Joseph Paduda's weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.
From the Rocky Mountains comes this edition of Health Wonk Review; the always-erudite Louise Norris.
Delightfully illustrated and well written, this edition deserves your vote.
HWR's tech guru and all-around social media expert Julie Ferguson is this biweek's editor of Health Wonk Review.
There are lots of predictions and insights, and much discussion of reform and the Supremes.
The first edition of Health Wonk Review for the year is up at the OHP blog - a well-organized and quick review of what happened while you were otherwise engaged.
A very funny edition of HWR is up at Health News Review, Gary Schwitzer's always insightful blog on health news.
Well worth the visit!
Brad Wright's edition of Health Wonk Review has suggestions for everyone on your list - from wonkers (that's with an O, not an A !) to President Obama to Florida-domiciled relatives to the skeptic to the health reform repealer.
It's kind of like Philippine boxer Manny Pacquiao, short, sweet, and packing a big punch...
The deficit battle is on and politicians are in full voice - both in Washington and out on the hustings, where GOP candidates are loudly denouncing health reform as unAmerican and a job killer. Hipsters and greying hippies are occupying Wall Street and Main Street, while Tea Partiers are claiming they hold the title of most outraged. The one percent is wondering what the 99 percenters are so upset about, while the 99 percenters are after their well-coiffed scalps.
Into the bloody fray, with nary a fear for life or health, reputation or career, plummet our worthies, those denizens of the blog-o-sphere that specialize in separating the non- from the -sense, the BS from the fertilizer, the ill-formed opinion from the logically-based interpretation!
Join us as we follow their heroic deeds, gasp as you read their trenchant and timely missives, awed by their grasp of the incredibly-esoteric and yet critically important.
Let's get it started (cue Fergie...)
First out of the box are Shannon Brownlee and Joe Colucci of the New Health Dialogue. These erudite authors show no trepidation as they take on the opponents of the US Preventive Services Task Force, marshalling cogent, clear language to confront the fallacies of those who would condemn the USPSTF's stance on prostate screening. Watch out, Newtster!
Closely on their heels comes Maggie Mahar, who is very concerned the USPSTF will get defunded by some knuckleheads in Congress just because some physicians, device manufacturers, and others don't like hearing their stuff doesn't work like they say it does. Maggie, Maggie, Maggie! Where is your faith in the goodness of mankind??
Jaan Sidorov wants to make sure we don't get all amazed by Siri and her techno-friends; we do need people involved in the care process, even if it is telemonitoring.
At the extreme other end of the political spectrum is John Goodman, who's 'penned' an intriguing treatise on what we should be doing about long term care. He has five main points, several of which I - dare I say it - actually concur with. Wonder of wonders!
Chris Langston reports from his first meeting of the Medicare Payment Advisory Commission - that rationer of care also known as MedPAC. No, it's not a medical device company's PAC, it's the group that heavily influences Medicare's payment and coverage policies. For all those who decry them durn gubmint byoorowkrats, read Chris' post.
Big news is coming soon, with the Medicare Shared Savings Final Rule amongst the biggest (at least among us kids). Health Affairs has a multi-post entry that you can best find at their blog; discussing the key aspects of the Shared Savings program in detail. If this is your thing, click on!
Tinker Ready's flavoring her post with a hefty dash of outrage from Boston's Occupiers - who don't like the private company - health insurance linkage one little bit.
From deep within the world of insurance, David Wlliams emerges with an explanation of the "Explanation of Benefits" he got from his insurance company, as explained by his provider. It's pretty entertaining, and surprisingly well-written. Of course, anything that's remotely readable that comes from an insurer or provider is deemed "well-written"...
On a macro scale, one topic that deserves much more consideration is population health. From that part of the wonking world comes a great post on disparities between - and some of the reasons for - health status in rural and urban areas. Thanks to Kristen Siemering for her entry!
Louise - a very experienced and highly knowledgeable insurance broker in Colorado, thinks the folks predicting the demise of the insurance broker are misguided, misinformed, and just plain wrong. There is value there, value that can't be replaced easily or cheaply.
Another view comes from Bob Vineyard, who's commenting on one exchange that seems to be struggling.
Trudy Lieberman's thinking that those employer policies that don't provide much coverage and have massive deductibles and copays are not serving employees - or their families - well.
The Insurance Exchanges are slated to play an important role in reform - and California is well on the way with their's. After multiple meetings and much dialogue with lots of stakeholders, Linda Leu is seeing good progress.
Another perspective comes from Jason Shafrin, who thinks the exchanges may not do much to help competition as many markets are already consolidated.
Gary Schwitzer takes the mass/statistically illiterate/medically ignorant media to task in his post on media's common mistakes - well, that's not exactly what it's about, but pretty close. Gary points out that what you read may well be, well, wrong.
One area that cries out for clear, cogent explanation is the whole hospital readmissions uproar. Fortunately, Bradley Flansbaum's here to clear things up!
Your faithful author's contribution is a treatise on what's REALLY going on in Massachusetts post-reform. Hint - it's been five years, and things are starting to change - a lot.
Roy Poses continues to shine his very bright light on inappropriate or concerning links between research and commercial entities - as he's ben doing for as long as I can remember. This week he takes the NYTimes to task for not asking the tough questions about an academic institution's desire to work more closely with private industry. Roy is great, but I hope he checks under his car before he starts it every morning.
While all the attention is on the health insurance market, Jon Coppelman hasn't missed a big story in workers comp - the market for insurance looks to be getting harder, with pricing ticking up. That big gust of wind that just went by? Nope, not a hurricane remnant, but a sigh of relief coming from Liberty Mutual, Chartis, Hartford, and the Travelers...
Now that this is put to rest, we can all hit the sack, secure in the knowledge that here, in (YOUR HOME TOWN), we are safe and sound, protected by misinformation by these diligent pursuers of the truth. Or at least their version of it.
cheers!
This fortnight's edition of Health Wonk Review is ably hosted by Joe Collucci of the New America Foundation - just like the muppets, it is short and sweet.
long time HWR host David Williams is the brains behind this week's edition. lots of good info relayed concisely.
thanks David!
It's August. Things are supposed to be slowing down, as record heat waves hit the south central part of the nation, vacations thin out offices and shorten commuting times, and parents rejoice that their beloved offspring - and their detritus - will soon be somewhere else most of the time.
(photo from illinois.edu)
But in health policy world, the pace just picked up - a lot. Far from the summer doldrums, activity related to the debt limit, IPAB, Medicare reform and Health Exchanges is at a late-September pace.
To start us off, here are four posts focused on the recent stupidity around the debt limit expansion, and the impact of that stupidity, that merit top-of-the-fold placement.
WARNING
here's a picture of a health care exec before reading the following two posts....
First, let's ruin your day with the scariest post of the summer (if not the year) from Bob Laszewski. Bob's view of the debt limit deal will ruin the vacation of any provider:
"Physicians, facing a 29.5% Medicare Sustainable Growth Rate (SGR) fee schedule cut on January 1, 2012, need to be really worried. That 29.5% cut is part of the existing budget baseline from which the super-committee needs to cut hundreds of billions more--much less find tens of billions of dollars to put these doc cuts off again. Hospitals ... have to be in the bull's eye this time. Drug companies are a particularly juicy target for liberals who don't like them and conservatives who wish the Part D program had never been passed. Medicare Advantage insurers have recently been reporting record profits--not something you want to be doing when the Congress is looking for lots of cash.
While there is a 2% cap on any cuts that could occur to Medicare in the $1.2 trillion default trigger, there are no limits to what the super-committee can cut." [emphasis added]
My view is there are going to be big cuts in provider reimbursement, which will inevitably lead to cost-shifting to private payers. That means insurers, healthplans, self-insured employers, and workers comp payers can expect higher pricing and utilization, and soon.
And here they are after reading those posts...
The prolific Maggie Mahar has posted a thorough and well-documented piece on the whole debacle, citing Paul Volcker among others to note this should have been a routine process - after all, " George W. Bush raised the debt ceiling seven times for a total increase of 90 percent. Ronald Reagan raised the debt ceiling 18 times for a total increase of 199 percent, which is the highest ever percentage increase in U.S. history. So far President Obama has raised the debt ceiling three times for a total increase of 26 percent."
Maggie quotes the AP on the potential (I think highly likely) that "payments to doctors, nursing homes and other Medicare providers could be trimmed, as could subsidies to insurance companies that offer an alternative to government-run Medicare."
Finally, Jaan Sidorov educates us on the relationship between US Treasury ratings and health insurers, noting "With an announcement of a downgrade, millions of dollars of insurer money in reserves and surplus could evaporate."
Gotta love David Williams' post Health care reform in 2 short sentences. Read it.
Absent any game-changer along the lines of David's, we're going to have to rely on science and smart policy - which means the Independent Payment Advisory Board. Jonathan Cohn's post at Care and Cost makes a compelling argument to not repeal, but rather retain, if not strengthen, IPAB. Jonathan notes "there's a ton of data to suggest it [Medicare] doesn't do a very effective job of fostering good quality".
Which leads us to Avik Roy who contributes a post citing Cato's Michael Cannon's research to make the point that politicians don't care about waste fraud and abuse in Medicare and Medicaid because it's other people's money. He must be talking about the GOP, as much of the 'waste and fraud' could have been eliminated if the GOP-led Congress and Republican President hadn't: a) passed and signed the Medicare Modernization Act which prohibited CMS from varying payment based on efficacy of drugs and devices; b) continued the gutting of Federal outcomes research; c) passed Medicare Part D while prohibiting CMS from negotiating drug prices with pharma; and d) suspended Pay-as-You-Go rules that would have required cuts in other programs to offset the huge cost increases from these programs.
Oh, and many are now looking to kill IPAB, which promises to reduce unnecessary and wasteful spending...
Sticking with cost control, our buddy Hank Stern thinks the Institute of Medicine's support for coverage of birth control pills at no cost to women may lead us down a slippery slope - if birth control pills are "medically necessary', what about Rogaine?
Health Affairs contributed a thoughtful and compelling piece on the impact of ACA on employer health insurance, focusing on the McKinsey study's conclusion that lots of employers will drop health insurance. Authored by the redoubtable Jeff Goldsmith, the post makes compelling reading. Among the more thought-provoking passages are these:
- "the large employer's influence on benefit design has been a major enabler of escalating premiums. The main influence hasn't been first dollar coverage, but rather their preference for open access, point-of-service plans..."
