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Budgetary Treatment Of Proposals To Change The Nation's Health Insurance System [May 29, 2009] Medical And Health Education Reform Symposium [May 28, 2009] Do Electronic Health Records Help Or Hinder Medical Education [May 27, 2009] Balancing Act: Comparative Effectiveness Research And Innovation In U.S. Health Care [May 26, 2009] Health Reform: the Cost of Failure [May 22, 2009] Massachusetts Health Reform: The Myth Of Uncontrolled Costs [May 21, 2009] Policy Options For Financing Health Care Reform [May 20, 2009] What Does A College Degree Cost? [May 19, 2009] Trustees Issue Report On Financial Status Of Medicare [May 18, 2009] GAO Report On Medical Education Debt And Specialty Choice [May 11, 2009] Clinical Prevention And Population Health Curriculum Framework [May 8, 2009] National Health Care Quality And Disparities Reports [May 7, 2009] Across The States 2009: Profiles Of Long-Term Care And Independent Living [May 6, 2009] WHO Policy Briefing On The Socioeconomic Safety Divide [May 5, 2009] Health Care In Rural America [May 4, 2009] Many Underserved Areas Lack A Health Center Site [May 1, 2009] Broadening Participation In Graduate Education [April 30, 2009] Social Media's Challenge To Traditional Health Care [April 29, 2009] Trends In Laboratory Medicine [April 28, 2009] Health Care Opinion Leaders Views On Slowing The Growth Of Health Care Costs [April 27, 2009] New Horizons For A Healthy America: Recommendations To The New Administration [April 27, 2009] Challenges Of Health System Capacity Growth [April 17, 2009] Health, United States, 2008 [April 15, 2009] Health Reform: Delivering For Those Who Deliver Health Care [April 14, 2009] ODPHP Seeks Comments on Healthy People 2010 Objectives [April 13, 2009] White House Office Of Health Reform Established [April 9, 2009] Innovative Medical Research At The Molecular Scale [April 8, 2009] Health Literacy, eHealth, And Communication: Putting The Consumer First [April 7, 2009] Building A Healthier America [April 6, 2009] The Economic Argument For Disease Prevention [April 3, 2009] Financial And Health Burdens Of Chronic Disease Grow [April 2, 2009] Professional Medical Associations And Their Relationship With Industry [April 1, 2009]
Budgetary Treatment Of Proposals To Change The Nation's Health Insurance System A mandate requiring all U.S. residents to purchase health coverage would not be considered a new form of federal taxation as long as individuals could choose from a wide variety of private plans and no government entity was responsible for collecting their premiums, according to a Congressional Budget Office (CBO) report issued on May 27. In CBO's view, the key consideration is whether a proposal would be making health insurance an essentially governmental program, tightly controlled by the federal government or whether the system would provide significant flexibility in the types, prices, and number of private-sector sellers of insurance available. CBO in 1994, when lawmakers were considering the Clinton administration's health reform proposal, concluded that a proposed requirement that employers and employees make payments into government-run insurance pools would constitute a form of taxation and a major expansion of the federal government. The report can be accessed by clicking http://www.cbo.gov/ftpdocs/102xx/doc10243/05-27-HealthInsuranceProposals.pdf . Medical And Health Education Reform Symposium To advance health care reform, doctors, nurses, and allied health staff need improved skills to: coordinate care, manage chronic conditions, and keep patients well. On April 27-28, 2009, national leaders joined together to build consensus on changes needed in medical and health care education to facilitate health care reform best. More than 150 nationally-recognized experts began the conversation, which will set priorities and areas for future development and action recommendations. Written summaries of the symposium and web casts of the sessions can be accessed by clicking http://www.mayoclinic.org/healthpolicycenter/2009-summaries.html . Do Electronic Health Records Help Or Hinder Medical Education Background to the debate: Many countries worldwide are digitizing patients' medical records. In the United States, the recent economic stimulus package (“the American Recovery and Reinvestment Act of 2009”), signed into law by President Obama, includes $17 billion in incentives for health providers to switch to electronic health records (EHRs). The package also includes $2 billion for the development of EHR standards and best-practice guidelines. What impact will the rise of EHRs have upon medical education? This debate examines both the threats and opportunities in an article published in PloS Medicine. The article can be accessed by clicking http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000069 Balancing Act: Comparative Effectiveness Research And Innovation In U.S. Health Care Comparative