Committee Faces Economy and Health Care Issues

The Energy and Commerce Committee's health subcommittee in the U.S. House of Representatives is examining the state of federal health care programs, including Medicaid, which have suffered due to budget shortfalls at the state level. These budget shortfalls are caused by the current downward spiral in the financial sector.

This examination comes on the heels of nationwide cries for assistance from governors across America. As belts tighten everywhere, the impact is felt in our already ailing health care system.

From the Associated Press via Forbes:

While health care is typically seen as the one part of the economy least affected by downturns, recent reports show the financial meltdown already is affecting health care decisions.

Almost one third of patients surveyed by Kaiser Family Foundation last month said they had skipped medical treatment, up from 24 percent in April. Drugmakers like Pfizer Inc. (nyse: PFE - news - people ) also have reported fewer prescriptions are being filled compared with this time last year.

It's a good thing that there are several plans being developed to reboot the system in Congress right now. With a reform-minded President on his way in, one who has already stated that health care is a top priority, the time is right. Besides, as I have commented in the past, fixing some of the cost issues currently burdening the system will have significant impact on the overall economy.

Remember, health care accounts for a lot of US spending....

SOURCE: "Ahead of the Bell: Health care hearing" 11/13/08
photo courtesy of Janie-Jan, used under its Creative Commons license

Health Care in Congress

With almost two and a half months until President-Elect Obama takes the Oath of Office, the U.S. Congress is already ramping up a number of plans to address the health care crisis.

Robert Pear of The New York Timesreports:

Without waiting for President-elect Barack Obama, Senator Max Baucus, the chairman of the Finance Committee, will unveil a detailed blueprint on Wednesday to guarantee health insurance for all Americans by facilitating sales of private insurance, expanding Medicaid and Medicare, and requiring most employers to provide or pay for health benefits.

President-Elect Obama's aides have stated that he welcomes congressional efforts and has encouraged that body to take the lead on this high priority issue. Sen. Baucus, who we have been following here for some time, calls for universal coverage as the final goal. He is not the only one drafting proposals of this nature, however; several others from his own party have ideas in the works as well.

Other Democrats with deep experience in health care are also drafting proposals to expand coverage and slow the growth of health costs. These lawmakers include Senator Edward M. Kennedy of Massachusetts and Representatives John D. Dingell of Michigan and Pete Stark of California.

While each proposal is going to be unique, Mr. Pear says that they will all be "broadly compatible," with the President-Elect's stated positions on the subject. The Baucus plan would go one step further with its universal coverage goal; President Elect Obama's approach would only mandate coverage for children.

It looks like we will be seeing a plethora of options presented soon, a huge step forward as we move towards Health Care Reform Now!

SOURCE: "Senator Takes Initiative on Health Care" 11/11/08
photo courtesy of Kimberlyfaye, used under its Creative Commons license

Warrior Care Month: U.S. Veterans and Mental Health

One of the things that made growing up "interesting" was the fact that my father came home from Vietnam suffering mental health issues. Without going into detail, let's just say that it made me acutely aware of how important the issue of mental health care for our nation's veterans truly is.

So, as we advance towards the advent of a new administration, it is wonderful to see that others are raising awareness of the issue. With the promise of an extensive reboot of health care, the viability of which has yet to be tested, it is important to not let this one aspect get left behind.

According to this press release, the American Psychiatric Association (APA) is working hard to keep this issue on the radar. Their efforts are going into overdrive right now because thanks to the U.S. Department of Defense, November has been named Warrior Care Month this year.

The APA joined other mental health organizations today in recognizing Give an Hour, a national grassroots network that provides free mental health services to military members and their families.

"Not all wounds are physical. There are those hidden injuries that impact the mental health of soldiers, their friends, families and dear ones," said Carolyn Robinowitz, M.D., APA past president at the press event. "All wounds need attention, and a soldier's mental health wounds are no different. The combat experience presents a multitude of challenges to service members -- challenges that persist and affect those with whom they interact."

In addition to Give An Hour, the APA has compiled an array of resources on issues such as post-traumatic stress disorder (PSTD), depression, and other issues facing veterans on www.healthyminds.org. Recent studies by the RAND Corporation indicate that over a third of our troops return from combat with some level of mental health issue.

SOURCE: "Veterans Day Highlights Need for Military Mental Health Care" 11/10/08
photo courtesy of KimberlyFaye, used under its Creative Commons license

Digital Medicine, Intel, and the Common Platform

In 1999, there was a research study called "The Future of Fun" that examined trends in digital entertainment across 100 homes in the United States and Europe. An unexpected surprise was found amongst the results. Users asked for ways to help manage the chronic health problems of elderly relations, especially those geographically separated by great distance. Eric Dishman, who spearheaded the study, shopped these results to Intel, efforts which eventually led to the genesis of the company's Digital Health Group. Now Dishman, a social scientist, is director of product research as a result.

