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Notes from the Massachusetts Health Policy Forum
Vendredi 05 Décembre 2008 - 15:36 - 1 mois depuis - Blog - Health Business Blog I attended a forum devoted to the Impact of the 2008 Presidential Election on Health Policy this morning in Boston, and found it to be rather interesting. Professor Robert Blendon from the Harvard School of Public Health and Professor Stuart Altman from Brandeis were particularly good. Former Lt. Governor Kerry Healey and former MA Democratic Party Chair Phil Johnston weren’t bad either. From Altman: Altman’s Law, formulated based on his experience in the Nixon Administration and again in the Clinton era: “Everyone supports some form of national health insurance, but if it’s not their plan then their preferred alternative is the status quo.” He added that he hopes Altman’s Law is repealed in 09. From Blendon: Driver of what happens after the election is whether the issue was a big one for the winning candidate, which in the case of health care and Obama it was. There’s no possibility of adding taxes to the middle class to pay for health care expansion. Therefore whether or not programs receive significant expansion depends on whether Obama follows the Paul Krugman model (i.e., deficit spending during the depression –the more the better– is good) or chooses instead to listen to Harvard economists who tend to argue for a “down payment” strategy of expanding SCHIP and maybe a bit more The health care issue Obama voters care most is cost –but they mean cost to them, personally, not cost as a percent of GDP Unlike McCain voters, Obama voters don’t view individual responsibility as central to health reform. That means health care consumerism won’t be a big feature of any reform From Johnston: President should let Congress develop the details of the plan and let Congress take credit. Senators Baucus and Kennedy are well-aligned to lead in the Senate and to cooperate with Obama. (This was not the case under Clinton where Senator Moynihan wasn’t on board.) House leadership is much less certain. From Healey: Obama should: Allow states to innovate, by granting waivers as was done for Massachusetts Use the military health system as a test bed for health care delivery reform Focus on actions that can be taken unilaterally, such as signing people up who are eligible for existing programs but are not enrolled Persuade other rich countries to pay more for drugs so we can pay less |
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Price Transparency for Medical Devices
Vendredi 05 Décembre 2008 - 15:05 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines Pricing information can motivate physicians to work with the prices and price variation of medical devices. Health Affairs |
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Vaccine Makers Urge Speedy Accord on Pandemic Plan
Vendredi 05 Décembre 2008 - 10:54 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines Governments need to overcome their "pandemic fatigue" and act quickly to finalise a response plan to potential flu threats, leading drugmakers said on Thursday. Reuters Health Information |
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Institute of Medicine Recommends More Sleep, Fewer Work Hours for Residents
Vendredi 05 Décembre 2008 - 09:53 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines A new IOM report recommends strategies to reduce medical resident fatigue-related errors and improve safety by reducing duty hours. Medscape Medical News |
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Britain's DNA Database Policy Violates Privacy, European Court Decides
Vendredi 05 Décembre 2008 - 09:20 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines Britain violated the privacy of two people by storing their DNA profiles, Europe's human rights court ruled on Thursday -- a decision that calls into question rules governing the use of the country's DNA database. Reuters Health Information |
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Better Care, Better Bottom Line for Hospitals
Vendredi 05 Décembre 2008 - 06:40 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines R. Sean Morrison, MD, Prof. of Geriatrics and Medicine at Mount Sinai School of Medicine and Director of the National Palliative Care Research Center, discusses an economic reason for palliative care. The Medscape Journal of Medicine |
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Time for some hotel name changes?
