Health Wonk Review: More than Birth Control Pills

Health care-related news topped the headlines this week. Mandates for insurers to include birth control pill in their plan benefits and news related to the Susan G. Koman foundation were featured on the front pages of most national newspapers.

While the birth control and Susan G. Koman stories are certainly important ones, there is a lot more brewing in the health policy world.  The American Health Lines (AHL) Alerts Blog lists four other important health care story-lines.

• House Democrats’ concern with HHS’ deference to states on the essential health benefits rules;
• A federal appeals court ruling that U.S. residents enrolled in Social Security are legally entitled to Medicare;
• The conference committee attempting to come to an agreement on a yearlong patch for the sustainable growth rate formula — known as a “doc fix” — which sets Medicare physician reimbursement rates; and
• States and the National Federation of Independent Business filing briefs with the Supreme Court in the multistate lawsuit against the federal health reform law.

Those are just a few of the stories you can read about in this week’s edition of the Health Wonk Review.

Birth Control

• The Disease Management Care Blog wonders whether the row over the inclusion of the birth control pills in the essential health benefits (EHB) package is just one example of a future where the rationing of medical care occurs through “hyper-rational, inflexible, evidence-based, legalistic, uniformist and technocratic decision-making.”
  
• Insure Blog discusses an unintended side effect of the birth control debate: “Knowing that all insurers are required by law to pay 100%, Obama just eliminated all price pressure. No matter what the charge is, we are required to pay it.”
• On Time.com, Maggie Mahar notes that the net cost of providing free contraception is less than zero because the savings are much greater than the costs of covering unplanned pregnancies.

Hospitals

• The Hospitalist Leader reports that the number of hours patient spend in observation units grew to around 36 million in 2009, from 23 million in 2006.  Who wins from this arrangement?  Not the patient.
• Wing of Zock examines how hospitals can mitigate risk when they receive bundled payments.
• Do value-based purchasing (VBP) programs incentives providers to decrease cost?  Although bundling and physician payments do reduce cost, the Healthcare Economist finds that in most cases VBP programs have no effect on spending levels.

Health Reform

• Will Health Reform be repealed by the Supreme Court?  Timonthy Jost of Health Affairs notes that the NFIB is arguing that if Court finds the minimum coverage requirement unconstitutional, it must strike down the entire Affordable Care Act.
• John Goodman’s Health Policy Blog writes that despite bipartisan proposals to reform Medicare–most recently a proposal by Ryan and Democrat Ron Wyden–there is no serious Medicare cost-cutting reform in ObamaCare.
• The Colorado Health Insurance Insider finds that people’s opinion of Health Reform has little to do with their understanding of the law; 47 percent of the uninsured felt that the ACA wasn’t going to affect them directly.
• “By 2020, the American health insurance industry will be extinct.”  Vince Kuraitis of the e-CareManagement blog disagrees.
• The Health Access Blog states that it is imperative to have “automatic and seamless mechanisms to get people enrolled” in health plans as soon as the Health Exchanges begin in January 1, 2014.  The question is whether these mechanisms will be ready in time.

Republican Presidential Candidates

• Is Rick Santorum a serious candidate for the Presidency? The Health Business Blog thinks that based on his health care platform, the answer is a resounding no.
• Avik Roy posts on Forbes about the history of Republicans and the individual mandate.  Romney said in a debate in Las Vegas last October, “we got the idea of an individual mandate…from [Newt Gingrich], and [Newt] got it from the Heritage Foundation.”  Even Richard Nixon proposed an employer mandate in 1974.

The Grab Bag

• Health Care Renewal gives a recipe for an effective stealth marketing of poor performing medical treatments:  i) suppress contrary research, ii) use ghostwriters to write ‘expert’ reports, iii) gain support of key opinion leaders, iv) intimidate those who threaten to expose these problems.
  
• Healthcare Talent Transformation gives physicians a 13-step plan for EMR implementation.
• HealthBlawg discusses the first HIPPA enforcement action against a business’s associate that has improperly released protected health information.  What was the problem?  The associate left an unencrypted laptop loaded with PHI in a rental car which was later stolen.
• Workers’ Comp Insider posts a cautionary tale about when chiropractors go bad. Workers Comp fraud is not just for claimants.