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"Searching for Vital Signs: Best and Worst of Health Care 2005"...The Century Foundation presents a look at events in health care for the last year

Leif Wellington Haase . a senior program officer and Health Care Fellow at The Century Foundation, developed this insightful list.

The Century Foundation conducts public policy research and analyses of economic, social, and foreign policy issues, including inequality, retirement security, election reform, media studies, homeland security, and international affairs. The foundation produces books, reports, and other publications, convenes task forces, and working groups and operates eight informational Web sites. With offices in New York City and Washington, D.C., The Century Foundation is nonprofit and nonpartisan and was founded in 1919 by Edward A. Filene.

 

The Best

  • The Bill & Melinda Gates Foundation, which fights preventable disease in the developing world and is bucking the obstacles to success. Since 2000, The Gates Foundation has donated more than $6 billion to this cause—more than almost any single donor country and four times the annual budget of the World Health Organization. Part of Gates’ 2005 commitment: $258 million to fight malaria, which infects 300 –500 million people a year and kills around 1 million, mostly African children. It’s admirable that Gates is tipping the scales mildly on medical research funding—only about 10 percent of current dollars go toward research on diseases that account for 90 percent of annual deaths worldwide. Better yet, his example is prodding and shaming nations and international organizations into changing their priorities.
  • State-level policymakers who are pushing universal health coverage. As the cause languishes in Congress, legislators like Governor Rod Blagojevich of Illinois, whose Healthy Kids bill will cover all uninsured children in the state, and members of the Vermont House of Representatives, which voted for a universal health coverage bill in April, are keeping the torch lit.
  • Take Care New York. An ambitious, simple, and no-nonsense Web site introduced by New York City Public Health Commissioner Thomas Frieden to improve public health citywide. Thanks to his education efforts and tough anti-smoking legislation, the number of smokers in the city has dropped by an estimated 200,000 over the past three years. Governing magazine rightly named Frieden one of its public officials of the year.
  • Minnesota hospital systems that have stopped gouging uninsured patients. One of the ongoing scandals of U.S. health care is that uninsured patients frequently have to pay more than patients covered by large insurers for the same procedures. Then they get dunned by bill collectors as they try to dig out of impossible financial holes. Under an agreement with Minnesota Attorney General Mike Hatch, this honor roll of hospitals—Allina, North Memorial, Park Nicollet, and HealthEast Care—agreed that uninsured patients with annual household incomes not greater than $125,000 would pay no more than the large insurer rate for their treatment.
  • U.S. pediatricians. They’re stopping overprescribing antibiotics to youngsters, one of the leading bad news stories of past years. In not entirely unrelated news, American kids are the healthiest ever.
  • The Veteran’s Health Administration. Just a few years ago, most VA hospitals were a laughingstock and a disgrace. Now the VHA system is leading the pack in comparison with other health plans on health care performance measures. Moreover, the VHA is at the forefront of efforts to introduce lifesaving new technologies and reduce medical errors.
  • The Patient Inform Web site. The news media tends breathlessly to report new medical findings without any context—e.g. what kind of study, who paid for it, how it compares to existing knowledge in the field. This Web site, co-sponsored by the American Cancer Society, the American Diabetes Association, and the American Heart Association, attempts to analyze key medical findings in language suited to a lay public. It also suggests how patients should interpret the data in making their treatment decisions. Maybe the idea of having a nation of informed medical consumers is a pipe dream—but Patient Inform is on a noble quest to prove the contrary.
  • Medicare’s pay-for-performance initiatives. For the first time ever, Medicare will reduce payments this year to hospitals that don’t report their performance on a set of health quality measurements. Pay-for-performance—which allows payers to reward or penalize doctors and hospitals on their success in meeting certain goals, such as meeting evidence-based clinical standards or providing appropriate preventive care—has been slow to take root in many practices, hospitals, and health plans. If Medicare’s pay-for-performance initiatives are a harbinger of things to come (along with new standards called for by the Institute of Medicine), this could change for the better.
  • U.S. life expectancy reaches an historic high. It’s up to almost 79 years. To be sure, rising trends in obesity might tip this in the opposite direction before long, but let’s toast success while we can.
  • Best health care satire. No contest: "A Healthcare System That Works" (for pets).

