Organ network looks to address regional disparities
Filed under: Conflicts of interest, Health care reform, Hot Health Headline
American Medical News‘ Kevin O’Reilly writes that, spurred on by attention paid to Apple boss Steve Jobs’ trip to Tennessee to take advantage of shorter liver transplant waiting lists, the United Network for Organ Sharing (which has a government contract to run the country’s Organ Procurement and Transplantation Network) will meet in the spring of 2010 to address socioeconomic and regional variations in access to donated organs (see a graph of regional waiting list sizes here).
Jobs did not break any rules, experts say, but he did use his resources to take advantage of an imperfect system. One of the biggest problems? Multiple listings, in which one wealthy patient hops on waiting lists across the country and plays the odds to get the fastest-possible transplant. In what may be an obstacle to reform, some argue that multiple listing is a reasonable practice used by rich and poor alike. Additionally, others say that regional differences in transplant wait times reflect more than just differences in access to health care; they also reflect the high cost of transporting live organs and differing regional success rates in encouraging new donors and standards for harvesting organs.
Related
- In a package for the Los Angeles Times, Charles Ornstein and Tracy Weber looked at UNOS oversight failures and what distinguished the best organ transplant centers from their less-successful peers. Here, the duo tell AHCJ members how they put the project together (includes tips on accessing and using UNOS and other transplant data).
- GAO report on correcting deficiencies at transplant oversight agencies
Where to find the facts on health care reform
With so many false claims about the health care reform proposals floating around, we thought this would be a good time to offer links to the actual proposals, as well as links to some good fact checking and and a plain-English explanation of the proposed reforms.
H.R. 3200, America’s Affordable Health Choices Act of 2009 (PDF)
- H.R. 3200 from OpenCongress.org that allows readers to comment on specific parts of the bill
- Summary of H.R. 3200 by the House Committees on Ways and Means, Energy and Commerce and Education and Labor
- Congressional Budget Office’s cost estimate for H.R. 3200, America’s Affordable Health Choices Act of 2009
- CBO’s special collection of documents, analysis, presentations and other publications about health costs
Affordable Health Choices Act from the Senate’s Health, Education, Labor and Pensions (HELP) Committee
Summary of the House Tri-Committee proposal by the House Committees on Ways and Means, Energy and Commerce, and Education and Labor
Sen. Max Baucus’ Call to Action, which is not intended to be a legislative proposal. It is his vision
for policy and the process in the upcoming health care reform debate.
Sen. Ron Wyden’s Free Choice Proposal
H.R. 676, The United States National Health Care Act or “Expanded & Improved Medicare For All,” introduced by Rep. John Conyers Jr.
Patients’ Choice Act, from senators Tom Coburn and Richard Burr and representatives Paul Ryan and Devin Nunes
Crossing Our Lines: Working Together to Reform the U.S. Health System, a proposal from former senators Howard Baker, Tom Daschle and Bob Dole
Fact checking the claims
Rand Corporation and the Kaiser Family Foundation both have online tools to let you compare the various health reform proposals.
Rand Corporation has links to key documents released by the White House, the Congress, federal agencies, and other stakeholders.
Health care reform: A simple explanation from Politifact’s Angie Drobnic Holan
Seven falsehoods about health care, from FactCheck.org
Covering Health: Parikh defends Emanuel of ‘death panel’ fame
Covering Health: More fact checking on health care reform
Covering Health: Making sense of health reform rumors
CNN’s Truth Squad looks at health care reform myths
See all Covering Health posts about health care reform.
Tompkins: Juvenile jails taking on mentally ill youth
Al Tompkins, the reliable story-spotter at the Poynter Institute, jumped at the potential to localize a New York Times story on how cash-strapped mental health systems are allowing young offenders with psychiatric disorders to be handled by the juvenile justice system instead of by mental health specialists.
According to The New York Times, which refers to the current situation as a “crisis,” two-thirds of the nation’s approximately 92,000 juvenile inmates suffer from at least one mental illness while at least 32 states are slashing the budgets of their mental health programs.
Doctor’s offices consumed by insurance hassles
Filed under: Health care reform, Hot Health Headline
Tamara Keith of the public radio program “Marketplace” went into a doctor’s office to find out where the money’s being spent at the point where the rubber meets the road.
Keith found a whole lot of wrangling with insurance companies, wrangling that consumed the time of assistants, physicians and patients alike. The practice Keith looked at was far from unique, she reports: “A recent Cornell study found nationwide it costs doctors $31 billion a year to deal with insurance companies. That’s about 7 percent of all spending on physician and clinical services.”
The story is the first of an occasional series called “The Cure: Remaking Health Care in America.”
University’s ties to testosterone therapy questioned
Filed under: Conflicts of interest, Hot Health Headline
When it comes to sketchy medicine, female hormone therapies have company. According to reporter John Fauber of the Milwaukee Journal Sentinel, the fast-growing field of testosterone therapy is “based largely on iffy science, promotion, manipulation and conflicts of interest,” much of which originated at the University of Wisconsin.