- "A surprisingly large percentage of the survey's respondents were not aware of many specific features of the legislation that will directly affect them."
- "it doesn't make sense, for small employers or their workers, for small employers to continue offering coverage given these incentives."
Health Access California's Anthony Wright digs deep into the Exchange issue. If Jeff Goldsmith's prognostications are right - and they may well be - the Exchanges will soon be the dominant channel for insurance distribution. Anthony's point that "health reform cannot fulfill its promise if the Exchange is not successful" is the core of his contribution, which provides a thorough and succinct summary of what Exchanges should be.
The ever-insightful Louise at Colorado Health Insurance Insider's got a great piece on her state's efforts to create an unbiased Health Exchange. As an independent insurance broker, her views are reality-based and observations are keen.
John Goodman's contribution is entitled "Everything We Are Doing in Health Policy May Be Completely Wrong". Goodman comes to this from his review of a study focused on a change in the maximum one-time supply of drugs in North Carolina's Medicaid program from 100 days to 34 days. Goodman posits this: "Suppose that for most poor people and most health care, time is a bigger deterrent than money." The study isn't available without purchase, so I wasn't able to find out what it actually said.
WorkCompInsider's Julie Ferguson, the progenitor of many work comp-related blogs and social media initiatives, gives comp folks a solid background on the use of social media to investigate work comp fraud, along with a treasure trove of links to sources, views, and legal advice.
Long-term contributor Roy Poses never relents in his pursuit of ethical issues in health care; his contribution for this edition is a two-part series on the for-profit hospice industry.
Roy cites a Bloomberg report suggesting that (here and here) for-profit hospices may increase revenue by aggressively recruiting patients, sometimes using deception, and sometimes including those who are not really terminally ill. However, they may then deny the latter group potentially life-saving care (because hospices are supposed to only provide palliation and improve quality of life for dying patients.) This suggests that hospices may function like real "death panels." Yet those who have ranted about the dangers of government "death panels" have not yet shown any concern with this.
That's not to say that health care professionals shouldn't pay close attention to the financials - a point Brad Flansbaum makes quite compellingly in his post on the impact of medicare rates, private payers, and their impact on hospitalists.
Kirstin Siemering sends us news of a company in Nebraska that's really, truly, totally committed to improving their employees health and wellbeing - and seeing huge returns in lower health costs, increased productivity, and higher quality.
From Amy Berman comes a cold blast of reality - she's been diagnosed with Stage IV breast cancer which has metastasized to her spine. Amy discusses a real and ongoing problem, one that greatly affects people and costs - the inability of many care givers to frankly discuss the reality of terminal illness with patients, and the resulting heroic efforts that cost billions while providing little, if any, benefit to the vast majority of patients.
Jessie Gruman's post gets the award for best title - Our Preference in Health News: Uncertainty or Naked Ladies? Jessie identifies the issue - we want quick, we want certain, we want easy - and no, we don't want to think. Err, I mean the folks who DON"T read HWR!
Jessie and Gary Schwitzer must've been experiencing the same frustration: Gary's contribution is a video summary of his experience reporting on health journalism, the first of his five-part series that should be must-watch for any health care journalist.
The post from Glenn Laffel's Pizaazz focuses on the impact health news/journalism can have on the patient, along with many patients' lack of basic computer, internet, and interpretive skills - skills many of us take for granted.
Kinda/sorta related is the post from Shahid Shah; who explains what the FDA's new draft guidance on mobile apps means to health IT vendors. It's a great summary of what kinds of apps may or may not be considered medical devices from a regulatory perspective and is worth reading if you're in the mHealth space."
And now, for something completely different, we offer Jason Shafrin's post on Brazil's health care system.
That's it. I'm off for a few days to Oklahoma City (what, that's not a common vacation spot?) next week, then a family vacation to Block Island. Hope your August is good - although I'm likely partially to blame if it isn't!
Julie Ferguson has posted the The Heatwave Edition of Health Wonk Review at Workers' Comp Insider - it's the only issue this July, so it's chock full of wonkery. Check it out.
This week Tinker Ready is hosting HWR; the proud Bruins and Springsteen fan adds her usually distinctive touch to this biweek's edition.
I add my congratulations to the Bs and sadness at the departure of Clarence Clemons - play a bit of Jungleland and you'll know why.
Our colleagues at Health Affairs have the honor of hosting this edition of HWR. Lots of great insights into the Medicare Trustees report, the growing body of work explaining the impact of health reform, and what states and employers are doing to control costs and improve quality.
Hank Stern hosts this week's edition of HWR, and keeps it tight and punchy.
The Incidental Economists have discovered that spring is in the blogosphere, with good and bad implications. Check out their edition this morning.
David Williams' edition of Health Wonk Review has a collection of some of the most thoughtful and insightful writing on the current debate about the 'Ryan plan', Accountable Care Organizations, and health care technology.
Highly recommended.
The Opening Day edition of Health Wonk Review is ably hosted by our favorite healthcare economist - Jason Shafrin.
He's got a tough follow up act, as Glenn Laffel's post two weeks ago ws great - but Jason comes thru in the clutch!
For his third time up to bat, Jared Rhoads is hosting Health Wonk Review over at the Lucidicus Project. Get the latest bi-weekly dose of health wonkery from the best and the brightest of the health policy blogs. Thanks Jared!
Jay and Louise are hosting this week's Health Wonk Review - doing their always-entertaining and insightful review of the best of the wonkosphere.
It's a big one!
WorkCompInsider and HWR technical guru Julie Ferguson hosts this biweek's edition of HWR.
Tight and well written, as usual for Juile
Anyone else feeling a bit of deja vu?
The blog world certainly is, with many of the entries for this edition of Health Wonk Review focusing on the ongoing battle over health reform, aka the Patient Protection and Affordable Care Act. (I'm always puzzled by pundits referring to PPACA as 'ObamaCare'; the President signed a bill that was sent him by the Senate; BaucusCare would be much more accurate)
Before we dive into the reform pool (water's awfully chilly this time of year here in New Hampshire), let's take a quick look at the work comp world, which is being hammered by costs associated with obesity - proof that every business is affected by our growing BMIs. The always-erudite Jon Coppelman briefs us on two compelling studies that will give all work comp actuaries pause at WorkersCompInsider.
We'll switch from waist to waste with Maggie Mahar's great post which asks (my words, not her's) 'why in hell are we still doing so many spinal fusions for patients with degenerating discs?' and then posits a possible (!) answer to her own question - money. (factoid - the number of fusions at US hospitals doubled between 2002 and 2008 - when costs hit $34 billion).
There's a great read on David Harlow's blog re the legal arguments around reform - quoting David, "The challenge to the individual mandate in federal health reform is grounded in the notion that the Commerce Clause of the US Constitution bars federal regulation of something so local as health insurance. Challenges to state health reform are grounded in the notion that Federal law (ERISA) pre-empts the field, making state regulation of something regulated by the federales (under authority of the Commerce Clause, by the way) impossible".
Jeff Goldsmith's contribution comes by way of the Health Affairs Blog, where he suggests a solution to the Medicare physician reimbursement mess debacle conundrum disaster. Jeff suggests "writing off the SGR "debt" to the federal budget as "uncollectable" and demanding both sacrifice and reform from the physician community in exchange." While I am most certainly reluctant to challenge someone as insightful and knowledgeable as Goldsmith, my inner cynic tells me 'no way'.
The economists' (and psuedo-economists') section
The argument/debate over whether reform costs or saves is a big part of the issue - perhaps as big as the legal one involving the Commerce Clause. We'll begin with Austin Frakt's take-a-step-back-and-think-about-this post; Austin reminds us that with - or without - reform, we're still screwed. (my word, not his)
Jason Shafrin - hat tip to the economist with the most contributions to HWR! - offers his thoughts on legal issues that may hinder adoption and growth of the current rage - the Accountable Care Organization.
RIch Elmore isn't an economist - but he knows his numbers. His post leads with this blast of ice water to the face - "The US, ranked just higher than Slovenia in performance among world health systems, has consistently higher prices than any other country surveyed by the International Federation of Health Plans."
Avik Roy thinks more employers will drop health coverage due to PPACA, despite evidence to the contrary from Massachusetts, and that this will add cost to the system, cost that CBO doesn't adequately address. I'd note that the CBO estimate also gives very little weight to the iPAC, a potentially very strong cost control mechanism.
My contribution discusses the conflicting claims by Ms Pelosi and Mr Boehner - Ms P says PPACA will save over a trillion while Boehner says it will cost $700 billion. You'll be surprised to learn neither number is credible.
The experts' section
Roy Poses gets my vote for most persistent, insightful, and thought-provoking observer of medical research, business, and ethics. His entry this fortnight discusses the fall of an apparently large and prestigious health care charity, which funded research projects at the most well-regarded academic centers - a charity that was involved with Bernie Madoff and some of his confederates.
We're pleased to have a submission from the John Hartford Foundation, where Amy Berman dissects the definition of 'good medicine' - patient-focused, clinically sound, or some combination?
Louise's contribution from Colorado is insightful as always - her state legislature is considering a bill that would repeal the Health Care Affordability Act, one authored by a physician who doesn't seem to proffer answers to the problem - growing numbers of uninsured Coloradans - the Act attempts to solve.
Glenn Laffel's back with an intriguing dissection of the microeconomics of flu shots - and why classical theory makes zero sense. Should be required reading for the 'market solves everything' crowd.
The creepiest entry I've ever read comes from David Williams, who's dug out the news that two sisters' life sentences in Mississippi were suspended on the condition that one donate a kidney to the other.
Avik Roy's edition of HWR is up at the Apothecary; Avik writes very well and his conservative leaning provides interesting perspective - check it out.
Brad Wright's edition of Health Wonk Review contains brief summaries of the best of the health policy blogosphere - lots of good information and insights that go waaaay beyond what you'll see anywhere else!
Heather Kelley of the Robert Wood Johnson organization is this week's host for HWR, and her ed is a fast read. Thanks Heather!
The fine folk at the New America Foundation host this fortnight's edition of Health Wonk Review - great stuff, done by really good writers.
From Colorado we get this week's edition of Health Wonk Review - with plenty of insight, briefly presented.
Thanks Louise!
Brief. To the point. Here.
that sums up Hank Stern's edition of Health Wonk Review - the best o' the blog-o-sphere.
Now that health reform is the law of the land, the focus has turned to implementing the law itself. As anyone knows, the real work, and the real impact, is in the details, the definitions, the requirements and operating guidelines.