The Worst

  • Presidential no-show. Twelve hundred policymakers and advocates for the elderly came to Washington in December for the White House Conference on Aging, which was meeting for the fifth time since 1961. Despite the obvious salience of aging issues—Medicare reform, long-term care, shortages of geriatric doctors—President Bush chose not to address his own conference, the first time ever for a sitting president.
  • Docs on the take? Needless to say, most physicians are ethical and conscientious—but the commercialization of modern medicine has sent many down the wrong path and put other doctors on the defensive. There’s a rogue’s gallery of unseemly behavior—possible conflicts of interest, dubious clinical trials, and ghostwritten scientific articles—here, here, and here, and in a valuable book-length expose by Jerome Kassirer, the former editor of the New England Journal of Medicine.
  • Health Savings Accounts (HSAs). These accounts, allowed by Congress in 2003, feature tax-favored savings accounts along with a high-deductible insurance policy. They are making modest inroads in employer-based health plans and in individual insurance markets. (Somewhere in the range of one million Americans are enrolled now, up from under half a million in September 2004.) While they are all the rage among health policy consultants who are touting “consumer-directed care,” HSAs are being terribly oversold. To learn in more detail why HSAs are unlikely to lower overall health care costs while quite possibly undermining existing small-group insurance coverage, read here, here, and here.
  • Wal-Mart tells the unhealthy: don’t bother applying. In an instantly notorious internal memo presented to a retreat of Wal-Mart’s board of directors, the company’s executive vice-president for benefits recommended discouraging unhealthy job applicants, and recruiting a younger workforce, by arranging for “all jobs to include some physical activity (e.g. all cashiers do some cart-gathering).” To be fair, the memo as a whole less indicts Wal-Mart but the logic of employer-provided health care in general. Except for a sense of paternalism, decency, loyalty, and fair play, why should employers in a competitive market cross-subsidize the health costs of older and sicker employees when they are rationally competing for younger and healthier ones, for whom health coverage is a selling point in choosing an employer? And in fact Wal-Mart simultaneously introduced a new low-premium, high-deductible plan featuring health savings accounts that should appeal to younger, healthier, and single workers. Bashing Wal-Mart is good clean fun, but the core of the problem is the absence of good universal health insurance coverage for all Americans, young and old, healthy and sick (which employers should help fund, but not offer directly).
  • Whose moral hazard? Cervical cancer is diagnosed in about 10,000 U.S. women each year and kills about 3700. Merck has developed a vaccine for cervical cancer that targets the virus that causes 7 in 10 cancers and has shown impressive results in clinical trials. The company intends to apply to the Food & Drug Administration by the end of 2005 for permission to market the vaccine. (GlaxoSmithKline is also developing a cervical cancer vaccine.) Amazingly, the Family Research Council and other conservative groups have raised doubts about administering the vaccine to children (where it would be the most effective) because they fear that it will encourage promiscuity and undermine their preferred message of sexual abstinence.
  • South Carolina’s proposed Medicaid reforms. Trying to slow the rise in the state’s Medicaid costs, Governor Mark Sanford proposed giving 850,000 low-income South Carolinians personal health accounts that they would use either to pay for a managed care plan or to pay for “self-directed” care directly from providers. Though this idea has been progressively scaled back in response to withering criticism, the basic premise of including personal accounts in Medicaid simply doesn’t make sense. Personal accounts have little or no track record and private managed care plans haven't saved money for Medicare. So why would you take the most vulnerable, often least-educated, poorest Americans and make them the unwilling subjects of an unproven experiment?
  • The Medicare Drug Benefit. There’s a lot of potential for good here for low-income Medicare beneficiaries, who get tremendous help under the benefit with prescription drug costs. And it’s hard to criticize the impressive efforts of government officials, state and local volunteers, and private insurers to make sense, on behalf of older Americans, of this needlessly complicated benefit. But the early sign-up numbers don’t seem to be impressive—including, sadly, among low-income seniors and the disabled—and there are lots of minefields both structural and political ahead. To paraphrase Yogi Berra, for the drug benefit, it’s getting late early.

We note that the mayor of Biritiba Mirim, Brazil, has passed a law that forbids the town’s residents, until further notice, from dying. May you all have the same good fortune! Happy New Year!

 

 

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