Reading lists for health care journalists
In her column for Generations Beat Online, AHCJ member Eileen Beal offers a reading list for health journalists and focuses on two books in particular that she believes will help prepare reporters for the first wave of baby boomers, which will hit Medicare next year (scroll down to item 4, “Beal’s Beat”).
Photo by Beverly & Pack via Flickr.The subjects these books cover, doctors’ decisions and statistics, are broad enough to be useful to even those journalists not focused on aging coverage.
Her suggestions include “How Doctors Think,” by Harvard professor and oncologist Jerome Groopman, and “Know Your Chances: Understanding Health Statistics.
In an e-mail separate from her column, Beal pointed out that Covering Health readers also might be interested in an edited, ranked and extensive list of health resource books compiled by the Agency for Healthcare Research and Quality that includes general and specific offerings.
Lieberman: Joe’s looking out for folks at home
Sen. Joe Lieberman (I-Conn.) has been a vocal burr in the saddle of the Democrat majority’s push for health care reform. Writing for CJR.org, Trudy Lieberman seeks to explain why Joe Lieberman has so vigorously opposed measures like the “public option” and the long-term care CLASS Act. Trudy Lieberman says the senator’s position would seem to have something to do with his constituent base.
Independent Sen. Joe Lieberman at the 2008 Republican National Convention. Photo by NewsHour via Flickr.
Joe Lieberman comes from Connecticut, and Hartford is America’s insurance capital. It’s home base to Aetna, one of the country’s largest health insurers and a huge lobbying force this year, not to mention some lesser carriers that dabble in the health insurance business.
Trudy then goes down Lieberman’s reform stances issue-by-issue, pointing out exactly how vested interests in his constituency could have influenced each one.
There certainly seems to be some data to back Trudy Lieberman’s insights. OpenSecrets.org shows that the “Finance, Insurance & Real Estate” sector has been the largest donor to the senator.
We have public options now. Are they any good?
Filed under: Government, Health care reform, Hot Health Headline
ProPublica’s Sabrina Shankman reviews America’s existing “public options” for health care, finding mixed results and limited utility. In addition to Medicare and Medicaid, Shankman reviews a few less prominent institutions:
- The armed forces Tricare plan: Covers all active members of the military, retirees and their families, regardless of preexisting conditions. If you stick to military treatment facilities, it’s cheap.
- Veterans Health Administration: Veterans who meet its standards are guaranteed high quality care, but funding is tight at the VA right now.
- Indian Health Service: Allows American Indians and Alaska Natives free access to reservation clinics… until the service’s funding runs out, as it does about halfway through each year.
- Healthcare Group of Arizona: It was founded to provide afforable insurance to certain small businesses, but a lack of funds and climbing deductibles mean that many employers will be better off looking to the private market anyway.
Reuters has a handy summary of the key provisions of the latest bill likely to be considered by the House of Representatives.
Bundled payments may improve care, lower costs
Filed under: Health care reform, Health journalism, Health policy, Hospitals
Kaiser Health News’ Phil Galewitz looks at bundling hospital payments, a possible solution to the confusion and cost of separate billing. Under these programs (now in Tulsa and San Antonio, and coming soon to Denver, Albuquerque and Oklahoma City), “Medicare makes a single reimbursement for all the hospital and doctor care for heart and joint procedures, rather than making separate payments to the facility and physicians.”
In theory, the benefits are clear:
Bundling payments moves medical charges away from the traditional fee-for-service system that pays providers separately for individual services — an arrangement critics of the current system say leads to doctors and hospitals delivering more care, but not better care.
It looks like the program’s making a difference. A hospital executive admits the bundled payments make hospitals more reluctant to consult specialists (because the payment from Medicare remains the same and doesn’t rise to meet the cost of a specialist) but says the increased attention to quality brought by the bundling has improved patient care.
Similarly, Galewitz writes that a similar program in the mid 1990s “saved $42.3 million over three years, with costs decreasing from 10% to 37% at the four hospitals participating in the test.”
Rural health costs: Lower, but just as uneven
Writing on the rural news site Daily Yonder, Bill Bishop and Julie Ardery take a look at the Dartmouth Atlas, using only cost data from the two-thirds of hospital service areas that have mostly rural or exurban populations. They found that only 27 percent of the rural HSAs had Medicare reimbursement costs above the national average, but that variations in spending between rural areas were just as pronounced as those among their urban counterparts.
Bonners Ferry, Idaho, a town of about 2,500 near the Canadian border that’s home to the lowest Medicare costs of any American majority-rural area. Photo by prentz via Flickr.
The accompanying map is particularly nifty, not just because of what it shows about rural health differences, but also about the coverage and costs of rural hospitals.
To learn more about the Dartmouth Atlas and how to use it to determine how medical resources are distributed and used in the United States, read AHCJ’s Covering Hospitals, a slim guide that focuses on how journalists can best use Dartmouth Atlas and Hospital Compare.
Related
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- Covering Health: Poor, rural hospitals have higher death rates
- Covering Health: Students look at rural health care in north Ga.
