Thursday Themes

Yesterday, Center for Medicare and Medicaid Services (CMS) Chief Donald Berwick finally testified in Congress. You may recall that he was recess appointed, so Congress didn't hold hearings on his nomination and they've been itching for a chance to question him. Dr. Berwick is a true innovator who advocates paying for quality performance rather than paying for services regardless of out come. Dr. Berwick pushed quality of care and defended health reform as a cost cutter.

Here's a short piece in the Wall St. Journal showing that the average deductible has increased substantially, to $1200 from about $770 five years ago. Interestingly, at yesterday's Anthem rate hearing, they said their average deductible is about $1700. This is what people do when premiums get too high - they agree to a higher deductible, and then they don't get care or amass debt because they can't afford the deductible, copays and coinsurance.

Politico reports that Democrat Ron Wyden and Republican Scott Brown are introducing legislation that would allow States to opt out of health reform's individual mandate. The law already allows States to apply for waivers of the mandate starting in 2017 if certain conditions are met. The argument here is that Oregon (Wyden) and Massachusetts (Brown) are already innovating around health care and should be allowed to apply for a waiver earlier, in 2014, if conditions are met. The exact conditions are fuzzy, but Massachusetts already has universal healthcare with an individual mandate, so this is not about Massachusetts. Wyden is generally well-meaning, but I hope this sort of step doesn't start reform on a path to unraveling.

There's concern about the food safety bill, which is stuck in the Senate. The delay appears to surround Senator Diane Feinstein's attempt to get a ban on BPA in food packaging (mostly plastic water bottles, as I understand it). Others would just like to vote on the bill as passed by the House so that its protections will kick in.

And I'm watching this study on whether chronic fatigue syndrome is linked to a retrovirus called XMRV. So many chronic fatigue sufferers are told it's all in their heads and there's nothing wrong with them. Wouldn't it be something if it were tied to a retrovirus -- and hopefully, that would mean that it could be treated eventually, as well.

And in Arizona, the budget cuts include money for organ transplants. Really? So there's something more pressing than life and death?

And finally, Democrats are asking anti-reform GOP-ers to forgo government-run, government-funded health insurance. It would be nice if the GOP-ers just said "point taken," but I doubt they will respond at all.

And that's what I've got this morning. I suspect I'm missing something -- after all, I did work until 9:30 pm and I started this at 4:30 am, so I'm a little tired! -- so check back later for an update. Jennifer