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Massachusetts health care — wonky, with a healthy dose of reality

US health policy

Atul Gawande on Health Reform Inaction

Atul Gawande, surgeon at Brigham & Women's Hospital, author, MacArthur "Genius" award winner, and veteran of the Clinton health care campaign, tries to diagnose the political challenge to health system reform in today's NYT (subscription required). Admirable effort. Here are some excerpts: As a surgeon, I’ve seen some pretty large tumors. I’ve excised fist-size thyroid cancers from people’s necks and abdominal masses bigger than your head. When I do, this is what almost invariably happens: the anesthesiologist puts the patient to sleep, the nurse unsnaps the gown, everyone takes a sharp... Read more »

Disease/Care Management -- Preliminary CMS Results Not Promising

For nearly a decade, lots of folks (we included) have been pointing to disease and care management strategies for the chronically ill as an important direction to improve quality of care and lower/control costs. Preliminary results are in for the largest evaluation of this approach to date, and the results are ... disappointing. In 2002, the federal Centers for Medicare and Medicaid Services (CMS) picked 15 demonstrations (out of 53 applications -- none principally in MA) to test the worth of a variety of approaches in the Medicare fee-for-service population. The Mathematica Policy... Read more »

Health Reform Travelogue: Learning in OK What Might Have Been

Friday at the University of Oklahoma on a MA health reform panel: yes, they want to understand what we did. Oklahoma has about half the MA population (3.4 million) and more than 600k uninsured (over 20%). Hosted by UofO President David Boren. Health policy trivia – how many remember Sen. David Boren and the Boren Amendment? Answer below. Four speakers at the Forum: me, former MA HHS Sect. Tim Murphy, Georgetown Health Policy Dean Judy Feder, and Cato Institute Michael Tanner. Here was the most interesting part for me. Murphy gets to ask me a question, and he notes that in Romney’s... Read more »

The New and Emerging Politics of National Health Reform

Check out this excellent New York Times Magazine story from last Sunday on the unusual alliance between Oregon Senator Ron Wyden and Safeways Supermarket CEO Steve Burd that led to introduction of Wyden's national health insurance scheme earlier this year. Read more »

SCHIP Reauthorization -- The Fight Is On

Great Robert Pear article in today's New York Times on the rapidly developing fight between the Bush Administration and Congress over reauthorization of the ten year old State Children's Health Insurance Program (SCHIP): "The Bush administration says it will strenuously resist Democratic plans for a threefold expansion of the Children’s Health Insurance Program, ensuring a clash with Congress over the most important health care legislation being considered this year." Yahoo! Make our day. Bush wants unlimited dollars for war. Bipartisan leaders in Congress want to triple money to get... Read more »

Dems Debate/Discuss Health Care -- Does It Matter?

If you missed it, click here to access portions of Saturday's health care debate by the Democratic presidential candidates, sponsored by the Center for American Progress and the Service Employees International Union. Basically, every candidate endorses one form or another of universal coverage for all Americans during their first term. Hilary Clinton reiterated her stance yesterday: Read more »

Leavitt's Delusion -- and Our Burden

Rant time. Friday’s Kaiser Health Policy Summary contains a report on US DHHS Secretary Mike Leavitt testifying to Congress why the feds should not cut payments to Medicare Advantage plans – even though it is thoroughly documented that these plans (designed to save taxpayers money by managing care) actually cost up to 10% more per enrollee than “wasteful” fee for service. Leavitt’s comment: “There are those who want the government to do the market’s job,” Leavitt said. “The president and I are for competition. If the world has learned anything from the 20th century, it is that the... Read more »

On the Revised Estimate of Number of US Uninsured

Good statement from Commonwealth Fund President Karen Davis on the new revised estimates of the number of US uninsured released yesterday by the Census Bureau. Bottom line -- no big deal. But this should serve as a cautionary tale to anyone who takes any estimate of the uninsured -- federal, state, private -- as 100% reliable: "While the new Census Bureau figures on health insurance released today reveal that the 2005 estimates were lower than previously reported, they nevertheless affirm that the number of Americans without insurance has risen rapidly since 2000. The new figures also help... Read more »

Dem Pres Candidates to Debate Health Care This Saturday

Already? Yup. This Saturday, seven candidates for the 2008 Democratic presidential nomination will participate in a "Presidential Forum: New Leadership on Health Care" sponsored by the Center for American Progress and the Service Employees International Union. You can watch it live via the web. The three front runners -- Clinton, Obama and Edwards have all endorsed universal health care, though only Edwards has released a detailed plan. Click here for the website if you want to watch this Saturday at 12:15pm (EST) from the University of Nevada. You've got nothing better to do, right? Read more »

NYT Poll -- The New Health Reform Wave Keeps Growing

If you missed it, see the New York Times article yesterday detailing results from a national survey indicating a strong majority of Americans want national health reform and a government backed guarantee of universal coverage. Click here if you would like to see a short video presentation of the results. About half are willing to pay $500 or more in new taxes to make the guarantee real. And more are willing to see the Bush tax cuts repealed. And a whopping 84% support expanding the State Children's Health Insurance Program (SCHIP) to cover all uninsured kids. Read more »


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