And that's what this edition of HWR is all about.
Fundamentals
Let's begin this edition of HWR with a quick review of the fundamentals - starting with Tinker Ready's reminder that "All health care is local." Actually she's channelling Atul Gawande in her report on his talk at the National Quality Colloquium this week. Gawande's summary of why that's the case is a very helpful reminder as we contemplate implementing reform.
My contribution to this edition asks the rather uncomfortable question "Managing health care costs - whose job is it?" WIth health plan associations whining about the lack of cost controls in the reform bill, one has to ask - exactly what function do health plans perform? If they're asking the government to control costs, what is their purpose?
Friend and colleague Gary Anderberg is guest-posting over at Workers Comp Insider this biweek; Gary's post is similar to Tinker's in that his focuses on health insurance, and the services covered by insurance, are really 'risk management tools' to help maximize productivity. True True True, and a wonder more don't think the same way...
On the "Good News' front,"Congratulations If You Were Born Between 1952 and 1964" takes a look at the recently released report that shows health reform just extended the financial solvency of the Medicare Part A Trust Fund by 12 years. Brad Wright also stresses that we're not out of the woods with the cost problem--2029 isn't that far away--and we need to realize that this isn't a problem we can solve, as much as it's a tension that we have to figure out how to navigate.
In that vein, the always-insightful Jason Shafrin tells us the real story re the impact of reform on state budgets - not too good, but not too bad, either.
Reactions to reform
The opposition to reform continues to make its case; Anthony Wright documents the ongoing efforts by Anthem Blue Cross of California to stop California's health insurance exchange. Anthony opines Anthem's actions "should be a clarion call for California consumers about why we need to advance these bills, this year."
In a related post, Roy Poses digs deep into Wellpoint's rate increases, and finds out that the employee tasked with announcing the increases had serious concerns, concerns that may have led to her termination. As always, Roy finds the truth and does some of the best reporting in the blogosphere.
These last two stories are particularly important, because as Aaron Carroll warns us, insurance companies are very good at what they do. Which in this instance is risk selection. Talking in this case about Medicare HMO enrollment, Carroll elaborates:
"Somehow the private insurance HMOs figured out a way to get the healthy people to jump ship out of the another plan into theirs!
Not only that, but people who left the (private) HMOs and went back to the (public) Medicare used 180% more care after leaving than the people who stayed. Somehow the private insurance HMOs figured out a way to convince the sicker people to jump ship back to the public plans."
Jaan Sidorov notes that "the odds against prevailing against a Presidential veto are..questionable and the waste of political energy would be atrocious." But Jaan does think that the bill can be improved, and offers serious ways opponents should move.
The always -informed and -informing Maggie Mahar thinks the liberals/progressives who are hoping the anti-reform folks succeed (as it will usher in a single payer system) are basing their hopes on faulty assumptions, namely that Americans will like a Medicare-for-all plan. Maggie notes "A great many Americans have employer-based insurance that they like--particularly if they work for large companies. They don't want to give it up for an unknown government plan."
Maggie adds: "we're all lucky that large companies are covering so many people with benefits that are, on average, rich and comprehensive."
EHR, benefits, and babies
One of the keys to health reform is widespread adoption of Electronic Health Records; David Blumenthal and Dr Don Berwick (yes, the same Don Berwick who runs CMS) document the significant progress being made in that direction, emphasizing the new regs on 'meaningful use'. Anyone remotely involved in EHR should read their post...
But before we adopt those EHRs, make sure to shred the patient records - or suffer the consequences described by David Harlow.
Implementation is all about the details - and there are bazillions of them, all critically important to those directly impacted. Jay talks about maternity coverage, and the absence of clarity about same in Colorado - even though all plans are supposed to provide coverage as of 1/1/2011...
Ryan opines that health plans authorized by the Feds should cover birth control, but only because we own the consequences if we don't.
All carrot and no stick - Innovation in insurance - oxymoronic to some, just plan moronic to others (sorry, couldn't resist). Our old friend and colleage David Williams writes about the problems realizing the potential of Value-Based insurance Design, noting "in practice most VBID programs encourage the use of high value services but don't discourage the use of low value services."
Important in their own way
Kinda-but-not-really related is this piece from Adam Fein of DrugChannels, who broke the story about CMS's quest for a vendor to survey retail prices, payment, and utilization rates for pharmacy - as well as wholesale pricing. Could this lead to a substitute for AWP? Dare we hope?
Joanne Kenen reminds us why the ER is no place for palliative care, providing insights into what happens there - and more importantly - why.
John Goodman calls Medicaid "the most abusive health plan of all" in his post. Goodman bases his claim on states revising Medicaid enrollment and eligibility requirements, calling them 'rescissions'. Ed. note - the reason most of these folks lost their coverage is the states where they lived ran out of money to fund Medicaid. Tax increases would've solved that 'problem'...
Finally, over at InsureBlog, Mike Feehan says health plans should keep their reserves, no matter what Consumers' Union thinks.
That's what Jaan Sidorov wants to know as he hosts the latest ed of Health Wonk Review.
Jaan's keen commentary on the best of the last biweek's health wonkery is well worth the read - even if you're not stuck in O'Hare while thunderboomers roll thru.
HWR guru and lead organizer Julie Ferguson's got the editor's pen this week, and uses it to great effect with the Dog Days of Summer edition.
Julie's focused on post-reform 'what now' and 'what's this mean' issues, covering those devilish details with contributions from Uwe Reinhardt, Jaan Sidorov, Maggie Mahar, and other great writers on all things health.
Brad Wright's edition of Health Wonk Review is a terrific synopsis of the blog-o-sphere's take on the latest research on policy, cost, outcomes, and the impact of reform.
This is an excellent read.
Thanks to Tinker Ready for her work on HWR _ her edition is up and running, and an excellent read.
David Williams - one of the smarter people in the health care business - hosts this week's Health Wonk Review.
David keeps it brief while still adding his own take on contributors' posts.
See you there.
Long time blogger and HWR host Hank Stern is at it again, this time with an edition of Health Wonk Review that is notable for its brevity, and as usual, his own unique brand of humor.
check it out.
Rich Elmore has posted Health Wonk Review: Special Edition on Health Care Reform - an excellent roundup of the health policy blogosphere's reaction to the landmark legislation. Don't miss the one page time-line cheat-sheet.
Minna Jung at the Robert Wood Johnson's blog on reform is this biweek's host of Health Wonk Review. If you thought the first round games of the men's NCAA hoops tourney were crazy, you'll think it was all tranquilio when you read her post.
an excellent review, with some good forecasting as well
Health reform is kabuki theater - indeed. Brad Wright does a terrific job of finding the parallels and cutting thru the blather to focus on the whys, whos, and whens in the latest edition of Health Wonk Review.
Here's Brad's lead:
"Kabuki theater is a Japanese dramatic art form known for its elaborate costumes, make-up, and over-the-top performances."
the parallels are striking!
There have been many creative themes for Health Wonk Review, but none more than Brady Augustine's channeling of Dr. Phil in this week's edition.
Brady's point is at this time of increasing polarization we would do well to step back and try to identify and coalesce around some common goals, objectives, themes.
If we don't, the health system we deride today will be much better than what we end up with in ten years' time.
Oh, and you've got to watch the Jon Stewart video clip...
If ever there was a time to be writing about health reform, this is it.
It's an even better time to be reading about health reform. Is health reform dead, or is it just snoozing, waiting for a Prince Charming to lay on the smooch it needs to reawaken, full of promise and hope?
(hint, this guy doesn't look much like Senator Brown...)
Before we get to the next chapter in the story, we're going to hear from clinicians and politicians, policy gurus and providers, health administrators and educators, insurance brokers and Medicaid advocates, IT pros and pharmacists - in short just about everyone fits under the big wonk tent.
And where better to start than down in the trenches, where the real problems with our health care system are all too visible. Merrill Goozner kicks us off with an excellent summary of the new news on why hospital costs vary so much across the country - hint, NYC is pricey not because of high wages, but because CMS pays hospitals a ton to educate doctors and two tons for dispro. A great example of how unseen factors influence employers' - and taxpayers' - costs.
Drug prices are one source of consternation to many, with price control advocates complaining about big pharma's unfettered ability to set prices, and free market fans countering that without that ability pharma couldn't afford to develop new meds. A post that should get both thinking comes from David Williams, who describes how a pharma company is losing out, while patients are benefiting, without taking sides. A thought-provoking piece to be sure.
Julie Ferguson sends in an a synopsis of what could be a really fun development. Now that 14 states allow medical marijuana, when will it be part of a workers comp drug formulary?
For the real druggies among you, Adam Fein does a deep dive into the world of drug pricing and the future thereof.
Glenn Laffel asks why all the companies fighting over the Feds' $19 billion allocated to electronic health records are offering guarantees that their version will meet HHS' standards (hint - if they don't, users stand to lose big bucks).
And finally, back to the Gooz, who's penned a report on how the once-promising area of personalized, genomicly-specific cancer care is off to a very slow start.
Wrapping up the discussion of health care at the ground level, we welcome the Robert Wood Johnson Foundation to HWR. The RWJF blog team (what, they have a whole team? man I'm some kinda jealous!) posts on over-utilization of diagnostic imaging. Their post is a terrific synopsis of how several communities and provider organizations have reined in MRI spending by using clinical guidelines. Great stuff!
Jaan Sidorov wants the Obama administration to get crackin' and name a head for CMS. He wants a fresh face and strong leadership for the folks who run about 40% of our health spending. Not a bad idea...
And when they do, the new boss should start working on long term care. Kyle Pinion reports that this is one area of health care that is in desperate need of fixing, specifically to address some of Medicaid's deficiencies.
Sleeping Beauty could sure have used a little LTC - can you just imagine the poor gal's bed sores?
At the state level, the purpling of Massachusetts sent shock waves thru the political landscape and got several contributors thinking hard about the 'whys' and 'what nexts'. The general sense is now-Senator Brown is not looking to step into the Prince Charming role anytime soon (although he did vote for Mass' health reform).
Tinker Ready's piece asks if "Voters Reject[ed] the Massachusetts Health Reform Model?, and the sense is - they may have, but not because they didn't want reform, they just didn't want reform 'lite'.
Who needs health insurance?!
All the way across to t'other side of the country, we find Anthony Wright walking us thru Rush Limbaugh's recent encounter with what may be the most 'socialized' medical system in the country - Hawai'i. Limbaugh has a great solution to the health insurance problem - don't buy any. He's figured out how regular Americans can get by without coverage. The man's a geenyus!
