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

US health policy

John Kitzhaber's Archimedes Movement

For 20 years now, John Kitzhaber has been one of the most interesting individuals in U.S. health policy. An emergency room doc, Oregon State Senate President and two-term Governor, he was the force behind the Oregon Health Plan which combined a major expansion in Medicaid eligibility with a priority list of services that would -- and would not -- be provided to Medicaid enrollees. Kitzhaber's on a new kick now -- to get federal agreement to give Oregon all the dollars spent on health services in the state (Medicare, Medicaid, lost revenue from tax deductibility of health insurance, and more... Read more »

US Health Care -- Mediocre at Best

In case you haven't seen it, the new Commonwealth Fund report on US health system performance, published by Health Affairs, is essential reading. Click here to see it. Here's the summary: The United States has many of the world’s best-equipped hospitals and most highly specialized physicians. At 16 percent of gross domestic product (GDP), U.S. health spending is double the median of industrialized countries and since 2000 has been growing more rapidly than before. Yet the United States is the only major industrialized country that fails to guarantee universal health insurance; coverage in... Read more »

New National Blog on Uninsured and Access

Check out the new National Health Partnership Blog by clicking here. It's put together by our friends at the Universal Health Care Action Network in Ohio, a meeting and information exchange ground for state folks looking to expand health care access. It's an ecumenical bunch, not wedded to the perfect way, looking at any and all approaches to moving us forward. Nice job, and already full of some interesting and useful posts. Welcome to the fray! Read more »

Personal Responsibility and Health Care

Two compelling articles in this week's New England Journal of Medicine on personal responsibility and health care. The topic is West Virginia's new Medicaid requirement that low income Medicaid clients sign "member responsibility and rights" agreements. Clients who don't uphold their end -- taking medications, keeping medical appointments, and avoiding unnecessary ER visits -- will have some of their benefits reduced or eliminated. In the first article, Drs. Gene Bishop and Amy Brodkey explore the WV plan and the ethical dilemmas it creates for physicians: Read more »

Culture, Not Malpractice, Keeps Docs from Apologizing

The best definition I ever heard for the word "culture" is: "the way we do things around here" -- wherever here may be. The definition comes to mind as I read this account from the Kaiser Daily Health Report on a new study about why docs fail to inform patients about medical errors: Read more »

Summer Reading: The Great Influenza

If you have not read it, here's a high recommendations for The Great Influenza by John M. Barry. It's the story of the deadliest pandemic in history and a lot more. It's the story of the emergence of modern medicine in the United States and Europe between 1875 and 1920. It's the story of a nation in the grips of a war hysteria so severe that freedom of the press and other civil liberties were tossed aside. Ought to be required reading for any public official with any oversight over public health. Read more »

Prescription Access Litigation Project Scores Win Against "Average Wholesale Prices"

Our friends at Community Catalyst's Prescription Access Litigation Project had a big win this past week on a federal lawsuit attacking the use of "average wholesale prices" by pharmaceutical companies. On August 10, 2006, a settlement agreement for $70 million was reached between GlaxoSmithKline and the Plaintiffs. In a trial set for November 2006, Plaintiffs will continue the case against Bristol Myers Squibb, AstraZeneca, Johnson & Johnson and Schering-Plough. See details below: The "Average Wholesale Price” or AWP has long been the pricing benchmark for almost all prescription drug... Read more »

MassHealth and the 2005 Deficit Reduction Act

The Mass. Medicaid Policy Institute has released a timely and useful new fact sheet, "MassHealth and the Deficit Reduction Act of 2005: New Proof-of-Citizenship and Asset Rules." You can obtain it by clicking here. The DRA contains a number of provisions designed to reduce federal Medicaid spending; the two covered by this fact sheet are among the earliest to take effect and have the most direct implications for MassHealth members. The fact sheet describes the provisions and the potential effects. The provisions are new, so we don't know yet the actual effects. MMPI poses key questions at... Read more »

Kerry's Health Plan Shows the Shifting Ground

Sen. John Kerry held a Faneuil Hall event yesterday to announce his ideas to provide health coverage to all Americans. Click here for the Boston Globe account. Key details: Kerry's plan would start with health coverage for all children by boosting federal reimbursements to states through their Medicaid programs. It also would allow individuals and employers to purchase the same health plan available to federal employees, and would reduce insurance costs across the board by having the federal government pick up catastrophic care insurance. Read more »

John Kerry Sponsors 7/31 Faneuil Hall Health Care "Dialogue"

US Sen. John Kerry is sponsoring a health care dialogue at Boston's Fanueil Hall on July 31 at 12 noon. Here's the invitation: Dear Friends, On July 31, I hope you'll join me to wade into a debate that underscores everything that's at stake here at home -- the struggle for health care that works for everybody. Few problems in our country have remained more intransigent, or have found less political leadership willing to tackle them, than health care. While Washington remains cautious, the problem gets worse. Over the last six years, six million more Americans have joined the ranks of the... Read more »

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