Health Wonk Review #25
Welcome to the Silver Edition of Health Wonk Review, celebrating HWR's 25th bi-weekly installment. No need to wait for the 50th installment to celebrate; in the words of the immortal bard, "All that glitters is not gold."
To quote another poet:
All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.
From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be blade that was broken,
The crownless again shall be king.
Those of you who are J.R.R. Tolkien fans will recognize these lines and appreciate them in their original context; others may wish to read into these lines some echoes of their own thoughts on the current national political scene. I'll leave my own thoughts unspoken; feel free to divine what they may be -- but please, no wagering.
On to the task at hand.
This past fortnight could have been dominated by posts concerning the President's health plan unveiled in the State of the Union address. Instead, I would say that the plan has served as a trigger for broader debate.
There were, of course, posts on the plan. I think Matthew Holt at The Health Care Blog wins the prize for most comments on a post regarding the Bush plan. Michael Cannon at Cato @ Liberty stakes out a position that the plan is not a tax hike for some high wage earners. At Managed Care Matters, Joe Paduda says that the plan will not help the often disenfranchised folks with pre-existing conditions.
Jane Hiebert-White at the Health Affairs Blog notes that health care reform has not lost its luster, and that the interest in health care reform has emboldened the early participants in Decision 2008 to touch this "third rail" and offers links to further discussions of some candidates' views (Clinton and Obama). A Healthy Blog highlights Edwards' plan and sees a Massachusetts influence.
While not one of our usual suspects, Mark Thoma, at Economist's View, brings together a couple of articles about the decoupling of health insurance from employment, including coverage of the winners of this week's strange bedfellows award, Wal-Mart and SEIU. There's some lively discussion in the comments.
Interest in how other countries manage their health care and health insurance systems seems to wax and wane over time; these days, interest seems to be on the rise. Living through the Massachusetts experience in wrestling with the question of what is an affordable health insurance plan (under the Massachusetts universal health care law) made me think that the intended beneficiaries might have to hock the family silver, if they had any, in order to afford the plans proposed by the HMO's. A Healthy Blog's post on the subject garnered a lot of comments about European models, their (lower) costs, and whether they were worth discussing. Here at HealthBlawg, I posted a link to the recent Commonwealth Fund report comparing the rate of growth in costs in the U.S. vs. certain European countries over the past 25 years (and offering prescriptions for slowing the rate of growth here). InsureBlog's Henry Stern reacts to talk of nationalized health care systems by arguing that the grass isn't always greener.
At The Antidote: Counterspin for Health Care and Health News, Emily DeVoto delves into the American College of Physicians' proposed health plan which, she observes, goes beyond coverage and into prevention and holistic care, in an interview with the College's government affairs VP.
The policy debate extends beyond the issue of coverage. However, without coverage -- and sometimes without the "right" coverage -- there is no access to timely and adequate health care services. Jason Shafrin, at Healthcare Economist, has a post up about two studies highlighting the gap between access to emergency services (which is near-universal, thanks to EMTALA) and access to follow-up care (good to dismal, depending on source of payment).
Many states are hard at work on various forms of universal health care plans. Meanwhile, the Lone Star State is forging ahead with a single-disease prevention effort. Beth Newell offers her Health Care Musings on HPV, Rationing and Health Ethics.
While I've seen a ton of commentary on the Texas initiative, Roy Poses at Health Care Renewal chews on the dearth of ink (and bytes) on the anechoic story of HRDI. (Great adjective, Roy.) In brief, HRDI was a for-profit corporation created, owned and operated by the CEOs of 30-odd prominent U.S. health care systems and hospitals. The main purpose of this organization seemed to be to sell memberships to select corporations which sell products and services to hospitals, in exchange for face-time with the hospital and health system CEOs. It was shut down by the Connecticut AG.
You're probably wondering: What about EHRs? Well, Micky Tripathi at the MA eHealth Collaborative Blog recently wrote about a malpractice insurance credit now available to Massachusetts docs with EHRs, noting that malpractice insurers would otherwise remain free riders, benefiting from the investments of others in EHR systems through improved care and reduced claims activity.
You also must be wondering: How will the U.S. Energy Policy Act of 2005 affect HIT? Hint: The Act shifts Daylight Savings Time from an April-November affair to a March-October one. Well, Shahid Shah, The Healthcare IT Guy, explains everything one might need to attend to in order to ensure that HIT systems are not bolloxed up by the Act's monkeying with our clocks. Shahid says it's not Y2K (well, neither was Y2K . . .), but forewarned is forearmed.
Despite the thrill of the national health care policy debate, some Americans were preoccupied with football this past week; Jon Coppelman at Workers' Comp Insider is no exception. He contemplates the sad case of former New England Patriots linebacker Ted Johnson and the lessons for sports medicine and workers' compensation return to work programs.
-- David Harlow