Grand Rounds: Health Business Blog-style

FoIB David Williams hosts this week's extensive round-up of great medblog posts. As usual, he adds his own unique perspective (and dry wit) to each post. Do stop by.

Conflicting Messages

What might these two seemingly unrelated items have in common:

TNR's Maisie Allison tipped us to "How American medicine is destroying itself." It begins with a 50 year old quote stating that "complete and lasting freedom from disease is but a dream remembered from imaginings of a Garden of Eden."

The question at the heart of the article is quite simple, really: Can we really conquer disease? At what price?

We've had a War on Poverty, a War on Drugs, a War on Illness. Untold billions (trillions?) of dollars later, victory has still not been achieved (and yes, defining "victory" is another challenge altogether). Are we spending our resources wisely?

Let's continue, shall we?

FoIB Bob D alerted us to this Policy Digest essay which asks "Will Comparative Effectiveness Research Kill More People than It Helps?"

The premise of this piece is that, among the myriad of potential treatment options available for a given diagnosis, it's often challenging to determine which one is the most effective. The process by which this is determined is called Comparative Effectiveness Research (CER), and it's one of the New, Hot Things© on the health care radar.

It's also the subject of a major push by the Feds to generate more cost effective health care results.

But will it?

According to a study by folks at the University of North Carolina (Hi, Jeff!) and the Center for Medicine in the Public Interest, the answer is a resounding "Nope:"

"Instead, it will force cuts in pharmaceutical and medical device research and development, resulting in 32 million lost years of life and economic losses totaling $1.7 trillion."

And why is this?

Well, here's a clue:

"Health care costs are the focus of most policy considerations because this demand is heavily subsidized by taxpayers."

Ya think?

I believe that there are some dots that can be connected here. How about you?

HHS, Privacy, and Your PHI

HHS Secretary Shecantbeserious may be relaxing some privacy rules:

"The Department of Health and Human Services says patients should have the right to see who has accessed their electronic health records."

The advent of HIPAA dramatically changed how I do business. For one thing, I can no longer routinely call up clients' docs to ask for help with medical records. It's more difficult (and time consuming) than ever to get answers from a home office. Keeping up with all the privacy rules threatens to become a second vocation.

But I don't feel any more secure, and I'm not convinced that my clients do, either. And I'm not sure that the new rules (as proposed) do much to allay those concerns:

"(P)eople would be able to request an "access report," which would name the particular persons who viewed their electronic health records ... it would not explain the purpose of that access."

If anything, I think this would engender even more distrust about the use of our private health information.

HHS Touts PCIP Success

Kaiser Health News reports that 20,000 have enrolled in the government PCIP (Pre-existing Condition Insurance Plan) for high risk individuals.

PCIP has been around almost a year.

HHS estimated 4,000,000 were eligible for PCIP and 200,000 would enroll.

In 10 months they "sold" 20,000 policies to 4,000,000 needy individuals.

Back in 2009 the government sold 700,000 cars in 6 weeks to needy individuals as part of Cash for Clunkers.

Why don't they get out of the health insurance business and in to the car business?

ACO, Hold the Mayo

Part of Obamacrap calls for the establishment of ACO's (Accountable Care Organizations). The idea is these providers will deliver equal or better care at lower prices than the traditional health care model.

Kaiser Health News reports a hold out in the ACO race.

The Mayo Clinic says it will not be part of a critical piece of national health care reform under the government's proposed rules. The prestigious Rochester clinic is raising questions about accountable care organizations, or ACOs, which are supposed to be updated — and better — versions of health maintenance organizations. Approved as part of the 2010 health care law, they are designed to improve care and cuts costs by over half a billion dollars a year. But Mayo says the proposed regulations from the federal Centers for Medicare and Medicaid Services (CMS) conflict with the way it runs its Medicare operations, which treat about 400,000 patients a year

Give me and ACO but hold the Mayo.

Grow Up

Obamacrap made it possible for children to stay on their parents plan until age 26. This is past the age when they can legally drive, vote and drink adult beverages.

So why does DC still consider them children?

CNNMoney has this comment.

The government had hoped that extending the age for dependent coverage to 26 would drastically reduce the large number of young adults who do not have any health care coverage.

But the survey's results show that parents, already facing higher costs to cover their families, are put off by the additional costs of taking advantage of the new provision.

Well why didn't Washington just make it a REQUIREMENT that parents buy health insurance on their children?

sometimes it costs less to buy an individual plan for an adult child than to add them to a parent's plan, especially if the child lives in a region not covered by the parents' doctors or provider networks.

In most cases this is true, but some college students already have a number of issues that cannot be solved in the individual health insurance market.

I have had parents contact me about coverage on their college student children only to discover the student admits to using marijuana and other illegal drugs, has a DUI, or has psychological problems such as anxiety or depression and taking expensive medication. So in some cases they cannot get insurance and in others the cost is prohibitive to cover the pre-existing conditions.

There are also parents that call looking for health insurance for their pregnant college student.

Sorry, it doesn't work that way. You buy insurance BEFORE you need it.

So what we see is few college students buying coverage on their own and the ones going on mom & dad's insurance are those that can't get private insurance in the open market.

The eHealth survey of 500 parents of full-time college students and recent grads shows just how uneasy parents are about the costs of the new provision.

43% of parents would keep their adult kids on their plan only if it was free.
38% of parents said they don't plan to keep their kids on their health insurance plan until age 26.
30% said less than one year was the fairest amount of time to provide adult kids with health insurance.
56% said they would either not provide any financial assistance at all or do so for one year or less.

Not so surprising.

Free is what many seem to expect when it comes to health insurance. Especially Obamacrap.

Shame Insurance?

What would you pay for the opportunity to hit the "unsend" button on that blistering email you sent in a fit of pique? How about accidentally forwarding that naughty pic? To your boss?

"Internet Shame Insurance is a very simple Google Chrome extension that adds privacy reminders ... to help you avoid the most common online communication faux pas. The extension sits in the background and springs into action only when you're about to post a status update or reply all."

[Insert NY CongressCritter reference here]

[Hat Tip: Ace of Spades]