Fauber found the questionable ties during an investigation of company-funded UW courses that count as continuing education credits for local physicians. Despite the lack of rigorous research into testosterone therapy’s effects, UW courses (with material created in part by drug company contractors and involving studies authored by doctors with drug company ties) and other like them have helped push testosterone therapies, especially Solvay’s AndroGel, to millions of American males. In his extensively researched piece, Fauber takes on not only local conflicts of interest, but also the male hormone replacement and anti-aging movement.
Parikh defends Emanuel of ‘death panel’ fame
Filed under: Government, Health care reform, Health policy, Hot Health Headline
Pediatrician and blogger Rahul Parikh published an defense of Dr. Ezekiel Emanuel, an Obama adviser and the right wing’s latest target, on Salon.com. Opponents have used a few out-of-context quotes from Emanuel’s articles on medical ethics to accuse him of providing justification for so-called “death panels” that folks like Sarah Palin are alleging will make pronouncements on who does and doesn’t deserve health care (Salon’s Alex Koppelman rounds up some of the most popular arguments here).
Parikh paints a picture of Emanuel, whose brother Rahm has also received a fair amount of right-wing vitriol, as an uncompromisingly realistic but fundamentally moral and helpful man who has helped doctors trapped in the daily grind to better understand the bigger moral picture that comes with their particular calling.
Related
Wall Street Journal health blogger Jacob Goldstein points out a WSJ editorial that Emanuel wrote in opposition to euthanasia. In it, Emanuel argues that patients choose assisted suicide based more on mental than physical illness.
For the vast majority of dying patients, Emanuel wrote, “legalizing euthanasia or physician-assisted suicide would be of no benefit. To the contrary, it would be a way of avoiding the complex and arduous efforts required of doctors and other health-care providers to ensure that dying patients receive humane, dignified care.”
Pew: Health care coverage still tops news
Filed under: Health journalism, Hot Health Headline
The Pew Research Center’s Project for Excellence in Journalism has found that health care coverage filled more available news space than any other topic (PDF) for a third straight week.
Health coverage is down from the high of 25 percent it reached two weeks ago and the 19 percent it registered last week, but at 16 percent it still attracted more attention than the economy (which hit 15 percent). Health coverage numbers were again buttressed by heavy exposure on cable news (37 percent) and talk radio (33 percent), with debate in those outlets revolving around acrimonious town hall meetings.
Markets offer examples to improve costs, quality
In a New York Times op-ed, Atul Gawande, Donald Berwick, Elliott Fisher and Mark McClellan discuss a recent meeting of doctors and leaders from 10 U.S. regions that are providing high-quality care for lower costs.
“Our criteria were simple: find regions with per capita Medicare costs that are low or markedly declining in rank and where federal measures of quality are above average.”
They found a number of idea that could be applied nationally to reduce health care costs and improve the quality of care, including:
- using electronic systems to improve communication among physicians
- investigating the overuse of CAT scans
- tracking measures of quality and meeting cost-reduction goals
- merging two underutilized hospitals
- adopting electronic systems for patient data
The writers say that, in these more efficient areas, “neither the physicians nor the citizens reported feeling that care is ‘rationed.’”
Does stimulus-funded research stimulate?
Filed under: Government, Hot Health Headline, Studies
Reporter Michelle Breidenbach of the Syracuse, N.Y., Post-Standard considers local academic research being funded by stimulus money and wonders just how much these projects – many of which were turned down previously and selected for stimulus money based partly on timing considerations – are really stimulating the economy. There were no job-creation or buy-American strings attached and, while ostensibly health-related, studies covered such esoteric topics as wild ticks on lab mice and the interaction between marijuana and malt liquor consumption.
With a story localization model that can be applied across the country, Breidenbach used the NIH’s grant-tracking site to check in on stimulus-funded projects getting underway at a number of nearby universities, then contacted researchers and assessed their work’s impact on the local economy and on human knowledge in general.
Canada takes Monsanto, Dow’s word on safety
Filed under: Conflicts of interest, Government, Hot Health Headline
Martin Mittelstaedt of the Toronto Globe and Mail looks into the Canadian government’s approval of “one of the most complicated genetically engineered plants ever designed,” a strain of feed corn stuffed with eight different sets of foreign genes.
The super-corn will resist numerous common pests as well as the popular herbicide Roundup. The problem, Mittlestaedt reports, is that Canadian health agencies never assessed the new plant’s safety and instead relied on the plant’s developers to make sure it was safe.
The health agency said in response to questions from The Globe and Mail that it didn’t have to do so, because it is relying on the two companies making the seeds, agriculture giants Monsanto Co. and Dow AgroSciences LLC, to flag any safety concerns. But the companies haven’t tested the seeds either, because they say they aren’t required to.
Monsanto and Dow have, however, tested each of the eight characteristics individually, a precaution which some experts say doesn’t go far enough and may not detect allergens or other dangerous consequences of mixing so many traits in one place. Likewise, Mittlestaedt says that UN food safety guidelines recommend that the foreign genes be tested in combination as well as independently.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