effectiveness research (CER) has risen to prominence in the debate over national health care reform. Equally important in this debate is the role of innovation, long the engine for growth and advancement in our health and our health care system. To date, however, there has been little discussion about how CER might have an impact on the dynamics of innovation in health care. A white paper examines the likely impact that federally funded CER will have on innovation and suggests issues policymakers should consider to achieve the best of both worlds: vast improvements in the evidence base supporting health care and sustained development and adoption of valuable innovation throughout the health care system. The paper is based on research by the New England Healthcare Institute (NEHI), including a series of focus groups and expert interviews with a wide range of health care stakeholders and an expert roundtable discussion held in Cambridge, Massachusetts in October 2008. The paper can be accessed by clicking http://www.kaiseredu.org/picks/health_policy_picks.aspx . Health Reform: the Cost of Failure A new report from The Urban Institute uses the Health Insurance Policy Simulation Model (HIPSM) to quantify the intermediate and longer-term implications if America's health care system is not significantly overhauled. Under a range of economic scenarios, the analysis shows an increasing strain on business owners and their employees over the next decade if reform is not enacted. There would be a dramatic decline in the number of people insured through employers and millions more could become uninsured. There would be large growth in Medicaid/CHIP enrollment and spending and increased spending on uncompensated health care. Middle-income working families would be the most affected. The report can be accessed by clicking http://www.urban.org/UploadedPDF/411887_cost_of_failure.pdf . Massachusetts Health Reform: The Myth Of Uncontrolled Costs Despite a public perception that the state's landmark health care reform law has turned out to be unaffordable, a new analysis by the Massachusetts Taxpayers Foundation finds that the cost to taxpayers of achieving near universal coverage has been relatively modest and well within initial projections of how much the state would have to spend to implement reform, in part because many of the newly insured have enrolled in employer-sponsored plans at no public expense. The Foundation report concludes that state spending on the reform has increased by $350 million between fiscal 2006, the last year before reform, and fiscal 2010 - an average annual increase of only $88 million. The report can be accessed by clicking http://www.masstaxpayers.org/files/Health%20care-NT.pdf . Policy Options For Financing Health Care Reform Chairman Max Baucus (D-MT) and ranking member Chuck Grassley (R-IA) released a 41-page document on May 18 outlining policy options for financing health care reform. The paper is the third and final to be released before the senators draft health reform legislation. The options, which will be discussed at a closed-door committee meeting today, include a number of proposed spending cuts and new or revised taxes. The paper can be accessed by clicking http://finance.senate.gov/sitepages/leg/LEG%202009/051809%20Health%20Care%20Description%20of%20Policy%20Options.pdf . What Does A College Degree Cost? College tuition prices keep rising while state budgets are stagnant or shrinking. Policymakers increasingly are calling for increases in the number of Americans who obtain some higher education or training. Those factors have led more state legislators, trustees, and others to argue that, to accomplish the latter goal given the former circumstances, colleges are going to have to lower what they spend to produce the average credential they award. Any discussion of lowering the "cost per degree" must start, however, with a more fundamental question: What does a degree cost to produce now ? That question may be basic, but it is not simple, according to a new report from the Delta Project on Postsecondary Education Costs, Productivity, and Accountability makes clear. The report can be accessed by clicking http://www.deltacostproject.org/resources/pdf/johnson3-09_WP.pdf . Trustees Issue Report On Financial Status Of Medicare The Boards of Trustees of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund (commonly referred to as the "Medicare trustees") May 8 released their annual report on the current status and projected financial condition of the Medicare program. The trustees report that the hospital insurance (Part A) spending began exceeding tax revenues received by the federal government starting in 2008 and the trust fund will be depleted by 2017, two years earlier than predicted in the 2007 and 2008 reports, reflecting much lower projected payroll tax income as a result of the recession. According to the trustees, a major factor contributing to the increased spending relative to the tax