Health Wonk Review –Waste, Warnings and the Future

 

Last week I hosted Health Wonk Review for HIO.  This round-up of some of the health care posts published over the past two weeks includes:

–  A piece by Managed Care Matter’s Joe Paduda that takes a hard look at “Flu season and Tamiflu,” and asks “Which one’s more hyped?”

 – A investigative post on Health Care Renewal that reviews “The Tragic Case of Aaron Swartz,”  the young computer activist who faced criminal charges for downloading thousands of scientific scholarly articles from the site JSTOR. After being pursued by a “tough as nails, relentless federal prosecutor,” Swartz committed suicide. Yet blogger Roy Poses notes, this same U.S. Attorney has been “soft as a marshmallow when dealing with top executives of health care corporations.”

– A post by The Hospitalist Leader’s Brad Flansbaum questioning the ACA’s assumption that a high rate of hospital readmissions signals waste. Just how many were preventable?

 –  In  a provocative post on Health Business Blog, David E. Williams asks why Cincinnati hospitals are furious because some employers have signed up for an insurance plan that would pay all hospitals just 40% more than Medicare pays for the same service.  The Hospitals claim  that isn’t enough. Moreover, each hospital would like to set its own prices—quietly. (This allows brand-name hospitals to charge far more than some of their competitors, for exactly the same services. )

 – On Wright on Health, Brad Wright describes a new rule, proposed by the Department of Health and Human Services that could prove “disastrous” for patients on Medicaid: “HHS is now attempting to woo states into participating in the Medicaid expansion by allowing them to increase cost-sharing in Medicaid” for all but the poorest of the poor. (More bloggers and reporters might want to write about this. The proposed rule will be open for comment until Feb. 13.)

 

POST A COMMENT

The Newest Health Wonk Review—on Health Affairs

Chris Fleming hosts the latest edition of Health Wonk Review, a compendium of recent posts on health care blogs.

On Managed Care Matters, Joe Paduda offers 5 predictions for health care in 2013.  He’s convinced that all but a handful of states will expand Medicaid. (“The pressure from hospitals and providers will be overwhelming.”) He also predicts that “The feds and CMS will get even more aggressive on Medicare and Medicaid fraud.”  (For what it’s worth, I think he’s right on both counts.)

                                       Food for Thought

Some posts are likely to stir controversy, either because they’re rebutting the conventional wisdom, or because they’re questioning some deeply held beliefs.  I think these posts are important because they define issues that we should all think about.

Over at Colorado Health Insurance Insider, Louise Norris examines the question of whether smokers should pay more for their health insurance.  Under the ACA, smokers can be charged up to 50 percent more than nonsmokers.  . . .

“Norris prefers the carrot over the stick,” Fleming observes, “endorsing the requirement that all plans cover tobacco cessation programs as part of the ACA’s preventive services mandate, although she cites evidence showing that implementation of this requirement has been inconsistent. “ (It’s worth noting that tobacco cessation programs work. “Sticks,” behavioral psychologists tell us, just aren’t nearly as effective.) 

The Hospitalist Leader’s  Brad  Flansbaum suggests that our emphasis on getting everyone vaccinated during a severe influenza (and claims about Tamiflu) may well amount to “oversell.”  Eye-opening.

 At the Innovative Health Media Blog  David Wilson writes: “The Medicare Annual Wellness Visit  (AWV) is the perfect vehicle to address the increasing need for early detection of cognitive impairment.  The AWV” gives physicians the opportunity “to provide such a screening and receive reimbursement for it .

“Once a patient shows the need for additional testing physicians can use self-administered computerized tests to perform the additional screening without referring the patients to another doctor or office,” he adds. “ This also creates additional reimbursement for physicians.” 

MM–I can’t help but ask: “Since we have no cure or effective treatments for Alzheimer’s (or most forms of senile dementia) do you really want to know that, in three or four years, you may  be diagnosed with full-blown Alzheimer’s?”

Certainly, seniors who want this testing should have access to it. Perhaps, one day, accumulated data will help researchers understand the disease. But Medicare patients should know that they can say “No” There is no requirement that this be part of your Annual Wellness visit.

On the Health Business Blog, another David Wilson has published a post that is likely to be even more controversial. He argues that “The Nursing Shortage is a Myth.”

We have plenty of nurses,  Wilson suggests. In fact, in the future, he writes, “robots will be replacing nurses “just as robots have replaced “paralegals” and “actuaries.” (“Insurance companies used to hire tons of them, but their work can be done much more efficiently with computers.”)

Over at Wright on Health, Brad Wright takes a look at the recent Institute of Medicine report comparing health in the U.S. to health in other wealthy nations. He notes that data on preventable deaths among young people points to the importance of public health interventions, including reducing access to guns.

  Continue reading

4 COMMENTS SO FAR -- ADD ONE