But wait, perhaps Rush isn't so bright...I'm betting Jennifer Lyon wouldn't think so, because she was also 'self-insured', at least until she passed away from breast cancer. When asked why she hadn't seen a physician earlier. Lyon said, "I didn't have insurance, which is a big part of it. And it really wasn't changing much. But a year later, I felt another lump, and then I felt something under my armpit." Read more here.
Oops, back to the drawing board, big (and I don't mean tall) guy...
Well, at least Limbaugh doesn't have to deal with insurance companies - lucky guy. Over at the Digerati Life, the Ms DL laments; well, no, that's much too weak an adjective - we'll go with detests - dealing with insurance company claim forms resulting from her family's decision to go PPO instead of HMO.
Roy Poses MD has been a HWR'er since our denouement, and always gets the award for post no one else would have thought of. This ed. it's about three California health centers with notable quality issues, that somehow still managed to pay execs big bucks in the form of incentive payments. Roy says "The rationale for these bonuses, given out at a time when the university system was under major financial constraints, was that they were incentives for exemplary performance and patient care."
Peggy Salvatore weighs in on a study that says people trust their providers more than the government to protect the privacy of their health care data. (don't these people read the news?!)
As we say in New England, Go figure...
So without reform, what happens...
Well, some believe reform is still possible, others don't. We'll start off with a point-counterpoint minus the hair pulling and hurling of invective - courtesy of Health Affairs. Henry Aaron wants the Senate bill enacted and 'fixed' in reconciliation. For those who have dismissed this out of hand, Aaron's piece may well make you reconsider. The counterpoint comes from Joseph Antos; he wants incremental reform including the ability for insurers to sell policies across state lines...
Brad Wright agrees with Aaron, as he also thinks reform may not be dead yet, but it will require passage of the Senate bill by the House and making changes via reconciliation.
And long time HWR'er Hank Stern disagrees with Antos (when it comes to health insurance, Hank's a very knowledgeable guy, so perhaps Antos should be calling Hank).
But wait, Mike Feehan, a colleague of Hank's, agrees with Antos, noting that this might also address the issue of mandates and force more competition.
Joanne Kenen of The New America Foundation laments the lack of primary care, the lack of real funding for primary and preventive care, and the impact the demise of reform will have - more of the same. And costs will therefore increase to deliver care that should never have been necessary. Sigh.
David Harlow opines that all is not lost, and lays out his wish list for reform now that Senator Brown is, well, Senator Brown. David believes reform can happen without the bigwig pols getting involved.
Friend and colleague Maggie Mahar doesn't want any initial reform effort to start with ending the insurance industry's anti-trust exemption, calling the current interest in this move 'pandering'.
Brady Augustine is a bit more - ticked off. In his contribution, he asks the insightful, yet idealistic question; "How can Congress expect providers to work together in interdisciplinary teams and accountable care organizations if it is unwilling to do the same?" Brady believes reform should have come from the middle. Me too.
Louise in Colorado (one of the best health insurance bloggers in the 'sphere) has a very interesting suggestion on how to address pre-existing condition exclusions without an enforceable mandate. Go read it.
On the macro-est level, we welcome John Goodman, who believes reform is not about health reform but about collectivism, and more specifically how we shouldn't let government take over health care. Goodman says "in matter of health, private decision-making is socially intolerable". Ed note - I disagree, strongly with the premise and the conclusion.
The Incidental Economist thinks the real problem is political feasibility, and that's where things went so horribly wrong.
Alas, we close this chapter (it's bed time for your faithful author) leaving this story to the next HWR editor - Brady Augustine at medicaidfirstaid.com. He's an old hand at this editor of HWR stuff, and has the honor of hosting the Fourth Anniversary Edition!
He'll let you know if the smooching's started
It's great to have Jaan Sidorov back hosting Health Wonk Review; his Avatar theme works even for those of us who have yet to see the blockbuster. Health Wonk Review.
This is just a great edition - thanks Jaan.
Colorado Health Insurance Insider is one of the gems of the blog-o-sphere; written by two people who are in the health insurance trenches every day, it brings a much-needed real-world perspective to the health reform, insurance, and policy discussion.
Yesterday's post was no exception - for a great summary of the best of the risk and insurance blogs, read Louise's latest.
Brian Klepper has exercised his editorial authority and tightly focused this biweek's edition of HWR on the fading promise of health reform. Whether you agree with his perspective or not, Brian's work is thought provoking at the very least.
I'd be remiss if I didn't note that other bloggers, and in particular Maggie Mahar, have a much more positive view of reform. Her take provides a worthy counterpoint to those of us less sanguine about the impact of reform.
The brains behind health wonk review is this edition's host as well, with a pre-holiday edition featuring Santa, sausage making, and sentient statements from sensible bloggers.
boy that was pretty bad. but don't hold that against Julie's post...
Friends and colleagues Jay and Louise at Colorado Health Insurance Insider host this week's edition, featuring the Simpsons explaining all things health policy - as only the Simpsons can.
Great stuff, all in one place for your edification!
You gotta see this.
I'm much embarrassed to inform you, dear reader, that Tinker Ready of Boston Health News published the latest - and greatest - of the health wonkosphere last week, while I was asleep at the virtual switch.
Tinker's HWR is here; you have to see the video of the AHIP singers.
No, really, you have to!
Or at least two out of three are featured on Brady Augustine's edition of Health Wonk Review.
This is a really, really good edition.
Health Wonk Review is up at David Williams' Health Business Blog.
With thousands of folks getting all wonk-y at town hall meetings, it's no surprise that David's edition is chock full of all that's reform. He did managed to separate wheat from chaff, so it's also all good...
Jaan Sidorov is hosting this biweek's edition of HWR; there are more than a few new bloggers featured, along with some old vets. But the great thing about Jaan's edition is it covers the entire spectrum of reform - and a few other topics highly relevant to today's debate.
And the guy can write...prose AND poetry.
In Joe's absence, no need to go without your regular health care policy fix. He lent me the keys to his kingdom so that you could be alerted to a fresh edition of Health Wonk Review posted by Paul Testa at The New Health Dialogue Blog.
- Julie Ferguson
Ken Terry of BNet is this biweek's host of HWR. Ken's a rookie host but you couldn't tell from this ed. His compendium is punchy and a fast read.
And an essential one as well.
It's here. Almost.
At long last, health reform is no longer just an idea, a glimmer in the distance, a subject of interest only to those writing doctoral theses, policy papers, and other intellectually interesting but practically useless missives.
Dare we say it; reform is actually possible, perhaps more possible than at any time since 1964.
There are currently no fewer than six (6) health reform bills before Congress, plus about a dozen more waiting in the wings (well, maybe just a couple). Now that there's actually something concrete to review, discuss, and dissect, the experts from Health Wonk Review's editorial board have unlimbered their virtual electron microscopes, dusted off their intellectual scalpels, and fired up their mental PET scanners.
Here, laid bare for the benefit of health wonks everywhere, is the combined wisdom of the greatest minds inhabiting the wonk-o-sphere...(click here for the soundtrack, and turn those speakers up)
First, why?
For that, we asked Senator Byron Dorgan (D ND) to tell HWR's readers why he thinks now is the time to act on reform. Here's the Senator's contribution.
"After months of preparation and study, the U.S. Senate is beginning to draft health care reform legislation. The Health, Education, Labor and Pensions (HELP) Committee is writing its bill this week, and the Finance Committee is expected to begin drafting its own version of health care reform legislation next week [emphasis added].
The Senate Democratic Policy Committee (DPC), which I chair, has also just issued a new policy paper which documents the urgent need for health care reform. It lays out the facts on what the cost of inaction over the past eight years has been.
Health care reform is also economic reform. Ever-rising health care costs contribute significantly to the current economic crisis. People between jobs – and that too often means that they are also without health insurance coverage – often face potential financial catastrophe. Even people with jobs and health insurance struggle to cope with high insurance premiums, co-payments and prescription drugs.
You can view video clips of some of the first floor speeches in the health care reform debate by several of my colleagues who are working to advance health care reform in the Senate are here.
Democrats know that, for our economy to truly recover and prosper, we must help middle-class families, businesses, and federal, state, and local governments cope with skyrocketing health care costs. We are committed to enacting health reform that addresses the health care cost crisis and ensures quality, affordable health care for all Americans."
From Senators to students, HWR welcomes all. Emma Walsh-Alker asked her fellow fifth-graders why kids need health reform; their answers echo Sen. Dorgan and add their own thoughts - which are wise indeed.
The public plan option
The public plan has incited and excited all, from de facto leaders of the GOP to undergrad student debating societies. It is variously viewed as a way to ensure all Americans get good, affordable health care or a devious way for single-payer advocates to slowly but surely kill off the private insurance industry. While there are lots of opinions out there, our good friends at Health Affairs have perhaps the most comprehensive perspective from a variety of posters, guest and otherwise. We'll start out with their contributions...
Policy vet Jeff Goldsmith doesn't think the plan is worth the risk, but Joe White disagrees, arguing that there's 'dangerous' confusion about Medicare's ability to control costs.
A trio of experts want to make sure policymakers think thru the lessons we've learned from Medicare, some of them quite painful (and wildly expensive to boot).
Some wonks believe there are better alternatives to the Medicare for Everyone plan, with Hal Luft proposing one alternative, and your author proposing to use the VA system (it has better outcomes, lower costs, and happier patients than pretty much any other delivery/payer system).
And colleague and good friend Bob Laszewski thinks the public plan option may really be a well-disguised way to cut reimbursement, instead of what the country actually needs - a way to "sweat the waste out of the system".
Me? I'm thinking the Public Plan Option is a great way to distract reform's opponents from key issues, a bargaining chip to use when the Dems need a few GOP votes to pass a 'bipartisan' bill.
David Williams digs into the differences of opinion between 'experts' and the public on all things health care. His review of Drew Altman's piece provides interesting insights into the core issue of explaining/understanding/debating health reform.
A terrific companion/supporting post comes from Louise at Colorado Health Insurance Insider (one of the few bloggers actually in the health insurance brokerage business). Louise discusses the public's belief that private health insurers have profit margins over 20%...Hello, AHIP, is anyone there awake?!
Ken Terry argues that the focus on the public plan could kill any chance that a reform bill will pass.
