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'. Sat, 03 Sep 2011 01:53:43 +0100 http://www.medworm.com/index.php?rid=5181736&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fberwick-to-keynote-health-affairs-briefing%2F Don Berwick, the Administrator of the Centers for Medicare and Medicaid Services, will keynote Health Affairs’ September 8 briefing on controlling health care costs. At the briefing, Health Affairs will release its September 2011 issue, “The New Urgency To Lower Costs.” Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181736 Thu, 01 Sep 2011 14:09:50 +0100 5181736 http://www.medworm.com/index.php?rid=5181737&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F31%2Fthe-challenges-of-payment-reform-and-administrative-simplification%2F As both a Canadian and an analyst who focuses on US healthcare, I have an abiding curiosity in comparisons between the US and Canadian systems, so it was with great interest that I read the recent Health Affairs article by Dante Morra and coauthors entitled “US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181737 Wed, 31 Aug 2011 16:57:12 +0100 5181737 http://www.medworm.com/index.php?rid=5169545&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-physicians-have-a-role-in-controlling-healthcare-costs%2F2011.08.27 The Role of Physicians in Controlling Medical Care Costs and Reducing Waste by the RAND Corporation and David Geffen, University of California Los Angeles School of Medicine, Santa Monica was just published in the Journal of the American Medical Association (JAMA).  I do not think the JAMA should have published this article. 1.Why would the JAMA publish such an article? 2. Why are physicians blamed for all the waste in the system? 3. Why is it the physicians’ responsibility to eliminate waste when they are not the cause of the greatest percentage of the waste? “The amount of money spent on medical care is increasing faster than the gross domestic product (GDP), and the federal deficit is increasing.” The initial statement assumes that the government deficit is increasing because phy... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169545 Sat, 27 Aug 2011 21:05:19 +0100 5169545 http://www.medworm.com/index.php?rid=5158921&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Fmedicares-looming-risk-transfer%2F Editor’s Note: Below, Jaan Sidorov analyzes the risk-shifting inherent in proposals for Medicare reform. Today, Health Affairs Blog is also publishing the first installment of a two-part post by Troyen Brennan and Thomas Lee, which addresses risk-shifting in the health care system as well. Suppose, despite my good health and lifelong habit of avoiding doctors, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158921 Wed, 24 Aug 2011 15:53:07 +0100 5158921 http://www.medworm.com/index.php?rid=5158922&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Frisk-shifting-in-health-care-and-its-implications-part-one%2F Editor’s Note: Below, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discuss the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two tomorrow, Brennan and Lee will discuss the implications of this shift [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158922 Wed, 24 Aug 2011 15:50:18 +0100 5158922 http://www.medworm.com/index.php?rid=5158999&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-patients-considering-the-idea-of-medical-tourism-to-receive-health-care%2F2011.08.24 I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new. Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website y... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158999 Wed, 24 Aug 2011 14:00:07 +0100 5158999 http://www.medworm.com/index.php?rid=5158854&cid=t_106517_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fthe-core-cities-health-network-report-new-horizons-and-new-challenges%2F Scan or click to download 'The Core Cities Health Network Report: New Horizons and New Challenges' Title:  The Core Cities Health Network Report: New Horizons and New Challenges The Skinny: Report from the Core Cities Health Network that identifies that understanding the commissioning task for securing healthcare for large city/urban areas will be essential for established (and yet to be established) GP commissioning consortia and new statutory Health and Wellbeing Partnership Boards. Building effective partnerships across agencies ensures that local health care strategies for city populations must be informed and driven by health improvement and the reduction of health inequalities. Publisher: DH Published: August 2011 Size: 35p. Filed under: Ooops Missed Category! Tagged: Annu... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158854 Tue, 23 Aug 2011 12:56:43 +0100 5158854 http://www.medworm.com/index.php?rid=5158858&cid=t_106517_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-home-health-care-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide: Improving Transitions from the Hospital to Home Health Care to Reduce Avoidable Rehospitalizations' Title: How-to Guide: Improving Transitions from the Hospital to Home Health Care to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking to aviod rehospitalisation on return to the community detailing initial steps to create an enhanced transition to home health care in the first 48 hours after the patient is discharged from the hospital, a post-acut... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158858 Tue, 23 Aug 2011 07:59:04 +0100 5158858 http://www.medworm.com/index.php?rid=5159283&cid=t_106517_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F42OlfYrK2Vg%2F This is the start of a new series of posts that I plan to do over the next week or two. I’ll probably try and space them out so that they don’t overwhelm anyone. However, it’s going to be a series of common EMR implementation issues that I hear over and over again. This series was prompted by a post on HIStalk by Inga where she talked about her visit to the doctor and his complaints about his EHR implementation. As I read through the list of complaints, I realized that they were all complaints that I’d heard before. If I’ve heard them all before, then they must be pretty common and worth talking about more. Ideally the discussions in this EMR implementation series will help practices and doctors that are implementing an EMR to avoid these issues. I also know t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159283 Fri, 19 Aug 2011 19:45:47 +0100 5159283 http://www.medworm.com/index.php?rid=5139672&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F18%2Fimplementing-health-reform-informing-consumers%2F One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139672 Thu, 18 Aug 2011 14:49:06 +0100 5139672 http://www.medworm.com/index.php?rid=5139683&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIyG05aaQWBI%2F Viagra Protection: A federal judge ruled yesterday that a Pfizer patent on the erectile-dysfunction treatment Viagra is valid and enforceable, protecting the blockbuster drug against generic competition until 2019, the WSJ reports. Teva Pharmaceutical had proposed a generic version of the drug, arguing that certain claims of that 2019 Pfizer patent were invalid, the paper says. Cheap Screening: Hospitals are advertising inexpensive low-dose CT scans for current and former smokers on the heels of a government study that found such lung-cancer screening can save lives in a certain group of people, Kaiser Health News reports. But the study didn’t fully answer questions about who might benefit from the screening and how they should be screened, and the tests produce a lot of false positi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5139683 Tue, 16 Aug 2011 12:43:51 +0100 5139683 http://www.medworm.com/index.php?rid=5130664&cid=t_106517_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fnhs-reforms-in-england-managing-the-transition%2F Scan to download 'NHS reforms in England managing the transition' Title: NHS reforms in England: managing the transition The Skinny: Nuffield Trust report that assesses the 2011/12 Operating Framework for the NHS together with guidance on the operation of Payment by Results (PbR) in 2011/12. Establishes the key challenges associated with managing the transition to a reformed NHS, as envisaged in the White Paper: Equity and Excellence: Liberating the NHS, and proposes ways in which the risks associated with transition might be mitigated. It suggests there is a need for clear guidance on the governance and structural arrangements for emerging GP consortia, to ensure adequate local and national accountability for quality, financial control and value for money. The report also identi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130664 Mon, 15 Aug 2011 08:16:29 +0100 5130664 http://www.medworm.com/index.php?rid=5118590&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F11%2Fhealth-spending-projection-spin-cycle-rinse-and-repeat-or-reset%2F One of the annual rituals of Washington’s health policy calendar involves the release of projections for the next ten years of national health spending by actuaries at the Centers for Medicare and Medicaid Services (CMS). It then is followed immediately by desperate efforts by various interest groups and advocacy “analysts” to spin the new numbers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118590 Thu, 11 Aug 2011 16:41:21 +0100 5118590 http://www.medworm.com/index.php?rid=5118599&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FrouRwKPghUc%2F We already know that health-care spending and use can vary wildly depending on where a person lives. But most of that evidence comes from Medicare data, notably reports by the Dartmouth Atlas Project. Those analyses don’t say anything about spending patterns for people covered by commercial insurance. A report out today from Thomson Reuters tackles that issue. It looks at spending for children, adults and seniors covered by employer-based insurance. And, like the Medicare analyses, it finds geographic variation. But the patterns for private and public insurance spending are different. McAllen, Texas, for example, has been pegged by Dartmouth as one of the top-spending areas in the country. When MedPAC, a commission that advises lawmakers on Medicare, conducted its own analysis of act... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5118599 Wed, 10 Aug 2011 19:37:29 +0100 5118599 http://www.medworm.com/index.php?rid=5118591&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F10%2Fhealth-affairs-briefing-confronting-costs%2F On September 8, Health Affairs will release its September 2011 issue, “Confronting Costs.” The issue explores the third element of the famed Three-Part Aim for health care: namely, the objective of lowering costs. Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears the burden of health costs; the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118591 Wed, 10 Aug 2011 15:36:17 +0100 5118591 http://www.medworm.com/index.php?rid=5107477&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fjulys-most-read-ha-blog-posts%2F Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107477 Tue, 09 Aug 2011 13:44:43 +0100 5107477 http://www.medworm.com/index.php?rid=5107728&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002144.html There's a lot of myth and fiction surrounding opioid abuse, addiction, and dependence, a situation that leads to misunderstanding the drivers, and solutions to the problem. With NCCI reporting narcotics account for a quarter (about $1.4 billion) in work comp... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=5107728 Mon, 08 Aug 2011 23:00:00 +0100 5107728 http://www.medworm.com/index.php?rid=5107480&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIiCmhrGO5qA%2F At first blush, Washington’s tough talk about fiscal austerity doesn’t look good for drug makers. Government programs including Medicare and Medicaid spend $99 billion each year on prescription medicines, according to Washington consulting firm Avalere Health, making for a ripe cost-cutting target. Not surprisingly, drug stocks have dropped with the rest of the market recently. As the WSJ reports, pharma companies have ramped up their lobbying, warning that cuts to the drug prices paid by Medicare’s drug benefit, for example, could mean loss of some of the industry’s 675,000 jobs and investment in new lifesaving treatments. Yet pharma’s prospects aren’t necessarily so dire, say experts like Avalere’s CEO Dan Mendelson, a former Clinton administrati... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107480 Mon, 08 Aug 2011 20:37:40 +0100 5107480 http://www.medworm.com/index.php?rid=5107483&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FzI5sxWjKWVE%2F Reversal of Course: The federal government won’t try to force the resignation of Forest Laboratories CEO Howard Solomon after the company last year plead guilty to drug-marketing misdemeanors, the WSJ reports. Solomon wasn’t named in the criminal action but the government had sought to exclude him from doing business with the government under a clause of the Social Security Act. Bad Habit: New research shows that when it comes to lung-cancer risk, smoking within 30 minutes of waking up in the morning is worse than waiting at least an hour before lighting up, the BBC reports. It’s not clear why, but one possible explanation is that people suck in smoke more intensely when they smoke first thing in the morning, increasing exposure to chemicals. Unclear Effectiveness?: The U... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107483 Mon, 08 Aug 2011 12:40:52 +0100 5107483 http://www.medworm.com/index.php?rid=5107521&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-a-medical-recommendation-is-over-the-top%2F2011.08.07 I saw a lady with a boil. It began as a small red bump which got bigger and harder, then drained white stuff, and was now getting better. The reason she was worried about it was its location: it was on her breast. This was why the chief complaint officially read, “Breast lump” despite the fact that it was technically no such thing. I examined her carefully, determining that the pathologic process was indeed confined to the skin and clinically did not involve the actual breast tissue in any way. However because she was of an age for screening mammography, I did take the opportunity to urge her to have it; which she did. The problem arrived with the radiology report: A marker is placed over the area of palpable abnormality. Mammographic images reveal normal breast tissue with no mass or ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5107521 Sun, 07 Aug 2011 21:00:35 +0100 5107521 http://www.medworm.com/index.php?rid=5103426&cid=t_106517_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fuk-ms-patients-may-lose-one-medication-option%2F You know when the chief executive of the UK MS Society, Simon Gillespie, is quoted as saying “…people with MS would be better off living almost anywhere else in Europe…” in a press release, things are going terribly wrong for multiple sclerosis patients in that country. Mr. Gillespie’s remarks came on the heels of a decision by the British National Institutes for Health and Clinical Excellence, or NICE (the agency that recommends action to the National Health Service (NHS) as to what medication costs the NHS should cover for patients), that the oral MS med Gileyna (fingolimod) should not be paid for by NHS. NICE seems to have flat-out ignored science in their decision and focused instead on cost alone. Going so far as to compare the medication’s results to that of patients taki... Life with MS blogs http://www.medworm.com/rss/comments.php?id=5103426 Fri, 05 Aug 2011 19:37:35 +0100 5103426 http://www.medworm.com/index.php?rid=5096149&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FbrUJztOZS6E%2F Early Focus: Research increasingly suggests that Alzheimer’s disease damages the brain years before symptoms appear, raising the possibility that treatments should be focused on this early phase if there’s a hope of slowing or reversing the disease, the WSJ reports. That’s why Pfizer, Johnson & Johnson and Bristol-Myers Squibb are looking to treat patients with signs of milder memory loss, the paper says. Hackable Devices: Security researcher Jay Radcliffe says insulin pumps and blood-sugar monitors can be hacked, too, raising the question of how to keep high-tech medical devices secure, the Associated Press reports. Many devices contain wireless chips, but most are too small to contain encryption technology, the AP says. Lab-Grown Sperm: Mouse sperm created from embr... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5096149 Fri, 05 Aug 2011 12:33:21 +0100 5096149 http://www.medworm.com/index.php?rid=5077641&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F29%2Fa-call-for-physicians-to-contribute-to-solutions-not-costs%2F  It’s time for America’s physicians, particularly its highly paid procedural specialists, to make a choice.  Are we primarily businessmen with a keen eye on the financial bottom line, or are we above all professionals, well versed in the healing arts and dedicated to our patients’ care, regardless of their circumstances?  America’s medical system is breaking [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077641 Fri, 29 Jul 2011 14:11:18 +0100 5077641 http://www.medworm.com/index.php?rid=5077642&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F28%2Fu-s-health-spending-projected-to-grow-5-8-percent-annually%2F All health care spending in the United States is projected to grow at an annual average rate of 5.8 percent for the period 2010 through 2020, 1.1 percentage points faster than expected growth in Gross Domestic Product (GDP). By 2020, health care spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077642 Thu, 28 Jul 2011 13:48:45 +0100 5077642 http://www.medworm.com/index.php?rid=5069421&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F27%2Fthe-beacon-communities-at-one-year-the-mississippi-delta-experience%2F The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the fifth in a series of Health Affairs Blog posts in which leaders of several Beacon communities discuss their [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5069421 Wed, 27 Jul 2011 18:59:24 +0100 5069421 http://www.medworm.com/index.php?rid=5069475&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-is-the-most-costly-healthcare-expenditure%2F2011.07.27 The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of  healthcare costs in the population. The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases. U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year. This is a result of a combination of factors. Chief among them is the increasing incidence of obesity. Who spends the money? (more…) *This blog post was originally published at Repairing the Healthcare System* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5069475 Wed, 27 Jul 2011 12:00:54 +0100 5069475 http://www.medworm.com/index.php?rid=5050506&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F18%2Fpatient-advocates-flies-in-the-ointment-of-evidence-based-care%2F The women recounted how their lives had been saved as they pleaded for the Food and Drug Administration not to withdraw approval for Avastin as a treatment for advanced breast cancer. They did so even without evidence that it provides benefit and with evidence that it confers risks. Their efforts were ultimately not successful: the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050506 Mon, 18 Jul 2011 18:07:44 +0100 5050506 http://www.medworm.com/index.php?rid=5036229&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-real-world-of-medicine-today%2F2011.07.17 The old joke in medicine goes, ‘don’t get sick on July 1st.’ That’s because it’s the day when new resident physicians, freshly graduated from medical schools across the land, begin their training programs. Although they have spent four years in undergraduate school and four years in medical school, it’s residency where physicians are made from the raw material of knowledge-rich, experience poor high achievers. However, even in residency physicians are seldom told the entire story of how the practice of medicine, and their lives, will look and feel as their careers evolve and they enter the medical work-force. Since our profession changes from year to year and administration to administration, it seems a good time to mention some of the things upcoming young physicians will face... Better Health blogs http://www.medworm.com/rss/comments.php?id=5036229 Sun, 17 Jul 2011 16:00:50 +0100 5036229 http://www.medworm.com/index.php?rid=5028116&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F14%2Flow-income-patients-in-california-experiences-and-expectations%2F Editor’s Note: Another Health Affairs Blog post published today also discusses the California health care system and how the Affordable Care Act will affect the way the state meets the needs of low-income patients. Many low-income patients have had little or no choice about where they obtain health care. But this will change when the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028116 Thu, 14 Jul 2011 18:24:00 +0100 5028116 http://www.medworm.com/index.php?rid=5028130&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FUWutRQPKQBI%2F Chip-Factory Cancer Cases: Samsung Electronics Co. says a report by consulting firm Environ International found no link between cancer in six workers and the chemicals they were exposed to at a semiconductor manufacturing facility, the WSJ reports. Previous reports by South Korea’s occupational health and safety agency have also found no link. But Samsung workers and others have said there were far more leukemia and lymphoma cases among chip-factory workers. Data from the latest study are not being immediately released. Reconsidering Risk: The FDA warned that when used to prevent pelvic organ prolapse, surgical mesh carries a higher risk of adverse effects like pain, bleeding and infection, without necessarily providing additional benefit over traditional surgical stitches, the Assoc... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028130 Thu, 14 Jul 2011 12:43:45 +0100 5028130 http://www.medworm.com/index.php?rid=5008444&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002127.html The number of of people dead from opioid analgesic use quadrupled over the last nine years. Opioids are synthetic opiates, and include methadone, OxyContin, Percocet, Oxycodone, fentanyl, and Actiq. 11,499 people died as a result of opioid usage in 2007,... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=5008444 Thu, 07 Jul 2011 23:00:00 +0100 5008444 http://www.medworm.com/index.php?rid=5008114&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F06%2Fhypercostitis-political-theater-in-massachusetts%2F The Play’s the Thing. America boasts the highest health care costs on God’s green earth, and Massachusetts spends more per capita than any other state. Some might say we have a problem. On June 30th, Massachusetts completed four days of hearings on run-away medical costs — what drives them and how to rein them in. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008114 Wed, 06 Jul 2011 16:35:34 +0100 5008114 http://www.medworm.com/index.php?rid=5008115&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F05%2Fjosts-look-at-court-fight-over-reform-tops-ha-blogs-june-most-read-list%2F Tim Jost’s analysis of crucial appellate arguments over the constitutionality of the Affordable Care Act leads June’s list of most-read Health Affairs Blog posts. Jost examines the arguments before the federal Eleventh Circuit Court of Appeals in a challenge to the legislation brought by more than half the states and the National Federation of Independent [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008115 Tue, 05 Jul 2011 16:31:47 +0100 5008115 http://www.medworm.com/index.php?rid=4992789&cid=t_106517_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FEm4rJk2IfV0%2F Every time I hear a story about consumer empowerment in healthcare, I get optimistic that consumers really can make a difference in containing runaway healthcare costs. Then something comes along to make me think that it’s a pipe dream. I just had one such occurrence. Trending on Twitter right now is the meme “#pricesthatshockyou.” Just for fun, I clicked. Right near the top I saw this: #bbpBox_86598503140294656 a { text-decoration:none; color:#009e9e; }#bbpBox_86598503140294656 a:hover { text-decoration:underline; }Honestly, i don't know why the american gov't makes the people pay so much for medical bills. Its not always their fault #pricesthatshockyouabout 1 hour ago via webReplyRetweetFavorite@jadedheartsxoDαnαit Uh, the American government doesn’t set... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4992789 Fri, 01 Jul 2011 02:12:19 +0100 4992789 http://www.medworm.com/index.php?rid=4984686&cid=t_106517_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F69M-eNcvLh4%2F As they say, every little bit counts. And so drugmakers may be heartened to hear that the perception held by physicians of the pharmaceutical industry has actually improved this year - 58 percent of docs say they have a somewhat positive or extremely positive overall impression. This is, however, up just 2 points from last year. But this is also the first time since 2004 that a positive impression increased. Consumers, on the other hand, are heading in other direction - 46 percent have an extremely or somewhat negative impression this year, up 1 point from last year. Overall, one could argue the bottom line tallies for both groups is largely static, although perhaps docs are most sensitive to new approval and R&D issues, while consumers tend to focus on safety and price. The responses... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4984686 Thu, 30 Jun 2011 13:56:33 +0100 4984686 http://www.medworm.com/index.php?rid=4984408&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F30%2Fin-first-appellate-case-a-significant-victory-for-the-affordable-care-act%2F On June 29, 2011, the Sixth Circuit federal court of appeals held that Congress has the power under the Constitution to adopt the minimum coverage requirement of the Affordable Care Act. The decision in Thomas More Law Center v. Obama is very significant for several reasons.  First, it is the first ruling by a federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4984408 Thu, 30 Jun 2011 11:22:04 +0100 4984408 http://www.medworm.com/index.php?rid=4984674&cid=t_106517_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2F7o_rmx0_U28%2Ffailure-of-google-health-and-what-it.html According to the Pew Internet and American Life Project, 80% of the American adults who use the Internet report that they regularly go online for access to health information. But so far, the Internet has not helped drive the adoption of health records created and maintained by consumers. 

That's why Google announced last week that it is shutting down Google Health, a personal health record service that allows individuals to centrally store and manage their health information online.Why hasn’t the Internet empowered consumers to manage their personal health information the same way it has better informed them about medical conditions? 

There are three reasons. But the underlying cause is that there is no such thing as a consumer in the American health care system today. A consu... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4984674 Wed, 29 Jun 2011 14:31:00 +0100 4984674 http://www.medworm.com/index.php?rid=4984650&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F06%2Fback-on-avastin-debate.html Last year I blogged about the Avastin debate where it was shown that it did not help women with advanced breast cancer. Now it down to the wire, there will be a meeting next week which will probably pull the plug on its use as a breast cancer drug. But there are patients taking Avastin and claim it has saved their lives. They claim they benefit from it and don't want it pulled. What is wrong here? I think lots of things.- While Avastin is a promising drug in treating some cancers, it is not working to treat breast cancer. There is lots of data behind it saying it does not work.- The patients who are receiving it, are they really benefiting from it? Or are they experiencing a placebo effect - maybe a few but not so many? Or is something else they are doing causing the decreases in their can... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4984650 Wed, 29 Jun 2011 10:14:00 +0100 4984650 http://www.medworm.com/index.php?rid=4975863&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-physical-exams-save-healthcare-costs%2F2011.06.28 I’ve often heard physicians say that “the history is 90% of the diagnosis.” In other words, they can usually determine the underlying cause of a patient’s problem just by listening to their account of how it evolved. The physical exam is merely to confirm the diagnosis, and is often cursory, limited, or ignored. I believe that the physical exam is far more important than it seems – and I learned this during my recent oral medical specialty board examination. Although I have been sworn to secrecy regarding the content of the test questions, I will share an epiphany that I had during the exam. The examiners’ job is to describe a patient and then ask the examinee what else she’d like to know and what she’d do next. With each description, I found... Better Health blogs http://www.medworm.com/rss/comments.php?id=4975863 Tue, 28 Jun 2011 22:00:21 +0100 4975863 http://www.medworm.com/index.php?rid=4975833&cid=t_106517_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FFJsb-MgrxMU%2F By Walter OlsonLast December the Consumer Product Safety Commission (CPSC) adopted new standards for crib design, a step mandated by the famously overreaching Consumer Product Safety Improvement Act of 2008 (CPSIA). The commission decided to go well beyond a set of voluntary design standards that had been widely adopted the year before; it also chose to make the new rules retroactive, rendering unlawful the sale of many existing cribs whose overall safety record is otherwise acceptable—no one would think of subjecting them to a recall, for instance. Commissioner Nancy Nord: The day care industry did protest that the rule, as proposed, would result in approximately a $1/2 billion hit to a group that could not immediately absorb costs of such magnitude, especially on the heels of having ju... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4975833 Tue, 28 Jun 2011 13:26:01 +0100 4975833 http://www.medworm.com/index.php?rid=4968442&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F24%2Festablishing-sensible-cost-sharing-for-medicare-cancer-patients%2F A new study by Avalere Health, presented at the recent meeting of the American Society of Clinical Oncology, analyzed the pharmacy claims of 10,508 commercially-insured and Medicare patients who required oral therapy for cancer. The purpose of the study was to assess the effects of cost-sharing on the abandonment of these medications. The analysis showed [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4968442 Fri, 24 Jun 2011 15:19:10 +0100 4968442 http://www.medworm.com/index.php?rid=4960013&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F22%2Fa-physician-fallow-program-to-improve-quality-safety-and-costs%2F In a recent New York Times op-ed, Rita Redberg MD, a cardiologist and Chief Editor of Archives of Internal Medicine, described the American health system’s penchant for delivering high volumes of “procedures and devices [to] patients who get no benefit and incur risks from them.” The culprit, of course, is fee-for-service reimbursement, used by Medicare, Medicaid and commercial [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4960013 Wed, 22 Jun 2011 19:12:02 +0100 4960013 http://www.medworm.com/index.php?rid=4960067&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwho-is-responsible-for-the-hospital-bills-of-prisoners%2F2011.06.22 Are government entities required to pay the hospital bills of incarcerated prisoners?  This is a scenario that happens quite often.  Jailed patients are admitted onto the hospitalist service through the ER for anything from patients faking seizures in the ER to chest pain to drug overdoses.  When patients are under the custody of the city, state or federal system, those entities are required to pay for necessary acute health care services.  I don’t know, maybe it has something to do with a prisoner’s constitutional right.  You lose your right to vote, but not to get a liver transplant. So what happens? Jailed patients get admitted and guards, sometimes, one, two or three at a time, are required to be at the patient’s bedside 24 hours a day.  If the patient needs to ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4960067 Wed, 22 Jun 2011 18:00:00 +0100 4960067 http://www.medworm.com/index.php?rid=4952778&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZRXlyIX7UPk%2F What are the biggest perceived sources of wasted health-care spending? Like opinions of Jerry Lewis’s movies and David Hasselhoff’s singing ability, answers vary by country — at least according to Deloitte’s latest survey of health-care consumers in different nations. The overall survey covered 15,735 consumers in a dozen countries. People in ten countries (all but Brazil and China) were asked about sources of waste. Most Canadians and UK-ers say the top dollar/pound-waster is lack of responsibility by individuals for their own health. Consumers in the U.S. and six other countries put redundant paperwork at the top of the list. Those two options were also cited by most countries as the second-most wasteful source of spending — except that Belgians ranked unnec... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4952778 Tue, 21 Jun 2011 17:24:00 +0100 4952778 http://www.medworm.com/index.php?rid=4953299&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F06%2Fscreening-tests-good-or-bad.html There is a little furor (debate, discussion, disagreement, shouting match, hoo-haa, to-do, etc) going on regarding screening tests. First of all are the disputes about which tests should be done and when - mammograms at 40 or 50, prostate checks - are they worth it, and more. All sorts of meetings are going on around the country and doctors and specialists and other 'important' people are arguing about it and some even are quitting their jobs over them. Well, they can argue all they want because I don't want to get into a discussion about whether they are important or not because that's not my business. And 'with your medical history, they need to be sure', so I get them all anyway. (Well not the prostate checks, but the rest of them.)I think its great that they will be free to encourage p... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4953299 Mon, 20 Jun 2011 09:52:00 +0100 4953299 http://www.medworm.com/index.php?rid=4952777&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F17%2Fthe-mixed-demerits-of-bending-the-cost-curve%2F Political scientists emphasize the importance of “framing” in policy debates.  The health care cost control debate in the United States has been reframed by the promotion of a metaphor, “bending the curve.”  This metaphor has merits but they are decidedly mixed. The sudden popularity of the idea of “bending the cost curve” is significant because [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4952777 Fri, 17 Jun 2011 13:41:22 +0100 4952777 http://www.medworm.com/index.php?rid=4953305&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F06%2Fblame-game.html New cancer treatments, often chemotherapy, are being developed that are available in pill form. This is easier on the patient that IV, does not require long hospital visits for infusions, and should be less expensive overall. But they aren't necessarily cheaper. One in six senior cancer patients are not filling their oral chemotherapy prescriptions and the thought is the cost. One woman was told that she should take an oral chemo for her kidney cancer but found out the co-payment on medicare was $2400 - which she could not afford. And the blame game begins: "Private insurance companies that deliver the Medicare prescription benefit say the problem is that drug makers charge too much for the medications, some of which were developed from taxpayer-funded research. The pharmaceutical industry... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4953305 Tue, 14 Jun 2011 10:23:00 +0100 4953305 http://www.medworm.com/index.php?rid=4921420&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-must-do-their-part-to-reduce-unnecessary-hospital-expenses%2F2011.06.10 Hospital costs are out of control. We have an aging population living longer with more complicated presentation of disease. We have an insurance driven platform instead of a health driven accountability. The long term sustainability of that architecture is one of guaranteed insolvency. One way or another hospitals are going to find their lifeline cut off. Medicaid is bankrupt. Hospital profit margins from Medicare have been negative for almost a decade. In addition, the rapid rise in private insurance premiums and industry’s gradual but accelerating exit from the health insurance benefit market all tell me that hospitals must find a way to reduce the cost of providing care. There are many ways hospital costs can be reduced. Administrators are paid handsomely to make it happen. Either... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921420 Fri, 10 Jun 2011 21:00:00 +0100 4921420 http://www.medworm.com/index.php?rid=4921377&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F1EmFLo4w4a4%2F Talk to anyone for very long about how to improve health care in the U.S. and you eventually hear something along the lines of: “We have to start paying physicians for getting and keeping people healthy instead of for doing as many procedures and tests as possible.” According to a report from Merritt Hawkins, a big physician search and consulting firm, that isn’t yet happening to a significant degree in the real world. The company’s annual report on recruiting incentives finds that 74% of the jobs they recruited for in the year ending March 31 featured a performance bonus. Of those that offered such a bonus, in 90% of the cases it was linked to “fee-for-service style volume.” Meantime, fewer than 7% of the jobs offering bonuses rewarded physicians for me... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921377 Thu, 09 Jun 2011 19:16:22 +0100 4921377 http://www.medworm.com/index.php?rid=4921370&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F09%2Fanalyzing-a-crucial-battle-in-the-legal-war-over-health-reform%2F For a lawyer, the argument of Florida v. the Department of Health and Human Services before a three judge panel of the Eleventh Circuit Federal Court of Appeals on Wednesday, June 8, was a beauty to behold.  (For a non-lawyer it was probably tedious, repetitive, and much too long).  Three active and very well-prepared judges [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4921370 Thu, 09 Jun 2011 13:44:03 +0100 4921370 http://www.medworm.com/index.php?rid=4921610&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002115.html Our colleagues at Workers Comp Insider sent us news of Florida Governor Rick Scott's latest idiocy - he issued an executive order requiring drug testing for all state employees every quarter. The master of simple solutions to complex problems has... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4921610 Wed, 08 Jun 2011 23:00:00 +0100 4921610 http://www.medworm.com/index.php?rid=4911444&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fq0AruYBDkxI%2F Proposed individual-policy premium increases have made California a flashpoint in the debate about rising health-insurance costs. Now, in an op-ed published by the San Francisco Chronicle, the chairman and CEO of Blue Shield of California, Bruce Bodaken, says his company will limit profits to 2% of revenue. If at the end of the year net income exceeds that threshold “because medical costs were lower or investment income was higher than we had projected, we’ll return that amount to our members and the community,” he writes. The policy will continue as long as “Blue Shield remains financially solvent, with sufficient funds to make the investments needed to stay competitive.” Blue Shield of California will make payouts this year based on 2010′s profits, whi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911444 Tue, 07 Jun 2011 17:09:55 +0100 4911444 http://www.medworm.com/index.php?rid=4911446&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FmrLV7gLbBZE%2F With looming cuts to Medicare payments for preventable readmissions,  hospitals are stepping up efforts to improve discharge planning and follow-up once patients go home, today’s Informed Patient column reports. So many organizations are jumping into the readmissions space that the Commonwealth Fund and the John A Hartford Foundation last year funded an “action guide” to help health care executives sort through the programs. One solution getting growing attention is Project Red — for Re-Engineered Discharge — developed by Boston University; in a study at Boston University Medical Center the program and its after-hospital care plan for patients reduced readmissions by 30%. Brian Jack, the Boston University researcher who developed RED, tells the Health Blog that under a new ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911446 Tue, 07 Jun 2011 13:29:01 +0100 4911446 http://www.medworm.com/index.php?rid=4911447&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FLgEdoVoucfk%2F One-Two Punch: Companies are increasingly testing combinations of cancer drugs in earlier-stage trials, attempting to deliver a knockout blow to the disease and prevent it from becoming drug-resistant, the WSJ reports. At the American Society of Clinical Oncology meeting, GlaxoSmithKline reported early-stage data on two experimental drugs being used in tandem; meantime, Bristol Myers-Squibb and Roche last week signed a deal to test two melanoma treatments together. Side effects are a big concern when two drugs are used together. Health-Care Burden: Retired Maj. General Arnold Punaro, a member of a military advisory group, says that given the rising costs of health-care and pensions, the Department of Defense is on the path to becoming “a benefits company that may occasionally kill a ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911447 Tue, 07 Jun 2011 12:47:52 +0100 4911447 http://www.medworm.com/index.php?rid=4902679&cid=t_106517_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2F5a-g09FML7k%2Freal-costs-of-social-media.html We all know social media is not free. David Fleet recently posted a very informative infographic compiled from the expertise of multiple organizations to illuminate the true costs of social media. The graphic expounds on the hidden costs of social media campaigns including staff costs, advertising consultant fees, platform creation and apps. The costs on the low end total up to about 200,000 on average for a small operation and increase exponentially from there depending on staff size and involvement in the space. But not to worry, the article goes on to praise the impacts that social media can have on a campaign including engagement, brand awareness and overall reach. ePharma Summit West is your opportunity to hear from the guru’s of social media in the pharmaceutical industry and fi... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4902679 Mon, 06 Jun 2011 19:05:00 +0100 4902679 http://www.medworm.com/index.php?rid=4902423&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-myth-of-the-rich-doctor%2F2011.06.05 This is my column in June’s EM News. ‘But you’re a rich doctor, right?’ Have you had that conversation? There’s a certain expectation of physicians, that we’re all just filthy rich, overflowing with boxes of cash tucked neatly away beneath our gilded beds. When we were building our house, our builder talked with my wife: ‘Jan, I want you to meet me to look for counters and cabinets. Don’t bathe the kids. Put them in dirty play clothes and don’t wear anything nice. Don’t ever tell them your husband is a doctor.’ He’s a wise man. What he knew was that the word ‘doctor’ means ‘cash.’ Or at least, means ‘cash’ to the popular mind. I wonder if this perception is the reason patients come to the emergency department and say things like this: ‘I don’t have ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4902423 Sun, 05 Jun 2011 17:00:02 +0100 4902423 http://www.medworm.com/index.php?rid=4893381&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FvIfg8bDkWsA%2F Frosty Reception: The Obama administration’s proposed guidelines governing how hospitals and doctors can form accountable care organizations are unpopular with many health-care providers, who say they won’t participate in the program unless the financial incentives are improved and the regulatory burden reduced, the WSJ reports. ACOs are intended to coordinate care for Medicare patients, with an aim to improving quality while saving the government and providers money. MRSA in Cows: Researchers have discovered a new strain of MRSA — the nasty staph infection that is resistant to certain antibiotics — that can exist in cows as well as humans, the Washington Post’s Checkup blog reports. A researcher at the University of Cambridge said it’s unlikely the stra... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893381 Fri, 03 Jun 2011 12:31:46 +0100 4893381 http://www.medworm.com/index.php?rid=4893371&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F02%2Fcreating-value-based-incentives-for-primary-care%2F In a remarkable recent interview, Donald Berwick MD, Administrator of the Centers for Medicare and Medicaid Services (CMS), eloquently described his vision of value-based health care. Paying for value is an incentive…The underlying idea of improvement is that American health care, historically built in fragments, often cannot achieve for patients what it really wants to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893371 Thu, 02 Jun 2011 17:25:08 +0100 4893371 http://www.medworm.com/index.php?rid=4893388&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIvoEVEAlUxE%2F A year ago some policy folks raised the alarm that the budget for the federal high-risk insurance pools would be sufficient to cover only about 200,000 of the several million folks who might be eligible to participate. Medicare’s actuary predicted funding for the pools would run out by this year or 2012. But as it turned out, many fewer people than expected signed up for the program, which was created by the health-care overhaul law and designed to insure people who couldn’t get affordable coverage on the individual market because of pre-existing conditions. Only about 18,000 people have enrolled. As Kaiser Health News and NPR reported last month, experts blamed high premiums and low consumer awareness for the tepid response. So now, as the WSJ’s Washington Wire blog repo... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893388 Wed, 01 Jun 2011 13:51:46 +0100 4893388 http://www.medworm.com/index.php?rid=4872049&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F26%2Fhealth-wonk-review-memorial-day-edition%2F If you’re traveling over the long weekend, you’ll want to take along some reading material. While some might reach for a good novel by John Grisham or Dan Brown, the health policy blogs in this edition of the Health Wonk Review tackle equally compelling mysteries. Was the Medicare Trustees report really that gloomy? If Workers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4872049 Thu, 26 May 2011 13:29:21 +0100 4872049 http://www.medworm.com/index.php?rid=4862842&cid=t_106517_136_f&fid=38061&url=http%3A%2F%2Fprma-enhance.com%2Fdocuments%2FACS%2520Air%2520Miles%2520Program.pdf A growing number of breast cancer patients are now choosing to travel for their care, particularly for some of the more advanced breast reconstruction procedures. Insurance may cover the health care expenses but the cost of the hotel and air fare falls on the patient. Now, some patients may qualify for financial assistance to cover these extra expenses thanks to two special programs: Assistance with Air Travel Expenses The American Cancer Society (ACS) Air Miles program is a joint effort between Mercy Medical Airlift (MMA)/National Patient Travel Helpline (NPATH) and the American Cancer Society. The program is designed to help patients with the cost of air fare when traveling for cancer-related treatment. Please call the ACS at (800) 227-2345 to find out if you are eligible for help wit... Breast Cancer Reconstruction Blog blogs http://www.medworm.com/rss/comments.php?id=4862842 Wed, 25 May 2011 01:41:14 +0100 4862842 http://www.medworm.com/index.php?rid=4862499&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FaoROgnr8uUk%2F URL Pharma’s gout treatment Colcrys has been controversial from the get-go. The active ingredient in the drug, colchicine, has been used for ages; URL Pharma commissioned studies to show it was safe and effective, won three years of marketing exclusivity from the FDA to treat gout flareups and promptly raised the retail price from pennies to more than five bucks a pill. The company has said the price is in line with other approved, branded gout drugs and that its trials helped establish a dosage and make the medication safe for everyone. It also set up a patient financial assistance program. But four members of Congress say URL Pharma has some ‘splainin to do. In a letter to Richard H. Roberts, the company’s president, CEO and chairman,  Sen. Herb Kohl and Reps. Henry Wa... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862499 Tue, 24 May 2011 17:53:08 +0100 4862499 http://www.medworm.com/index.php?rid=4862491&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F24%2Fprotecting-children-from-environmental-chemical-exposures-an-economic-priority%2F In the May Health Affairs issue, Sarah Vogel and Judy Roberts map out the disastrous history of the 1976 Toxic Substances Control Act (TSCA), the major legislation that regulates chemicals.  TSCA makes it difficult for the Environmental Protection Agency (EPA) to restrict use of any of the 62,000 chemicals already in commerce.  It does not [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862491 Tue, 24 May 2011 13:03:06 +0100 4862491 http://www.medworm.com/index.php?rid=4862502&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FcgbrDCumF4Q%2F What could primary-care physicians do differently to benefit patients’ health and cut risks, harms and costs? The National Physicians Alliance, a 22,000-member group of doctors that advocates for affordable, universal health care, came out with its own list — lists, actually, since there’s one each for family medicine, internal medicine and pediatrics. The group’s recommendations are published in the Archives of Internal Medicine. The suggestions reflect the consensus of the physician working groups that developed them. Field testers completed online surveys to rate each suggestion on the impact it would have on quality of care and cost, the strength of the supporting evidence and the ease of implementing the activity. Without further ado, here are the lists (stripp... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862502 Mon, 23 May 2011 21:18:21 +0100 4862502 http://www.medworm.com/index.php?rid=4862492&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F23%2Fjust-another-hospital-weekend-or-life-and-death%2F Suppose you need to drive from Boston to San Francisco, about 3200 miles, over the next 7 days.  At an average speed limit of 55 mph you could accomplish this by driving about 10 hours a day, including stops for rest and food breaks; a grueling but not impossible journey. Now suppose that gas stations [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862492 Mon, 23 May 2011 19:25:39 +0100 4862492 http://www.medworm.com/index.php?rid=4847955&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsurgeons-who-refuse-to-treat-obese-women-liability-containment-or-discrimination%2F2011.05.20 In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications. Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/ While I have not specifically “refused to treat” obese patients, I have in a few cas... Better Health blogs http://www.medworm.com/rss/comments.php?id=4847955 Fri, 20 May 2011 22:00:14 +0100 4847955 http://www.medworm.com/index.php?rid=4847935&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fhm0PMTJJvT0%2F As we gear up for the annual meeting of the American Society of Clinical Oncology — and its flood of studies on drugs and other treatments — let’s take a moment to consider the cost of those often life-saving therapies. It’s no secret that cancer is expensive. Even assuming no changes to cancer trends except an increase in patients due to the aging population, the NCI estimates medical costs will hit $158 billion in 2020 — and could rise to $207 billion assuming new therapies and diagnostics push up costs further. Two pieces of news out this week underline this point, and its consequences. Medco’s Drug Trend Report says that the oncology-specialty drug market, i.e. targeted therapies, could increase total cancer-drug spending by about 15% annually throug... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4847935 Fri, 20 May 2011 18:05:19 +0100 4847935 http://www.medworm.com/index.php?rid=4841411&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F19%2Fha-studies-focus-on-reducing-costs-reaching-the-underserved%2F The Affordable Care Act of 2010 is expected to extend health coverage to some thirty-two million previously uninsured Americans.  Two of the many challenges faced by both the private sector and the government are getting a handle on rapidly rising medical costs and providing care to the many new enrollees with chronic illnesses who are [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841411 Thu, 19 May 2011 19:36:27 +0100 4841411 http://www.medworm.com/index.php?rid=4841412&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F19%2Fthe-beacon-communities-at-one-year-the-colorado-experience%2F Editor’s Note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the second in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841412 Thu, 19 May 2011 18:56:51 +0100 4841412 http://www.medworm.com/index.php?rid=4841480&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprogressive-counter-point-the-ipab-could-be-a-good-thing%2F2011.05.18 I shouldn’t do this. It’s madness to try to delve into the minds of conspiracy theorists and try to make sense of their ravings. But I can’t help myself; I’m drawn like a moth to the flame. It never ends well. I only wind up with a horde of trolls in the comments telling me that I’m a glib supercilious idiot and should stick to medicine or go die in a fire or something. Sometimes it’s too hard to stay away. Maybe it was the personal affront I felt in the false imputation of ill motives onto progressives. Maybe it was the gross errors in fact, sitting there ripe for the plucking. I don’t know, but I just can’t resist a rebuttal to Dr Rich at Covert Rationing, who weaves a technocratic cost control body into a paranoid web of fantasy, conclud... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841480 Wed, 18 May 2011 21:00:00 +0100 4841480 http://www.medworm.com/index.php?rid=4841419&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FtFtbrRtzge0%2F There’s new evidence that the drop in patient demand for medications during the recession is starting to reverse. The annual drug trend report from Medco Health Solutions finds that last year’s increase in spending on pharmaceuticals was driven largely by increased use of medicines — a shift from the last few years. (Drug makers did continue to sharply raise the prices of their brand-name products last year, but the impact on overall spending was blunted by the increasing use of generics.) The report from pharmacy benefit manager Medco covers a sampling of the company’s clients. Spending on drugs rose 3.7% last year, the same as in 2009. Most of that increase was from growing use of medicines, particularly in diabetes and also some other chronic conditions. The 2.1% incr... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4841419 Wed, 18 May 2011 19:01:22 +0100 4841419 http://www.medworm.com/index.php?rid=4841420&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F-SBqDeD6Q9A%2F Employers will likely face health-care cost increases of 8.5% in 2012, but they’ll mitigate that burden by pushing more costs onto employees and making other changes to benefits, a PricewaterhouseCoopers report finds. Taking those plan changes into account, employers will see their health-care costs rise about 7%. (The report is based on a survey of about 1,700 employers, plus interviews with hospital execs and health-plan actuaries, among others.) Putting upward pressure on costs will be provider consolidation, cost shifting from Medicare and Medicaid by providers, and — interestingly — post-recession stress. “Several health plans interviewed indicated they were seeing more claims for stress-induced illnesses,” the report says. “Specifically, as stress ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4841420 Wed, 18 May 2011 16:08:33 +0100 4841420 http://www.medworm.com/index.php?rid=4841726&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002101.html Average Wholesale Price - the much-declaimed pharmaceutical pricing metric - is not going away anytime soon. Certainly not this fall, and very likely not next fall either. AWP is published by several firms, including Wolters Kluwer. WK's version, branded Medi-Span,... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4841726 Tue, 17 May 2011 23:00:00 +0100 4841726 http://www.medworm.com/index.php?rid=4828879&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fall-attempts-to-reduce-bureaucracy-in-the-healthcare-system-will-increase-it%2F2011.05.17 “The media is the message.” It does not matter if the policy has failed previously.  All that is important is the effectiveness of the policy’s presentation and its ability to manipulate the polls. The government’s purpose is to work for the people who elected it. It does not seem to be working that way at present. Bureaucrats create rules or regulations as they interpret the laws made by congress and the president. Regulations are controlled by the administration’s ideology. Many times the regulations in one area nullify the intended effect in another area. Regulations and bureaucracy inhibit the use of common sense in policy making for the benefit of the people. The people did not have an outlet to express their opinions or frustrations until blogging came into its own seven y... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828879 Tue, 17 May 2011 12:29:19 +0100 4828879 http://www.medworm.com/index.php?rid=4828842&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FuTjh1Y967tA%2F Not every hospital patient needs to get routine blood tests every day, but that’s common practice, leading to wasted money and time. A new study finds that simply making physicians aware of the cost of regular blood tests cut the daily bill for the tests by as much as 27%. Researchers from Brown University and the University of Miami started by monitoring the baseline daily per-patient cost for two common lab tests, complete blood count and total chemistry panel, among surgical patients at Rhode Island Hospital in Providence. Then they started a program of scripted weekly announcements to surgical house staff — the doctors-in-training who order the bulk of the tests — and their attending physicians, about the cost of those tests. At the beginning of the program, the daily... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4828842 Mon, 16 May 2011 20:36:09 +0100 4828842 http://www.medworm.com/index.php?rid=4828841&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F16%2Fthe-beacon-communities-at-one-year-the-central-indiana-experience%2F Editor’s note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the first in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4828841 Mon, 16 May 2011 16:14:39 +0100 4828841 http://www.medworm.com/index.php?rid=4828844&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FI01GOVFm0So%2F Newt Gingrich, now officially a candidate for the Republican presidential nomination, is staking out some of his positions on the divisive issue of health-care overhaul. As the WSJ reports, the former Speaker of the House dismissed the plan to rejigger Medicare put forth by the current GOP House majority as “right-wing social engineering,” while also endorsing the individual mandate to buy insurance that is vilified by critics on the right. The Medicare plan spearheaded by Rep. Paul Ryan would essentially replace the government insurance plan with vouchers to help seniors purchase private coverage. (The change would apply only to Americans aged 55 and under.) But the value of those vouchers would rise only as fast as overall consumer inflation, which has been outpaced by the ri... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4828844 Mon, 16 May 2011 13:57:15 +0100 4828844 http://www.medworm.com/index.php?rid=4828886&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcutting-healthcare-costs-in-spain-evidence-based-disinvestment%2F2011.05.16 In an economic downturn, two classic cost-reducing solutions come to mind in the healthcare services industry: reduce offerings (give fewer services)  or control demand (limit access to healthcare or increase copayments). There are many more but these two are the most frequently used. Actually, budget cuts in the Spanish region of Catalonia fit in the first type: they will need fewer resources (both human and material) because their services offered will shrink. It’s always controversial to cut healthcare services in Spain. Even talking about it leads to accusations of promoting total privatization, attacking the Welfare State and so on. But there is another way to cut services, drugs or technologies. It’s what Dr. Iñaki Gutierrez-Ibarluzea called ‘Evidenced-based disinvestment’ ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828886 Mon, 16 May 2011 11:00:10 +0100 4828886 http://www.medworm.com/index.php?rid=4820801&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FvSYrh2tgOck%2F If you need any more evidence that the growth in health-care costs is unsustainable, take a look at two reports out this week. Today, the Medicare trustees issued their annual assessment of the government insurance program’s fiscal health. The prognosis: the trust fund (covering hospital stays) will be exhausted in 2024, as the WSJ reports. That’s five years earlier than they predicted last year; the sluggish economy has led to lower payroll taxes, but health costs keep going up. And even that forecast comes with an asterisk. The long-term outlook for the trust fund and the Medicare Part B program, which pays for physician’ services, depends on assumptions that are “inevitably highly uncertain,” the report says: New technologies and interventions will continue... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4820801 Fri, 13 May 2011 18:58:25 +0100 4820801 http://www.medworm.com/index.php?rid=4820800&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F12%2Fwhat-health-reform-means-for-medicare%2F While President Barack Obama and congressional leaders continue to tussle over what to do about the nation’s unsustainable entitlement spending programs, the effects of the Patient Protection and Affordable Care Act (PPACA) seem to have gone largely unnoticed. This oversight is hard to explain. In recent decades, real Medicare spending has been growing at a [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4820800 Thu, 12 May 2011 12:26:08 +0100 4820800 http://www.medworm.com/index.php?rid=4813633&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F05%2Fis-this-even-news.html Health care costs for American families are increasing. Is this even news any more? When health care costs go down, that will be news.But I did pick a few nuggets out of this increase. First of all employers are pushing more of the insurance costs onto employees in an effort to control their costs. I don't see a problem with this. Your employer provides health insurance but where does it say that they have to pay for the vast majority of it? They don't. They have to pay for what they can afford. Health insurance is a benefit that is part of an employment package. This is true whether you are a CEO for a multinational or bagging groceries. If you are offered a job at $15/hour working in a retail store. It provides two weeks vacation each year and a 401K, and no health insurance. How does th... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4813633 Thu, 12 May 2011 10:59:00 +0100 4813633 http://www.medworm.com/index.php?rid=4813286&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-accountable-care-organizations-acos-will-fail-to-reduce-costs%2F2011.05.11 In an ideal world ACOs should work. There is no evidence that  untested and complex organizational structure of ACOs developed by Dr. Don Berwick (head of CMS) will improve quality of care and reduce costs. ACOs are supposed to provide financial incentives to health care organizations to reduce costs and improve quality. There are too many defects in the ACOs infrastructure to improve the financial and medical outcomes. At a conceptual level, the incentive for ACOs would be to increase efficiency and avoid overuse and duplication of services, resources, and facilities. In this model, ACO members would share the savings resulting from the increased coordination of care. I have said over and over again that excessive administrative fees and ineffective management of chronic disease is the m... Better Health blogs http://www.medworm.com/rss/comments.php?id=4813286 Wed, 11 May 2011 18:00:41 +0100 4813286 http://www.medworm.com/index.php?rid=4813229&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F11%2Fclinical-registries-the-opportunity-for-the-nation%2F In the early 1970s, the Cystic Fibrosis Foundation began tracking the health of patients with cystic fibrosis.  What began as a modest data collection effort is today a comprehensive clinical registry of 26,000 patients.  Caregivers and researchers use the registry to identify new trends in outcomes; recognize the most effective treatments; and design clinical trials [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813229 Wed, 11 May 2011 16:22:36 +0100 4813229 http://www.medworm.com/index.php?rid=4797771&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-medical-waste-does-a-6000-flashlight-improve-patient-outcomes%2F2011.05.07 So I’m rounding in the ICU the other day when I came upon this new hospital medical device.  It’s called a pupillometer.  What does this pupillometer do?  It  measures subtle changes in the light reflex of the pupil to help take the physical exam to the next level of precision. Or eliminate it, depending on how you look at it.  What used to be a basic physical exam skill is now being replaced by a $6000 piece of medical technology that can distinguish tiny changes in pupil size. Now the real questions remain.  Has this pupillometer device gone through the rigors of randomized trials in the ICU to define whether a  $6000 flashlight changes outcomes or mortality?   And if not, how do we allow medications to require such testing but not the technology that often changes n... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797771 Sun, 08 May 2011 00:00:00 +0100 4797771 http://www.medworm.com/index.php?rid=4794833&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F06%2Fnew-answers-on-macular-degeneration-important-questions-for-comparative-effectiveness-research%2F On April 28th, the New England Journal of Medicine published the results of a study that compared two drugs head-to-head for the treatment of age-related macular degeneration (AMD), the leading cause of legal blindness in the United States.  The two drugs, Ranibizumab (Lucentis) and Bevacizumab (Avastin), are very similar molecules and are both meant to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4794833 Fri, 06 May 2011 15:45:32 +0100 4794833 http://www.medworm.com/index.php?rid=4794836&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fbcec9l1MDKE%2F Off the Table?: It doesn’t look like the House Republicans’ plan to cut Medicare spending — providing seniors with a fixed amount of money with which they could buy private insurance — is going to be a part of budget talks, the WSJ reports. Cuts to entitlement programs are unlikely to be part of the negotiations over raising the debt limit, Rep. Paul Ryan has said. Supplemental Knowledge: A new study finds that taking vitamin E, selenium and soy supplements every day for three years doesn’t seem to help prevent prostate cancer in men at risk for the disease, Reuters reports. Observational studies had seemed to note a benefit for men who consumed those nutrients via food or supplements, but more rigorous studies, including this one, haven’t come to the sa... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4794836 Fri, 06 May 2011 12:37:20 +0100 4794836 http://www.medworm.com/index.php?rid=4789633&cid=t_106517_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Frn2r9MWhDMo%2F Conceived as part of health care reform, accountable care organizations may become the next big thing in lowering cost. The basic premise involves a network of doctors and hospitals that share responsibility for providing care to patients. Each ACO would receive financial incentives to provide quality care to Medicare beneficiaries while holding down costs. And since the intiative is scheduled to launch in January 2012, there is a scramble under way among physician practices and hospitals to form ACOs. The Obama administration, meanwhile, recently proposed guidelines on how ACOs will work (look here). But what are the implications for the pharmaceutical industry? We spoke with Ian Spatz, a senior advisor to Manatt Health Solutions, founder of Rock Creek Policy Group and a former vp for pub... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4789633 Thu, 05 May 2011 20:50:41 +0100 4789633 http://www.medworm.com/index.php?rid=4780288&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FL5ois3Zdctw%2F Is price transparency for everyday health services an important tool for lowering health-care costs? Howard McClure, who was just named chairman of the board of change:healthcare (and will transition to the CEO role over the next few months) thinks so. Change:healthcare provides employees enrolled in high-deductible health plans at participating companies with personalized information on how they might save money on their care by changing providers. And McClure, a former president of CVS/Caremark Pharmacy Services, says that when consumers see that their work colleagues got the same drug or dental checkup at a lower price, they often switch to the cheaper provider. And even if the savings are only, say, $20 on an office visit or $15 on a prescription, “it does add up,” he tells... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4780288 Tue, 03 May 2011 14:04:55 +0100 4780288 http://www.medworm.com/index.php?rid=4780312&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faccountable-care-organizations-acos-hmos-with-lipstick%2F2011.05.03 Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow. Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost. Thousands of physicians have been confused by the concept of ACO. Many have felt ACOs are an attack on their freedom to practice medicine the best they can. Many have rejected the concept because they feel they will have to be salaried by hospital systems. Many physicians do not trust President Obama or Dr. Don Berwick. The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations. The two cor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4780312 Tue, 03 May 2011 14:00:50 +0100 4780312 http://www.medworm.com/index.php?rid=4775365&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FhKrkifrkays%2F It can be tough to find the right antidepressant since any given drug works for — at most — about two-thirds of people who try it. Well then, wouldn’t it make sense to take more than one drug at the same time, you might ask? Some research,  including a major clinical trial called STAR*D, has suggested that strategy has merit. In that trial, thousands of patients were systematically given different medication regimens, including a combination of drugs, and the majority of patients found that their depression lifted. But a new study published in the American Journal of Psychiatry suggests that newly depressed patients shouldn’t start out with two drugs: combination therapy appeared to be no more effective than a single drug in improving depression symptoms. Some 665 ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4775365 Mon, 02 May 2011 21:33:33 +0100 4775365 http://www.medworm.com/index.php?rid=4775369&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FPe2plLZ0lF4%2F Looking Past the Cliff: In an interview with the WSJ, new Pfizer CEO Ian Read says that the company won’t lose all of the roughly $11 billion in sales generated by Lipitor when the anti-cholesterol drug loses patent protection later this year. Read also reiterates his intention to review Pfizer’s businesses and consider whether certain non-core units may “have a better value to Pfizer shareholders outside of Pfizer rather than in.” (If you can’t get enough of Pfizer this morning, Forbes also writes about the pharma giant.) Loving Embrace: Generic drug giant Teva is buying Cephalon for $6.8 billion, or about $81.50 per share, Bloomberg News reports. Cephalon had been fending off an unwanted $73-per-share bid from Valeant Pharmaceuticals, saying the offer was to... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4775369 Mon, 02 May 2011 12:27:33 +0100 4775369 http://www.medworm.com/index.php?rid=4775395&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-costs-does-your-doctor-know-when-youre-going-to-die%2F2011.05.01 One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea. Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775395 Sun, 01 May 2011 18:00:00 +0100 4775395 http://www.medworm.com/index.php?rid=4771024&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-medical-condition-is-the-most-costly-to-employers%2F2011.04.30 Ok…here’s a brain teaser.  What medical condition is the most costly to employers?  I’ll give you a hint.  It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians. If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both criteria…at least in terms of cost and the undiagnosed part. Four out of every ten people at work or sitting in the doctor’s waiting room suffer from moderate to severe depression.  Prevalence rates for depression are highest among women and older patients with chronic conditions.  Yet despite its high prevalence and costly nature, depression is significantly under-diagnosed (<50%) and under-treated by physicians. For em... Better Health blogs http://www.medworm.com/rss/comments.php?id=4771024 Sat, 30 Apr 2011 19:00:08 +0100 4771024 http://www.medworm.com/index.php?rid=4753649&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F26%2Fwhere%25e2%2580%2599s-the-patient-in-the-patient-centered-medical-home%2F The patient-centered medical home (PCMH) has grabbed the limelight as a new model of health care that offers an alternative to fragmented, impersonal and wasteful care that has become the norm throughout much of the U.S.  