Thursday, May 10, 2012

Health Wonk Review: Spring Hath Sprung! Edition

Well, flowers are a-bloomin' and veggies are a-growin' and we've got a bloomin' bumpercrop of interesting and wonky posts. This time, I'm eschewin' an official theme, and presenting posts in more-or-less the order received.

That qualifier's in there because this first post, from Dr. Bradley Flansbaum, wins my coveted (and extremely rare) "Editor's Choice" nod for his post that's at once informative, accessible, snarky and insightful.

 In his post, Dr. Flansbaum (who's the Director of Hospitalist Services at Lenox Hill Hospital in New York City), discusses the shortcomings of the well intentioned, but imperfect, Choosing Wisely campaign.  This was an effort, led in part by Consumer Reports, to identify questionable medical practices. Dr F notes that, ironically, "[v]oluntary guidelines generally do not command attention."

And he takes it from there. A most excellent read.

☼ Health Business Blog's David Williams, a longtime HWR contributor and host, scores an interview with the CEO of Taxachusetts  Massachusetts Blue Cross/Blue Shield. As we've long noted here at IB, MassCare has its flaws, but David's interview focuses on the role that commercial insurers play in reining in health care costs, and pushing for higher quality of care.

☼ Louise Norris, of the Colorado Health Insurance Insider's Norrises, is also a longtime 'Review contributor and frequent hostess. This week, she offers her insights into whether, as hospitals continue to grow and grow, they become "too big to fail." And if one of these behemoths does bite the dust, are we in for another government bailout (ala GM)?

☼ One of my favorite health care bloggers is the phantom known only as NWS (NotWithStanding)(real name: Geoffrey Prescott). NWS is about to take leave of us for a while to begin prepping for a medical licensing exam, but not before blessing us with this pair of gems about the ongoing "physician brain drain" and whether or not it's a valid claim:

Part 1.

Part 2.

☼ HWR co-founder Joe Paduda takes on the Grand Old Party, noting that while a lot of Republican lawmakers tout overturning [what we here at IB call ObamneyCare©], there seems to be a deficit of alternatives being offered. Further complicating matters, Joe observes, is that some GOP lawmakers want to keep at least part of the law intact. Interesting times, indeed.

☼ The host of the last HWR, Wing of Zock (have I mentioned that this would be a most excellent name for a rock band?) reports on a recent meeting, held in Beantown, about "Avoiding Avoidable Care." While that may seem redundant, WoZ notes that two of the major stakeholders (that being providers and insurers) seem to have competing interests, but are still "probably in the best position to effectively intervene: They are submitting or paying the claims for this care." The resulting stalemate is a challenge, but one which needs to be addressed.

☼ The estimable Dr Roy Poses has an exposé about a highly compensated CEO, whose company just happens to be in the health care business, and which company has also been fined almost $200 million (US) for violating the False Claims Act. Ouch! So how does the CEO square that circle? Well, you'll have to click the link to find out.

☼ At his Evidence Based blog, Michael Gavin offers a post on unintended consequences. What's a payer really on the hook for if treatment for (say) an accident leads to other drug use down the road?

☼ Jon Coppelman, blogging at Workers Comp Insider, ponders the fine line between voluntary and required. In this case, he takes a hard look at the recent Florida kerfluffle over drug testing for those on the dole and those on the state payroll.

☼ Dr Kerry Willis - a practicing family physician in Beaufort, NC - offers his advice on health care reform, from a physician's perspective.

☼ Over at the Disease Management Care Blog, Dr Jaan Siderov thinks we're in for a wave of mergers in the health care field. The key seems to be whether or not these will ultimately redound to the benefit of the consumer (and Dr S thinks it will).

☼ In her guest post at the Health Affairs blog, Diane Meier, Director of of the Center to Advance Palliative Care, takes to task physicians who really don't "get" the value of such care. She uses the case of a woman with Stage 4 breast cancer to make the point.

☼ Maggie Mahar's post claims that health care reform has been a huge victory for women. I think she's wrong, but her post is noteworthy for its analysis of women's health care costs.

☼ Do hospitals engage in aggressive debt collection practices? Anthony Wright lays out the case, including a special cameo.

☼ Greg Scandlen, posting at John Goodman’s Health Policy Blog, thinks that the major problem with individual health plans is that they're not subsidized by the taxpayer, and makes the case that employees and insurers would benefit by moving away from employer-based plans.

☼ Kat Haselkorn offers an interesting take on whether or not artificially lowering cholesterol levels is necessarily a good thing. While that may seem like a dumb question, consider this: all those statins cost real money, and may also offer a false sense of health security to overweight folks. And there's a real cost to all of those.

☼ Finally, exercising Host's Privilege, I'm offering two posts for your consideration. This actually makes sense, though: two of my (awesome) co-bloggers take opposite sides in the debate on whether or not insurance policies should be bought and sold across state lines. Both offer cogent, interesting rationales for their respective positions.



(Any double entendre is in the mind of the reader)

And that wraps up this week's Health Wonk Review. Please join Dr Jaan Siderov, another of my absolute favorite health wonk bloggers, when he hosts the next edition on the 24th.
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