Tag Archives: health policy

Science and Other News

Statins for the Healthy Eventually Means Almost Everybody

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Two new studies:

One of the studies, led by Gregg Fonarow of UCLA, examined 131,000 hospital admissions for heart disease and found that at least half of the patients had normal LDL levels. The other study [gated, but with abstract], called JUPITER, involved 18,000 people. It showed that giving a cholesterol-lowering statin to older people with normal LDL cut their risk of heart attack and stroke in half.

The implications:

JUPITER suggests that millions more older people – as many as 11 million, Yale researcher Erica Spatz reported this month – should be getting statins. That would bring the total to about 45 million people, or 80% of all men older than 50 and all women older than 60. [link]

Interesting Links

Hits & Misses – 2009/2/26

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Googling pays off.

Cancer patients who research treatment options are three times more likely to get the newest drugs than patients who don't spend extra time learning about their condition.

The doctor-patient relationship.

In an ideal world, people faced with medical decisions would discuss the pros and cons with their doctors. Doctors and patients would share opinions and information. And when doctors made recommendations, they would do so with patients' life circumstances and preferences firmly in mind… In the real world… too many people get care they don't want or need and miss out on options that make more sense for them.

Being fat is as bad as smoking.

Swedish researchers followed 46,000 men from the age of 18 for 38 years. Being obese or smoking more than 10 cigarettes a day doubled the premature death risk… Being overweight, seriously underweight or smoking 10 cigarettes or less raised it by 30%.

New Health Care Law

Daschle’s Gone; But His Health Board is in the Stimulus Package

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This is Betsy McCaughey writing at Bloomberg.com:

The National Coordinator of Health Information Technology will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and "guide" your doctor's decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, Critical: What We Can Do About the Health-Care Crisis.

New Health Care Law

Update on the Left’s Favorite Health Plan

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Reimbursement rates are so low, and billing the program so complicated, that it is hard for internists to get beneficiaries access to specialized care or timely interventions. For  patients, many of whom are uneducated or don't speak English, Medicaid is replete with paperwork, regulations and rejections that make the program hard to navigate, writes Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute and a former senior official at the Centers for Medicare and Medicaid Services.

Accumulating evidence shows that Medicaid recipients' poor health outcomes aren't just a function of their underlying medical problems, but a more direct consequence of the program's shortcomings.  Take the treatment of serious heart conditions: Continue reading Update on the Left’s Favorite Health Plan →

Health Alerts

A Health Plan for Barack Obama

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One of the best kept secrets in the last election was John McCain’s health plan. When focus groups revealed that ordinary voters had a hard time understanding the McCain plan, his campaign decided it was better not to explain it at all.

Other than two editorials in the Wall Street Journal (one by yours truly), I believe no McCain backer of substance really explained the McCain plan anywhere in print. Also, the only clear explanation on the Internet of how it all might work was at my blog. This left the field open for Barack Obama supporters to distort and mischaracterize the McCain plan, including some ideas that Obama’s health advisors supported before they became Obama advisors!

This was all very personally disappointing, since the McCain plan is based on Sen. Tom Coburn’s plan, which in turn draws on an article that Mark Pauly and I wrote for Health Affairs some years ago.

Yet there may be a silver lining here after all. As it turns out, to even begin to make good on the promises he has made, Barack Obama needs key elements of the McCain plan. He also needs key elements of Mitt Romney’s health reform, about which he has already had complimentary things to say. He can also borrow an idea or two from Sens. Ron Wyden and Bob Bennett. For that matter, he needs Pauly and Goodman, too. Here is how it might work.

Note: I’ve done versions of this for the Health Affairs blog and for the National Journal’s health blog. Continue reading A Health Plan for Barack Obama →

Health Insurance

Giving Arthritic Patients Another Shot

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Satire Alert The blogosphere has been humming with reports that the FDA certified a pistol as a "Class I Medical Device." [link] A reasonable idea (surely required under the Disabilities Act). But the FDA denies any such certification. [link] I agree with the FDA.  If they do approve a weapon let's hope they show more sense.   If your hand is arthritic, you can't be expected to pull and pull or push and push or squeeze and squeeze. A single depression, releasing up to, say, 20 rounds, would be much easier to operate and would afford much more protection. 

In the past we have had grave trouble with health policy folks and reporters who have no sense of humor whatsoever and cannot distinguish satire from serious commentary. So for all of you who might otherwise be misled, THIS IS TONGUE IN CHEEK.

httpv://www.youtube.com/watch?v=hEJ26h_cBqQ

This Gun's For Hire

Uncategorized

Pay for Performance

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Directives to trim waiting lists using pay-for-performance targets have created a host of unintended consequences for the British National Health Service (NHS).          

Targets create incentives to manipulate patient records and official statistics, corrupting data used to measure system performance. Spot checks of NHS hospitals show that they extensively manipulated the data that were supposed to be used to compile waiting lists. Techniques included deliberately booking operations on days patients were known to be on vacation (thus creating an excuse to suspend them from waiting lists in their absence [link], excluding patients from lists if they had waited "too long" and arbitrarily reclassifying patients so that they were shifted to lists that were not monitored [link]. Continue reading Pay for Performance →