The PCMH model promises each patient a primary care provider leading an interdisciplinary care team, with the intent of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4753649 Tue, 26 Apr 2011 17:58:32 +0100 4753649 http://www.medworm.com/index.php?rid=4742360&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fo_wUPcC7lrY%2F High-deductible health policies and Rep. Paul Ryan’s budget plans for Medicare both assume that health costs can be kept down by treating patients more like consumers. The thought is that those of us with insurance are disconnected from the price of our health care — since we usually don’t pick up the bill — and that having more skin in the game would make us more fiscally careful about the goods and services we use. As one commenter, SLC, wrote in response to our recent post on high-deductible plans, “Let consumers take charge and be responsible, and stop assuming they are incapable of rational decisions.” In his NYT column today, economist Paul Krugman takes issue with that notion of patient as consumer, saying health care isn’t the same as other... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4742360 Fri, 22 Apr 2011 16:44:32 +0100 4742360 http://www.medworm.com/index.php?rid=4742387&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-much-does-it-cost-to-bring-one-drug-to-market%2F2011.04.22 Despite the variety of health systems across hundreds of different countries, one feature is near-universal: We all depend on private industry to commercialize and market drug products. And because drugs are such an integral part of our health care system, that industry is generally heavily regulated. Yet despite this regulation, little is publicly known about drug development costs. But aggregate research and development (R&D) data are available, and the pharmaceutical industry spends billions per year. A huge challenge facing consumers, insurers, and governments worldwide are the acquisition costs of drugs. On this point, the pharmaceutical industry makes a consistent argument: This is a risky business, and it costs a lot to bring a new drug to market. According to PhRMA, the U.S. ph... Better Health blogs http://www.medworm.com/rss/comments.php?id=4742387 Fri, 22 Apr 2011 14:00:37 +0100 4742387 http://www.medworm.com/index.php?rid=4742533&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002084.html There's a good bit of confusion out there about the two physician dispensing bills on the table in Florida. There are two separate issues here that are often conflated in the media. First are the pill mills - those storefronts... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4742533 Thu, 21 Apr 2011 23:00:00 +0100 4742533 http://www.medworm.com/index.php?rid=4734046&cid=t_106517_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FHARaQeQERsI%2F By Caleb O. BrownThe Institute for Humane Studies Learn Liberty project continues to offer clear-headed analysis in video form. The latest effort features Ben Powell of Suffolk University explaining the concept of concentrated benefits and diffuse costs in the context of ongoing budget fights. Cato recently produced two short videos on complementary aspects of the budget fights. For a more detailed treatment of many aspects of public choice, get your free (cheap!) copy of Cato’s excellent book, Government Failure: A Primer in Public Choice. Public Choice and Spending Cuts is a post from Cato @ Liberty - Cato Institute Blog (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4734046 Thu, 21 Apr 2011 14:07:15 +0100 4734046 http://www.medworm.com/index.php?rid=4734026&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F21%2Fwill-price-competition-lead-to-quality-competition%2F Editor’s Note: In addition to John Goodman (photo and bio above), this post was coauthored by Gerald Musgrave and Devon Herrick. In our third-party-payer health insurance system the price for care is typically set by entities external to the doctor-patient relationship.  As a result, providers rarely compete for patients based on money prices. Potentially they [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4734026 Thu, 21 Apr 2011 13:13:12 +0100 4734026 http://www.medworm.com/index.php?rid=4734098&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fchildhood-education-may-be-the-key-to-reducing-healthcare-costs%2F2011.04.21 In a recent op-ed in the San Francisco Examiner, William Dow, a professor of health economics at UC Berkeley, commented on the importance of education as a means of enabling more people to afford health care insurance. In my view, education is important not simply because an educated population can more easily pay for health care. The main importance is that educating children will allow those children and their children to have healthier childhoods, less burden of disease as adults, access to more personal and communal resources to deal with whatever disease they have and less need for health care, and that translates into less health care spending. Let me frame this in terms of the San Francisco Bay Area. In a series of articles in the Contra Costa Times last year, Susanne Bohan and San... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734098 Thu, 21 Apr 2011 11:00:01 +0100 4734098 http://www.medworm.com/index.php?rid=4734099&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-accountable-care-organizations-acos-will-not-solve-our-healthcare-cost-crisis%2F2011.04.20 In 2009 President Obama stated that Accountable Care Organizations (ACOs) were going to be pilot programs in real world settings. The goal was to see if they effective in reducing costs and increasing “quality of care.” The results of the pilot programs have not been published. Last week despite the lack of proof of concept HHS and CMS announced new proposed regulations for ACOs. The new delivery and payment model the agency estimates could serve up to 5 million Medicare beneficiaries through participating providers, and also potentially save the Medicare program as much as $960 million over three years. How were these estimates derived? It could be another accounting  trick by President Obama’s administration. The idea of coordinating care and developing systems of care is a great... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734099 Thu, 21 Apr 2011 01:00:07 +0100 4734099 http://www.medworm.com/index.php?rid=4734103&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-paul-ryans-medicare-budget-cuts-going-to-harm-the-elderly%2F2011.04.20 For some time now, numerous loved ones and dear friends have been advising and occasionally urging DrRich that, perhaps, it has become a bit inappropriate, and even unseemly, for him to continue in his longtime position as President and sole member of Future Old Farts of America (FOFA). For a not unsubstantial interval DrRich ignored this advice, feigning incipient deafness. But finally, after some focused study of that which these days returns his gaze in the mirror, and reluctantly concluding that maybe his loved ones have a point (and not wishing to seem Cranky), DrRich has reluctantly decided to resign from (and therefore disband) FOFA. DrRich is pleased to announce that he has accepted a new position as President and sole member of Glorious Old Farts of America (GOFA). And it is in th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734103 Wed, 20 Apr 2011 14:00:32 +0100 4734103 http://www.medworm.com/index.php?rid=4734329&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002082.html This morning's NYTimes has a heart-crushing story about a town in Ohio devastated by abuse of OxyContin and other prescription narcotics. Here's what prescription drug abuse has done to Ohio. - in 2007, deaths from prescription drug abuse (PDA) in... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4734329 Tue, 19 Apr 2011 23:00:00 +0100 4734329 http://www.medworm.com/index.php?rid=4734043&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FqSjr_d_ypaA%2F High-deductible health plans are in part intended to cut down on unnecessary medical spending by putting more of a consumer’s dollars at stake. But there have been concerns that people who have low incomes or chronic diseases might cut back too deeply and scrimp on needed care. A new study from the Rand Corporation finds that particular fear is unfounded, at least in the first year of enrollment, and in the group they studied — 360,000 families who signed up between 2003 and 2007. Researchers looked at families living in low-income areas, and also those that included a person with a costly chronic disease, such as diabetes or kidney disease. And, lead author Amelia Haviland, a statistician at Rand, tells the Health Blog, there was no more cutting back among those vulnerable pop... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4734043 Mon, 18 Apr 2011 21:27:57 +0100 4734043 http://www.medworm.com/index.php?rid=4723782&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F18%2Fcomparative-effectiveness-research-how-can-it-change-practice%2F The Patient Protection and Affordable Care Act (ACA)  is designed to increase the number of U. S. citizens with access to health insurance.  Along with augmented access to health insurance and hopefully health care for millions of the currently uninsured, as well as some degree of overall health care cost containment,  the ultimate success of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4723782 Mon, 18 Apr 2011 13:59:19 +0100 4723782 http://www.medworm.com/index.php?rid=4723808&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhospice-patients-spend-less-overall-time-in-hospital-but-more-days-in-the-icu%2F2011.04.16 Chronically-ill Medicare patients spent fewer days in the hospital and received more hospice care in 2007 than they did in 2003, but their intensity of care increased as well, according to a report by the Dartmouth Atlas Project. While in the hospital less, patients had many more visits from physicians, particularly specialists, and spent more days in intensive care units, as result of growth in intensive care and specialist capacity, the researchers said. Intensive interventions can lower a patients’ quality of life and cost more, the researchers noted. About one-fourth of all Medicare spending stems from the last year of life, and much of the growth in Medicare spending is the result of the high cost of treating chronic disease, the authors noted. Following patient preferences for ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723808 Sat, 16 Apr 2011 22:00:00 +0100 4723808 http://www.medworm.com/index.php?rid=4714710&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F14%2Fthe-proposed-accountable-care-organization-antitrust-guidance-a-first-look%2F Editor’s note: This post, by Joe Miller, is part of a series of Health Affairs Blog posts examining the proposed rules and guidelines implementing the Medicare Shared Savings Program, issued March 31 by the Centers for Medicare and Medicaid Services and other agencies.  You can read other posts in the series by Mark McClellan and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4714710 Thu, 14 Apr 2011 19:11:59 +0100 4714710 http://www.medworm.com/index.php?rid=4709282&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002076.html Today's local news reported the arrest of a doctor from our small town for allegedly illegal prescribing controlled substances. The physician, by all accounts a well-liked and generally respected member of the community, was charged with illegally prescribing "Demerol, Percocet,... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4709282 Tue, 12 Apr 2011 23:00:00 +0100 4709282 http://www.medworm.com/index.php?rid=4704795&cid=t_106517_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fms-drug-presentations-theyve-changed%2F There was a day in my community when a person with MS could spend nearly one night per week at one of the pharmaceutical company-sponsored multiple sclerosis drug seminars around the country, complete with free meals. They were “dinner and a [multiple sclerosis] show”! Like many of our readers, I spent more than a few of these evenings learning about the disease modifying drugs, but also learning quite a lot about the doctors who presented at these meetings. Nearing a decade post-diagnosis, I could safely say that I no longer attend (and am seldom invited to) these seminars. I get information in other ways when something new comes out – for example, at events such as the CCSVI program I attended in Seattle in January. Last week, however, I decided to sit in on one of the drug company... Life with MS blogs http://www.medworm.com/rss/comments.php?id=4704795 Mon, 11 Apr 2011 20:34:47 +0100 4704795 http://www.medworm.com/index.php?rid=4693286&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftreatments-for-kids-with-autism-and-cerebral-palsy-on-insurance-chopping-block%2F2011.04.08 One of the great challenges facing the folks who have been tasked to implement the Big O’s health care law is defining “essential benefits,” the core medical services that insurers must cover. Despite its voluminous nature, the law is remarkably vague in this regard. It does identify 10 care categories that health plans must provide to consumers who use federally-funded health insurance exchanges to select a plan, but the categories and associated lists aren’t comprehensive or specific (the categories appear at the end of this post). The Institute of Medicine has been tasked to flesh out the lists of required services. It has begun work amid a frenzy of lobbying by private insurers and consumer groups. Habilitative services are one contentious area, and they illustrate the challe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4693286 Fri, 08 Apr 2011 20:00:28 +0100 4693286 http://www.medworm.com/index.php?rid=4684315&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-primary-care-physicians-keep-specialists-from-ordering-too-many-tests%2F2011.04.07 There are many tips to saving money on medical costs like asking your doctor only for generic medications, choosing an insurance plan with a high deductible and lower monthly premiums, going to an urgent care or retail clinic rather than the emergency room, and getting prescriptions mailed rather than go to a pharmacy. How about getting your old medical records and having them reviewed by a primary care doctor?  It might save you from having an unnecessary test or procedure performed. Research shows that there is tremendous variability in what doctors do.  Shannon Brownlee’s excellent book, Overtreated – Why Too Much Medicine Is Making Us Sicker and Poorer, provides great background on this as well as work done by the Dr. Jack Wennberg and colleagues on the Dartmouth Atlas. S... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684315 Thu, 07 Apr 2011 17:00:00 +0100 4684315 http://www.medworm.com/index.php?rid=4684317&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-republican-healthcare-plan-the-good-the-bad-and-the-ugly%2F2011.04.07 I am all for any proposal that will improve heath care in America. Improvement means controlling costs, covering all Americans so no one has to worry about going bankrupt to pay for health care. Improvement means access to quality care without having to worry about losing your job, which means losing your coverage. Improvement means a system where all incentives are aligned to prevent disease, rather than using expensive technologies and hospitals to treat disease after the fact. Any proposal that gets us there has my vote. In the GOP “Path to Prosperity” budget for 2012, they propose a few things that are good and a few big things that are bad…really really bad. First the good. Capping the medical malpractice lawsuits for “pain and suffering” would be a huge ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684317 Thu, 07 Apr 2011 12:00:00 +0100 4684317 http://www.medworm.com/index.php?rid=4684254&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FDNKoV5e0DlA%2F It’s an exciting time for physicians and mothers-to-be interested in preterm labor, a condition that’s not usually in the headlines. Today, researchers announced that a study conducted by the NIH, in conjunction with Watson Pharmaceuticals, found that using a progesterone gel in certain women at risk of preterm delivery cut the odds of having a premature baby by 45%. As the WSJ reports, the research focused specifically on women with a short cervix — a major risk factor for early delivery. And then there’s Makena. The FDA in February approved the drug — available for years from compounding pharmacies at about $10 or $20 per shot — to prevent early labor in women who have already had a preterm birth. But the new price, set by the company that won exclusiv... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4684254 Wed, 06 Apr 2011 20:56:15 +0100 4684254 http://www.medworm.com/index.php?rid=4684255&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FdnPEoGUfkLI%2F Express Scripts, a pharmacy-benefit manager, released its annual drug trend report today, which offered a bit of good news on the health-care cost front: Overall drug spending grew just 3.6% last year, compared to 6.4% the year earlier. Actual prices for branded medications have kept rising at a fast clip, growing 9.7% last year, up from 9.1% the year earlier, as the WSJ reported at the time. But prices for generic drugs fell in 2010 by 10.2%, and that, combined with their increased use, helped to moderate the overall drug-spending trend, Express Scripts says. Still, Express Scripts says a lot of unnecessary money — $403 billion per year, according to the way it crunched national stats — is being spent on drugs that don’t produce a health benefit. The company says consumers wa... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4684255 Wed, 06 Apr 2011 16:08:42 +0100 4684255 http://www.medworm.com/index.php?rid=4684321&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-elderly-men-be-screened-for-prostate-cancer%2F2011.04.06 A study in the Journal of Clinical Oncology found that “that men in their seventies had prostate cancer screening nearly twice as often as men in their early fifties, who are more likely to benefit from prostate cancer detection and treatment.” An American Society for Clinical Oncology news release includes this quote: “Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer. We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefitting the patient and paradoxically can cause more harm than good,” said senior author Scott Eggener, MD, assistant professor of surgery at the University of Chicago. “We were also surprised to fin... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684321 Wed, 06 Apr 2011 14:00:27 +0100 4684321 http://www.medworm.com/index.php?rid=4677052&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F04%2Fmore-on-health-care-costs-for-public.html Here in Massachusetts there is a state law which says municipalities must negotiate with unions whenever they want to make changes to the current health care plans and payments. So what has happened is towns are spending more and more each year of their budgets on health care for employees. A report was done by two organizations here that reviewed the costs in 14 towns. If you are a public employee in those towns, you pay an average of $11 co pay for primary care, $14 for specialists, generic drugs cost you $8, brand drugs cost $15, non-preferred brands cost $31. You also have no copayment for imaging and no deductible. Are your costs anywhere near that? And probably up to 85% of your premiums are paid by your employer. The report recommends that the state law be changed. The governor is b... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4677052 Tue, 05 Apr 2011 10:16:00 +0100 4677052 http://www.medworm.com/index.php?rid=4670108&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-pressured-not-to-order-tests-then-sued-if-they-dont%2F2011.04.02 Cardiologists in Connecticut are standing up to the lack of liability protection in the state’s new low-income health plan called SustiNet: The SustiNet program would create large pools of people, including those who can’t currently afford health insurance, that would theoretically drive down premium costs by competing with the plans of private insurers. Among other cost savings, it would designate a single doctor or practice for each patient, to reduce emergency care use, and create new “best-use” procedures for a variety of ailments to reduce the number of tests doctors order. But a key provision of the plan was that doctors, in return for following the new procedures and ordering fewer tests, would be protected from malpractice suits if the outcome of a case was ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670108 Sat, 02 Apr 2011 21:00:00 +0100 4670108 http://www.medworm.com/index.php?rid=4670313&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F04%2Fwhen-business-interests-come-first-part.html A few weeks ago, I blogged about drug over pricing. A drug company had gotten FDA approval for a medication previously sold by compounding pharmacies for $10 per dose. They were going to sell this medication at $1500 per dose. This was a drug for preventing premature births. Well guess what - the drug company is responding to critics and has reduced the price from $1500 per dose to $690 per dose. Still a hefty price but its nice to see a significant price reduction.But then the business question comes in - what was their profit margin on the drug where they had such a cushion that they could reduce the cost by so much. This is clearly too much for me so early in the day but even without doing the math they were making a lot of money off this drug. The real point of this is in the closing l... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4670313 Sat, 02 Apr 2011 11:07:00 +0100 4670313 http://www.medworm.com/index.php?rid=4664344&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002066.html For some time we've been hearing about drug costs heading back up - driven by utilization increases (the all-too-common driver) more than price. Of late, price has started to take over the lead as the main cause of drug cost... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4664344 Wed, 30 Mar 2011 23:00:00 +0100 4664344 http://www.medworm.com/index.php?rid=4658460&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002065.html This am's WorkCompCentral reported that Florida Gov. Rick Scott spoke out in favor of a ban on physician dispensing of Scheduled drugs - those medications regulated/tracked by the DEA. It's indeed encouraging that Scott has finally decided to do something... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4658460 Tue, 29 Mar 2011 23:00:00 +0100 4658460 http://www.medworm.com/index.php?rid=4653334&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcollaborative-care-can-decrease-mental-health-costs%2F2011.03.29 I briefly scanned the Robert Wood Johnson synthesis report on mental and medical co-morbidity so I thought I’d summarize the highlights for the blog. If you’d rather watch the recorded web seminar you can hear it here. The report relied on systemic literature review to look at the relative risk and mortality associated with co-morbid medical and mental health conditions. The looked at studies using structure clinical interviews, self-report, screening instruments and health care utilization data (diagnostic codes reported to Medicaid). This is what they found: 68 percent of adults with a mental disorder had at least one general medical condition, and 29 percent of those with a medical disorder had a comorbid mental health condition These findings support the conclusion that th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4653334 Tue, 29 Mar 2011 12:00:00 +0100 4653334 http://www.medworm.com/index.php?rid=4642570&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F7lj1zDfVKeo%2F A number of hospitals and health systems around the country are adopting safety programs to reduce harm to both mother and infant in the delivery room, according to a story in the WSJ’s special report on health-care innovation. But in at least one case, innovation has drawn some unexpected–and apparently unwanted–attention. In  last month’s issue of the American Journal of Obstetrics and Gynecology , New York Weill Cornell Medical Center and New York-Presbyterian Hospital reported impressive results from an obstetrics safety program, which trained teams in standard protocols to reduce the risk of  birth injury. Now the hospital and the study authors are protesting the fact that a bill being introduced in the state assembly would mandate its use for all hospitals in the sta... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4642570 Mon, 28 Mar 2011 14:37:26 +0100 4642570 http://www.medworm.com/index.php?rid=4642598&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-medical-educations-high-price-tag-drive-some-healthcare-costs%2F2011.03.27 My column in Sunday’s Greenville News. ‘Medical education shouldn’t cost an arm and a leg.’ I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year. And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their medical educations. Another young woman I recently met is in residency and her loan payments are around $2000 per month. Thinking back on my own medical education, it seems my tuition was around $5000 per year. But then, what with all the Saber Toothed Tigers, Neanderthals and stone surgical tools, things were simpler.. These day... Better Health blogs http://www.medworm.com/rss/comments.php?id=4642598 Sun, 27 Mar 2011 12:00:49 +0100 4642598 http://www.medworm.com/index.php?rid=4636561&cid=t_106517_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fdisabled-in-the-uk-to-be-hurt-by-reforms%2F In the United Kingdom, the letters ESA and DLA stand for programs similar to those in the United States (SSD & SSI). Here, Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues, (not Social Security taxes) which is designed to help aged, blind, and disabled people with little or no income. It provides cash to meet basic needs for food, clothing and shelter. Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes. In the United Kingdom, the Employment and Support Allowance (ESA) and the Disability Living Allowance (DLA) are designed to help people who can’t work due to (among other things) disablin... Life with MS blogs http://www.medworm.com/rss/comments.php?id=4636561 Fri, 25 Mar 2011 20:25:35 +0100 4636561 http://www.medworm.com/index.php?rid=4636411&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FdFl1yrlFTy0%2F A study out today finds that high-deductible health plans do cut down on health-care spending – but also prompt patients to get less preventative care. The RAND Corporation, which ran the study, says it is the largest ever of its kind. The group studied more than 800,000 families and found that when they moved to plans with deductibles over $1,000, health spending dropped an average of 14%. But the study also found that those families cut back on things like childhood immunizations, cancer screenings and diabetes tests. Childhood vaccination rates among families in traditional plans rose, while they dropped among those in the high-deductible plans, for instance. RAND says that drop happened even though high-deductible plans waive the need to pay a deductible when receiving preventative s... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4636411 Fri, 25 Mar 2011 18:36:53 +0100 4636411 http://www.medworm.com/index.php?rid=4636553&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002063.html I wasn't there, but certainly heard enough about it to wish I was. I'm referring to CWCI's annual meeting held yesterday in San Francisco, a meeting that might well have been subtitled "Opioids and the Doctors who prescribe them". The... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4636553 Fri, 25 Mar 2011 00:00:00 +0100 4636553 http://www.medworm.com/index.php?rid=4626784&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FmQOeYi9WDRA%2F The National Football League has locked out some 1,700 players. And now those athletes are responsible for some job-related costs that used to be picked up, at least in part, by the league and their teams — including, as the Washington Post reports, their health and fitness expenses. Those can be substantial. Health-insurance coverage under COBRA will run about $2,400 a month for a family, the former senior director of benefits for the now-dissolved player’s union tells the WP. (Injuries will be covered by worker’s compensation.) But then there are the expenses that most of us don’t incur in the course of doing our jobs. “Healthy players will have to pay for their massages, acupuncture services, chiropractic treatment, personal training, fitness classes and an... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4626784 Wed, 23 Mar 2011 17:39:30 +0100 4626784 http://www.medworm.com/index.php?rid=4622223&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FqAhHpEvyEbg%2F Extending Life: When combined with chemo, Bristol-Myers Squibb’s experimental melanoma drug ipilimumab helped extend the life of patients with metastatic melanoma who’d received no previous treatments, Dow Jones Newswires reports. The FDA is scheduled to announce this week whether it has approved the drug — which would be sold under the brand name Yervoy — for use in metastatic melanoma patients who have already been treated with another therapy, DJN says. The Cost of MS: Prescription-drug prices are rising, as we’ve reported. Today Bloomberg News highlights one disease for which that is especially true — multiple sclerosis, where the price of therapies rose by as much as 39% in 2010. The cost of those drugs is becoming similar to that of cancer therapie... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4622223 Tue, 22 Mar 2011 12:26:33 +0100 4622223 http://www.medworm.com/index.php?rid=4615077&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F14yIjIFPtJY%2F Food Worries: Elevated radiation levels were found in spinach and milk from areas near the Japanese nuclear power-plant disaster over the weekend, prompting the government to today suspend shipments of those products, plus rapeseed, from certain prefectures, the WSJ reports. In addition, radiation was found in tap water in a village about 20 miles from the plant. The radiation isn’t at levels at which it would cause any immediate health risks, the paper says. Lipitor Legalities: Generic drug-maker Mylan filed suit in a federal court against the FDA, asking the agency to bar Ranbaxy Laboratories from exclusively selling a generic version of Pfizer’s top-selling statin drug Lipitor for 180 days, Bloomberg News reports. Mylan says it and other drug makers should be allowed to sell... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4615077 Mon, 21 Mar 2011 12:32:47 +0100 4615077 http://www.medworm.com/index.php?rid=4610785&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F18%2Fpallone-cites-michael-oggs-narrative-matters-essay-in-class-act-hearing%2F Michael Ogg’s Narrative Matters essay in the January issue of Health Affairs “powerfully illustrates the realities of the current long-term care environment,” Rep. Frank Pallone (D-NJ) said yesterday at a House Energy and Commerce Health Subcommittee hearing.  Pallone, the panel’s senior Democrat, entered the essay into the hearing record. Ogg suffers from primary progressive multiple [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4610785 Fri, 18 Mar 2011 15:39:56 +0100 4610785 http://www.medworm.com/index.php?rid=4606052&cid=t_106517_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FFiK0SOKwv4Q%2F Where, oh where, did your health care budget go? A larger chunk apparently went to pay for brand-name* prescription meds which, on average, rose 6.9 percent last year. The increase nudged past the 6.8 percent average advance registered in 2008, which was the largest annual jump since Barclays Capital began tracking price hikes, The Wall Street Journal reports. Some of the biggest: the Benicar blood pressure pill sold by Daiichi Sankyo rose 29.3 percent; the Gleevec cancer treatment marketed by Novartis jumped 20.9 percent; Johnson & Johnson’s Concerta pill for ADD moved up 19.7 percent; Pfizer’s Lipitor cholesterol blockbuster popped 12.4 percent, and the Plavix bloodthinner sold by Bristol-Myers Squibb and Sanofi-Aventis rose 13.2 percent. Obviously, drugmakers are &#8220... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4606052 Thu, 17 Mar 2011 12:15:48 +0100 4606052 http://www.medworm.com/index.php?rid=4592345&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F15%2Fwhat-employers-don%25e2%2580%2599t-spend-for-health-will-cost-them%2F Recently it was reported that the federal government has issued more than a thousand waivers concerning various provisions of the Affordable Care Act. Some of the earliest and most high-profile waiver requests involved the McDonald’s restaurant chain, whose capped benefit “mini-med” plans, — provided by McDonald’s to 30,000 hourly employees, about 8 percent of all [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4592345 Tue, 15 Mar 2011 17:04:05 +0100 4592345 http://www.medworm.com/index.php?rid=4642758&cid=t_106517_114_f&fid=35410&url=http%3A%2F%2Fletstalkhealthcare.org%2Fblog%2Fblog-post-title-lorem-ipsum-dolor-sit-amet%2F Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut eu turpis odio, non vehicula nisl. Vivamus justo urna, dictum vitae dapibus sit amet, ullamcorper eu dui. Sed quam est, imperdiet vel faucibus non, hendrerit ac tellus. Praesent eu ligula nibh, vitae pharetra lacus. (Source: HPHC) HPHC blogs http://www.medworm.com/rss/comments.php?id=4642758 Thu, 10 Mar 2011 02:48:14 +0100 4642758 http://www.medworm.com/index.php?rid=4566355&cid=t_106517_167_f&fid=38271&url=http%3A%2F%2Frebeccascritchfield.wordpress.com%2F2011%2F03%2F09%2Fneed-a-nutritionist-see-a-registered-dietitian%2F Who hoo! It’s a blog carnival for registered dietitians, celebrating #RDday (for those twitter-ers). Be sure to check back at this post for links to other blogs by my RD colleagues participating. I can’t wait to get into my piece, but I just can’t help myself to use this opportunity to explain what and RD is and why we are essential to the health and wellness of the people and a healthy economy. What is an RD? When you’re sick and you need to see a doctor, your doctor has a credential – the “MD” – which stands for medical doctor. The nurse takes your weight and blood pressure – and that person has a credential too – the “RN” – which stands for registered nurse. Then there’s the RD – which stands for r... Balanced Health and Nutrition Rebecca Scritchfield's Blog blogs http://www.medworm.com/rss/comments.php?id=4566355 Wed, 09 Mar 2011 14:24:11 +0100 4566355 http://www.medworm.com/index.php?rid=4549728&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F04%2Fthe-real-issue-controlling-all-health-care-costs%2F The current cry to reduce Federal deficits and debt growth by reducing Medicare and Medicaid entitlements is totally missing the key issue: the need to moderate all health care inflation. This should be the time for a national debate on how to best tackle the underlying cost problem, for the sake of our future, the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4549728 Fri, 04 Mar 2011 17:16:19 +0100 4549728 http://www.medworm.com/index.php?rid=4522081&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F25%2Fhouse-family-planning-cuts-bad-medicine-and-bad-economics%2F Last week, on February 19, under the pretext of cutting the federal deficit, the United States House of Representatives voted to eliminate funding and end reimbursement to health care providers supplying crucial sexual and reproductive health care to millions of women and men across the country.   The provisions are part of the House-passed Continuing [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4522081 Fri, 25 Feb 2011 14:01:03 +0100 4522081 http://www.medworm.com/index.php?rid=4517248&cid=t_106517_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002038.html An article about opioids and chronic pain featured in WorkCompCentral's [subscription required] professional columns section this week should be required reading for anyone involved in comp. The explosive growth in the use of opioids among the general population, and specifically... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=4517248 Thu, 24 Feb 2011 00:00:00 +0100 4517248 http://www.medworm.com/index.php?rid=4498275&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faggressive-care-when-is-it-better-for-patients%2F2011.02.19 The recurring narrative among health reformers is that hospitals that provide more care raise health costs, but don’t necessarily improve quality. This has lead to a backlash against so-called “aggressive” hospitals and doctors, with upcoming financial penalties to match. But the situation, as always, appears to be more nuanced than that. In her column in the New York Times, Dr. Pauline Chen looks at one subset of patients who actually may benefit from aggressive care: Those who suffer surgical complications. The study, found no difference in the rate of complications for aggressive and nonaggressive hospitals. But when they looked at all the patients who had complications and examined their outcomes, the researchers found that regardless of the urgency of their operations, those pat... Better Health blogs http://www.medworm.com/rss/comments.php?id=4498275 Sat, 19 Feb 2011 17:00:29 +0100 4498275 http://www.medworm.com/index.php?rid=4489635&cid=t_106517_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FRX7stlKncCc%2F By Daniel J. MitchellHere's a video arguing for the abolition of the corporate income tax. The visuals are good and it touches on key issues such as competitiveness.   I do have one complaint about the video, though it is merely a sin of omission. There is not enough attention paid to the issue of double taxation. Yes, America's corporate tax rate is very high, but that is just one of the layers of taxation imposed by the internal revenue code. Both the capital gains tax and the tax on dividends result in corporate income being taxed at least two times. These are points I made in my very first video, which is a good companion to the other video. There is a good argument, by the way, for keeping the corporate tax and instead getting rid of the extra layers of tax on dividends and capital ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4489635 Thu, 17 Feb 2011 21:13:01 +0100 4489635 http://www.medworm.com/index.php?rid=4489672&cid=t_106517_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fadult-vaccines-most-doctors-dont-stock-all-of-them%2F2011.02.17 Less than one in three primary care practices offer all 10 recommended adult vaccines, citing a variety of financial and logistical reasons. Researchers sponsored by the Centers for Disease Control and Prevention sampled 993 family physicians and 997 general internists. Of the respondents, 27 percent (31 percent of family practitioners and 20 percent of internists) stocked all 10. Results appear in the Feb. 17 issue of the journal Vaccine. The 10 vaccines were hepatitis A; hepatitis B; human papillomavirus vaccine (HPV); combined measles, mumps, and rubella (MMR); meningococcal conjugate vaccine (MCV4); pneumococcal polysaccharide (PPSV23); tetanus diphtheria (Td); combined tetanus, diphtheria, and pertussis (Tdap); varicella; and zoster. Of the responding practices, two percent plan... Better Health blogs http://www.medworm.com/rss/comments.php?id=4489672 Thu, 17 Feb 2011 19:00:00 +0100 4489672 http://www.medworm.com/index.php?rid=4489622&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F17%2Fdefining-essential-benefits-congress-once-and-future-role%2F A non-governmental advisory body has begun to define one of the most important elements of last year’s health reform law. A committee of the Institute of Medicine will develop recommendations to the Department of Health and Human Services on how to define an “essential health benefit.” The ultimate resolution of this question, which may not [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489622 Thu, 17 Feb 2011 18:38:46 +0100 4489622 http://www.medworm.com/index.php?rid=4498270&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FrTploBTmdU4%2F Americans have been using fewer and less expensive medical services due to a sluggish economy and a drive by employers to push onto workers a larger share of health costs. A report out from Moody’s Investors Service today says some of that toothpaste isn’t going back in the tube: analysts see a “more permanent shift in consumer behavior” that will “continue to constrain health-care demand.” “We don’t think that employers will necessary increase coverage even if the economy improves,” Diana Lee, VP and senior credit officer at Moody’s and lead author of the report, tells the Health Blog. She acknowledges that a lot of different factors have been pegged as possible explanations for the drop in usage last year. For example, some insu... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4498270 Wed, 16 Feb 2011 21:35:08 +0100 4498270 http://www.medworm.com/index.php?rid=4489623&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F16%2Feradicating-polio-will-we-succeed-this-time%2F Editor’s Note: The Bill and Melinda Gates Foundation and other global health leaders recently launched a new effort to eradicate polio. Below, Scott Barrett comments on the potential rewards and the risks of this new initiative, and in another post Judith Kaufmann offers her thoughts on the new initiative as well. The global effort to eradicate polio [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489623 Wed, 16 Feb 2011 20:42:19 +0100 4489623 http://www.medworm.com/index.php?rid=4489624&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F16%2Feradicating-polio-challenges-and-questions%2F Editor’s Note: The Bill and Melinda Gates Foundation and other global health leaders recently launched a new effort to eradicate polio. Below, Judith Kaufmann comments on the potential rewards and the risks of this new initiative, and in another post Scott Barrett offers his thoughts on the new initiative as well. On January 31, Bill Gates introduced [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489624 Wed, 16 Feb 2011 20:37:38 +0100 4489624 http://www.medworm.com/index.php?rid=4477683&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F14%2Fsebelius-tells-story-of-ha-narrative-matters-author%2F In a speech last week at the Kaiser Family Foundation, Health and Human Services Secretary Kathleen Sebelius said that the Administration was looking at ways to buttress the financing of a new long-term care insurance program included in the Affordable Care Act. This comes in response to concerns raised by President Obama’s National Commission on [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4477683 Mon, 14 Feb 2011 17:29:55 +0100 4477683 http://www.medworm.com/index.php?rid=4464473&cid=t_106517_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FW-oT9cWJkGA%2F The Cleveland Clinic banned hiring smokers since 2007, and hospitals in at least eight states have recently done the same, the NYT says. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4464473 Fri, 11 Feb 2011 14:04:28 +0100 4464473 http://www.medworm.com/index.php?rid=4459931&cid=t_106517_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F10%2Fthe-individual-mandate-neither-essential-nor-enough%2F All eyes are focused on the many state challenges to health reform.  Florida’s recent federal court decision held the entire health reform law unconstitutional, based on the unconstitutionality of the mandate requiring all U.S. citizens to maintain a minimum level of health insurance coverage beginning in 2014, or pay a penalty.  Virginia’s earlier decision severed [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4459931 Thu, 10 Feb 2011 19:48:36 +0100 4459931 http://www.medworm.com/index.php?rid=4445786&cid=t_106517_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FSQe9ZSH2R2w%2F By Michael F. CannonFrom my latest Kaiser Health News op-ed: When 34 Senate Democrats joined all 47 Republicans last week to repeal ObamaCare's 1099 reporting requirement, their votes confirmed what their talking points still deny: ObamaCare will increase the deficit, no matter what the official cost projections say... This public-choice dynamic [of concentrated benefits and diffuse costs] is why the Congressional Budget Office, the chief Medicare actuary, and even the International Monetary Fund have discredited the idea that ObamaCare will reduce the deficit. It is one of the principal reasons why, as Thomas Jefferson wrote, "The natural progress of things is for liberty to yield, and government to gain ground." In other words, the game is rigged in favor of bigger government. It als... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4445786 Mon, 07 Feb 2011 16:22:35 +0100 4445786 http://www.medworm.com/index.php?rid=4436907&cid=t_106517_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F02%2Ffinances-and-cancer.html You get cancer and then you have to pay for it. Financially - not just emotionally or physically. In addition to nasty treatments that leave you physically drained, you are expected to keep your regular work schedule so you have an income. I was reminded of this by a friend yesterday who referred me to an online discussion of the financial toll of cancer. Insurance doesn't cover everything. Co-pays and prescriptions start to add up and you have to miss work due to surgery and chemo therapy.My story is a little different but I think the point is there. I was laid off from my job two weeks before my breast cancer diagnosis. I was trying to look for a job through surgeries and chemo. Ha, it didn't work. I did get requests for interviews and accepted them - thinking I could drag myself there w... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4436907 Fri, 04 Feb 2011 11:18:00 +0100 4436907