Finally Friday -- And Monday's Columbus Day!

Advocacy for Patients is closed on all postal holidays. So the question is: will Jennifer take the day off and rest like she should? If you see a blog post on Monday, you have my permission to yell at me.

And now, the news.

Today's big story: the Institute of Medicine came out with its recommendations for the essential benefits package. You may recall that, under health reform, the Secretary of Health and Human Services has to come up with an essential benefits package -- the floor that all insurance will have to offer to be offered on an exchange and to be considered the minimum coverage you can have to avoid a penalty for violating the individual mandate. The Institute of Medicine was supposed to come up with a first shot at this. What they wrote (in 340 pages) is that cost must be taken into account, and the Secretary should come up with an essential benefits package that would guarantee that insurance premiums would not exceed a benchmark set by the Secretary. The scope of these plans would be tied to small employer plans, which some consider to be a bit stark. Coverage will include the usual areas -- hospital, doctors, labs, diagnostics, prescription drugs, maternity care -- the big areas. But the details are still fuzzy and according to the IOM, should depend largely on cost. I have read the summary but not all 340 pages yet, so I'm trying not to panic here, but this is huge. And the insurance industry likes it, making me even more nervous. But the idea is to maximize coverage by keeping it affordable, focusing on high value treatments that are proven to work. I'm all for that -- but what about the person with the rare disease for which there are no proven treatments? It's people around the edges who suffer when we talk about controlling costs. Is it fair, right, acceptable to abandon them? We will see the HHS rules some time in 2012.

Innovation is the key, as providers find new ways to deliver health care that are less costly, more efficient.

Here's an interesting take on the individual mandate and why it's really not so different from other parts of the tax code.

And what are we going to do about disparities in health care based on race? We have to confront this issue head-on, but nobody seems to know how. Trauma care is harder to access for African-Americans and those in rural areas. Illegal immigrants have nowhere to go but emergency rooms, where we all pay the bill. And most of all, poverty has a bigger effect on health care than race or ethnicity or geography, although each of those plays a role, too. Minority and low income folks are less likely to have a regular health care provider than others, so no continuity of care, no care coordination -- the most inefficient way to deliver care.

President Obama is trying to get an extension of federal unemployment benefits -- and there are people who are unemployed who oppose that. I'm so confused.

The US Preventive Services Task Force says no more routine prostate cancer screenings -- they don't save lives and often lead to treatment that causes pain, impotence and incontinence. That doesn't mean you can't have the test done; it just means it's not among the free preventive services that are offered.

And that's today's news. Have a great day. Jennifer