Brian Klepper and David Kibbe urge the administration's Health Reform Team to take notice of the health industry's Achilles Heel in their planning. They make the case that universal coverage should be off the table unless the industry relents on specific aspects of current business models.
The Benjamins...
This is going to be really really expensive, so expensive that it will be unaffordable from the get go. That's my interpretation from reading a post from the actual, real live insurance real world's InsureBlog. Bob Vineyard takes Sen Baucus to task; "Baucus proposes tax subsidies for those making up to roughly $88,000 per year for a family of 4. Isn't that just about everyone?"
Merrill Goozner's post is a terrific synopsis of "where's the money going to come from." He discusses cost reductions, potential tax revenues and sources thereof, and concludes with thoughts on the potential impact of raising taxes on the middle class.
Michael Tanner over at the Cato Institute makes the rather compelling point in his post that the current proposals do precious little to address costs. Tanner's point is a valid one; cost control requires saying 'no', and so far no one's even whispering the word.
RIchard Eskow reminds us that any reform plan must address the huge impact of health care costs on the middle class; he notes that almost two-thirds of bankruptcies in 2007 were caused by medical problems.
Anthony Wright expands on Richard's trenchant observation, noting "people expect health coverage to prevent them from going into bankruptcy. If it doesn't do that, then it doesn't deserve to be called coverage."
Reform's impact on hospitals, docs, and others
Brady Augustine has an intriguing post about the knuckleheaded way hospital and their advocates have responded to health reform, drawing parallels to the auto industry. He contends that instead of hiding behind lobbyists and legislative protection (like the Big Three did for so many years) they should get their rears in gear and actually try to make themselves better.
DrRich (his name, not his economic status) laments the downtrodden status of the primary care provider, putting it in historical context, describing CMS' impact on PCPs, and taking on the American College of Physicians' support of a bill before Congress that, among other things, "renders nurse practitioners as full-fledged primary care providers".
'Ill and Uninsured in Illinois' makes DrRich's case - maybe better than he does, with her/his post on why retail clinics aren't the answer for the medically underserved.
Adam Fein sees more consolidation among PBMs (pharmacy benefit managers) in the future; he makes a compelling case.
And from our good friend Jon Coppleman comes this comparison - If health care is the proverbial 800 pound gorilla, then the medical portion of workers comp is a 15 pound Maine Coon cat. Jon wonders whether health care reform will crush workers’ compensation.
The MassExperiment or, is that lighthouse working?
Pro- and O-pponents of national health reform can find much in the Massachusetts experiment to support their respective positions, but those in neither camp can provide the most Mass-based insight. Here goes.
Relative newcomer Tinker Ready's video-rich post on a Boston-based debate between single payer and mandated insurance, as well as a meeting between single-payer advocate Dr Steffie Woolhandler and Senator Max Baucus (D MT) (Bet that was fun...) gives readers interested in learning lots about Mass just what they need.
David Harlow's post identifies the holy trinity of reform - quality, access, and cost, noting that in Massachusetts they began with access. He opines that President Obama should back off his apparent goal to get all three done at once.
Not strictly Mass-related, but definitely Harlow-related is the post from Walter Jessen at HighlightHealth. Jessen observes that a recent study shows Americans value access to providers as their "most essential and highest valued health priorities."
Newly-minted Ph.D Economist Jason Shafrin (congratulations, Jason) has studied the impact of Massachusetts' health reform on waiting times. His data indicate it takes longer to see a primary doc and some specialists, but less time to get into a cardiologist these days.
Hold on a second, says Joanne Kenen; the USAToday study used by Jason has a lot of other data about waiting times in lots of other towns here in the US of A. Joanne's review presents a decidedly mixed picture - both of Mass and many other cities. The top stat is this - over the last four years, the average wait across the US to see a doc for nonemergent care more than doubled - from 8.6 to 21 days.
(These last two posts are but one example of why the blog-o-sphere is so great)
The Politick-ing
Ya gotta love Jaan Sidorov! Really, ya gotta! His post dismantles the various signatories to the now-infamous 'Dear Mr President, we'll save $2 trillion' letter. Here's an appetizer: "Representing the medical device and remote monitoring industry, this group [AdvaMed] promises that overuse of their technology will reduce overuse of other medical care."
Not to be outdone Glenn Laffel MD PhD at the difficultly-named Pizaazz recommends Sens Baucus and Kennedy caucus, and do it quickly, before they are forced to settle their differences on the White House hoops court. (my money's on the skinny black guy...)
Maggie Mahar's posts are always relevant and precise; she knows of what she speaks. Maggie's coverage of Sen Jay Rockefeller's (D WV) bill to greatly expand MedPac's power to and reduce Congress' role in determining Medicare benefits is a prime example. Few are following this, but it could well be the key to controlling Medicare's costs in the future.
Jonathan Cohn has the scoop on the meeting wherein President Obama voiced support for Rockefeller's bill.
The always-interesting American Spectator has an insider's view of GOP Senators' perspectives on yesterday's release of 'the Kennedy bill'. Snippet - "Enzi was "very disappointed" with the release of the Kennedy bill, and said the senator feels that all the time Republicans spent talking to Democrats may have been in vain since the majority wasn't listening to them."
Not sure where it goes but it definitely deserves mention
HWR has been around for more than three years, and Roy Poses MD has been one of the reasons for that longevity and credibility. Roy is one of the blog-o-sphere's most perceptive industry watchdogs, and his current post is no exception.
Don't change that channel!
Health reform will be leading the headlines for the summer and well into the fall. And Health Wonk Review will keep you informed, educated, and up to date with the best of the blog-o-sphere.
Jason Shafrin hosts the next edition of HWR at Healthcare Economist; his perspective and expertise will undoubtedly make the June 24 edition one of the best.
Health Wonk Review welcomes a new host - the Boston - based Tinker Ready hsa this week's edition up and running with a Jersey theme.
Welcome, Tinker!
Julie Ferguson at Workers Comp Insider's edition of Health Wonk Review shows why HWR continues to be a must-read. Her approach today is bullet points, quick summaries, and lots of posts.
Others have grouped posts into separate categories, used food, holidays, elections, or music as organizing principles.
Regardless of which method is used, there's always something new fresh and different.
And with health policy and health reform taking up much of the front page, HWR is more timely than ever.
David Harlow isn't just a health blogger, he also has another life (how does he do that?!).
In this other life, he's made time to post an excellent summary of the blogosphere's take on President Obama's first hundred days.
It's pretty interesting.
At Bob Laszewski's site today, where he's hosting this fortnight edition of Health Wonk Review.
For those in the mood of a healthy dose of realism, Glenn Laffel's Health Wonk Review is just the ticket. Glenn, a first-time host, brings a fresh perspective and great style.
Anthony Wright's edition of HWR incorporates the wisdom of Yogi Berra - something that would be most useful in DC these days...
beautifully illustrated, too, Anthony!
David Harlow is this bi-week's host of Health Wonk Review; his edition is both articulate and artistic.
Thanks David!
Brevity is Jason Shafrin's approach. go see his review of the best in risk blogging.
We welcome a new host to the pantheon of Health Wonks, Brady Augustine of Medicaid Front Page. Brady's initial effort is a winner - the Watchmen edition.
Brady writes very well, and has a flair for design, too.
David Williams' edition is brief and well done. Go here.
Jaan Sidorov, MD ME (Musical Expert) hosts this biweek's Health Wonk Review. Hosts are always challenged to find a new and fresh approach; Jaan has come up with musical accompaniment for each post - and his tastes are quite diverse.
An excellent HWR, made all the more so by the post-inaugural timeframe.
Brian Klepper is hosting the New Year's edition of Health Wonk Review, and has a lot of new contributors to start out 2009. There's a wealth of information and insight on reform, costs, regulation and care management - all timely and pertinent. Head on over.
From the sprawling city of sun and sin (LA, not LV), comes today's edition of Health Wonk Review. Kind of retro, which we Health 0.1 types can relate to!
This two week-post-election edition of the Cavalcade of Risk combines a bit of prognostication about the directional impact of the political winds, a lot about the economy and impact thereof, and a few posts that manage to be both topical and intriguing-ly random.
upfront disclaimer - somehow I managed to offer to host CoR in the middle of the annual workers comp conference - an incredibly poor decision on my part as this is a rather busy time for your author. That's my excuse for the brevity of this edition. But, hey, it's a quick read!
First, here's Julie Ferguson's contribution - warning, it addresses the burning question - what to do if you own a bar and the bartender's nude?
We'll begin with health-related submissions, and no better way to kick off the CoR (and over the ant hill) than with Bob Laszewski's post on the failure of the free market in health insurance. Bob's oservation is straight forward - since HillaryCare went up in flames, the free market had fifteen years to prove itself. It failed miserably. No excuses and no whining.
What's next? Louise takes Bob's logic another step with her contribution, wherein she makes the case for allowing individuals to 'buy in' to Medicare.
Maggie and Niko of Health Beat follow up with a discussion of the possibility of a dramatic restructuring of physician compensation - shifting more dollars to primary care and away from specialists.
Nancy Germond from D&B (corporate bloggers are coming!) contributes her views on the likely implications of a Blue Washington.
I have a somewhat different perspective; my take is there will indeed be health reform, although it will not be in a single massive bill.
Economist Jason Shafrin reveals one of the many obstacles to meaningful health reform - patient pressure as docs who actually use decision support systems find that patients feel, well, that this makes them less 'physicianly'.
Khan contributes a post on an issue of concern to those of us with older progeny; Health Insurance Options for Students.
Long-time contributor and pharma expert David Williams is of the opinion that big pharma may be preparing to shoot itself in the foot. Alvaro Fernandez continues our brief sojourn into the world of pharma - his post details the new sleep therapy - and it isn't a pill.
Henry Stern, LUTCF, CBC informs us about what happens when politicians go too far in expanding programs - and it isn't anything good.
In the non-health-related world, LAL believes the next meltdown will be in auto debt, pointing out that the average car loan is about $25k..
A very well done review of the current liquidity crisis and how it impacts the financial environment is up at VoxEU. The
http://www.workerscompinsider.com/archives/000963.html
Onto the property and casualty insurance world...
Eric Turkewitz has done a masterful job researching a key liability issue, personal injury due to President Bush's Dog Biting a White House Reporter (Can Bush Be Sued?).
Jon Coppelman somehow draws a link between frozen embryos and workers comp. Really.
Workers Compensation expert James Moore reports on some interesting developments in West Virginia's Workers Comp program, and a state-run but commercially insured risk pool for problem industries.