Jeudi 04 Décembre 2008 - 19:23 - 1 mois depuis - Blog - Health Business Blog Coming soon: Four Seasons Resort and Spa Econo-Zone. Hotels may not realize it yet, but the words “spa” and “resort” are fast becoming a kiss of death. Earlier this week I spoke to executives from two separate big pharma companies who told me that they were no longer allowed to book meetings at hotels with the words “resort” or “spa” in the name. It’s not in keeping with the image they want to project, especially in the new depression. Ironically, it could actually be a frugal move to book business in high end hotels and resorts right at the moment. With so many cancellations, resorts are sitting on non-refundable deposits for meetings, but facing spare capacity. Many are ready to deal. Speaking of hotel deals, I’ve been using Hotwire for hotel booking recently and have found some great bargains. (If you’re not familiar with the service, you can choose among different hotels based on their location and characteristics. Hotwire tells you the price but not the name. Once you book and pay they reveal the name of the hotel.) Earlier this week I stayed at the Hilton in downtown Washington, DC for $86, compared with a $250 AAA rate. That’s down from the $101 I paid there a few weeks ago. What’s fun about using Hotwire is that I often end up at hotels that are nicer than I’d feel comfortable staying at, even with a corporate discount. PS –Of course, hotels don’t typically provide frequent stay points when booking through sites like Hotwire. So I was pretty shocked a few minutes ago when I received an email from Hilton encouraging me to use their website for bookings but also granting me points for my Hotwire-booked stay: HHonors points, airline miles and stay credit toward tier status are not awarded for stays booked through third party online sites. However, we have made an exception for your recent stay at the Hilton Washington. Going forward, though, we wanted to remind you that to ensure you receive HHonors points, miles and stay credit when you book online, be sure to make your reservations through www.hiltonfamily.com or any Hilton Family website. 21fe |
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Exposure to Noise In Orthopaedic Theatres - Do We Need Protection?
Jeudi 04 Décembre 2008 - 15:09 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines The orthopedic theater is a noisy place. How much hearing damage is caused to both staff and patients? International Journal of Clinical Practice |
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FDA, WebMD Announce Partnership
Jeudi 04 Décembre 2008 - 08:47 - 1 mois depuis - Newspaper & TV news - Medscape Business of Medicine Headlines FDA alerts and other information will appear on WebMD; the FDA Web site will link to WebMD. WebMD Health News |
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Maybe health care consumers aren’t as dumb as they look
Mercredi 03 Décembre 2008 - 20:39 - 1 mois depuis - Blog - Health Business Blog It’s been clear for some time that consumers don’t tend to make use of health care quality reports even when they’re available. If anything, consumer reliance on such reporting is dropping. According to the Kaiser Family Foundation : Fewer U.S. residents use Web sites that rate health services when selecting insurance plans, hospitals or physicians, according to state and national studies… A survey released in October by the Kaiser Family Foundation found that fewer than 15% of U.S. residents used quality ratings services to help them make decisions about health insurance plans, hospitals or physicians, compared with about 20% of people who said they had used comparative quality ratings in 2004 and 2006. Most people said they never have seen or used comparative quality information services, the survey found… Bryan Liang, executive director of the Institute of Health Law Studies at California Western School of Law, said, “The basic problem of these kinds of ranking systems is that patients do not choose on the basis of scores,” adding, “They choose on the basis of personal familiarity and experience with the health care entity or provider” It sure sounds like consumers need more education to act on the information that’s out there. The CMS website Hospital Compare has even been running an advertising campaign to encourage consumers to make use of such data. But maybe consumers are rational to ignore quality ratings, at least for hospitals. An article in the current Health Affairs (Choosing The Best Hospital: The Limitations of Public Quality Reporting ) reveals why this may be so. The authors identified five public reporting services (Hospital Compare, HealthGrades, Leapfrog Group, US News and World Report, and Massachusetts Quality and Cost Council) and used them to compare various Boston-area hospitals on four non-emergent conditions: community acquired pneumonia, total hip replacement, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). The services provided wildly inconsistent rankings, even on the same measures. For example: …the two hospitals ranked first for CABG by at least one service were also ranked fourth and last by another… Conversely, the two hospitals that were ranked last for CABG by at least one service were ranked first or second by another. But even more damning than that is that the ratings don’t reveal any serious differences. Most rating systems did not perform statistical tests, but when they did, all nine hospitals were indistinguishable. In fact only one hospital (out of 71) in the state had cardiac mortality that was statistically better than the mean. It’s actually even worse than that. The scores for each hospital represent an average across physicians and cases. Who’s really able to say what the quality will be for a given patient with a given doctor? Considering the state of the art, no wonder people rely on personal experience, relationships, and anecdotes when choosing a hospital? By the way my preferred way to choose a hospital or physician is to speak to the fellows, or –better yet– have a family member who’s a doctor do so. Fellows are in the best position to see and understand what really goes on, and are still young and idealistic enough to level with you about it. I admit this is not a practical route for most people, but that doesn’t stop me from recommending it. |
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