Elections have consequences – Health Wonk Review’s post-election edition

Elections have consequences.  I don’t often quote Karl “Turd Blossom” Rove, but it certainly seems apropos now, three days after an historic election.  There are a plethora of interesting story lines surrounding the election and the hows, whys, and whos thereof.  We’ll keep our focus on those related to health policy, the impact on reform, and let the experts opine.

First out of the blocks is Bob Laszewski with his post listing some of the major health policy issues facing the President and Congress. Included among the challenges is addressing the fiscal cliff – I’m not as optimistic about our “leaders'” ability to get that fixed anytime soon.

Health Affairs’ contribution comes from Tim Jost, “Election 2012: A Win For Health Reform, But Much Work Remains” gets a bit more specific; “November 6 was a good night for health care reform, and for the millions of Americans who will benefit from it, but a great deal of work needs to be done before reform becomes a reality.  It is time for the administration to roll up its sleeves and get to work,” Tim says. He describes the areas where  important guidance and rules are promptly necessary to implement the Affordable Care Act, and he also points out continuing threats to the ACA such as challenges to the preventive services contraception mandate and premium tax credits on the federal exchanges, as well as the looming deficit reduction negotiations. We’ve less than 14 months till this thing fully kicks in, and time’s awasting.

The estimable Maggie Mahar explores the demographics of the vote in “The Nation is Divided, Not between Whites and Minorities, but between the Past and the Future. “ She sees this as a victory by the future population over the past. Maggie’s take is that “Women, minorities, and young people re-elected President Obama…This is not to say that, going forward white men will not also be in positions of power.”

Anthony Wright at Health Access blog is pretty darned excited about the result, and its implications for the nation’s largest (in population) state.  “A Great Night for California and for Health.” Anthony isn’t too giddy to remind us “this isn’t the end of the campaign, but the beginning of ACA implementation and the fiscal fight over Medicaid and Medicare.? 

Louise is one of our “battleground state” contributors and sends us via Colorado Health Insider a post responding to another’s recommendation that one can be “self-insured” if you’re careful enough.  Louise thinks not, saying “To be fair, I agree wholeheartedly with the tips he gives for “making health insurance a bad bet“.  Things like eating well, exercising, avoiding excess alcohol, not smoking, driving safely, managing stress, safe sex, not sharing needles, etc. are all great ideas.  They’re all things that our family does every day.  I’ve been told I’m a health nut, and I don’t shy away from the accusation.  I make green smoothies (kale and veggies and fruit all blended up – drink up!), exercise nearly every day and refuse to drive if I’ve had even a single glass of wine.  I fully plan on living to be a hundred.  But I would never ever go without health insurance for myself or my family.”

Fortunately, Obamacare (remember when that was a pejorative term?) includes wellness and prevention benefits; new contributor Chuck Smith at informthepatient.com has several posts lauding the benefits of pre-illness care.

John Goodman of the National Center for Policy Analysis contributes “Socialism Kills”, on the impact of “economic freedom” on population mortality. Actually, the research isn’t about socialism per se; rather John cites the libertarian Fraser and Cato Institutes as the source for underlying research on how “economic freedom” contributes to longevity.  I haven’t read the two studies, but I’m curious if those two august organizations factored in the impact of potentially confounding factors, such as the many wars in Africa, rapid rise in starvation in several countries, an deaths from disease.  Also wondering how the headline could possibly be true in the face of data indicating longevity in most European countries exceeds that in the good ol’ US.  In fact, as the only industrialized nation without universal health insurance, we rank behind every EU country in life expectancy – including Greece, Malta, Cyprus (my birthplace) – and even lower than Chile…

I take a different approach, looking at the implications of Obamacare for workers comp – and surprise some by opining that overall, it’s good news indeed.

There are a few folks out there looking at things other than reform and the election – thank goodness!

InsureBlog’s Bob Vineyard reports that more docs are beginning to shun insurance in favor of cash, and explains why.

Dr Roy Poses continues his tireless pursuit of profiteers, this time going after the cozy relationships existing in the medical-publishing industry.

In Marketers’ Systemic Influence over Ostensibly Scholarly, Peer-Reviewed Publications: the Medtronic Infuse BMP-2 Example, Roy informs us:

A US Senate committee report detailed yet another example of how marketers working for industry (in this case, for Medtronic, a biotech/ medical device company) sought to systematically but covertly influence the ostensibly scholarly medical literature and the public discussion to sell more of their product…Those who advocate the evidence-based medicine approach, as I do, must not be naive about the extent that the evidence-base has been deliberately corrupted.  We need stronger measures to protect the integrity of clinical science.

Hospital Quality Reporting in Italy is the subject of Jason Shafrin’s post, wherein he discusses P.Re.Val.E Italy’s hospital quality initiative. Pretty comprehensive approach…

A change in Medicare policy will have a significant impact on post acute care (and home services). Brad Flansbaum digs into the details of a recent settlement between CMS and the Center for Medicare Advocacy.

The American Academy of Family Physicians is pushing back on nurse practitioners’ role in primary care. David Williams explains why they aren’t doing the same to specialists. Evidently the family practice docs are OK if specialists act as generalists, but oh no, not those nurses (disclosure, my daughter is a nurse..)

We wrap up this edition with a state-based discussion of workers comp reform; Tom Lynch of Workers’ Comp Insider offers “A Modest Proposal for New York” for fixing what’s wrong with the state’s workers’ comp system.

Finally, apologies as this, the post-election edition of Health Wonk Review is out a bit later than usual this week as I was in Las Vegas for the National Workers Comp Conference.  Fortunately, my fellow bloggers were able to keep up their writing to keep you, dear reader, fully abreast of the issues and implications thereof.