Louise has put a lot of effort into this week's edition of HWR, and it shows. Really shows.
Her thoughtful analysis of each post makes for a cohesive, coherent whole - definitely greater than the sum of the parts.
David Harlow at HealthBlawg has posted his techno-rich version of HWR. I'm jealous of his technical prowess, and want to know how he gets Dorothy's shoes to click...
Editor's note - this is perhaps the most serious, thought-provoking edition of HWR I've had the honor of hosting. There's a lot of meat here, so don't expect to multi-task your way through.
These are momentous times. Not only will we be electing a new President, a third of the Senate, and all of Congress in less than three weeks, we're also facing the biggest economic crisis in modern times. The combination of these two events looks like it will result in a much broader and deeper role for the Federal government in private industry.
Who would have thought taxpayers would be subsidizing loans to automakers, buying up bank stocks, guaranteeing interbank lending, and bailing out huge insurance companies? (If that 'who' is you, I would have appreciated a heads'-up before by portfolio cratered...)
The unthinkable is now the inevitable. I can also sense a subtle but nonetheless significant shift in the health policy world, as politicians and pundits absorb the implications of Federal intervention in the capital markets and begin to consider other areas of market failure - such as health care.
The financial crisis and government's attempt to solve it are driving the health policy discussion in two distinct directions - one argues that there will be no money for reform, thus any reform will be incremental, while the other argues that the financial meltdown is precisely the time to fix health care and access to care.
For anyone thinking that health care is not that big a deal, Bob Vineyard of InsureBlog's post >$85,000,000,000,000 and Counting . . .is a big bucket of icy cold reality in the form of the looming $85 Trillion (yes, that's with a "T") unfunded Medicare liability.
Okay, now that we have your attention, here's what the best and brightest are thinking.
Lets frame the conversation with a post from the always-thoughtful Maggie Mahar on the question 'Is health care an "individual right" or a "moral responsibility" that a civilized society understands that its citizens deserve? Maggie prefers the "moral responsibility" frame; in her view we should look at healthcare collectively, individuals should not have to "demand" health care as a "right".
Maggie isn't the only blogging wonk thinking about the right v responsibility question. From a health care perspective, the second McCain-Obama debate was interesting for all of about five minutes. But in that short period of time, Tom Brokaw raised an issue that goes to the very heart of the debate: Is health care a right or a responsibility? It drew this post from Merrill Goozner at GoozNews.
Len Nichols of the New America Foundation also weighs in on the debate. Len gleaned a few nuggets from the brief discussion of health care at >HEALTH POLITICS: Truthful—and Helpful—Moments in Presidential Debate
The two men who will have a lot to say about what actually happens are named Obama and McCain. Next up is Health Affairs Blog, where several posts wrestle with the differences between the presidential candidates' health reform plans. Harvard economist David Cutler and Obama advisor calls the McCain plan "out of touch", while AEI economist Tom Miller and unpaid McCain advisor defends McCain's plan.
Over on the Huffington Post, MIchael Millenson doesn't like the McCain reform plan one bit. In his view, McCain's plan is radical and reckless.
Bill Scher at the Campaign for America's Future is one wonk pushing hard for major change. He's no fan of incrementalism (and gently takes me to task for my advocacy of same), calling for us to stop worrying abut short term budget issues and focus on bigger issues.
(Ed. note - yes, most posts appear to favor Obama/take McCain to task. I had to search on my own to find (instead of relying on folks to submit their posts) for those supporting McCain's positions. After twenty minutes I gave up. If anyone has any solid, well researched posts send them on and I'll issue an update to this post.)
My take? We can do a lot to help people get coverage, with no impact on the Federal budget or taxes. If the Feds force insurers to stop denying coverage for pre-existing conditions, outlaw medical underwriting, and require community rating and a basic benefits plan, a big part of the problem would be solved. Note several commenters disagree...
Bob Laszewski is having none of this. His post on the disconnect between political reality and wishful thinking is firmly in the 'lets get real folks health reform is a non-starter'. As a long time industry vet, astute observer of the realities of Washington, and pragmatist of the highest order, Bob's views merit careful consideration - especially if you disagree...
Those who actually work on the front lines - selling health insurance and servicing their customers, have a reality-based perspective that is vitally important. Louise at Colorado Health Insurance believes "In order for health care reform to work, it has to work for everyone. We need a solution that spreads the cost of health care evenly across the entire population (adjusted for income, just as taxes are) and doesn't leave large groups (like people with pre-existing conditions) to fend for themselves with no good health insurance options available."
Continuing our virtual trip out west, Anthony Wright takes issue with those who believe reform must be either state OR federal in his postAn unspoken, untrue consensus....
Andrew's colleague Beth Capell takes it to those who claim mandated employer coverage is a Job Killer ; and she's got some good research to back up her assertions that it isn't.
Christopher Weaver discusses how the media is writing about health care in the election coverage. Weaver's observes coverage from the national media is scarce and spotty, while local media does a much better job of translating policy into what it means for real folks.
That's it for policy. But policy is not the only thing on the minds of HWR contributors. Roy Poses MD's post digs into the accusations that Pfizer Suppressed and Manipulated Clinical Studies of Neurontin. Roy found a rather awkward quote from a Pfizer exec, to wit: "we are not interested in having this paper published at all because it is negative."
Brain Blogger reports on the latest recommendations on residency hours, with >Are Doctors Super Human?.
From the work comp side of the world, Tom Lynch Of Workers’ Comp Insider offers a tried-and-true primer on managing workers comp costs and getting injured employees back to work in Eight steps to controlling workers comp.
Jon Coppelman takes another peek under the covers of the AIG debacle - hint, it's nothing to examine on a full stomach.
David Williams did an email interview with Mark Bard of Manhattan Research re: the Revolution Health/Waterfront Media merger; David asks some tough questions about how media companies are evolving their web strategies.
David Harlow (no relation to David Williams, at least none I'm aware of) knows a lot about certification of hospitals - a rather arcane but increasingly important issue. David reports on CMS' decision to allow DNV to break the stranglehold on acute care hospital certication deeming held for decades by the organization formerly known as JCAHO. ( passing a JCAHO survey means that a hospital is "deemed" to be in compliance with Medicare Conditions of Participation (aka Medicare certified) and can forego a government survey; up till now JCAHO has been the only game in town.)
From an attorney to an economist, our next post from Jason Shafrin addresses the issue of medical licensing, specifically whether it improves or harms the quality of medical care
Daniel Goldberg's contribution provides much-needed perspective on one main component of health reform - the claims for and potential benefits of 'prevention'. It may not be all its cracked up to be.
Jaan Sidorov digs into CMS' medical home initiative, providing some much needed insight into what could be a major change in the way Medicare handles some aspects of primary care. This is a BIG DEAL.
We conclude this edition with a post from north of the border. Sam Solomon presents > Coalition urges doctors to reject Ontario pay deal, saying, "An argument over a new contract for Ontario physicians is spiraling towards a civil war inside the doctors' union. Among the issues: disagreement about the extent to which the current economic climate -- and government's projected budgetary struggles -- should affect negotiations."
I'm shot, and you probably are as well. That's OK, because you now have two weeks to rest up for the next edition of health wonk review.
to read health wonk review are here.
Jason's given us a quick synopsis of the best of the wonks sorted by topic.
Colleague Jaan Sidorov is hosting today's edition of Health Wonk Review. Jaan's writing is terrific, as is the content - objective, too!
Friend and colleague Hank Stern's latest edition of Health Wonk Review is up, fresh and ready for viewing.
Thanks Hank!
I'm honored to once again Hank Stern's Cavalcade of Risk, a kinda sorta departure from the usual stuff I do with MCM. [One caveat - I tried to use the auto-poster app, and the weird spacing results resulted from that effort. After slogging thru it for many (well, a few at least) minutes, I gave up - apologies for the spacing]
Today we'll begin with Silicon Valley Blogger's reminder that with a few rare exceptions, the house always wins. In this case the 'house' is the stock market, and SVB reminds us to ditch emotion and focus on reality (good luck with that!) at When Beating The Stock Market Is Really An Illusion
The Stock Teacher contributes a post on the risks - financial and emotional, inherent in investing in high-flying stocks (something few of us can relate to, I'm sure) at Ouch- CROX Just Taught Me A Lesson.
Jim asks a question we all should consider when buying or renewing insurance - what's my appetite for risk? Jim's is higher than some.
Joe Manausa's perspective on the Fannie and Freddie bail out bill is very local - HR 3221 is Good For Tallahassee.
Sticking with the real estate theme for a moment, one of my new favorite blogs is penned (typed sounds so déclassé') by
Jason Voiovich. His contribution for this ed. of CoR is Reverse mortgage: Hero or villain?, an excellent and thorough review of the pros and cons for consumers and mortgage brokers.
FMF has a quick update on the state of medical tourism - net is there's a lot more going on these days, including acceptance of medical tourism in some Blue Cross and Aetna plans; read More Insurance Firms Allow Medical Tourism
I was looking forward to reading Nancy Germond's take on management in her post entitled Consider the Total Cost of Jerks to Your Organization. I was not disappointed. My only addition is that most of us (your author included) exhibit jerk-y behavior from time to time, so please don't tar all with the same damning brush!
Raymond contributed multiple posts, including a thoughtful and well-researched piece on federal deposit insurance -something any IndyMac saver wished they'd read thoroughly a few months before that bank cratered. Click thru to
Is My FDIC Insured Checking Or Savings Account Safe If My Bank Fails? to see what would happen to you if your bank followed suit.
As host, I get to pick who's here and who stays on the sidelines - a difficult task, but a necessary one if we are to retain your interest - and one principle is to avoid multiple posts from the same contributor. I also get to break my own rules, and Jim's post on car rental insurance is well written and brief and educational - which covers the requirements in my book. Before you head out on that trip, read Credit Card Rental Car Insurance is Secondary Coverage!?
Our august founder and resident sage, Henry Stern shows his age (and lack of memory loss) Car 54, Where Are You (and how's your insurance)?, an entertaining look at the possible use of vehicle gps tracking devices by insurance companies. Big brother, indeed - but at a lower premium...
It will come as no surprise that the leading cause of death among public safety employees was heart attacks and vehicular accidents. What did surprise me - a lot - was the death rate among volunteer firefighters. That's the report from Workers' Comp Insider, the go-to source for the latest in the WC world.
