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HWR’s not taking any time off!

Nope, the wonkers are hard at it while the rest are vacationing…we know you’re busy, so we’ll do this one quick – but NOT dirty!
This biweek’s edition of Health Wonk Review starts with the big question – we all know there’s a shipload of waste in the health care delivery and reimbursement system.  So, what do we do about it?
David Cutler and host Harold Pollack discuss what it might take to reduce wasteful spending in the healthcare system and what makes healthcare organizations successful. Is healing the system as simple as treating patients well?
Maggie Mahar brings us an excellent piece on the issues inherent in living longer – dealing with the medical conditions that arise as we age, and paying for them.  A thoughtful and comprehensive discussion.
The most expensive health insurance in the nation is in…a group of mountain towns in Colorado.  Louise explores this as only she can – discussing all sides of the issue, and asking if people who live in less well-to-do areas should be expected to essentially subsidize the cost of living for people who live in resort communities?”
My contribution is a piece on a new tool for folks interested in tracking health care costs, spend, and related matters.  Detailed, specific, and user-friendly, its a welcome addition to the geek’s armamentarium.

The impact of provider market consolidation is being felt all around the country – but the effect may not be as clear as one may think.  From the good folk at Health Affairs we get two Contributing Voices pieces on provider consolidation and market power in health care:

While hospitals are consolidating, there’s also significant stress within management as many hospitals are still struggling to transform their culture from one that worked in the past to one that will thrive in the new world of health care. And some places, like Lehigh Valley Health Network, are further along in the journey. 

Despite Its Best Efforts, ObamaCare Might Improve Some Health Care Delivery is by John R. Graham, NCPA Senior Fellow; Graham finds that certain aspects of ObamaCare might be leading to unintended outcomes that improve medical care.

Kynecting the Dots on Obamacare discusses the puzzling but very real dichotomy between what people don’t like (Obamacare) and what they like (all the parts of Obamacare). Sen. Mitch McConnell’s recent comments about Obamacare and the state health insurance marketplace in Kentucky make it clear that he’s in a quandary as well…

The public debate about the price of Sovaldi (sofosbuvir – Gilead) continues, but is completely focused on whether $1000/ pill for a “miracle” cure can be justified, not on whether in fact the drug is a miracle cure.  But a third skeptical appraisal of the current evidence from clinical research about the drug concluded that the evidence that the drug cures nearly everyone, will prevent most bad results of hepatitis C infection (cirrhosis, liver failure, liver cancer, premature death), and is safer than previous alternatives is weak and questionable.  It seems that the marketing and public relations blitz for Sovaldi and other new, extremely expensive anti hepatitis C drugs has been so effective that it has prevented people from thinking critically about the evidence.  Skeptical, level-headed appraisal of clinical evidence would go a long way to addressing our dysfunctional health care system.  Fortunately, Roy Poses has kept a sharp focus on the important issues…

At Workers Comp Insider, Tom Lynch profiles Dr. Jennifer Christian, a key thought leader in the occupational health arena, focusing on some of her key initiatives aimed at changing the landscape for disability management.

Should you trust your doctor more than Wikipedia?  That’s the question posed by David Williams, who, while finding fault with the study that finds fault with Wikipedia, still believes you should probably rely on your doctor more than you rely on Wikipedia.
Addressing one of the more politically charged issues of the day, InsureBlog’s Kelley Beloff offers her unique perspective on the goings-on at the VA, explaining that it’s *not* a scandal but “business as usual.”

We conclude with a very different type of post, by Amy Berman; Updating her April 2012 Narrative Matters essay, Berman discusses her experiences since being diagnosed with terminal cancer and choosing to utilize palliative care.

Next up to bat:   June 19 when Julie Ferguson at Work Comp Insider takes the reins!

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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