revenue is the beginning of the retirement of the baby boomers, which dramatically increases the number of enrollees relative to the number of workers. Furthermore, as the average age of Medicare beneficiaries increases, health care utilization for each beneficiary increases, thus further increasing the cost of the program. GAO Report On Medical Education Debt And Specialty Choice The report can be accessed by clicking http://www.gao.gov/new.items/d09438r.pdf . Clinical Prevention And Population Health Curriculum Framework The Healthy People Curriculum Task Force has revised the Clinical Prevention and Population Health Curriculum Framework , which is the first structured and comprehensive curriculum agenda for integrating clinical prevention and population health into the education of students across the health professions disciplines. The academic community is encouraged to apply this Framework to curriculum design, evaluation and accreditation efforts. First released in 2004, it includes common, core subject matter and increases the opportunity for education and training in inter-professional teams. The Framework consists of 19 domains within four updated components: 1) Evidence-Based Practice; 2) Clinical Preventive Services and Health Promotion; 3) Health Systems and Health Policy; and 4) Population Health and Community Aspects of Practice. The revision process took place over the course of one year with two draft revisions and web-based public comment. The Framework is part of the Task Force's Education for Health agenda which seeks to integrate prevention and population health into K-12, college, health professions, and continuing education programs. The Task Force has proposed a series of objectives that would form an educational underpinning for Healthy People 2020. The Task Force includes the Association of Schools of Allied Health Professions. The curriculum framework can be accessed by clicking http://www.aptrweb.org/about/pdfs/Revised_CPPH_Framework_2009.pdf. National Health Care Quality And Disparities Reports Published by the Agency for Healthcare Research and Quality, the annual 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. The reports found:
The National Healthcare Quality Report can be accessed by clicking http://www.ahrq.gov/qual/nhqr08/nhqr08.pdf. The National Healthcare Disparities Report can be accessed by clicking http://www.ahrq.gov/qual/nhdr08/nhdr08.pdf. Across The States 2009: Profiles Of Long-Term Care And Independent Living Across the States 2009: Profiles of Long-Term Care and Independent Living is the 8 th edition of a report by AARP. Published approximately every two years, the Across the States series was developed to help inform policy discussions. The report presents comparable state-level and national data for more than 140 indicators, drawn from various sources into a single reference. The report can be accessed by clicking http://assets.aarp.org/rgcenter/il/d19105_2008_ats.pdf WHO Policy Briefing On The Socioeconomic Safety Divide The U.S. is not alone in the world in attempting to deal effectively with various kinds of health problems. Injury and violence are a leading cause of death and disability in the WHO European Region. Wealth is a major determinant of health and there is a steep social gradient of ill health due to injuries and violence. Addressing this important cause of inequity in health is a matter of social justice. A policy briefing from the WHO summarizes evidence on the socioeconomic safety divide from a large systematic review: Socioeconomic Differences in Injury Risks. A Review of Findings and a Discussion of Potential Countermeasures. It provides messages for policy-makers, researchers, and public health advocates and safety planners on what can be done to address this safety divide. A copy of the policy briefing can be accessed by clicking http://www.euro.who.int/document/e92197.pdf . Throughout rural America, there are nearly 50 million individuals who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. A report Hard Times in the Heartland provides insight into the current state of health care in rural areas and the critical need for health care reform. The report can be accessed by clicking http://healthreform.gov/reports/hardtimes/ruralreport.pdf. Many Underserved Areas Lack A Health Center Site Health centers funded through grants under the Health Center Program--managed by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)--provide comprehensive primary care services for the medically underserved. In a report issued yesterday by the Government Accountability Office (GAO), it was noted that HRSA's grants to open new health center sites increased access to primary health care services for underserved populations in needy areas, including medically underserved areas (MUAs). However, HRSA's ability to place new health center sites in locations where they are most needed was limited because the agency does not collect and maintain readily