Jason Shafrin is one of the better health care economists. His contribution is a synopsis of Health Affairs' article on the Chinese health care system - a fast and educational take which includes this nugget
>the top social concern in China is “high medical expenses.”
On to my little corner of the world - IN-surance (that's how southerners pronounce it). Colleague Richard Eskow notes the recent demise of FL Gov. Charlie Crist's effort to cover more Floridians was doomed to fail from the outset.
Louise from the great state of Colorado chimes in with an interesting take on mandated universal coverage, Colorado State University style. Seems grad students are forced to buy into the CSU plan unless they can prove they have the same-or-better coverage.
From the east coast, David Williams finds that some docs in Massachusetts want to try to force drug stores to not provide medical care, by "barring health care providers from selling tobacco products". David notes this is a slippery slope; I'd add that it reminds me of the old artisan guild strategies, as well as some of the more distateful aspects of union featherbedding...
Lastly comes this contribution from your author, a dissection of the reasons folks go without health insurance.
And with that, we're outta here!
And does his usual superlative job over at the Health Policy and Market. The blog roll keeps increasing, and the fresh insights are more than welcome.
Colleague David Williams has a new take, fresh look and punchy style in his edition of Health Wonk Review.
His version is a fast read, too.
Health Wonks - get your cuppa and spend a few minutes catching up on the best and brightest in the virtual wonk world. Jaan Sidorov delights and amazes, and the list of blogs just keeps on growing.
HWR welcomes back Health Affairs as the host and editor of this biweek's edition. Jane Hiebert-White brings her distinctive Washington flair to HWR, one that is quite timely given all the wonking-about among candidates and pundits alike.
Friend and colleague Hank Stern is hosting this week's Health Wonk Review edition.
Hank's summary is concise and a fast read.
Jeez, they're good.
Maggie Mahar and Niko Karvounis host this fortnight's edition of HWR, and obviously spent a lot of time and smarts on the effort.
Particularly excellent is the discussion of the new Tier 4 pricing for drugs - there are several provocative posts that really explain the potential impact.
Merrill Goozner shows why he's one of the best in his edition of HWR over at the Health Care Blog.
He's also been kind enough to separate the wheat from the chaff for you, dear reader, leaving only the best for your reading pleasure.
Here in New England we're about to welcome spring - that glorious time of year when the wind howls and the rain pours and mud covers all, best enjoyed while standing outside freezing your tukus watching one of your progeny splash up and down a lacrosse field.
What better time to sit in a warm car, editing the latest edition of HWR?
Roy Poses eviscerates Robert Jarvik for his pathetic attempts to portray himself as an active, vigorous guy, presumably made so by taking the meds he is touting - Lipitor.
I'm equally-if-not-more outraged, but for a much less important reason. What I loved about the ads was the shot of Jarvik sculling in a racing shell on a beautiful lake. I picked up sculling after rowing for four years at Syracuse University. After competing for another seven years in singles, doubles, and quadruple sculls, I hung up the oars, only to pick them up again recently.
So I was delighted to observe and comment on Jarvik's smooth technique, his graceful catch and solid balance, the ease with which he released the water at the end of the stroke and let the boat run out; well, I was delighted but my family got really tired of my endless soliloquies on the finer (well, OK, minute) points of Jarvik's sculling.
Turns out it wasn't him, but some stunt guy. Reports now indicate Jarvik's butt has likely never been in a racing shell. Which ticks me off - first that the jerk was lying, and second that he didn't pick me to do the stunt work.
Merrill Goozner's hosting this week's edition, which looks to be one of the most comprehensive and contentious to date.
He's off to California on vacation, so post a comment and chide him for slacking while the rest of us are working...
David Williams keeps it brief and to the point - today's edition of Health Wonk Review is a snappy read.
One of the cleanest, clearest carnival presentations is this week's Carnival of Risk, hosted at the digerati life.
very very well done.
Vince Kuraitis is a rookie host posting like a veteran. Vince's edition of HWR is neatly categorized, entertainingly written, and evidence of all the good stuff out there in the world 'o wonks.
He has a special section for the spam hosts get...
Colleague and blog mentor Julie Ferguson is this week's host of the Cavalcade of Risk. Got to get her to show me how to do those cool photo inserts...
Friend, fellow blogger, and mentor Bob Laszewski is the host of the first Health Wonk Review of 2008.
Bob (you may have heard him opining on NPR night before last in a piece on All Things Considered) is brief, factual, and entertaining.
Although I'm not sure about his characterization of the income status of two featured bloggers...
The final 2007 edition of Health Wonk Review is hosted most capably by David Harlow. David has given us all a great holiday gift!
Always one to oblige fellow blogger and Cavalcade of Risk Hank Stern (he of InsureBlog fame), I eagerly agreed to host this week's edition of the CoR.
Little did I suspect just how popular the 'cade has grown - I've been inundated with entries
Continue reading "Cavalcade of Risk - the pre-holiday edition" »
In the almost-two years we've been publishing Health Wonk Review, we've been fortunate to entice some of the clearest thinkers in the web-o-sphere to host each bi-weekly edition.
Roy Poses et al at Health Care Renewal keeps that tradition alive, adding posts from a few newer entrants while artfully weaving in contributions to produce a cohesive, highly readable edition.
The Health Wonk Review community welcomes a new host - Maggie Mahar of Health Beat. Maggie's edition reflects a new approach - not content with a comment or two about blogger's submissions, she's gone the extra mile (or more) and tied them all together in a seamless, and well-presented piece.
My vote for best edition of Health Wonk Review 'EVER' (say with teen female inflection) goes to Hank Stern for today's version.
applause applause applause!
Our favorite health care economist hosts this week's edition of HWR, in his usual organized style. Jason's introduced a new idea - post of the week.
See if you agree...
Not snow, nor wind, nor dark of night, nor being at the Aspen Health Institute has prevented Jane Hiebert-White from hosting this biweek's edition of Health Wonk Review.
And the furor over Bush's veto of S-CHIP makes for some heated posting.
Today, we’re leading with a quote from W, from a talk in DC October 28, 2003 …”As you know, these are open forums, you’re able to come and listen to what I have to say…"
That's not what we do here at HWR
Well, we screwed up, but our mistake is your delight.
Many thanks to Dr Bob at The Doctor Is In. We mistakenly directed Blog Carnival posts to his blog instead of the similarly named host of today’s issue, The Doctor Weighs In.
The good Doctor kindly took the initiative to make a posting today so we have double the HWR coverage. Our thanks to Dr. Bob for being on the ball! His blog is quite interesting – go check it out!
Brian Klepper's the host of this biweek's edition of HWR; his writing is terrific, especially when he opines on the posts.
And the selection of posts is provocative...
The latest edition of Health Wonk Review is up at Medical Humanities. Get out your dictionary, you're going to need it!
The brains behind Health Wonk Review reside in Julie Ferguson's noggin; and this fortnight's edition resides at Workers Comp Insider.
While lots of folks have been taking vacation, not so with the various and sundry contributors to HWR!
If you haven't been reading Health Wonk Review of late, the latest edition shows what you're missing. Bob Laszewski's selections show just how far the health policy blog world has progressed in the last 18 months.
Richard Eskow at the Sentinel Effect must'ov been up most of the night writing the latest Carnival of Risk. Enjoy the fruits of his labors!
Jay at Colorado Health Insurance Insider hosts this fortnight's edition of HWR. Jay leads with Sicko-related posts, and does an admirable job.
David Williams has put together the best of the policy wonk-o-sphere in his edition of Health Wonk Review. To "know what you don't know", head on over.
HWR once again welcomes RIchard Eskow to the list of august, erudite, and articulate bloggers fortunate enough to be asked to host this seminal compendium. We're fortunate to grab some of his blog time away from his other pursuits on Huffington Post...
Check out Richard's efforts at The Sentinel Effect.
the latest and greatest from the world of insurance and risk management resides this week at the Cavalcade of Risk. Read on, oh insurance geeks!
Hank Stern, veteran HWR host and erudite observer of all things health insurance and policy related hosts this biweekly edition of Health Wonk Review.
Here's to Hank!
Health Wonk Review is well into its second year, and getting bigger with each bi-weekly edition. Jason Shafrin, renowned health care economist/blogger, hosts this fortnight's effort.
Jane Hiebert-White at Health Affairs has just posted the latest and greatest of the health policy blogosphere. Her edition is rich with the latest on policy, with compelling posts for and against "socialized medicine".
Matthew Holt isi hosting this week's edition - click thru for the latest and greatest.
Return with us once again to the enlightened pens (ok, keyboards) of the policy wonks as they pass on their pragmatic, practical, and perspicacious prose to you, dear reader, in this publication of HWR.
Yes, it's been a year since Matt Holt, Julie Ferguson and I launched Health Wonk Review. Thanks to all the guest hosts, tech folks (thanks Dmitriy and Shahid), and readers in wonk-land, HWR is gaining readers and traction.
Julie has the honor of hosting the anniversary edition, and offers a tip of the glass to all.
Salud!
After a year of badgering other bloggers to host an edition of Health Wonk Review, I've been guilted into hosting the Cavalcade of Risk, a related-but-different grand rounds of things insurance- and risk-management related.
I'm doing this from a beach-side hammock in Puerto Morelos, MX, so if there are garbled sections, blame it on the cervezas.
Health Wonk Review's list of contributors is expanding edition-to-edition, and the latest hosted by Health Affairs' Jane Hiebert-Smith continues the trend. There's solid material from the State of the Union address and the various state reform proprosals, not to mention drug pricing and the new Congress.
David Williams at Health Business Blog is hosting the latest edition of the Cavalcade of Risk.
Check out the entry on physicians who direct some "risky" patients to the ER, and the reasons they do.
Roy Poses MD has done just a bang-up job on today's edition of Health Wonk Review. It's just stuffed with great material!
The number of health policy blogs is going thru it's expansion phase; with new entrants jumping into the fray every nano-second. The best of the (relatively) recent efforts include Health Affairs, Bob Laszewski, and a brand spanking new blog, The Sentinel Effect.
Richard Eskow, one of the smartest people in the managed care business and has been posting at the Huffington Post for quite a while with much success. Richard has been in the business on the payer side for over 20 years, consulting with HMOs, tech companies, politicians, workers comp insurers, and providers. He's especially good on the data analysis stuff.
He also plays a mean guitar.
Hey, Managed Care Matters was nominated for one of the Best Medical Weblogs of 2006!.
Thanks to whomever entered the blog, and I'll send out info on voting when it starts (tomorrow, I think).
