Wednesday, April 29, 2009

Health Wonk Review--The Best Health Care Posts on the Web!

This week it's my turn to host Health Wonk Review, a regular review of some of the best health care posts on the web.

Veteran Henry Stern starts things off this time with a timely discussion about just who should have the most say about your health care. If someone else (say, the government) is paying for your health care, how much say should your own doctor have? InsureBlog's Stern explores a recent court case that looks to determine just that in a post called, "Compassionate Gummint Care."

A big issue in Washington these days is Medicare physician compensation. Some might be surprised to know even a small change to Medicare payments has a big impact on the private market--even workers' compensation. Joe Paduda at Managed Care Matters presents, "Medicare's changes to physician compensation; the impact on provider and provider networks" here.

This week Shahid Shah responds to inquiries about why healthcare IT is in the state that it's in. He reminds us why it's not the Doctors' fault and that just money dumped into technology budgets won't help without reworking incentives and the financial side of health care. Shahid N. Shah gives us, "Why Health Care IT is in the state that it is in", at The Health Care Blog.

Indian doctors developed an open heart surgery procedure where the patient is still awake. Health IT use in India is 60% compared to only 20% in the U.S. The Healthcare Economist reviews these and other interesting facts in his post "Health Care in India." Jason Shafrin writes about it in, "Health care in India" posted at Healthcare Economist.

Jerome Groopman and Pamela Hartzband decry the overreaching quality metrics that force physicians into standardized practices that are not always in a patient’s interests. They have a point, but Dave Williams argues they are too dismissive of the patient safety concerns that got us to this point. David Williams presents, "Quality and danger" posted at Health Business Blog.

Glenn Laffell, at Pizaazz, suggests the "ironic possibility that Big Insurance, which helped derail HillaryCare in '93, "is now threatening to do the same thing this time around...and it may just be able to recruit an old ally in its resistance movement...providers" in his post, "They're Baaack."

Over at Supporting Safer Healthcare, Rita Schwab notes, "Healthcare metrics are ubiquitous, but are they always helpful?" Rita Schwab presents, "Quality and Metrics, Finding the Right Mix."

In Colorado, Jay Norris discusses his state's debate over creating a one-state single-payer health plan in, "Colorado Single Payer House Bill Abandoned" over at Colorado Health Insurance Insider.

Health 2.0 is big and getting bigger. Kelly Sonora writes about it in, "25 Excellent Social Media Sites for Your Health, posted at Nursing Assistant Guides.

David Harlow was on the organizing committee of HealthCamp Boston, held last week in conjunction with SocialPharmer Boston, the day before the Health 2.0 conference. HealthCamps are unconferences looking at the use of Social Networks, Open Standards and the latest Internet and Mobile Technologies in the transformation of Health Care. He offers an archive of the live tweets from the event, "HealthCamp Boston/SocialPharmer Boston Twitterstream via Cover It Live."

"Swine Flu Meets Workers' Comp!" Jon Coppelman tackles looks at the issue of whether workers comp benefits will cover swine flu over at Workers Comp Insider.

Do as I say not as I do? "Here's a bit of irony for you. Dr. Jacques Chaoulli, the Montreal doctor whose lifelong goal has been to loosen restrictions on private funding for health care in a public system with long wait times, was found to have acted irresponsibly by not treating a man quickly enough at the private clinic where he was working." Sam Solomon presents, "Waiting-room death triggers review of Quebec private clinic rules" posted at Canadian Medicine.

"How Much Can Comparative-Effectiveness Research Do?" Ken Terry has a post about the "disingenuousness of both sides in the comparative effectiveness research debate." He uses the current controversy over virtual colonoscopy to make the point that scientific evidence is not always sufficient to overcome political pressure on the BNET blog.

Democrats win the option to consider health care legislation under "reconciliation" rules, meaning they need 50 votes -- not 60 -- to pass reform. Jonathan Cohn thinks, "This is a game-changer and, paradoxically, could actually increase the likelihood of bipartisan action." Jonathan Cohn presents Reconciliation: This Changes Everything posted at TNR's The Treatment.

"A comprehensive national reform plan should include a definition of basic benefits, but the task of designing the package faces serious policy dilemmas and political obstacles. Historically, the debate has been framed as affordability vs. comprehensiveness. Fortunately, a new strategy has emerged in recent years: value-based benefit design." That's Bill Kramer's message in, "Skinny or Rich? Benefit Design in National Health Reform."

Here's a post that highlights new articles and research about eliminating "junk" insurance, and the need to define what "coverage" means in the context of federal health reform's efforts to expand, mandate, and secure "coverage." Anthony Wright offers, "Coverage that counts..." posted at Health Access WeBlog.

Francois de Brantes and Lawton Burns argue that changes to the payment system, and the process through which clinical integration emerges, must drive changes in the organization of the delivery of care, and not the other way around in a post at Health Affairs Blog, "Payment Reform Should Drive Delivery System Reform.",

The Health Care Blog, nominated David Kibbe and Brian Klepper's article for this edition of HWR, "An Open Letter to the New National Coordinator for Health IT: Part 2 - Opening the Aperture of Innovation." [An article that also appeared on this blog.]

This article, the 2nd in a series concerning the health IT portion of the Obama stimulus, HITECH, looks at the risks associated with tying the electronic health record industry to vendor-specific technology. Using examples from Apple's iphone applications and AT&T, Kibbe and Klepper state, "limiting the kinds of devices and software applications that can handle standardized health care data to a few government (or government agent)-certified products would dramatically stifle innovation and utility while raising (or at least maintaining) costs."


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