Health Wonk Review – Valentine’s Day Edition: Here’s Your Heart!

By Peggy Salvatore, MBA

Healthcare Talent Transformation blog contributor

Readers note: All images in this blog were taken from the web and are in the public domain. No proprietary images were used.

Our intimate relationships are a lot like our nation’s healthcare system. Okay, maybe not, but this is, after all, the Valentine’s Day edition of HWR, so how about if you play along and we pretend to find analogies anyway?

Dependable, strong, with a firm foundation and a bright future:  If this describes our healthcare system to you, here’s your heart:

But seriously, for the rest of us, let’s look at what’s really going on.

Not everyone is enamored with the way our health system is run today or is looking forward to the changes anticipated by health reform. Bob Vineyard at Insureblog registers his skepticism in HIX and ObamaCare  where he sounds unsure whether the government can deliver on its promises. If you’ve been burned and are worried about getting burned again, here’s your heart:

More developments on aspects of healthcare implementation, as Louise at Colorado Health Insurance Insider tell us that a move to repeal the health insurance exchange in the Rocky Mountain state fell far short of the support needed to undo it. Louise writes, "Given all of that, and given the progress that Colorado has made over the past two years in creating the state’s marketplace and implementing various other healthcare reforms (both state-based, like maternity coverage and gender-neutral premiums, and ACA-related, including the recent push to expand Medicaid), I would say that Colorado is on track to greatly improve its overall healthcare outcomes. Efforts to set the state back to square one in terms of reform efforts are probably politically motivated rather rooted in any real attempts to bring about real healthcare improvements for the people of Colorado."

Challenges to Obamacare are wending their way through the courts. Maggie Maher at Healthinsurance.org tells us in her post IRS ruling a ‘disaster for Obamacare?’ Not quite.  The claim that – as a result of an IRS ruling – “millions” will be left uninsured under Obamacare is “fear-mongering, pure and simple,” says blogger Maggie Mahar. In her posts, Mahar rejects the arguments of a February 4 Forbes article that she says plays right into the conservative claim that Obamacare is "a disaster."

For the young and young-at-heart, at California Access Health the opinion on Obamacare is more positive as Anthony Wright tells us that despite a recent infamous article in Buzzhead, there are some obvious and non-obvious reasons why Obamacare is a boon to young adults.

For more on Obamacare, John Goodman at Health Policy Blog wants to take a balanced approach to health reform and try to find something for everyone. Here is John Goodman’s piece, Why I Am More Egalitarian Than Most Liberals on Health Care.  John offers solutions to health care reform that meet the criteria of both liberals and conservatives.

Do you need help sorting through the fine points of the doc payment debacle brought to you by the Resource-Based Relative Value System Update Committee, or RUC, that arcane AMA committee that sets physician rates? Then here’s your heart,  as Dr. Roy Poses over at Health Care Renewal  explains how the committee is weighted toward specialists  who value procedures and devices over the cognitive services delivered by primary care physicians. This week he discusses the negative affect that has on reimbursement rates for PCPs. It’s a thorough discussion of a difficult issue.

Julie Ferguson at Worker’s Comp Insider states, "A worker's first day at work shouldn't be his last day on earth." Studies show that approximately 27 percent of job-related fatalities involve employees who have been on a new job for less than 90 days. Julie talks about the case of an untrained temporary worker who suffered a gruesome death on his first day on the job in a Bacardi bottling plant in Florida.

Also on the labor front, the NLRB has issued a series of reports based on its decisions in cases regarding employer regulation of the use of social media by employees. Now that the validity of recess appointments to the NLRB has been upended by the DC Circuit Court of Appeals, these – and many other – NLRB rulings are technically invalid. Should health care employers therefore ignore the NLRB precedents on regulating social media? David Harlow of HealthBlawg says no – the contours of the rules should still be followed in sensible social media policies.

Over at Disease Management Care Blog,  Dr. Jaan Sidorov warns his fellow physicians that non-physician professionals and lay-persons are managing to achieve a remarkable degree of medical expertise. He strikes a neutral tone with this controversial topic, but in the meantime wonders if "care management" is one way for consumers to sort it all out.

Disease management, testing and drugs go hand-in-hand, and at Health Affairs Blog, David Rothman analyzes studies that show people are unwilling to forgo testing and drugs in the interest of appropriate utilization, even when experience shows no real benefit to higher levels of utilization. In his post, he talks about the reluctance of Americans to consider evidence that certain medical tests and screenings might be unnecessary, harmful, and not worth the money (although he points out that Americans are more suspicious of drugs): "When we asked [focus group participants] about specific recommendations by professional medical societies and the U.S. Preventive Services Task Force that, for example, women between the ages of 40 and 49 should forgo mammograms or that older men might not want to take a PSA test, participants were not merely dismissive but disdainful...These kinds of recommendations, many of them believed, were part of a plot to save money and they refused to give them credence."

Stretching our Valentine’s Day metaphor nearly to the breaking point, we ask the question: Is nursing home patient care better when the nursing home is doing it for the love, not the money? More accurately, do non-profit nursing homes really provide better care than their for-profit counterparts?  Jason Shafrin at  Healthcare Economist analyzes a study that shows that, when controlled for proximity to the patient’s home, non-profit nursing homes fare better, using measures like changes in ADL functioning and hospital readmission rates, than for-profit nursing homes.  For those nursing homes that aren’t in it for the money, here’s your heart:

You might have other kinds of concerns of the heart. If you suspect that your loved one is inclined to deceit, perhaps this blog will strike a chord for you. Joe Paduda  in IRS, Health Care Premiums Under ObamaCare and Right-Wing Distortions at Managed Care Matters dissects inaccuracies in the press accounts of the projected cost of health insurance under health reform. That $20,000 price tag for health insurance for a family of four being thrown around in the press just ain’t so, says Joe. If you’re wondering who might be hiding something, here’s your heart:

As you’ll see from our next entrant, Brad Flansbaum at the Hospitalist Leader, I had a tough time deciding who would get the question mark heart. In Blink Twice, Rub Eyes: QI Floaters and Spots, Brad has literally assembled a collection of snapshots from studies that show how some of our most touted and expensive efforts to improve patient care are, at best, inconclusive and, at worst. totally useless.  It’s an impressive collection of unimpressive results. Since Brad’s question mark heart went to Joe Paduda, I guess we’ll call it a wrap.

From those of us at Healthcare Talent Transformation to all our fellow HWR bloggers, here’s your heart:

Take a look at my last blog post on the effect of training and change management on meeting federal standards for health IT here, Training and Change Management Maximize Our Investment in Health Information Technology.

Thank you for the opportunity to host Health Wonk Review. I can be reached at Peggy.Salvatore@healthsystemed.com or peggy.salvatore@gmail.com.

Comments

[hgstern]

Oh my gosh - GREAT job, Peggy!!

Thanks so much for hosting, and for including our post (and in the top position, no less!).

[Jonena Relth]

Thanks Peggy,
As always, your healthcare coverage is balanced and well played!
Awesome job!

[IT Consultant Dallas]

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