- Covering Health: S. Dakota may be model of health-care efficiency
- Covering Health: Dartmouth Atlas: Powerful when used right
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They gave us Part D, now protect it from reform
Filed under: Conflicts of interest, Government, Health care reform, Health journalism, Pharmaceuticals
ProPublica’s Olga Pierce reports that at least 25 of the folks who helped push through pharma-friendly Medicare Part D six years ago are back as lobbyists,and this time they’re fighting to make sure the plan isn’t reduced by reform-related budget cuts.
Pierce’s piece can be divided into three sections, each illuminating and alarming in its own way: How this crew of insiders pushed the envelope to force through Part D in 2003 (Hint: A legendary abuse of the legislative process helped), how they’ve returned and who’s paying them (see a nifty chart of those connections here), and what they’re up to this time around (more of the same, only this time they’re wealthier).
Alongside Pierce’s story, she and ProPublica have launched “Eye on the Health Care Reform,” a feature in which Pierce will keep up with the reform effort’s legislative journey.
Workshop explored issues of aging America
More than 70 people attended AHCJ’s Aging in the 21st Century workshop last weekend, where former HHS secretary Donna Shalala discussed the health reform proposals and former FDA commissioner David Kessler discussed the nation’s obesity epidemic.
Sam Grogg, dean of the University of Miami School of Communication, left, moderates a session with Thomas Prohaska of the Center for Research on Health and Aging at the University of Illinois at Chicago and Sara Czaja of the Center on Aging at the University of Miami. (Photo by Carla K. Johnson for AHCJ)
AHCJ treasurer Ivan Oransky live-tweeted from the workshop, which featured panels about the health care workforce, aging in ethnic communities, brain research, elder abuse and more.
Shalala said she is confident that health care reform will pass and that consensus is within reach. She says the biggest issue remains how to pay for reform and bring down health care costs.
The Miami Herald’s John Dorschner reports that “speaker after speaker laid out a grim scenario” for aging in the United States, with a smalller health care workforce available to care for a growing elderly population.
Presentations from the workshop will be available for members on the AHCJ Web site later this week. A slideshow from the event is now online.
How will health reform affect Medicare?
Filed under: Government, Health care reform, Hot Health Headline
The Associated Press’ Carla Johnson looks at how health care reform might affect those currently covered by Medicare, focusing on five key areas: Medicare Advantage, prevention, hospitalization, electronic medical records and prescription drug coverage. Here are the basics:
- Medicare advantage is popular but relatively expensive. Some private insurers may leave the program if funding is cut, forcing some seniors to change providers. Cuts may also hit extras like hearing aids and health club memberships.
- Preventative services such as mammograms and diabetes classes will be better covered under most proposals.
- Some plans may punish hospitals with high readmission rates and encourage all hospitals to work to keep patients from coming back.
- Any move to electronic medical records and better coordination of care would benefit Medicare patients and providers, as Medicare suffers from many of the same inefficiencies as the system at large.
- As for the notorious prescription drug coverage “doughtnut hole,” the house democrats have proposed a plan that would fill it in by 2023.
S. Dakota may be model of health-care efficiency
Filed under: Health care reform, Hot Health Headline
Jon Walker of the Sioux Falls Argus Leader reports on how South Dakota’s status as the 47th cheapest market in which Medicare does business may provide a model of health care efficiency which the rest of the nation can follow.
The comparisons come from the Dartmouth Atlas Project, which shows the Upper Midwest and Great Plains leading the way. It concludes that economizing does not hurt quality.
Local health officials wish their ability to control costs would spare them from cost-cutting measures included in proposed reform legislation, Walker reports.
“One of our big disappointments with the health care reform package … is that it does nothing to recognize efficient, high-quality health care,” said Dave Hewett, president of the South Dakota Association of Healthcare Organizations.
(Hat tip to Kaiser Health News)
Moon on Medicare reform, supplmental insurance
As part of her Excluded Voices series in the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, talks to medicare expert Marilyn Moon about the program’s weaknesses and about proposed reforms to the system. Moon pushes for a simplified deductible system, says supplemental insurance is a major concern for subscribers and calls private vouchers a “hail Mary pass.”
Moon offers a sober assessment of Medicare’s financial status, saying that many reformers operate under the implicit assumption that there are inefficiencies in the system that may not actually be present. In the end, reforms can’t escape the fundamental fact that you can’t lower taxpayers’ costs without increasing those of Medicare users.
“The public also needs to realize that refusing to insure certain tests and treatments that do not work is a good approach, not a bad one as some critics have charged,” Moon said.
Lieberman asked Moon what the “biggest risk faced by people now on Medicare” was.
The gaps in Medicare’s benefit package mean that anyone who can afford to will seek supplemental coverage. That coverage is expensive and often not a very good deal. When people buy what’s called “Medigap” insurance, on average they may be getting back only seventy-five cents worth of health care for every dollar they spend. Administrative costs are also high. But going without such coverage is risky since the basic Medicare package has no catastrophic protection for those with very high expenses.
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Don't miss Health Journalism 2010, AHCJ's annual conference. You'll walk away from his world-class program with story ideas, new sources, stronger reporting skills, chances to meet newsmakers and network with other journalists. Fellowships are available.
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