The reason I am pointing all this out is simple. Intel is making a push to be the first on the ground offering integrated home health serves.

Via Rick Merritt at EETimes:

The Intel Health Guide is a PC customized to monitor vital signs and deliver health services to elderly patients managing chronic health conditions. Based on an Intel motherboard, the system is designed to be simple enough for technophobic users but robust enough to have received FDA Type 2 certification in August, a first for the company.

Intel provides the software to run both the new device and computers used by health care professionals to track and communicate with patients using it. The chip maker will even host those services and provide consulting to health care groups who want to set them up.

So here we have a fusion of two of my favorite topics: electronic medical records and care for chronic conditions. Attention to either of these subjects stands to reduce the overbearing cost of health care in this country; the combination of both could be a great boon.

With the Baby Boomers entering retirement at ever increasing rates, the market for this sort of device and interface will expand almost exponentially. In pure business terms, it is massive.

The move is an effort to define a common platform for the emerging field of remote health care expected to reach $5 billion in 2010 and explode to $34 billion by 2015, according to a recent report. It also marks a major expansion for Intel which has been studying the health care market for several years, but to date focused on defining systems and standards.

Looks like the game is changing. The Perfect Storm for health care reform spoken of by George C. Halvorson seems to be gaining strength!

SOURCE: "Intel rolls health care system and service- Chip maker hopes to set platform for personal care" 11/09/08
photo courtesy of k0a1a.et, used under its Creative Commons license

A Thought on Health Care Spending

As is needed in these troubled times, President-Elect Barack Obama is marshaling his forces for January 20 when he is is sworn into office. As that time approaches, it will be interesting -- as it is with any new resident of the Oval Office -- to see what elements of his health care platform will make it into actuality.

Our President-Elect certainly has an awareness not only of the importance of health care issues, but also an awareness of how important it is to his constituency. This is demonstrated by the amount of ad spending his campaign engaged in that addressed health care issues.

Via Jacob Goldstein on the Wall Street Journal (Oct 25, '08):

Barack Obama is going big on health-care advertising. He’s spent $113 million — 68% of his total TV ad budget — on commercials that include a health-care theme. Only 13% of John McCain’s TV ad spending has gone for health-related commercials.

By spending more than half his ad budget into health care, the Obama has created expectations that he will have to follow through upon. I predict we will be hearing a lot more about electronic health records soon!

SOURCE: "Obama Has Spent $113 Million on Health-Themed Ads" 10/24/08
photo courtesy of iChaz, used under its Creative Commons license

Post Election: Health Care and The Obama Administration

President-Elect Barack Obama will be taking the reigns on January 20, 2009. He takes office amidst a veritable hailstorm of crises: the financial meltdown, the housing meltdown, the wars, and, according to voters, health care.

Rebecca Ruiz over at Forbes brings us a recap of Obama's plans along with an examination of what the next steps will be and what direct effect we will experience. In one of the first of what will no doubt become an endless stream of speculation between now and January 20, she explores the pros, cons, and unknowns of the subject.

One particularly telling quote in her article comes from John Sheils, senior vice president of the Lewin Group, a health care policy research company in Falls Church, VA:

Sheils' analysis found that Obama's plan would decrease the number of uninsured by 26.6 million beginning in 2010. The estimated federal cost of enacting the plan is $1.17 trillion from 2010 through 2019. By 2010, annual spending on health care is expected to reach $2.7 trillion. But Obama's plan is expected to cut spending by $54.1 billion in the next decade. The savings are important, but regardless, the price tag is staggering.

Another thing that Sheils notes is that one crucial flaw remains unaddressed, a crucial flaw that George C. Halvorson has expounded upon in his most recent book: incentives. Currently, incentives in the health care industry are geared towards care services and procedures performed instead of being based on actual health results.

This article is particularly advised reading, especially for its last few paragraphs where Ms. Ruiz looks at the potential interactions on this subject once Obama is sworn in and the discussion moves to the floor of Congress.

On the whole, it seems like there is positive news in the wind.

SOURCE: "What Obama's Health Care Plan Means For You" 11/05/08
photo courtesy of realjameso16, used under its Creative Commons license

The President Elect Faces Hard Work On Health Care

So history has now been made. On January 20, 2009, our 44th President will take his place as Commander-in-Chief. That man will be Barack Obama. With the vast majority of health care organizations backing his plan, and a seeming mandate from the people, he should be in a position to rapidly enact change, correct? Well.....no. Not really.

You see, like everything in life, health care reform is going to cost. With $700 billion recently allocated to the financial bailout, I would be willing to wager that purse strings are going to be a bit tight. Then you add in the $455 billion budget deficit. To be blunt, I think it could be a fight for every penny. Of course, the one thing that is a huge variable, as his winning campaign has shown all along, is President Elect Obama's seeming mandate from the people. How much leverage will that give him with Congress?