available information on the services provided at individual health center sites. Because each health center site may not provide the full range of comprehensive primary care services, having readily available information on the services provided at each site is important for HRSA's effective consideration of need when distributing federal resources for new health center sites. The report can be accessed by clicking http://www.gao.gov/new.items/d09667t.pdf . Broadening Participation In Graduate Education The U.S. system of higher education is arguably the best in the world, but there is a leak in the pipeline. Even as the nation is becoming increasingly diverse, some groups remain highly underrepresented in graduate schools, particularly in science and engineering. The face of higher education does not mirror the face of the nation. The proportion of college students who are members of underrepresented groups has been increasing, from 22 percent in 1997, to about 28 percent in 2006, however, not enough students from underrepresented groups obtain their degrees and not enough go to graduate school. A new report from the Council of Graduate Schools (CGS) entitled, Broadening Participation In Graduate Education highlights programs that have had success in enhancing diversity and inclusiveness in graduate education and offers policy recommendations aimed at identifying and cultivating talent wherever it exists, with particular emphasis on developing domestic talent from traditionally underrepresented groups. Copies of the report are available at the CGS bookstore at http://www.cgsnet.org/Default.aspx?tabid=79&CategoryID=1&Category2ID=7&List=0&Level=2&ProductID=97 . Social Media's Challenge To Traditional Health Care Social media on the Internet are empowering, engaging, and educating health care consumers and providers, according to a new report, The Wisdom of Patients: Health Care Meets Online Social Media , published by the California HealthCare Foundation (CHCF). The role of the Web has evolved from the information-retrieval of "Web 1.0" to "Web 2.0," which allows individuals who are not necessarily technologically sophisticated to generate content. At the same time, social networks ranging from MySpace to specific disease-oriented sites are blossoming. According to the report, social networks in health are proliferating so rapidly that new services are already under development to help health consumers navigate through them. Among the Health 2.0 sites discussed in the CHCF report are DiabetesMine and PatientsLikeMe, a social health network and online forum. Another site, WEGO Health, is a social health network and wiki. The target audience is "prosumers" (expert consumers) who want to dig deeper and with more specificity into health topics. For example, someone could search for videos about diet and lifestyle changes among African Americans with Type 2 diabetes. In addition to specialized sites, more than 500 groups meet on Facebook to discuss diabetes; more than 2,000 chemotherapy-related photos are posted on Flickr; and some 36,000 YouTube pages are devoted to some aspect of surgery. The report includes brief portraits of social media health pioneers. It also provides an extensive list of resources on Health 2.0, health social networks, health wikis, patient blogs, health podcasts, and health video-sharing sites. The document can be accessed by clicking http://www.chcf.org/documents/chronicdisease/HealthCareSocialMedia.pdf . Laboratory medicine, which plays an integral role in health care, is handicapped by overuse, under use, and misuse of services; poor communication and coordination; and inefficiency. A new report by the California Healthcare Foundation provides an overview of today's laboratory medicine sector and the economic, regulatory, workplace, technological, and other factors that are shaping it. The report looks at several issues such as: challenges related to testing standards, the qualifications and availability of lab personnel, and regulation of cutting-edge tests; and how technological advances, along with cost-effectiveness analyses and comparative effectiveness research are altering the testing landscape. The report can be accessed by clicking http://www.chcf.org/documents/chronicdisease/LabDataTrends.pdf . Health Care Opinion Leaders Views On Slowing The Growth Of Health Care Costs Leaders in health care and health care policy believe the U.S. must rein in the growth of health spending, and most believe it is possible over the next 10 years to maintain the current proportion of gross domestic product (GDP) devoted to health care, the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey finds. Nearly all respondents (96%) agreed that spending must slow, and large majorities expressed support for a range of strategies to reduce costs, including many of those outlined in President Obama's budget blueprint. Large majorities of opinion leaders support such cost-reduction strategies as replacing