New Feature: KHN’s Selection Of Thought-Provoking Magazine Articles On Health Policy Issues
Today, we begin this new weekly feature, which will provide a selection of thought-provoking articles from a variety of sources. If you have seen anything you think we should include, please let us know: KHNnews@kff.org, and please put "Worth Reading" in the subject line.
The New Yorker: The Hot Spotters
If Camden, New Jersey, becomes the first American community to lower its medical costs, it will have a murder to thank. ... Jeffrey Brenner, a physician in Camden, New Jersey, has used data mining and statistical analysis to map health-care use and expenses. His calculations revealed that just one per cent of the hundred thousand people who made use of Camden's medical facilities accounted for thirty per cent of its costs. ... In his experience the people with the highest medical costs-the people cycling in and out of the hospital-were usually the people receiving the worst care. If he could find the people whose use of medical care was highest, he figured, he could do something to help them. If he helped them, he would also be lowering their health-care costs (Atul Gawande, 1/24).
Earlier, related KHN story: New Jersey Program Finds Alternatives for ER 'Super Users' (Campbell, 3/9/2009)
Newsweek: Why Almost Everything You Hear About Medicine Is Wrong
If you follow the news about health research, you risk whiplash. First garlic lowers bad cholesterol, then-after more study-it doesn't. ... But what if wrong answers aren't the exception but the rule? More and more scholars who scrutinize health research are now making that claim. It isn't just an individual study here and there that's flawed, they charge. Instead, the very framework of medical investigation may be off-kilter, leading time and again to findings that are at best unproved and at worst dangerously wrong. ... As medical costs hamper the economy and impede deficit-reduction efforts, policymakers and businesses are desperate to cut them without sacrificing sick people (Sharon Begley, 1/23).
The Weekly Standard: About Those Death Panels
The Arizona Medicaid story was not grounded in conservative heartlessness or hypocrisy. It resulted from a single-payer health care system crashing into a budgetary brick wall. The real lesson here is that "single payer" and "death panels" go together like "See's" and "candy." Our current private system certainly has serious problems that need addressing. But no private insurance company would dare unilaterally deny a previously qualified patient life-saving surgery, as Arizona did. Only government can get away with something like that (Wesley J. Smith, 1/31).
Mother Jones: The Chamber Of Commerce's Health Reform Heretics
The group is hell-bent on undermining health care reform, but some of its local affiliates-gasp!-kind of like the law. In October 2009, the US Chamber of Commerce had a full-scale revolt on its hands. A few months later, about a dozen local Chambers of Commerce publicly broke away from the group, arguing that the national organization had swung too far to the right and no longer represented its members' views. Now, some of the same questions are beginning to surface over the Chamber's hard-line stance on health care (Suzy Khimm, 1/25).
The Nation: Does Contraception Count As Prevention?
After the wrangling over what would be included in the final bill, prochoice advocates lost big: in order to obtain insurance coverage for abortion, policy-holders will have to pay for it separately. But a provision to the healthcare reform law added by Senator Barbara Mikulski that required all new health insurance plans to cover preventive services for women with no out-of-pocket cost to patients survived. The problem is that the law doesn't specify exactly which services should be on the list ... after the fight over abortion coverage almost derailed healthcare reform, many politicians are now extremely skittish about coverage related to sex and women's bodies, fearing it will damage public receptivity to the bill (Sharon Lemer, 1/18).
Governing: Food Policy On The Menu
As local governments address serious social problems, from unemployment to environmental sustainability to public health, food policy questions intermingle. With limited resources, public officials have to grapple with tough questions: What about our food supply should fall within the bounds of public policy? What is better left off of the government's already full plate? (Tim Glynn Burke and Christina Marchand, 1/24).
Hospitals & Health Networks Weekly: ACOs Forging The Links
Building an accountable care organization is viewed by many hospital executives as the holy grail as they try to figure out how to better manage patient care across the continuum and as they brace for the growth in bundled payments. Yet, relatively few hospitals and health care systems are ready to form ACOs today. One reason is that their physicians are not ready. Unless a hospital employs most of its staff, ACO success depends on having physician organizations with which to work, and those are still few and far between (Ken Terry, 1/2011).