Maggie Fox, Health and Science Editor over at Reuters shares some optimism from the Senate floor:

But Senate Majority Leader Harry Reid predicted the momentum for change would be there. "We have no alternative," Reid told National Public Radio on Wednesday morning. "A wave of hope has swept the country."

Reid said Republicans would not dare to block legislation, given Tuesday's voter mandate.

The next few months are going to be very interesting....

SOURCE: "ANALYSIS-Even with mandate, Obama faces health care pain" 11/05/08
photo courtesy of EricaJoy, used under its Creative Commons license

Electronic Medical Records

Shari Roan of the Los Angeles Times thinks that "[i]f ever a case was made for electronic health records, perhaps this is it." The reason? A Canadian study of over 3,000 patients on the subject of continuity of care and patient/doctor communication. The primary finding of that study is that when tracking records, only 22% of them are available between visits to two or more health care providers. That's roughly one fifth; not much continuity in the care there.

Via Ms. Roan's article:

"We believe that poor exchange of information between physicians caring for the same patient may be detrimental to the quality of patient care," said the authors of the study, from the Ottawa Health Research Institute. Sometimes, doctors use hand-written notes that are difficult to transfer, the study noted. Other times, doctors aren't aware of visits to other doctors or they may think the records from previous visits aren't necessary.

If all physicians and other health care providers have to access the same consistent system in order to read a person's medical records, the chance of data slipping through the cracks reduces drastically. Once the immediate rush of post-election craziness dies down, I look forward to seeing what our new Commander-in-Chief plans to do in regards to EMRs. At least we knew going into it that both sides backed the idea from the beginning.

SOURCE: "Canadian doctors don't share their patients' records either" 11/03/08

Photo courtesy of Sirkully used under its Creative Commons license

Health Care Reform Research on Election Day

Okay, folks. As someone who has become addicted to using his iPhone for web surfing when stuck in lines, I'm going to provide an election day resource list for those of you doing just that. Here are some of the pertinent pages available online so that you can do any last minute research while waiting for your opportunity to be part of the process. With record level voter turnout expected, and long lines across the nation during early voting a few days ago, I am willing to say it's a safe bet you may find some time on your hands.

• Scott Whipple of The New Britain Herald takes a look at likely outcomes for health care should either side win. [link]
• Channel 6 Action News, an ABC affiliate, provides video comparing the candidates' plans. [link]
  
• Paul Krugman compares the plans in an Op-Ed for The New York Times. [link]
• The AP Fact Check article by Calvin Woodward covers many issues as well as health care [link]
• The Kaiser Family Foundation's Daily Health Policy Alert [link]

Let us hope that we all have the opportunity and the motivation to participate in this election. No matter which way things go, it will have a drastic impact on health care for every American. In the meantime, I hope that some of today's post is useful for the iPhone, Blackberry, and Google Phone set!

Thank you for being part of the process! Let us hope for a healthy four years!

photo courtesy of SanFranAnnie used under its Creative Commons license

American Hospitals Rated

Grades are in on American hospitals, and while not horrible, they are also far from exceptional.

The American public has been queried about their satisfaction with our nation's hospitals in the first nationwide survey of its kind and their opinion is not stellar. Called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the survey was created by a public-private partnership including a wide variety of agencies. (The Centers for Medicare and Medicaid Services and the federal government's Agency for Healthcare Research and Quality are central players in this partnership.)

Conducted in roughly 60% of all United States hospitals during a timespan running between July '06 and June '07, the HCAHPS polled patient perceptions of the health care they received. The survey itself was conceived to assist in crafting hospital policies while also helping provide consumer tools allowing informed heath care decisions.

The eight areas of patient perceptions covered in the survey were:

• Communication with doctors, communication with nurses
• Quality of nursing services
• Communication about medications
• Pain control
• Information received when leaving hospital
• Were hospital rooms were clean and quiet.
  

While the survey respondents were not glowing in their praise for our hospitals, they did reveal some surprising things. Ashish Jha is the assistant professor of health policy at the Harvard School of Public Health and lead author on the NEJM paper that analyzed the survey data. His analysis of the data collected brings some interesting details to light.

Via Laura Blue of TIME Magazine:

Jha's analysis of the data found that patients liked not-for-profit hospitals more, on average, than for-profit hospitals. Institutions with more nurses per patient were also more popular than those with fewer. And, on the whole, the hospitals that scored better according to the survey were also those that performed better on more traditional measures of clinical performance, such as providing the appropriate emergency treatment for heart attack or correctly following procedures designed to reduce risk of medical error.

If you want to find and compare hospitals using the data unearthed in this study, you can do so on the Medicare site here.

SOURCE: "Patients Give U.S. Hospitals So-So Marks" 10/30/08
photo courtesy of Jose Goulao, used under its Creative Commons license