing about health care reform every day, it seems, especially since President Obama is trying to pass legislation from the rising costs for Americans. That’s why I was pleasantly surprised to see that a group of Milwaukee area employers seem to be ahead of the curve. They have found a way to lower costs while still providing great health care options for their employees. Four years ago, a group of fourteen Milwaukee employers teamed up to figure out how to lower their health care costs. They employers got bids from area hospitals and physicians, and when someone submitted too high a bid, it was thrown out. They also worked with the people who submitted bids to make sure the health care was up to par, and that the costs remained at a reasonable level. (Not that they wo... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2716031 Wed, 19 Aug 2009 20:18:39 +0100 2716031 http://www.medworm.com/index.php?rid=2715934&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F08%2F19%2Fhealth-affairs-briefing-to-be-covered-on-twitter%2F Tomorrow’s Health Affairs briefing, “Fact Versus Fiction: Key Issues In Health Reform,” will be covered live on Twitter. Posts from Health Affairs deputy editor Sarah Dine will appear in real time on the Twitter “channel” #healthreform with important points and content from the event. You can follow the discussion on Twitter by searching on “#healthreform.” If you have a Twitter account, you can join the discussion and post to the channel by appending “#healthreform” to your messages. If you don’t have a Twitter account, you can register for one here. Copyright © 2009 Health Affairs Blog. This Feed is for personal non-commercial use only. All material published on Health Affairs blog, excluding links, is covered under a Creative Commons Attri... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2715934 Wed, 19 Aug 2009 15:34:48 +0100 2715934 http://www.medworm.com/index.php?rid=2709121&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FuE4MtKZPpdw%2F Two weekend stories from two coasts on immigration and the cost of health care: In California, a clinic’s practice of treating uninsured patients without asking about immigration status is being questioned, the WSJ reports. A local hospital was a key backer of the clinic, which can treat patients who need non-emergency care at a much lower cost than the emergency room. But the clinic gets funding from the county, and a county-appointed oversight board has said county funds shouldn’t be used to treat people who are in this country illegally. In Massachusetts, about 30,000 legal immigrants will lose state-subsidized health insurance coverage, the Boston Globe reports. Though the federal government and many states don’t help pay for these “special status” immigra... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2709121 Mon, 17 Aug 2009 14:39:13 +0100 2709121 http://www.medworm.com/index.php?rid=2695345&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FUAtpxu51UiM%2F Let’s pause for a moment from all those town halls to mention a different kind of large, public health-care gathering: More than 2,000 people showed up yesterday at a Southern California basketball arena seeking free medical and dental care. A nonprofit group called Remote Area Medical is holding a week-long clinic at the Inglewood Forum, the former home of the L.A. Lakers. There weren’t enough medical volunteers to treat everyone who showed up for the clinic’s first day yesterday, and hundreds of people spent the night in the parking lot in hopes of getting care today, the L.A. Times reports. The group, based in Nashville, was founded by a guy who spent years in the Amazon rain forest and wanted to help people in the developing world. But as time’s gone on, the or... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2695345 Thu, 13 Aug 2009 11:38:25 +0100 2695345 http://www.medworm.com/index.php?rid=2695314&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F13%2Fhealth-service-journal-2009-13th-august%2F Fade Fade: PCTs gear up for swine flu pandemic Fade Skinny: The NHS is working to tight deadlines to plan for another wave of swine flu – and estimate how much the outbreak will cost. PCTs have been asked by the Department of Health to predict how much they will spend during 2009-10 responding to the outbreak. Early figures seen by HSJ are between £1m and £2.2m for each PCT – resulting in a potential maximum of more than £300m. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: Costs, Current Awareness, Primary Care, Swine Flu (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2695314 Thu, 13 Aug 2009 08:09:03 +0100 2695314 http://www.medworm.com/index.php?rid=2695348&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FMzG_I5O7jyM%2F It’s rare for doctors to have frank discussions about cost and prognoses with the families of dying patients, Peter Pronovost writes today in a guest column on WSJ.com. That will have to change if the nation is to control the rise of health costs. But Pronovost (pictured), a Johns Hopkins doc who works in the intensive care unit, notes that the daily realities of the ICU show just how complex things can be for each patient — and, he argues, attempts to improve communication between doctors, patients and families could easily have unintended consequences and create new problems. Should we ensure weekly family meetings? Should we provide patients and their families detailed information about prognosis and costs? Should families incur more of the cost for patients with low likelih... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2695348 Wed, 12 Aug 2009 13:36:38 +0100 2695348 http://www.medworm.com/index.php?rid=2681882&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F6uGq3Dq_dM4%2F The double whammy of falling local tax revenues and more people seeking charity care is a tough blow for many of the nation’s big public hospitals. But in his latest WSJ.com column, Abraham Verghese returns to R.E. Thomason, the El Paso public hospital where he was on staff as an internist for 11 years — and finds what he calls “a miracle.” The hospital, recently renamed University Medical Center, has turned its finances around and improved ties with the community and relations with its own staff. A new CEO has scrutinized everything from prosthetic knees — he cut costs by choosing a single model and negotiating a low price — to patients’ own financial claims — some patients had more money than they claimed, allowing them to pay for at least ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2681882 Fri, 07 Aug 2009 12:42:46 +0100 2681882 http://www.medworm.com/index.php?rid=2726887&cid=t_255373_72_f&fid=38877&url=http%3A%2F%2Fwww.laseroffers.com%2F2009%2F08%2Fcosmetic-surgery-as-part-of-job-hunting-strategies%2F Nationwide, a growing number of people are turning to cosmetic procedures to put their best face forward as they look for a job – or try to hold on to the one they have. A survey of physicians by the American Academy of Facial Plastic and Reconstructive Surgery showed that 75 percent of them said [...]Post from: Aesthetic Laser OffersCosmetic Surgery As Part Of Job Hunting Strategies (Source: Aesthetic Lasers) Aesthetic Lasers blogs http://www.medworm.com/rss/comments.php?id=2726887 Thu, 06 Aug 2009 15:14:09 +0100 2726887 http://www.medworm.com/index.php?rid=2678609&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F07sRhlHBztM%2F Though Congress is adjourning for its summer recess, the health care debate is still a hot topic. A few of the highlights this morning: The first industry stakeholder to the table apparently gets a deal from the Obama adminstration, and the honor appears to go to drug makers. The New York Times reports that the pharmaceutical industry was assured by the administration that it wouldn’t have to bear any more of the costs of health reform beyond the $80 billion over 10 years that it previously agreed to. That pledge appears to be at odds with allowing Medicare to negotiate prices on prescription drugs — a provision included in a bill that recently cleared a House committee. Billy Tauzin, president of the drug industry trade group, told the NYT, “We were assured: ‘We ne... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2678609 Thu, 06 Aug 2009 13:40:51 +0100 2678609 http://www.medworm.com/index.php?rid=2678627&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fcommentology.html Reader Murry Ferris writes in: I am a 65 year old retired ad exec and also an insulin-dependent diabetic. I have other medical complications, but taking care of the diabetes is the big one. Every day I test my blood... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2678627 Wed, 05 Aug 2009 23:00:00 +0100 2678627 http://www.medworm.com/index.php?rid=2670929&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2F-HT0QjN3JtU%2F Only a few vacationers and year-round residents may have seen the lead story in the Martha’s Vineyard Gazette on Friday. The headline read “Island Hospital Fees are High”, and the story dealt with the cost of outpatient procedures at the hospital, which, according to the Gazette, are “many times higher than other area hospitals”. Using data publicly available through the state Division of Health Care Finance and Policy the reporter was able to compare payments for specific procedures and determine that for five of six categories of outpatient procedure the Vineyard hospital was among the most expensive in the state. An ultrasound costs $800, eight times more than the average cost at three nearby hospitals on the mainland, six miles away. A chest x-ray costs $290, more than three ... HPHC blogs http://www.medworm.com/rss/comments.php?id=2670929 Tue, 04 Aug 2009 15:03:15 +0100 2670929 http://www.medworm.com/index.php?rid=2670805&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fare-cadillac-health-plans-the-problem-.html By BILL KRAMER The debate over proposals to tax health insurance plans is confusing and frustrating. The proposals are usually described as a tax on “gold plated” or “Cadillac” health coverage. According to the media and many spokespeople on the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2670805 Mon, 03 Aug 2009 23:00:00 +0100 2670805 http://www.medworm.com/index.php?rid=2726891&cid=t_255373_72_f&fid=38877&url=http%3A%2F%2Fwww.laseroffers.com%2F2009%2F07%2Fdysport-is-new-botox%2F Injectable treatments for wrinkles go hand in hand with laser treatments and we continue our coverage of this field as it is of interest to all aesthetic physicians offering laser treatments. Dysport is an acetylcholine release inhibitor and a neuromuscular blocking agent, approved by the U.S. Food and Drug Administration (FDA) in late April 2009. Dysport [...]Post from: Aesthetic Laser OffersDysport is a New Botox (Source: Aesthetic Lasers) Aesthetic Lasers blogs http://www.medworm.com/rss/comments.php?id=2726891 Fri, 31 Jul 2009 20:17:16 +0100 2726891 http://www.medworm.com/index.php?rid=2660714&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FovFsKxmUPgE%2F It’s all well and good to talk about reducing unnecessary hospital admissions to help control health costs. But the definition of “unnecessary” gets a lot more complicated when you’re the one doing the admitting, ER doc Jesse Pines writes in a column on WSJ.com. He describes the case of a woman with a probable case of lung cancer who needed a comprehensive evaluation. She was on Medicaid, the government health insurance for the poor, which meant she’d have a hard time finding specialists to treat her as an outpatient. So Pines admitted her to the hospital, even though she wasn’t acutely ill. In the hospital, she got a biopsy, a formal diagnosis of lung cancer and a plan for outpatient treatment. She met with a psychiatrist and a social worker. Pines argu... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2660714 Fri, 31 Jul 2009 13:15:56 +0100 2660714 http://www.medworm.com/index.php?rid=2657590&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F3Uqg8V4-x00%2F For the moment, anyway, the health-overhaul narrative out of Washington is that the congressional logjam may be breaking up, with things starting to flow again. The big House bill has been stuck in the Energy and Commerce Committee. But a deal is afoot there, with liberal Dems agreeing to modify the bill to make it more acceptable to the Blue Dog Democrats. One change: exempting more small businesses from the requirement to offer insurance or pay a fee. Also under the deal, payments to doctors and hospitals under a new, government-backed insurance plan wouldn’t be pegged to Medicare rates, as they were in the original bill. Meanwhile, over in the Senate, Max Baucus said the bill the Finance Committee is working on would cover 95% of Americans at a cost of less than $900 billion over ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2657590 Thu, 30 Jul 2009 13:30:02 +0100 2657590 http://www.medworm.com/index.php?rid=2653674&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FrJHm1NlHc5M%2F Apparently, Americans are still OK with the idea of taxing rich people to pay for part of the big health-care overhaul now being debated in Washington. But they really don’t like the idea of requiring everyone to buy insurance. In the latest WSJ/NBC poll, 68% of respondents said raising taxes on families making more than $1 million a year was an “acceptable” option. But 60% of respondents said a mandate requiring individuals to buy insurance (with subsidies for people with low and moderate incomes) was “not acceptable.” That’s a huge swing from the WSJ/NBC poll last month, when only 31% of respondents said that option was “not acceptable.” (The wording changed slightly in July to note that people who could afford insurance but didn’t bu... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2653674 Thu, 30 Jul 2009 12:34:43 +0100 2653674 http://www.medworm.com/index.php?rid=2653679&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FhlTBgT3Pzj8%2F California health care and child-welfare services took a last-minute hit in the $84.5 billion state budget plan signed by Gov. Arnold Schwarzenegger yesterday. Raising the ire of Democrats, he used his veto power to slash nearly $500 million more from the final bill that had been agreed to by lawmakers, notes the San Francisco Chronicle and Los Angeles Times. The prolonged drive to close the state’s $24 billion budget gap has been a grueling process. “This has been a very tough budget, probably the toughest since I have been in office here in Sacramento,” Schwarzenegger said to the LA Times. “This budget is kind of like the good, the bad and the ugly.” Democrats say that Schwartzenegger didn’t have the authority to make the extra cuts, but the governor&... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2653679 Wed, 29 Jul 2009 14:01:49 +0100 2653679 http://www.medworm.com/index.php?rid=2653680&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPautPNdMPsk%2F Concern over Medicare is one theme of this morning’s health-reform coverage. Here are a few highlights: Seniors are worried about cuts to their Medicare benefits as a result of calls for reduced Medicare spending, reports the New York Times and WSJ. Members of AARP met with the president last night to discuss their concerns about seniors’ ability to continue to get costly services, like hip replacements. Obama tried to reassure them that the goal of cuts — the House bill proposes to reduce Medicare spending by $246 billion over the next decade — is to reduce wasteful Medicare spending, not benefits, notes the WSJ. Doctors’ groups don’t like the idea of an independent commission that would set the size of Medicare payments to health-care professionals, re... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2653680 Wed, 29 Jul 2009 12:58:37 +0100 2653680 http://www.medworm.com/index.php?rid=2648971&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F9x4yZXNF9qY%2F One of the biggest questions gripping partisans in the health-reform debate is how many people could end up in a government-run health plan. Conservatives, who are against a public plan that would compete with private insurers, are touting a Lewin Group study that projects that more than 103 million Americans will move to a public plan. Hogwash, say liberals, bolstered by a Congressional Budget Office estimate that only 11 million to 12 million Americans would do so. The Lewin report containing the 103 million figure was commissioned by the Heritage Foundation, a conservative group, and quickly became conservatives’ best weapon against the current House bill. Liberal Dem Rep. Pete Stark of California jumped on the report, putting out a missive last week titled “Fact Versus Fiction: The ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2648971 Wed, 29 Jul 2009 12:36:03 +0100 2648971 http://www.medworm.com/index.php?rid=2649101&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2F2ORbKFJe97w%2F In the swirl of national and local health reform activity, the issue of U.S. health care costs is the elephant in the room. The attempts of Congress to craft a workable (and affordable) piece of legislation are routinely foiled by an inability to find a solution to the cost containment problem. Perhaps they are not looking in the right places. A report issued by McKinsey last December entitled “Why Americans Pay More for Health Care” framed the issue in stark terms. The subject of a recent article in the New Republic, the McKinsey study argued that the use of expensive outpatient services, physician and pharmaceutical unit costs, cost-shifting from public payers, and consumer insulation from the true costs of care drive higher spending in America than in other OECD (Organization for Ec... HPHC blogs http://www.medworm.com/rss/comments.php?id=2649101 Tue, 28 Jul 2009 13:42:44 +0100 2649101 http://www.medworm.com/index.php?rid=2645283&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F07%2F28%2Flow-cost-high-quality-care-in-america%2F As President Barack Obama and his allies press their case for health care reform, the president exhorts that his vision will slow the growth of medical expenditures, expand coverage to millions, and improve the quality of care.  In the trenches, where millions of medical interventions occur daily, physicians and hospital managers who do the heavy lifting describe a far more grueling path “to bending the cost curve,” one that takes dedicated years to navigate and often loses money because the inflationary fee-for-service payment system rewards providers for rendering more, not less, health care.  At a conference last week, that was the clear message of doctors and managers who have tried to bend the cost curve while improving the quality of care in health care enterprises in commun... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2645283 Tue, 28 Jul 2009 12:33:55 +0100 2645283 http://www.medworm.com/index.php?rid=2648996&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fexplaining-runaway-healthcare-costs-on-lunch-clubs-and-lap-choleys-.html By BOB WACHTER Have you found yourself ‘splaining to friends and family why the healthcare system is so damn expensive? I’ve been teaching health policy for a couple of decades, and I’m surprised that my two favorite stories haven’t yet... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2648996 Mon, 27 Jul 2009 23:00:00 +0100 2648996 http://www.medworm.com/index.php?rid=2645524&cid=t_255373_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2FWIaXUAjqVRU%2Flong-term-care-costs-and-calculater.html Ever wonder how much long term care might cost you?I found this calculator over on the MetLife website. It is easy to use.Here are some national numbers. The cost could be lower or higher in your area. Numbers are a little dated.Average costs of long-term care in 2006:Private room in a nursing home $206 a day; $75,190 annuallySemi-private room in a nursing home $183 a day; $66,795 annuallyHome health care aide $19 an hourSource: MetLife Mature Market InstituteIn south Florida, you can hire an around the clock, live in, caregiver aide for $120-$150 a day (hired directly by you). Or, you can pay an agency $150-$180 a day for a person with similar experience and credentials.You might be able to find an assisted living facility in this area for as low as $3200 a month. South Florida is overbui... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=2645524 Mon, 27 Jul 2009 19:15:09 +0100 2645524 http://www.medworm.com/index.php?rid=2645278&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FwFOP_QcvGK8%2F Borrowing a line from President Obama’s playbook, the Centers for Disease Control said today that community organizing for change is necessary — in this case to deal with the obesity crisis. Focusing on community-based changes, not individuals’ efforts to lose weight, is critical, William Dietz, the CDC’s director in the division of nutrition, physical activity and obesity, told reporters during the agency’s first conference on the obesity crisis. The estimated annual medical costs due to obesity nearly doubled to $147 billion in 2008 from $78.5 billion in 1998, as the obesity rate rose 37% during the period, according to an article published online today in the journal Health Affairs and highlighted during the conference. Normal weight individuals incurred an... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2645278 Mon, 27 Jul 2009 18:26:24 +0100 2645278 http://www.medworm.com/index.php?rid=2645294&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fexplaining-runaway-healthcare-costs-on-lunch-clubs-and-lap-choleys-.html By BOB WACHTER Have you found yourself ‘splaining to friends and family why the healthcare system is so damn expensive? I’ve been teaching health policy for a couple of decades, and I’m surprised that my two favorite stories haven’t yet... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2645294 Sun, 26 Jul 2009 23:00:00 +0100 2645294 http://www.medworm.com/index.php?rid=2637803&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fthe-case-for-price-ceilings-for-health-services.html BY DAVID HANSEN Most in the current health reform debate agree on the need to curtail health care costs. Despite this, few discuss directly how health services are priced, though clearly this a central issue. Prices have both immediate impacts... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2637803 Fri, 24 Jul 2009 23:00:00 +0100 2637803 http://www.medworm.com/index.php?rid=2637808&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fthe-case-for-home-health-care.html By Dr. George Taler While Congress is debating health reform and struggling to accomplish the apparently competing goals of reducing costs while improving quality, I am part of a program that does both. As co-director of the Washington Hospital Center’s... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2637808 Thu, 23 Jul 2009 23:00:00 +0100 2637808 http://www.medworm.com/index.php?rid=2630119&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fpatient-heal-thyself-if-you-want-a-better-system-support-a-smarter-patient.html BY DON KEMPER If you want a better system, support a smarter patient . For weeks now Congress has been stymied by how to pay for extending coverage to the uninsured. While it may seem stupid to look to the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2630119 Wed, 22 Jul 2009 23:00:00 +0100 2630119 http://www.medworm.com/index.php?rid=2630049&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FF_65iTumUiQ%2F The Cato Institute will launch an ad campaign Thursday highlighting under-reported poll data showing Americans’ concerns that current health care reform plans will raise costs, limit choice and reduce the quality of their health care. The campaign will feature full-page ads in major national newspapers, in addition to radio spots focusing on why government-run health care cannot address the problems of growing costs and lack of coverage for many individuals and families. The campaign will expand in the weeks ahead. “Our goal is to help the American public navigate terms like ‘a public plan’ and ‘individual or employer mandates’ to understand what is really happening here,” said Ed Crane, founder and president of the Cato Institute. “The bottom li... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2630049 Wed, 22 Jul 2009 18:55:29 +0100 2630049 http://www.medworm.com/index.php?rid=2630336&cid=t_255373_136_f&fid=36162&url=http%3A%2F%2Fmyelomablog.com%2F2009%2F07%2F22%2Fcancercare-launches-new-program-to-help-multiple-myeloma-patients-cover-transportation-costs%2F A list member just told us about this. Thanks, Sandy! CancerCare Launches New Program to Help Multiple Myeloma Patients Cover Transportation Costs ‘Door to Door’ initiative offers individual grants to patients to help defray costs of transportation to and from medical care NEW YORK, July 20 /PRNewswire/ — CancerCare announced today the launch of the “Door to Door” program for patients with multiple myeloma. CancerCare’s program will provide individual grants of up to $600 annually to multiple myeloma patients for covering transportation costs such as gasoline and taxi, bus or train fare to and from their medical care. The program is funded in part by a generous grant from Millennium: The Takeda Oncology Company. CancerCare is a national non-profit organi... beth's myeloma blog blogs http://www.medworm.com/rss/comments.php?id=2630336 Wed, 22 Jul 2009 15:39:07 +0100 2630336 http://www.medworm.com/index.php?rid=2630121&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Freturn-to-mcallen-a-fatherson-interview.html By IAN ROBERTSON KIBBE By now, Dr. Atul Gawande's article on McAllen's high cost of health care has been widely read. The article spawned a number of responses and catalyzed a national discussion on cost controls and the business of... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2630121 Tue, 21 Jul 2009 23:00:00 +0100 2630121 http://www.medworm.com/index.php?rid=2625984&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FNoL1AE3M-nI%2F A local version of the national fight over whether to create a new, government-backed health-insurance plan took a dramatic turn yesterday: Democrats in the Connecticut Legislature overrode a veto from the Republican governor, putting the state on a path to create a new public plan open to everyone. A board will create the outlines of the new program, which is supposed to launch in 2012, the Hartford Courant notes. Gov. M. Jodi Rell vetoed the bill because of the cost, which she said could be $1 billion a year. Both supporters and opponents of the bill can look next door to Massachusetts for ammunition: That state’s universal health-care insurance plan has significantly reduced the number of people without insurance, but the cost has been high. The Legislature didn’t quite have... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2625984 Tue, 21 Jul 2009 19:08:45 +0100 2625984 http://www.medworm.com/index.php?rid=2626285&cid=t_255373_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Falcoholic-refused-care-dies%2F ‘Please help me Mum, I don’t want to die’: Last words of alcoholic, 22, who died after being refused liver transplant Mr Reinbach (left with his Mother) had the worst case of cirrhosis that doctors had ever seen in a man of his age but they refused to give him a new liver which could have saved his life. However, guidelines state alcoholic liver patients must abstain for six months outside a hospital environment. Regardless of public opinion and medical costs, is this humane? Full stories at; Man, 22, Dies After Liver Transplant Refused A 22-year-old alcoholic has died after being refused a life-saving liver transplant because he was too ill to leave hospital and prove he could stay sober. Man refused liver transplant dies A 22-year-old east London man who began binge-drink... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=2626285 Tue, 21 Jul 2009 14:58:01 +0100 2626285 http://www.medworm.com/index.php?rid=2621765&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FMoiYHfAmiRg%2F Taxing employed-sponsored health benefits, an idea getting a lot of attention as a way to help pay for the health-care overhaul, may lead to unintended consequences, James Klein, president of the American Benefits Council and John Sweeney, president of the AFL-CIO, argue in a Washington Post op-ed today. The pair say that with such a tax, younger workers may opt-out of health plans, which could disrupt employer-sponsored group insurance plans. If exclusions to the tax aren’t indexed to inflation, the levy could end up taxing far more people than intended. And, they continue, for some health-related benefits like dental and vision coverage, the tax could effectively become more expensive if consumers must be buy them using after-tax dollars. There are a lot of myths about who benefits... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2621765 Mon, 20 Jul 2009 18:05:09 +0100 2621765 http://www.medworm.com/index.php?rid=2621766&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FSRMLt1YtUwE%2F Drug makers Bristol-Myers, Eli Lilly and Amgen are now able to put on the label of their cancer drugs what kind of patients the drugs won’t work for: those with a mutation to a certain gene known as KRAS. The FDA approved the labeling change for Bristol and Lilly’s Erbitux, the companies announced this morning. Amgen said Friday that the FDA approved its labeling changes for Vectibix, which is in the same class of drug as Eribitux. Usually companies want their medicines to be used by as many patients as possible. But drug makers are recognizing the value of tailoring medicine to specific individuals based on certain genetic or other biologic markers. The thinking is that even if the population for whom the drug works is smaller, it will be more effective for those patients, and... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2621766 Mon, 20 Jul 2009 14:27:55 +0100 2621766 http://www.medworm.com/index.php?rid=2621767&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fuw7Cn8TBsDE%2F All eyes will remain on the plan to overhaul the health-care system this week, notes the Washington Post, though the Obama administration’s goal to have both the House and Senate deliver a bill to the president by August has softened, according to the New York Times. One of the issues highlighted in this morning’s health-reform coverage is the tax surcharge on wealthy Americans contained in the House bill. Currently, the bill proposes a tax increase on individuals making more than $280,000 and families making more than $350,000 a year. House Speaker Nancy Pelosi told Politico that she thinks the income threshold should be raised to individuals making $500,000 and families making $1 million annually “so it’s a millionaire’s tax.” She also said that much of he... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2621767 Mon, 20 Jul 2009 13:11:29 +0100 2621767 http://www.medworm.com/index.php?rid=2621768&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FQJ4289IBRfs%2F Here’s how a co-pay for a medicine is supposed to work: Insurers set up a tiered system where patients fork over a smaller co-pay for cheaper drugs and a higher one for more expensive, brand-name drugs. The setup is supposed to encourage patients to use cheaper generics. But the drug makers are disrupting that system, according to the WSJ. Increasingly, they are paying part of patient co-pays for brand-name drugs, forcing insurers to ante up for these pricer drugs. For instance, Pfizer’s blockbuster drug Lipitor costs more than $1,400 a year, four to eight times more expensive than a similar generic cholesterol fighter. So, Pfizer started giving patients up to $15 off their co-pay using a rebate card they got at their doctor’s office. Now, the drug maker provides cards di... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2621768 Mon, 20 Jul 2009 12:35:28 +0100 2621768 http://www.medworm.com/index.php?rid=2613839&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FGmrcqQ8eXsI%2F Controlling Medicare costs is a political minefield for Congress. So, with everybody talking about the costs of health-care reform, some key Washington figures are arguing that another body should make some of the hard decisions about Medicare. Peter Orszag, who runs the Office of Management and Budget, today sent Nancy Pelosi a piece of legislation that would create a new council to make recommendations on Medicare payment rates and other issues. Members of the council would be appointed by the president, confirmed by the Senate and serve five-year terms. The group would make recommendations, which the president could then accept or reject as a package. If the president accepted the package, Congress would have 30 days to block it by joint resolution. In the absence of such a resolution, ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2613839 Fri, 17 Jul 2009 21:38:25 +0100 2613839 http://www.medworm.com/index.php?rid=2613842&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FHOZzueOMhDc%2F One of the much-discussed drivers of the high cost of health care in the U.S. is that doctors are paid for every procedure and test, which gives a financial incentive to provide more and more treatments, even if they aren’t strictly necessary. That system could change drastically in Massachusetts, as the state struggles to pay for its universal health insurance plan. A Massachusetts commission yesterday recommended that the state shift its payment method from the ubiquitous “fee for service” formula to one where health-care providers would be grouped into networks and paid a flat monthly or annual fee. Here’s the WSJ story. The goal is to improve care while reducing costs by forcing health-care providers to work within a budget and coordinate care between providers,... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2613842 Fri, 17 Jul 2009 13:22:22 +0100 2613842 http://www.medworm.com/index.php?rid=2610897&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FyjoZaxyPIg0%2F Tucked into the depths of the 1,018 pages of the House health care bill is $125 million to fund a program that looks at the medical home. In a medical home, a primary care provider (such as a family doctor, internist, pediatrician or nurse practitioner) gets paid to serve as the main point of contact for a patient and coordinate care among specialists and other community resources. That kind of thing often doesn’t get paid for in the current reimbursement system. And better coordination might improve patients’ quality of care and save money, for instance, by reducing redundant lab tests. (Though some efforts to improve coordination have failed to save money.) But medical home pilot projects have been around for a while now. And in the context of a bill expected to cost $1 tril... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2610897 Thu, 16 Jul 2009 19:03:18 +0100 2610897 http://www.medworm.com/index.php?rid=2610898&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F0dTgAxob68k%2F Rationing is a dirty word in health-reform debates. It’s used as a warning by those who oppose a larger government role in health care, and it’s avoided by those who support a new, government-backed health plan. But rationing already happens in American health care, the philosopher Peter Singer argues in an article to be published in this weekend’s New York Times Magazine: We deny treatments to people who can’t afford to pay. Singer argues that public insurance plans, such as Medicare, can’t afford to pay limitless prices for treatments likely to extend life by a few months. If a treatment extends a cancer patient’s life by an average of six months, is it worth $100,000? Is it worth $1 million? Anyone who wants to pay for such a treatment out of their ow... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2610898 Thu, 16 Jul 2009 15:41:50 +0100 2610898 http://www.medworm.com/index.php?rid=2610900&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FtUBqVr_yqz0%2F Some college athletes are among the millions of Americans who wrack up huge medical bills because of being uninsured or underinsured, reports the New York Times. Though some schools offer good coverage, many others don’t pay for all of their student-athletes’ medical bills. Some do so only if a direct link between the injury and the sport can be established. If they can’t, students are forced to tap into their regular student health insurance, which may not offer the same amount of coverage and which may specifically exclude varsity sport injuries. The Times cites examples of a Colgate University rower who wracked up $80,000 in bills for pain in her back and legs that the school refused to pay because it said she was treated for an illness, not a sports-related injury. Th... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2610900 Thu, 16 Jul 2009 12:59:02 +0100 2610900 http://www.medworm.com/index.php?rid=2605973&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fthree-initiatives-to-reduce-costs-and-increase-health-care-efficiencies-.html BY DALE H. YAMAMOTO Two major objectives underlying all current health care reform proposals are to reduce health care costs and to improve the quality of health care delivery. In my recent essay, part of the Society of Actuaries’ new... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2605973 Wed, 15 Jul 2009 23:00:00 +0100 2605973 http://www.medworm.com/index.php?rid=2605958&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FkmNiezG47t8%2F Healthy lifestyle choices could cut health-insurance premiums in half for some people under a provision of a health-reform bill working its way through the Senate, the Boston Globe reports. The detail hasn’t drawn much notice, despite the fact that such carrot-and-stick measures are usually controversial. The bipartisan agreement by the Senate health committee, which came Monday night, says that employees who improve their health habits by eating well, losing weight and quitting smoking can receive a discount of up to 30% from companies offering group health insurance, should the bill become law. That discount could be boosted to much as 50% by the Obama administration. Currently, the law limits the maximum discount to 20%. These types of initiatives are often hotly debated. Some cri... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2605958 Wed, 15 Jul 2009 13:44:53 +0100 2605958 http://www.medworm.com/index.php?rid=2601993&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Feliminating-medication-waste-in-longterm-care-can-help-the-white-house-pay-for-its-health-plan.html BY CARLA CORKERN The news of an $80 billion White House deal with drug companies to lower Medicare drug costs targets $30 billion in savings for consumers covered by Medicare Part D, but the sources of the remaining $50 billion... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2601993 Mon, 13 Jul 2009 23:00:00 +0100 2601993 http://www.medworm.com/index.php?rid=2598191&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FWpZvflg_xZQ%2F Recent weeks have seen a swirl of speculation over whether President Obama will or will not re-appoint Ben Bernanke to the Chairmanship of the Federal Reserve Board, when his current term as Chair expires in January 2010. Almost all of the debate has centered on his actions as Chairman. This narrow focus misses an important piece: his actions, and words, as a Fed governor during the build-up of the housing bubble. What should have been Bernanke’s greatest strength as a Fed governor and later chair, his understanding of monetary theory and his knowledge of the Great Depression, has ended up being a weakness. While correct in his analysis of the role of “debt deflation” — where the deflation increases the real burden of debts and correspondingly weakens the balance s... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2598191 Mon, 13 Jul 2009 14:19:43 +0100 2598191 http://www.medworm.com/index.php?rid=2598227&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fcosts-are-not-the-same-as-rates.html BY PAUL LEVY Many "old" med ia outlets do not identify the authors of their editorials. Thus, when an opinion is offered, you have no way of knowing who wrote it or what their qualifications are. Your only recourse when... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2598227 Sun, 12 Jul 2009 23:00:00 +0100 2598227 http://www.medworm.com/index.php?rid=2588189&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPVee8UiSDpE%2F The debate over expanding health insurance coverage — and figuring out how to pay for it — is everywhere you look these days. In Connecticut, for example, the governor on Wednesday vetoed a pair of bills that would have pushed the state toward universal health-insurance coverage. M. Jodi Rell, the state’s Republican governor, said the plan for universal coverage would cost $1 billion a year — and pointed out that the state faces a projected $8.85 billion deficit over the next two fiscal years, the Hartford Courant reports. One of the bills would have opened up the state’s insurance pool to municipalities, small businesses and nonprofit agencies. The other would have aimed to create a public insurance pool that anyone could join. Both bills passed the state&#8... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2588189 Thu, 09 Jul 2009 14:21:02 +0100 2588189 http://www.medworm.com/index.php?rid=2584143&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FxkhEN92L49Q%2F As proposals continue to be bandied about on how to lower the cost of a health-system overhaul, one idea appears to be losing steam, that of taxing employer-provided health insurance. Sen. Chuck Grassley had talked up the proposal just last week. But the WSJ notes that other senators including Kent Conrad, he of the health co-op idea, say that a first-ever tax on such benefits is unpopular and would be difficult to explain to voters. Though it’s not completely off the table, the Senate is considering a broader spate of options to help fund the huge price tag of reform, including “modestly” limiting the tax deductions for the wealthy, a proposal President Obama has raised repeatedly. Just 30% of voters support a tax on benefits, according to a telephone poll conducted in ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2584143 Wed, 08 Jul 2009 12:31:02 +0100 2584143 http://www.medworm.com/index.php?rid=2584158&cid=t_255373_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fthe-affordability-model.html By ROBERT LASZEWSKI Most health care experts agree the reason our system is so unaffordable is because of all of the waste and unnecessary care—up to 30% of what we spend. I will suggest that it will take the genius... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2584158 Tue, 07 Jul 2009 23:00:00 +0100 2584158 http://www.medworm.com/index.php?rid=2580194&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FHj-Mze4JLds%2F Some familiar subjects are worth revisiting — like the fact that paying doctors for every test and procedure they do provides an incentive to do more tests and procedures. Sandeep Jauhar, a cardiologist, reflects on the subject in an essay in this morning’s New York Times. Jauhar’s main job, at academic medical center, gives him a bit of a buffer against the financial pressures faced by docs in private practice. But he recently began moonlighting on Saturday mornings at a private practice, and the new gig is a stark reminder of the way medicine is a business — and the business does better when doctors do more tests. He writes: A patient comes in with chest pains. It is hard not to order a heart-stress test when the nuclear camera is in the next room. Palpitations? ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2580194 Tue, 07 Jul 2009 12:35:02 +0100 2580194 http://www.medworm.com/index.php?rid=2576560&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FOyimcepTWHg%2F President Obama has said he is open to the idea of the health-care cooperative option proposed by Sen. Kent Conrad. But how feasible is is it to get such a plan, in which consumer owners would negotiate rates with private insurers, up and running quickly? Not very, according to Bloomberg. Paul Keckley, executive director of the Deloitte Center for Health Solutions, tells Bloomberg that if existing regional co-ops are the model, such plans can take decades to fully develop. “If we had 25 years, and we weren’t staring down the barrel of a shotgun on health costs, it’s a pretty neat concept,” Keckley told Bloomberg. “It’s a politically interesting solution. I just don’t think it’s a real practical one.” Seattle-based Group Health, the oldest... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2576560 Mon, 06 Jul 2009 13:41:47 +0100 2576560 http://www.medworm.com/index.php?rid=2576561&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FKGDyq0BoG6M%2F Hospitals, drug makers, insurers and doctors all want to make sure their voices are heard in the debate over how to overhaul the health-care system. To improve the likelihood of being heard, the health-care industry has hired more than 350 former government staff and members of Congress to lobby on their behalf, according to an examination of disclosure records by the Washington Post. Spending a lot of money lobbying in Washington is nothing new for groups like the pharmaceutical industry. But many health-care stakeholders are spending even more now: The health-care industry as a whole is spending more than $1.4 million on lobbying, according to the Post. And they’re using more former congressional insiders than ever. The Post highlights a recent meeting between aides to Sen. Max Ba... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2576561 Mon, 06 Jul 2009 12:51:04 +0100 2576561 http://www.medworm.com/index.php?rid=2572977&cid=t_255373_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F6f4pAeZ0-Ao%2F Sickle cell disease, like many chronic health conditions, comes with a large financial cost. New research shows that “the annual cost of medical care in the US for people who suffer from sickle cell disease exceeds $1.1 billion.” The disease cause an abnormality in hemoglobin, where “red blood cells can block small blood vessels.” The result is tissue damage, stroke, and other complications. Each patient pays an average of almost $2,000 per year to manage the disease. Image: sxc.hu. Share and Enjoy: Post from: Blisstree Costs of Sickle Cell Disease (Source: A Hearty Life) A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2572977 Mon, 06 Jul 2009 12:00:29 +0100 2572977 http://www.medworm.com/index.php?rid=2570987&cid=t_255373_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fthe-ms-community-weighs-in-on-the-health-care-debate%2F What does the multiple sclerosis community think about changes to medical policy?  This week in Washington, DC lawmakers began what is sure to be an arduous national debate on the subject of health care reform.  Already “both sides” are waging an advertising campaign based upon people’s fears and hopes. I figured that as we go into the long Independence Day holiday weekend, we might afford ourselves to express (and maybe someone making decisions a chance to read) our thoughts on the subject.  Few diseases have a more significant lifetime economic impact as multiple sclerosis. Even with “excellent” coverage, many of us are either cornered into taking one drug or another because of outrageous co-pays or give up many rewarding aspects of our lives so we can af... Life with MS blogs http://www.medworm.com/rss/comments.php?id=2570987 Thu, 02 Jul 2009 21:45:20 +0100 2570987 http://www.medworm.com/index.php?rid=2570398&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FUeEO0RLD9Aw%2F Can cost-effective health-care measures that have worked in poorer countries be applied to in the U.S.? That’s the question the WSJ asks amid the debate over how the U.S. can reign in health-care costs. It’s become clear that many stakeholders in the debate are in favor of figuring out what treatments and tests are most effective for patients but not limiting care based on cost. Read J&J CEO William Weldon’s letter on this topic in the Washington Post this morning. One example the WSJ cites is a program run by an AIDS clinic in Alabama that improved its no-show rates dramatically by giving patients prompt appointments and conducting interviews to help determine what factors might make a patient less likely to come back, which mimicks a similar program set up in Zamb... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2570398 Thu, 02 Jul 2009 12:44:26 +0100 2570398 http://www.medworm.com/index.php?rid=2570399&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fr9o3ZacEwMI%2F The agency that runs Medicare today suggested making an obscure accounting change that could make it easier for Congress to change how Medicare pays doctors. The issue goes back to a law passed in the 1990s that was supposed to ensure that the amount Medicare paid doctors for each beneficiary grew no faster than the overall economy. That didn’t happen. (The law created something known as the “sustainable growth rate,” or SGR, in Washington jargon). So now there are two different worlds. There’s the official world, in which doctors are scheduled to get a 21.5% pay cut from Medicare next year under SGR. And then there’s the real world, where Congress will intervene at the last minute to block the pay cut, as it’s done time and again in recent years. There... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2570399 Wed, 01 Jul 2009 22:17:33 +0100 2570399 http://www.medworm.com/index.php?rid=2570712&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2Fc9jmVENGohQ%2F This article is primarily about bundling payments around episodes of care, but the issues it raises - in both directions - apply in either context. With that said, I wonder about whether or not global budgets, at least in the short term, are the answer to our health care cost and quality problems.  For some provider organizations, global budgets work - but they work in large part because those particular clinicians believe in them, and want to practice in environments that are based on them (like Harvard Vanguard/Atrius HealthCare).  But that represents a fairly small slice of the practicing clinician community - I’m guessing 10-15 percent.  Maybe 20.  It’s also not clear to me that this issue, above all else, drives our cost/quality problem, since many other countries... HPHC blogs http://www.medworm.com/rss/comments.php?id=2570712 Wed, 01 Jul 2009 19:55:17 +0100 2570712 http://www.medworm.com/index.php?rid=2561223&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FEtCupauQm9w%2F Earlier this year, the National Institutes of Health came up with a priority list of projects that should get priority for the $1.1 billion in research funding included in the economic stimulus package. Today, the Institute of Medicine issued its own recommendations for the 100 health topics it thinks should get funding. Like the NIH’s list, high on the IOM’s list is conducting comparative effectiveness research on expensive biologics that treat inflammatory diseases. These include Remicade and Simponi from J&J and Schering-Plough, Abbott’s Humira and Enbrel from Wyeth and Amgen. In particular, the IOM recommends comparing “strategies of introducing biologics into the treatment algorithm,” which means comparing treatments with each other or other &#8220... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2561223 Tue, 30 Jun 2009 20:04:46 +0100 2561223 http://www.medworm.com/index.php?rid=2556092&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FyJ5iv7s5_bY%2F Amid much discussion around comparative effectiveness of medical treatments and whether cost should be a factor in treatment decisions, a new article in the Journal of the National Cancer Institute estimates it would cost $440 billion to extend life by one year for the 550,000 Americans who die annually of cancer, reports the WSJ. The authors, from the National Cancer Institute and National Institutes of Health, say that 90% of cancer drugs approved in the past four years cost more than $20,000 for 12 weeks worth of treatment. Some drugs have limited upsides, and these shouldn’t be developed unless they will cost patients less than $20,000 for a standard course, they say. Two more recommendations from the authors: doctors shouldn’t prescribe cancer medicines for non-approved p... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2556092 Tue, 30 Jun 2009 13:44:15 +0100 2556092 http://www.medworm.com/index.php?rid=2522872&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fpjvs_NV9Q-Y%2F California Gov. Arnold Schwarzenegger is bagging a plan to improve his state’s prison health-care system, which is known to be a mess, because of the $1.9 billion price tag. “We cannot agree to spend $2 billion on state-of-the-art medical facilities for prisoners while we are cutting billions of dollars from schools and health care programs for children and seniors,” Schwarzenegger said in a statement: A month ago, state officials announced a plan to build two hospitals and improve existing medical centers for inmates, according to the San Francisco Chronicle. But now, “it’s just not the right time,” state Corrections Secretary Matthew Cate told the paper. “At this time, we’re going to have to live within our means.” He adds that the ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2522872 Fri, 26 Jun 2009 13:57:29 +0100 2522872 http://www.medworm.com/index.php?rid=2522874&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZM_GwGCyjHI%2F A plan to reform health-care is going to cost a lot of money and Congress is working to figure out where it’s going to come from. Chairman Max Baucus of the Senate Finance Committee says he has crafted a new set of policy options that will allow the plan to be be fully paid for and that will meet the cost goal of $1 trillion over 10 years, the WSJ and New York Times report. Details from Baucus, however, were scant. Senate aids say the plan is likely to include reducing a tax credit to small businesses for providing health insurance for employees and delaying the expansion of Medicaid, according to the WSJ. The NYT says the bill will likely call for a new tax on employer-provided health benefits and a mandate for employers to help pay some health insurance costs for low-income worker... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2522874 Fri, 26 Jun 2009 12:29:29 +0100 2522874 http://www.medworm.com/index.php?rid=2515177&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FowTezEu8tlY%2F In a town hall meeting broadcast by ABC News last night, President Obama fielded audience questions about his health-reform plans, ranging from access to treatment to cost containment. Read the full transcript here. Afterward, ABC did a little fact checking on what the president said. Three samples: Obama has tried to assure individuals that they won’t be forced to switch doctors or change health plans with his new plan. But ABC notes — and the president acknowledged at his news conference Tuesday — that private companies can choose different plans for their employees on their own — and Obama isn’t proposing to change this. But, the president pledges, Americans won’t be forced by the government to switch to a new plan. Private health insurers are conce... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2515177 Thu, 25 Jun 2009 13:46:51 +0100 2515177 http://www.medworm.com/index.php?rid=2515178&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fsg4RkmPFQfc%2F The Obama administration is “committed to turning the heat up” on Medicare and Medicaid fraud, Health and Human Services Secretary Kathleen Sebelius said as the government announced a new string of indictments alleging $50 million in false Medicare claims. Medicare fraud has been a target for federal investigators for years, though their effectiveness has been questioned. Schemes to bilk the system have included payments to dead doctors, hospitals who recruited homeless people as fake patients and insurers who inflated the cost they say they spent on care. The U.S. spends $800 billion a year on Medicare and Medicaid, $60 billion of which is estimated to be lost to fraud, notes the WSJ. The indictments announced yesterday involved 53 doctors, health-care workers and patients and... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2515178 Thu, 25 Jun 2009 13:10:46 +0100 2515178 http://www.medworm.com/index.php?rid=2510297&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FEoqEJxoKhPg%2F Ending settlements in which branded drug makers pay generic ones to delay entry into the market, known as “pay-for-delay” settlements, would save consumers $3.5 billion a year, plus “significant savings” for the federal government, according to Federal Trade Commission Chairman Jon Leibowitz. In his speech to the Center for American Progress today, Leibowitz said that stopping such deals is an FTC priority and urged Congress to pass legislation to ban or limit such patent settlements, which the agency believes to be anticompetitive. Yesterday, the Supreme Court declined to hear such a case involving the nearly $400 million Bayer paid to Barr and other companies to keep generic versions of its antibiotic Cipro off the market until Bayer’s patent expired. Thes... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2510297 Tue, 23 Jun 2009 18:04:51 +0100 2510297 http://www.medworm.com/index.php?rid=2522906&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F06%2F23%2Fexpanding-coverage-for-low-income-americans-medicaid-of-health-insurance-exchanges%2F While the most visible national health reform fight at the moment focuses on a public plan option for people covered through health insurance exchanges (or gateways), a quieter debate is brewing over whether coverage for low-income people should be achieved through Medicaid expansions or subsidies to purchase insurance through an exchange. For example, the Senate Finance Committee’s coverage options paper indicated interest in expanding Medicaid coverage for people with incomes up to 100 percent or 150 percent of the federal poverty level, which would particularly help low-income parents and childless adults. Currently, the median income eligibility level for parents in Medicaid is 68 percent of poverty, or about $12,000 for a family of three, and only six states provide Medicaid coverag... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2522906 Tue, 23 Jun 2009 16:25:56 +0100 2522906 http://www.medworm.com/index.php?rid=2510300&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FV7zrdSvtqCU%2F While apparently not getting worse since its elevation to pandemic status, the H1N1 flu still will deliver quite an economic punch to Mexico, according to a World Bank report. As ground zero for the flu, Mexico’s gross domestic product might reduce as much as 2.2%, the report says. Tourism in the country is down 43%. Bloomberg has more on the study. The range of the potential economic impact from a pandemic is broad, according to a 2006 study cited by the World Bank. The low-end impact was estimated at 0.7% of global GDP, on the scale of the Hong Kong flu of 1968-69. At the high end, it could reduce global GDP by 4.8%, a figure benchmarked to the 1918-1919 Spanish flu. In the case of the current H1N1 outbreak, the impact depends on the severity of the pandemic when flu season rolls ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2510300 Tue, 23 Jun 2009 15:06:47 +0100 2510300 http://www.medworm.com/index.php?rid=2477542&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fcy8wOcJPGRw%2F Columnist Robert J. Samuelson, writing in this morning’s Washington Post: It’s hard to know whether President Obama’s health-care “reform” is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it’s imperative to control runaway health spending. He’s right. The trouble is that what’s being promoted as health-care “reform” almost certainly won’t suppress spending and, quite probably, will do the opposite… The president summoned the heads of major health-care groups representing doctors, hospitals, drug companies and medical device firms to the White House. All pledged to bend the curve. This is mostly public relations. Does anyone believe the American Medical Association can control t... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2477542 Mon, 15 Jun 2009 15:02:54 +0100 2477542 http://www.medworm.com/index.php?rid=2523628&cid=t_255373_134_f&fid=34841&url=http%3A%2F%2Fwww.diabetesmine.com%2F2009%2F06%2Faffordable-diabetes-wal-mart-tops-list.html I get loads of questions about where to find discounted meds and other diabetes supplies. Especially over at the DiabeticConnect community, costs are one of the hottest topics. Until now, I’ve been referring folks to Patient Assistance Programs, neglecting the fact that if you have a little bit of cash on hand, you can get [...] (Source: Diabetes Mine) Diabetes Mine blogs http://www.medworm.com/rss/comments.php?id=2523628 Mon, 15 Jun 2009 13:00:37 +0100 2523628 http://www.medworm.com/index.php?rid=2477605&cid=t_255373_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F4364   Two weeks later Atul Gawande’s New Yorker article has multiple interpretations.  This NY Times editorial provides another example – Doctors and the Cost of Care There is disturbing evidence that many do a lot more than is medically useful — and often reap financial benefits from over-treating their patients. No doubt a vast majority of doctors strive to do the best for their patients. But many are influenced by fee-for-service financial incentives and some are unabashed profiteers. This editorial blames the doctors.  As I read the article, the doctors in McAllen lived in a culture of excessive technology and service.  Others have focused on the examples of lower cost care, like the Mayo Clinic. How should we interpret Gawande’s article?&nbsp... DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=2477605 Sun, 14 Jun 2009 12:03:34 +0100 2477605 http://www.medworm.com/index.php?rid=2473229&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F06%2F11%2Fhospital-costs-and-quality-ashish-jhas-view%2F We examined whether hospitals that cost more provided better care than hospitals that had lower risk-adjusted costs. We found no relationship between risk-adjusted costs and patient outcomes but did find a small but consistent relationship between risk-adjusted costs and somewhat better clinical care. For those who have assumed that “you get what you pay for,” our findings are largely disappointing: hospitals that spend more don’t seem to have better outcomes and have only marginally better quality. Why we did this study High costs and variable quality are two of the main challenges facing clinical leaders and policymakers. There have been very few systematic examinations of whether health care providers that spend more money on their patients produce better outcomes (as one might im... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2473229 Thu, 11 Jun 2009 17:28:47 +0100 2473229 http://www.medworm.com/index.php?rid=2469684&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FjbbBB0cLtPc%2F Health care reform is making a lot of news these days.  President Obama is calling for “reform now,” Senators Edward Kennedy and Max Baucus are working on their own proposals, the U.S. House of Representatives is working on a number of plans, the so-called, “Blue Dog Democrats” in the House have come out against creating a “Medicare For All” program for the privately insured, and a variety of advocates and interests have suddenly landed opinion pieces, blog commentaries and talking head shots on the news and cable networks. I hesitate to pick a spot in all of this, because it’s kind of like engaging in a debate about hypotheses of one sort or another, but I do think there are some points worth making anyway. First of all, the problems we face ... HPHC blogs http://www.medworm.com/rss/comments.php?id=2469684 Wed, 10 Jun 2009 19:48:43 +0100 2469684 http://www.medworm.com/index.php?rid=2469441&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FVrm607VEGto%2F Well, sometimes maybe.  Reports the National Post: An investigation has been launched after a woman admitted to Montreal’s Royal Victoria Hospital for an induced birth was forced into a do-it-yourself delivery last month, with only her common-law partner to assist. “We’re taking it very seriously,” Dr. Matt Kalina, assistant director for professional services at the McGill University Health Centre, said. “We’re reviewing the specific events thoroughly with the family…. We’re using the lessons to improve our systems.” At about 5 a. m. on May 13, medical help failed to appear even after Karine Lachapelle’s water broke. Despite attempts to summon help by partner Mark Schouls, who was pushing the nurse-alert button with increasing fr... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2469441 Wed, 10 Jun 2009 13:12:20 +0100 2469441 http://www.medworm.com/index.php?rid=2469455&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FuKYsxUOPCiE%2F Most everybody wants the best deal for the money, but not everybody wants to settle for some potential options being excluded from the deal–no matter the cost of those options. So it goes in the continuing debate over comparative effectiveness research in health care. Backers think it will provide cost-saving data comparing different treatments, while opponents see an opening for government to ration treatment choices. See here and here for more on the subject. Just the term itself can cause sparks to fly, as Max Baucus, chairman of the Senate Finance Committee noted this morning when speaking to a Brookings Institution-sponsored conference on CER. “I suggested [to my colleagues] that we call it ‘Fred,’” he said. “That may be less ominous.” He continued: “Another name that we ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2469455 Tue, 09 Jun 2009 20:35:32 +0100 2469455 http://www.medworm.com/index.php?rid=2464104&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FVuuwjyzkASc%2F We’re sensing a pattern here. In 2004, the state-subsidized Oregon Health Plan had to stop enrolling new members due to money woes; the state decided to add 3,000 new members last March but had to pick them by lottery, out of a pool of about 80,000 hopefuls. In Massachusetts, the universal-coverage scheme instituted in 2006 is suffering from high costs. And in Washington state today, officials announced that rates for the state-subsidized insurance program called the Basic Health Plan will increase by an average of 70 percent by January. The goal: to cut the rolls from 100,000 members to 64,000 in order to save money. The legislature cut $255 million from the budget for the program between 2009 and 2011, a cut of 43%. Rather than drive people away with a lottery, or based on how lon... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2464104 Mon, 08 Jun 2009 22:46:34 +0100 2464104 http://www.medworm.com/index.php?rid=2464098&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FHmV7-vt55Qc%2F From a patient’s point of view, the ideal health insurance policy would offer unlimited access to medical services at no charge. Unfortunately, it is not feasible to offer this to everyone. The key to sustainable health care reform is restraining the use of services that have high costs and low benefits, says Cato adjunct scholar Arnold Kling.  In the video below, Kling examines the challenges facing health reformers and the feasibility of alternative proposals. (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2464098 Mon, 08 Jun 2009 15:11:28 +0100 2464098 http://www.medworm.com/index.php?rid=2458058&cid=t_255373_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F06%2F05%2Fdangerous-confusion-on-medicare-cost-control%2F In a May 15 Health Affairs Blog post, Jeff Goldsmith argues against creating a new Medicare-like public health insurance plan to compete with private plans. As part of his argument, Goldsmith asserts that Medicare has done a worse job of controlling costs than private insurers have done. Dr. Goldsmith’s bases this assertion on a recent paper by Richard Kronick, citing figures that Kronick in turn quoted from a study by the Congressional Budget Office. The problem is that, as CBO itself was careful to point out, the CBO study didn’t actually say that Medicare was worse than private insurers at controlling costs. In fact, the bulk of the available evidence indicates that Medicare has been better at controlling costs than private insurers. What Dr. Goldsmith Argued In Dr. Goldsmith’s wo... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2458058 Fri, 05 Jun 2009 14:08:04 +0100 2458058 http://www.medworm.com/index.php?rid=2452401&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FSpCfnAJ_d1w%2F When there are too many medical specialists in one region, Medicare costs go up — but patient satisfaction, quality of care and convenience remain the same, according to Peter Bach, a pulmonary specialist at Memorial Sloan-Kettering Cancer Center, in an op-ed in the New York Times. For example, New York City has twice as many specialists per 100,000 residents as Albany in update New York. Medicare spends $12,114 a year per patient in New York City but only $5,950 in Albany. A simple solution to the overpayment problem would be to use a bidding system, he says. Here’s how: Start by offering doctors a reimbursement rate per patient lower than the current rate and see how many sign up. If enough do, Medicare has saved itself and taxpayers a lot of money. If not enough do, up the b... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2452401 Thu, 04 Jun 2009 15:22:52 +0100 2452401 http://www.medworm.com/index.php?rid=2452402&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FxgOxVoN4DtA%2F Some 62% of all bankruptcies filed in 2007 were due in part to medical expenses, according to a new study. Even more striking: 78% of those individuals had insurance. Most people hit by such bankruptcies were considered middle-class, college-educated and owned homes, according to the study published online by the American Journal of Medicine. By the time they filed bankruptcy, those without insurance reported average medical bills of $26,971 and those with insurance, expenses of $17,749. Steffie Woolhandler, one of the study authors, believes that private insurers have failed to protect consumers from overwhelming debt. Woolhandler, an associate professor of medicine at Harvard, advocates a single-payer health-care system, the WSJ notes. “We need to rethink health reform,” she ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2452402 Thu, 04 Jun 2009 13:37:19 +0100 2452402 http://www.medworm.com/index.php?rid=2452404&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FcyaPk25Gf9Q%2F Health care costs are a mystery to most people. A McKinsey survey of consumers last January found that 75% of them simply answered “I don’t know” when asked how much treatment for a heart attack would run. Asked about the yearly cost of treating diabetes, 78% were clueless, and 82% had no idea how much it would cost to treat a family member with Alzheimer’s. The respondents who did think they knew were pretty far off the mark. On average, they estimated the heart attack treatment would cost $48,222, 135% more than McKinsey’s figure of $20,489. They were 54% too high on the diabetes, and 16% over the Alzheimer’s total. Of course, the cost of treatment varies widely depending on the details of the patient’s condition, as well as other factors including what part of the... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2452404 Thu, 04 Jun 2009 12:26:33 +0100 2452404 http://www.medworm.com/index.php?rid=2452748&cid=t_255373_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F7_WwNKsS9CU%2F Almost 2/3 of personal bankruptcies in the United States are the result of illness and overwhelming medical bills, despite having health insurance, say researchers. This is a 50% increase from 2001, just 8 years ago. And, it’s important to note 2 things. One is that bankruptcy is harder to declare now than it was before 2001 and that this research was done before the current economic situation, so the situation could, in fact, be worse. Researchers from Harvard Law School, Harvard Medical School and Ohio University worked together to produce the first known study of this type to cover the entire country. They found that the vast majority (over 77%) of the people who went bankrupt were among those who did have health insurance when they first became ill. According to a press release d... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2452748 Thu, 04 Jun 2009 10:30:21 +0100 2452748 http://www.medworm.com/index.php?rid=2452329&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F03%2Fhealthy-mind-healthy-body%2F Title: Healthy mind, healthy body The Skinny: NHS Confederation briefing that looks at opportunities to improve quality and efficiency in acute services by focusing on the needs of the significant number of patients who also have mental health problems complicating their care and discharge. Key points: One quarter of acute inpatients have mental health problems. Identifying and treating the mental health needs of acute inpatients early has a direct impact on the recovery of their physical health. Liaison services can improve care and bring costs savings as patients can be discharged earlier if their mental health needs are addressed. Services can also bring savings for primary care trusts (PCTs) by reducing re-attendances. Publisher: NHS Confederation Size of Document: 6p. Published: 07... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2452329 Wed, 03 Jun 2009 19:00:21 +0100 2452329 http://www.medworm.com/index.php?rid=2452384&cid=t_255373_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F0Id0gvZR0s0%2F There’s an old Yiddish saying that, “If my bubba had wheels she’d be a trolley.” So goes the logic of the Obama administration in their paper released yesterday, “The Economic Case for Health Care Reform.” Their claim is that reducing health care costs would help the economy. Yes, if health care costs were reduced it would likely help the economy, though we should remember that the health care industry is part of the economy. There is nothing in Obamacare, however, that will reduce costs. In fact, expanding coverage may cause costs to rise. One study by MIT’s Amy Finkelstein suggests that the prevalence of insurance itself has roughly doubled the cost of health care. So, if Obama succeeds in expanding insurance coverage, it’s very likely to increase the cost... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2452384 Wed, 03 Jun 2009 17:31:59 +0100 2452384 http://www.medworm.com/index.php?rid=2441196&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIMtv0NfMbcM%2F When the Health Blog has to go to the doctor, we fork over our $20 co-pay on the spot and usually any invoice that comes after within 30 days. Turns out that’s faster than it takes nearly two-third of major health plans, with their billions of dollars in reserves, to do just that. For the fourth year in a row, Athenahealth, a provider of online medical billing services to doctors and hospitals, has crunched some $7 billion in claims data to rank 172 national, regional and government health plans on how quickly and accurately they pay up. Check the rankings and news release. The results, for some, weren’t stellar. New York’s Medicaid program, a consistent bottom-of-the-pack finisher in previous years, took an average 161 days — almost half a year — to reimburs... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2441196 Thu, 28 May 2009 14:25:55 +0100 2441196 http://www.medworm.com/index.php?rid=2424392&cid=t_255373_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2FVvaZVoE1zs0%2Fwhy-perform-comparative-effectiveness-research.php Comparative Effectiveness Research (CER) answers basic questions about drugs and treatments. Is Treatment A better than Treatment B? Which one costs more over time? Answers to these questions can help doctors and patients choose cheaper and more effective treatments. What Exactly Is Comparative Effectiveness Research? In the latest issue of the New England Journal of Medicine, Jerry Avorn clearly explains why CER is so important. "The contested provisions were designed... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2424392 Wed, 20 May 2009 16:00:00 +0100 2424392 http://www.medworm.com/index.php?rid=2415683&cid=t_255373_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2Fwzcyyr9Z3Ug%2Fchart-controlling-health-care-costs.php Here's another great chart from The Commonwealth Fund. Last week I read a story about a woman who would go into the E.R. every week and complain of pain to get vicodin. Because the staff needed to be sure there was nothing wrong with her, they would inevitably perform a variety of tests. In one year, her hospital visits accounted for $98,000 in expenses. I don't know how common over-testing... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2415683 Mon, 18 May 2009 16:00:00 +0100 2415683 http://www.medworm.com/index.php?rid=2415528&cid=t_255373_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F001529.html This is more of a question than anything else. AWP (average wholesale price) as a pricing mechanism for drugs will eventually go away (due to a court order). There is an intense, if not very objective or helpful, debate re... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=2415528 Fri, 15 May 2009 04:00:00 +0100 2415528 http://www.medworm.com/index.php?rid=2405049&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%3A80%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FXKnnR0IFxZ0%2F A jobless benefit from Pfizer Pfizer is taking a page from the auto industry’s recession playbook with its program to offer free drugs to the unemployed. The company said today that it will give away a lot of its drugs to people with prescriptions who have lost their jobs and health insurance since January and had already been taking the drugs for at least three months. Patients can stay in the program for up to a year or until they obtain insurance, whichever is earlier. The eligible drugs include Lipitor, Viagra, Celebrex and Lyrica, but not the costliest specialty drugs for diseases such as cancer. It reminds us of a program that AutoNation, the U.S.’s largest auto dealership chain, rolled out to cover monthly car payments after a buyer becomes unemployed and has made three... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2405049 Thu, 14 May 2009 18:26:07 +0100 2405049 http://www.medworm.com/index.php?rid=2405051&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%3A80%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FgM4Zr9OhGho%2F The White House may have trumpeted the pledge this week by big players in the health industry to wring $2 trillion in costs out of the system over a decade, but apparently it took a while for the administration to get on board. Nancy-Ann DeParle, head of the White House’s health-reform office, was “skeptical” of the idea when she was first approached about it by Karen Ignani, president of trade group America’s Health Insurance Plans, DeParle told the Washington Post. She added that she thought at the time, “They probably don’t even know what these numbers mean.” By mid-April, the group pushing the idea also included a hospital organization and labor union. DeParle still wasn’t satisfied. Eventually a much larger coalition came together and t... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2405051 Thu, 14 May 2009 16:08:24 +0100 2405051 http://www.medworm.com/index.php?rid=2405673&cid=t_255373_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F001524.html Drug utilization declined slightly in 2009, while prices for brand drugs jumped eight percent. And specialty drugs, although a tiny portion of the total number of scripts, drove sixty percent of the overall growth in drug costs. The net? Medco's... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=2405673 Wed, 13 May 2009 04:00:00 +0100 2405673 http://www.medworm.com/index.php?rid=2404970&cid=t_255373_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F05%2F08%2Fnhs-reference-costs-2007-08%2F The documents below provide details on how and on what NHS expenditure was used in the 2007/08 financial year. The main purpose of these figures  is to provide a basis for comparison within (and outside) the NHS between organisations, and down to the level of individual treatments. Overview and summary Appendix RC1 Reference Costs Index (RCI) Appendix NSRC1 – NHS trust reference cost schedules Appendix NSRC02 Primary Care Trust Reference Cost Schedule Appendix NSRC03 PMS and Piliot Reference Cost Schedules Appendix NSRC04 NHS Trust and PCT Combined Reference Cost Schedules Appendix NSRC05 Non NHS Provider Schedules Posted in Financial Management, Grey Literature, NHS Tagged: Financial Management, Grey Literature, Health Economics, Reference Costs (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2404970 Fri, 08 May 2009 14:04:38 +0100 2404970 http://www.medworm.com/index.php?rid=2398904&cid=t_255373_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FLUdoAEdh0r8%2F A Payment Reform Commission in Massachusetts has been meeting for the past few months and discussing - natch - reforming the way health plans and government purchasers like Medicare and Medicaid pay for health care services.  Their primary objective is to move away from what’s commonly referred to as “fee for service” payments - in which physicians and hospitals are paid based on how many procedures they perform - to something that’s based more on healthy outcomes and good care management.  Their preferred solution, at least according to a story in today’s Boston Globe, is global budgets. This is very interesting.  Back in the early 1990s, I served as Secretary of Health and Human Services under former Massachusetts Governor Bill Weld.  Around that ti... HPHC blogs http://www.medworm.com/rss/comments.php?id=2398904 Thu, 07 May 2009 21:44:34 +0100 2398904 http://www.medworm.com/index.php?rid=2390216&cid=t_255373_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2F-EYG05nbFQU%2Fdeath-is-cheap-life-is-expensive.php Does improving health lower the cost of health care? I took this as a truism when I started this series of posts, but it turns out that may be a mistake. Ezra Klein continues his fantastic series of posts on health care reform with this gem. (I added the emphasis.)Paul Campos offers the standard argument against assuming that better health means lower costs: Not smoking makes you healthier. But refusing... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2390216 Wed, 06 May 2009 16:00:00 +0100 2390216 http://www.medworm.com/index.php?rid=2386833&cid=t_255373_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fx1yTe315HTo%2F Can Wal-Mart eliminate the drug-coverage middleman? The retailer’s $4 generic-drug program has already prompted lots of pharmacies to follow suit. Those programs are especially attractive to the uninsured, who pay for their drugs themselves. Now Wal-Mart is testing a program with an employer that offers insurance to its workers, heavy-equipment maker Caterpillar. Here’s how the WSJ describes the program: Wal-Mart gets a fixed markup over its cost for the drugs it sells to Caterpillar employees. Though Wal-Mart doesn’t reveal the costs to Caterpillar, they are verified by a third party. The markup guarantees a profit for Wal-Mart, while reducing the cost to Caterpillar. The employer has waived co-pays on generic prescriptions bought from Wal-Mart. This sort of thing sound... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=2386833 Mon, 04 May 2009 15:29:32 +0100 2386833