Also in the running for the "Best Health Policy/Ethics Weblog" are Hank Stern's InsureBlog, Health Business Blog, Rita Schwab's MSSPNexus, Kevin, M.D., Roy Poses' Health Care Renewal, and Effect Measure.
Now that's SOME competition!
A well-done and tip of the cup, er, cap to Rita Schwab of MSSP Nexus. Rita has done and exemplary job hosting the latest edition of Health Wonk Review, wherein the best of the biweekly blogosphere are brung to you.
Michael Cannon brings his Libertarian perspective to the latest edition of Health Wonk Review at his blog Cato-at-Liberty.
Michaels finds himself agreeing with Ezra Klein, complimenting Matthew Holt, and finding common ground with Lief Wellington Haase.
I can almost hear faint strains of "Kumbaya"...
David Williams is hosting Health Wonk Review in a return engagement. While David is somewhat misty over the old days of HWR, he does an excellent job coping with the growth of the "review".
The blog run under the auspices and banner of the highly esteemed journal "Health Affairs" is starting to get some traction.
Recent posts examining the implications of the elections on health care, GOP and Democratic views of the elections on health policy, and a well-done piece on the reality of the nursing shortage all bode well for the journal's blogging future.
Now if they could just figure out how to post every day...
Jason Shafrin of Healthcare Economist fame is hosting this edition of HWR. Jason's measured, analytical style makes for intriguing perspective on this week's contributions.
Ezra Klein is hosting the latest edition of Health Wonk Review, bringing his trademark trenchant style to the carnival of policy posts.
Health Wonk Review is up and sprinting. Despite a hint of chill in the air here in New England, the darn thing is growing like a weed. I attribute that to the hothouse conditions that exist in today's health care policy environment.
Thanks to all who submitted entries; a few did not make the cut as they were not remotely on-topic. Those that did make the cut represent the best of health policy blogging.
Continue reading "Health Wonk Review - the Harvest Moon edition" »
We've made two changes to Managed Care Matters.
Least obvious to most will be the change in color of hypertext links; we are now using blue, which is more easily read by folks w certain types of color blindness. Thanks to friend Terry Reardon for the suggestion. (he's a color blind orthopedic surgeon, who assures me that is not an occupational limitation...)
We've also added another step in the commenting process, asking submitters to enter a bit of text to verify they are a human and not a @#$%^&*&^%$^&**))*%%$## spam bot. Sorry for the extra step, but I can't go thru 200 spams a day looking for your pearls.
Hank Stern and Bob Vineyard of InsureBlog have prepared a virtual cornucopia of health wonk delights. Their edition of Health Wonk Review is indeed serious brain food. No reservations required, come as you are, and buon apetit'!
Hank Stern and associates at Insure Blog are awaiting your submission for this week's edition of Health Wonk Review.
I know it's the first day back from vacation, I also know it's time to get busy building traffic! Send your entry to Hank at InsureBlog@hotmail.com.
Perusing the blogroll on Managed Care Matters over the morning cup, I had that oh-so-rare flash of insight - the blog world is populated by some incredibly intelligent, deeply insightful, prescient folks. Some nutjobs too, but let's stay positive.
I know, what a "duh" comment. But really - here's some examples...
Effect Measure follows the bird flu as only public health experts, and I do mean experts, can.
Roy Poses et al at Health Care Renewal dig deep, really deep, into ethical issues, including Pfizer and publicly-funded medical schools. And there's a lot of muck to be raked by Dr. P.
Kevin Piper posts occasionally, but thoroughly. Really thoroughly. Read his piece on Medicare drug plans, risk corridors, and why smart players are going to make lots and lots and lots of money on Part D.
Medpundit is written by a practicing doc, who (among other talents) has this neat ability to find and report on strange, unsettling, and downright scary happenings in medicine and environs. Here's one on a report that Chinese prison officials are "harvesting" organs from executed prisoners - if that doesn't make your skin crawl...
And there's lots more. So the next time you're stuck on that interminable conference call, cruise on over to the blogroll and get entertained, educated, and enlightened. You may even find stuff that will be useful in the call...
This week's edition of Health Wonk Review is up at the Lucidicus Project, hosted by Jared Rhoads. Jared's done an admirable job culling from diverse sources; one of the best things about HWR is the wide range of perspectives and opinions.
When a community includes Matthew Holt and Jared Rhoads, that's a broad spectrum.
Apologies for acronym-itis; Matt Holt at The Health Care Blog has posted the latest edition of Health Wonk Review, employing his usual sharp wit and canny insight. Or is is sharp insight and canny wit..
You decide.
Julie Ferguson, the force behind more than a couple health-related blogs, is hosting the latest edition of Cavalcade of Risk at Workers Comp Insider. With only five editions, the C-cade is up to 20 entries, and quality ones at that.
Peruse and ponder the non-purple prose!
Fard Johnmar of Envision Solutions and Dmitriy Krugylak of The Medical Blog Network are working on a survey of health care related bloggers. The survey, which is on-line (natch) covers a variety of topics and is open to any blogger that devotes a third of their time to the health/medical world.
So if you qualify, hop on over and render your thoughts and opinions.
Jason Shafrin at Healthcare Economist has posted the latest edition of HWR for your reading pleasure. Contrasting opinions on quality, consumer directed care, and technology are featured in Jason's edition.
Jason Shafrin of Healthcare Economist is hosting this week's edition of HWR. Get your submissions in today or by 9 am tomorrow! You can use Dmitriy's automated entry system after registering here.
Julie Ferguson has outdone us all - an excellent edition of HWR is up and ready for your perusal and edification.
Send your submissions to Julie Ferguson at: julie AT julieferguson DOT com. Make sure you include-
your blog url
the entry url
a brief synopsis
Julie's doing other stuff today, so you have till 5 pm eastern.
Edition eight of Health Wonk Review is up at HealthVoices.
Hank Stern at InsureBlog has done an admirable job of filling in for Jack Mason, who was unable to perform host duties for this round of HWR.
On a moment's notice Hank has put together a well-written Review - thanks to Hank and contributors!
My regular job took precedence over getting HWR out on time last week - apologies to those of you who have been sitting at your keyboards waiting eagerly for the latest edition to once again enter the bitstream.
This edition's submissions range from the near-global to the very specific; they do share a common thread of (mostly) deep insight. So, enough from me and on to the musings of the health wonk-o-sphere...
Continue reading "Health Wonk Review May 4 (actually May 8) edition" »
Submissions for this week's edition of HWR are due Wednesday at 9 am est -. Health care policy, infrastructure, technology, admin, managed care and insurance bloggers are invited to send in their best of the last two weeks; I'm aiming to get this version up by the end of the day tomorrow.
The Fifth edition is up at Fard Johnmar's Envisioning 2.0. You have to see what he discovered in Einstein's files...
Health policy, informatics, insurance, and similar bloggers are invited to submit their posts for the fifth edition of Health Wonk Review. Fard Johnmar of Envisioning 2.0 is this week's host.
David Williams at the Health Business Blog is this week's host of Health Wonk Review. His style is brief and clear...I'm envious...
Further proof that health wonks with too much time on their hands can create havoc comes in Fard Johnmar's recent post about fellow wonks Matt Holt, Trapper Michael, Kate Steadman, Nick Genes et al.
Accolades and cheers for Fard, who gets the "most creative" award, and to Kate for passing it on to those of us too lazy to find it on our own.
If you don't get it, time to put aside that work and dive deeply into the wonk world...
Health Wonk Review's second edition is up at Matthew Holt's The Health Care Blog. In two weeks the thing has grown substantially; Kate Steadman will be the next host so here's hoping she has even more from which to choose.
Julie Ferguson and Chris Miller are working on getting the "official" HWR website (check this on Friday 3/10/06) up and running. Plans are to have it done by the end of next week so the second edition can be posted there after Matthew Holt gets it up and running on Wednesday (no pressure Matt).
In the interest of speed and fiscal prudence it will, well, look fast and inexpensive.
Chris Miller's firm, Artefact Design, will do the actual design stuff and hosting, and Julie will be responsible for making sure the content and structure work.
Helen Knight of KingKnight Communications is handling the "old media" exposure stuff. All are great to work with, incredibly focused on doing things right, and fun (I love to plug good people).
Several folks have expressed an interest in submitting posts to and being kept abreast of our latest venture, Health Wonk Review. Some have asked for copies of the "rules", a word that makes me break out in hives. So, here are the guidelines we're working with today.
1. HWR is going to be published every other week. This may change to weekly based on interest.
2. The host will rotate with each publication.
3. The host determines which submissions are included in their edition of HWR.
4. Submissions will include the poster's name or nom de chroniquer (the nickname under which they post), the url of the blog, the url of the submitted post, and a synopsis of the post.
5. Submissions are due by 9 am EST every other Wednesday - that means March 8, March 22, etc.
6. The host will include the name and email of the next host in their edition of HWR.
7. A separate website for HWR is in development and will be out sometime next week. Details to follow.
8. The host for next week is Matthew Holt - 'matthew@matthewholt.net'; March 22 host is Kate Steadman - ksteadman@gmail.com; April 5 is David Williams [dwilliams@mppllc.com].
9. We are going to see how this goes and take it from there. As of yesterday, there were 577 hits on "health wonk review" on google - so we are getting a bit of traction.
Finally, thanks to all for their contributions, support, and cross posting.
Joe
This is the premiere edition of Health Wonk Review, a biweekly (or so) compendium of the best of the health policy blogs. We've asked over two dozen health policy, infrastructure, insurance, technology and managed care bloggers to send in their best, provided to you in Cliff Notes style. We'll do this every couple of weeks or more often if the host wants to.
Why? Bunches of reasons.
First, the last two months have seen a renewed interest in the health care policy arena, triggered by Pres. Bush's State of the Union address, the financial difficulties of GM et al, the emergence of consumer-directed health plans, and the Part D mess.
Second, there are so many excellent policy blogs in the ether that it is impossible for anyone to keep abreast of them all.
Third, Nick Genes' Grand Rounds has done such an excellent job covering the medical blogger community it inspired us to try to do the same on the policy side (plus Nick has already done most of the heavy lifting figuring out this type of thing so we didn't have to do too much work).
And as you'll read, we're off to a pretty good start.
UPDATE - for a couple of late entries, click below...
Joseph Paduda is the principal of Health Strategy Associates.
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Copyright Joe Paduda 2004-2006. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.
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