UPDATE – Health Wonk Review

This is the premiere edition of Health Wonk Review, a biweekly (or so) compendium of the best of the health policy blogs. We’ve asked over two dozen health policy, infrastructure, insurance, technology and managed care bloggers to send in their best, provided to you in Cliff Notes style. We’ll do this every couple of weeks or more often if the host wants to.
Why? Bunches of reasons.
First, the last two months have seen a renewed interest in the health care policy arena, triggered by Pres. Bush’s State of the Union address, the financial difficulties of GM et al, the emergence of consumer-directed health plans, and the Part D mess.
Second, there are so many excellent policy blogs in the ether that it is impossible for anyone to keep abreast of them all.
Third, Nick Genes’ Grand Rounds has done such an excellent job covering the medical blogger community it inspired us to try to do the same on the policy side (plus Nick has already done most of the heavy lifting figuring out this type of thing so we didn’t have to do too much work).
And as you’ll read, we’re off to a pretty good start.
UPDATE – for a couple of late entries, click below…

Update – A couple of later entries snuck in while I was hammering away at the keyboard.
Two other entries came in via the ever-popular TPMCafe, this one by noted blogger Ezra Klein. Ezra highlights two studies to show that the problem w US health care costs is not due to defensive medicine and that other countries’ “rationing” of technology is an urban myth.
Leif Wellington Haase at the Century Foundation has done an excellent job drawing parallels and distinctions between the original launch of Medicare in 1965 and the Part D debacle. Leif notes that the Feds did a much better job in the mid-sixties…
From Roy Poses MD of Brown University’s Health Care Renewal –
Roy highlights a problem that few are talking about or publicizing – the potential for significant conflicts of interest when the top folk at academic institutions and/or medical schools and/or teaching hospitals also happen to serve on the boards of pharmaceutical companies and/or device manufacturers. Quoting Roy; “While it has been fashionable to berate individual physicians for the conflicts of interest that result when they take coffee mugs or pens with a manufacturer’s logo, there has been silence about health care leaders directing the companies whose logos may be on the pens and mugs.
Peter Murray’ s post on the impact of Web2.0 on health informatics was nominated by colleague Rod Ward. (if my summary sounds naive and ignorant, that’s because when it comes to 2.0, I am) As near as I can figure it, Web 2.0 puts a lot more power in the processors of individuals – enabling all of us to develop our own webpages, collaborate, work on individual parts of much bigger projects, share information – “the user as collaborator” instead of reader – more multi-directional rotary than one-way street. (we in New England call traffic circles “rotaries” – traffic enters, merges, exits, occasionally crashes). Peter notes that the individual creative control inherent in 2.0 may/will have implications for individual health records, semantics, and new medical informatics applications.
Rita Schwab at MSSP Nexus has sent a stop-and-think piece about physician addictions, the personal and professional toll, and the all-too-easy practice of termination of docs with addiction problems. I have personal knowledge of a very good doc who went thru an incredibly difficult and painful experience with substance abuse and came out of it – the doc is now head of the medical staff at a hospital and is even better at medicine than before.
Kate Steadman has jumped in with an admirable effort at explaining the “donut hole” deductible that makes Part D (and other insurance plans that have them) even more obtuse. Kate notes that donut holes tend to drive up out-of-pocket costs for the sicker people; meanwhile there is no evidence that this financial chicanery reduces health care costs.
From Evian at Free Canada comes a post discussing the recent announcement by Quebec’s Health Minister that the province will allow patients to go to private health care providers if their wait for certin surgeries exceeds six months. Evian sees this as a very important step in the “race” towards a “more rational health care system”.
Free Canada is one of the blogs under Trapier Michael’s marketplace.md website. Another is Medical Liberty, which submitted an interesting post on a MinuteClinic, a company operating clinics in Target, Cub Foods, CVS and other stores in several cities around the country. David notes that MinuteClinic posts prices in their facilities and prides itself on short waiting times for routine stuff.
Shahid Shah, aka the Healthcare IT guy, sent in a great piece about “pod slurping”, a process/threat wherein individuals can (theoretically) copy sensitive medical or business data into an iPod by downloading a search application, then plugging the iPod into a USB port where it scans databases for specific data. Yikes.
Shahid also is encouraging pharmaceutical outfits to jump into the blogging world.
Health Wonk Review co-founder Matthew Holt spent considerable time (and evidently lots of note paper) at HIMMS earlier this month, and sent in a combination presentation review/shot-of-cold-water-in-the-face/reality check from TPMCafe. Matthew notes that ex-Oregon Gov. John Kitzhaber MD is taking on the Herculean task of figuring out how a state should best spend its health care dollars. This in a post describing how IT alone will not solve our health care troubles, and how far behind the US is in terms of health care IT infrastructure (hint less than 25% of US primary care MDs use electronic medical records; over 80% of MDs in the UK and Canada do…)
Matthew has also been busy looking into Intel’s health benefits strategy (it involves HSAs, comprehensive benefits packages, and no, Intel is not contributing to HSA accounts although it is paying the entire insurance premium).
Finally, our colleague Jon Coppleman at WorkCompInsider has done some careful thinking about bird flu, noting that Peter Rousmaniere’s article on how undocumented and immigrant workers may turn out to be a significant “vector” (I hope I’m using that term correctly) for the disease if it becomes transmissable between humans. These workers are in close contact w poultry, rarely have health coverage, tend to avoid health care providers until really ill, and are not part of the typical American’s social circle. Jon points out that these factors make for a particularly scary pandemic growth medium.
Oh, one more – almost forgot my own entry in this premiere Review. The recent post on the relationship between higher copays and higher costs excited a number of readers from all political, educational, and experiential backgrounds. Like a good brawl between British soccer fans…
Matthew, I pass the baton.