Medicare's "sustainable growth rate" mechanism with fundamental provider payment reform, introducing competitive bidding for durable medical equipment, and negotiating pharmaceutical drug prices. Opinion leaders also favor promoting growth of integrated delivery systems, raising payments for primary care services and medical homes, and establishing a center for comparative effectiveness. The data brief can be accessed by clicking http://www.commonwealthfund.org/~/media/Files/Publications/Data%20Brief/2009/Apr/Slowing%20the%20Growth%20of%20Health%20Care%20Costs/1263_Stremekis_HCOL_Slow_Data_Brief_FINAL.pdf . New Horizons For A Healthy America: Recommendations To The New Administration A commission of national health experts convened by the Center for the Study of the Presidency and Congress (CSPC) has developed seven strategies to mobilize all sectors of American society. The report, New Horizons for a Healthy America: Recommendations to the New Administration , was released by the Commission on U.S. Federal Leadership in Health and Medicine: Charting Future Directions. America's health crisis does not have either a single cause or a silver bullet solution. Previous attempts at reform have often focused too narrowly on the financing and delivery of health care. New Horizons for a Healthy America adopts a more comprehensive perspective in framing its seven recommended strategies for a high-performance health care system and a healthier nation. The report can be accessed by clicking http://www.thepresidency.org/pubs/New_Horizons.pdf . Challenges Of Health System Capacity Growth Health system capacity in the U.S. has continued to expand in recent years. More than $39 billion was spent on health care construction projects in the U.S. in 2007, with the majority of spending going to build new hospitals and expand existing ones. Given these growth patterns, policy discussions about the amount and value of care delivered to Americans are increasingly focused on questions about the impact of changes in health system capacity. To better inform these discussions, a careful assessment is needed about the relationships between health system capacity and utilization, spending, and quality. A report examines more than 100 studies published over the past 40 years to synthesize the evidence on these connections and evaluate the forces that seem to be driving capacity change. In light of these findings, a number of policy levers that might help to better manage existing capacity and influence future capacity change are identified. The report can be accessed by clicking http://www.nihcm.org/pdf/CapacityBrief-FINAL.pdf . Health, United States, 2008 , is an annual report documenting changes in the nation's health through 151 detailed trend tables on health status and its determinants, health care utilization, health care resources, and medical expenditures. The report can be accessed by clicking www.cdc.gov/nchs/hus.htm . Health Reform: Delivering For Those Who Deliver Health Care The Center for American Progress Action Fund released a new report today entitled, "Health Reform: Delivering for Those Who Deliver Health Care" by Robert A Berenson and Ellen-Marie Whelan, that details how health reform will benefit health care professionals. Health professionals can play a decisive role in assuring that a broad health reform proposal that has their needs in mind is enacted into law. In recent rounds of efforts to achieve substantial health care reforms, health professionals have been largely relegated to commenting on important but ultimately peripheral issues. The report can be accessed by clicking http://www.americanprogressaction.org/issues/2009/04/pdf/health_reform_providers.pdf . ODPHP Seeks Comments on Healthy People 2010 Objectives The Office of Disease Prevention and Health Promotion (ODPHP) is encouraging comments on the existing Healthy People 2010 objectives, which will be used as a starting point for drafting a framework and objectives for Healthy People 2020. A more extensive public comment period on the drafted 2020 objectives will be conducted through the web site at a later date. ODPHP will convene three public meetings in late summer/early fall to gather input on the draft objectives. Comments may be submitted through the web site www.healthypeople.gov/hp2020/comments . White House Office Of Health Reform Established Yesterday, President Obama signed an executive order establishing the White House Office of Health Reform. In signing the order, he said that health care overhaul is one of the biggest priorities for the first year of his presidency. The office will be headed by former Clinton administration health official Nancy-Ann DeParle and it will be responsible for working with executive branch agencies, state and local officials, and Congress to enact health reform legislation, as well as overseeing implementation of policy. According to the order, the office will "provide leadership to the executive branch in establishing policies, priorities, and objectives for the federal government's comprehensive effort to improve access to health care, the quality of such care, and the sustainability of the health care system." In addition, the order calls for the creation of an HHS Office of Health Reform that will work with the White House Office of Health. The two offices will coordinate and shape President Obama's health care policies. Innovative Medical Research At The Molecular Scale Currently, the National Institutes of Health (NIH) invests about $200 million each year in biomedical nano-technology research that ranges from fundamental studies on the properties of nanomaterials to investigations of potential health and safety issues of nanotechnology products as they interact with the human body and the environment. Novel materials are being developed for ultra sensitive identification and detection of important molecules that change in the body when a disease strikes. Measuring changes in these disease markers will enhance the ability to understand, diagnose, and treat many diseases. Other types of nanostructures are being designed to deliver medicines directly to diseased or damaged cells and tissues in the body to accelerate the healing process. New diagnostic methods and treatments are emerging as more is learned to control the manufacture of nanomaterials and their actions in the body. Additional information can be accessed by clicking http://www.nih.gov/science/nanotechnology/pub_NANO_brochure.pdf . Health Literacy, eHealth, And Communication: Putting The Consumer First There is great enthusiasm over the use of emerging interactive health information technologies-often referred to as eHealth-and the potential these technologies have to improve the quality, capacity, and efficiency of the health care system. Many doctors, advocacy groups, policy makers, and consumers are concerned, however, that electronic health systems might help individuals and communities with greater resources while leaving behind those with limited access to technology. In order to address this problem, the Institute of Medicine's Roundtable on Health Literacy held a workshop to explore the current status of communication technology, the challenges for its use in populations with low health literacy, and the strategies for increasing the benefit of these technologies for populations with low health literacy. The summary of the workshop, "Health Literacy, eHealth, and Communication: Putting the Consumer First," includes participants' comments on these issues. The summary can be accessed by clicking http://www.nap.edu/catalog.php?record_id=12474#toc . Despite unprecedented biomedical achievements, Americans are sicker than they should be and are dying far too young. From the standpoint of the economy, the future and families, Mark McClellan ( Director, Engelberg Center for Health Care Reform ) and Alice Rivlin ( Senior Fellow, Metropolitan Policy Program , Economic Studies ) of The Brookings Institution discuss why the need to improve Americans' health is greater than ever. Their comments can be accessed by clicking http://www.brookings.edu/opinions/2009/0403_healthieramerica_mcclellan.aspx . The Economic Argument For Disease Prevention In a policy paper commissioned by the Partnership for Prevention, it is noted that unsustainable growth in medical spending has sparked interest in the question of whether prevention saves money and could be the answer to the health care crisis. But the question misses the point. What should matter (for both prevention and treatment services) is value – the health benefit per dollar invested. A package of effective clinical preventive services is discussed in the paper that improves health at a relatively low cost. Cost-effectiveness should also be examined for disease care, the major driver of health spending, which can best be controlled by shifting investments from expensive low-value services to more cost-effective interventions. The policy paper can be accessed by clicking http://www.prevent.org/images/stories/PolicyPapers/prevention%20cost-effectiveness.pdf . Financial And Health Burdens Of Chronic Disease Grow Almost three in 10 working-age Americans with diabetes, asthma, depression or other chronic conditions lived in families with problems paying medical bills in 2007—a significant increase from two in 10 in 2003, according to a national study released today by the Center for Studying Health System Change (HSC) and funded by the Robert Wood Johnson Foundation. The report can be accessed by clicking http://www.hschange.org/CONTENT/1049/. Professional Medical Associations And Their Relationship With Industry Today's issue of the Journal of the American Medical Association contains an article by Rothman et al on the relationship between p rofessional medical associations (PMAs) and industry. They play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society. |
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