Tuesday Tidbits

Only Tuesday? Darn. Oh, well. Here's the news:

Massachusetts was the first state to go to universal health care to address coverage, and now they're focusing on cost. They are looking at becoming the first state to pay providers differently. They are considering a global payment system so they pay networks of providers to keep you well rather than paying for each service you get. I can't help being a little nervous -- providers may try to avoid "expensive" patients like those with chronic illnesses. Or they may try to avoid spending money by ordering that test or that treatment. But they would pay on a sliding scale, so the network of providers would get more money for taking on someone like me than they would for a healthy person. We have to do something about cost, and I think it's great that someone's out there experimenting, thinking outside the box. We need more innovation if we are going to get a handle on cost.

Indeed, we need patients to play a more active role in their own health care, to be informed decisionmakers and partners with their doctors.

There are other innovations happening. Blue Shield of California is giving teams of providers grants to try to deliver health care more efficiently.

The Tea Party is proposing its own deficit reduction plan this week, and repeal of health reform will be front and center. However, they've found that there's a lot less enthusiasm about making major changes to Social Security and Medicare. Funny, though -- they would tighten eligibility for Social Security disability. What ever happened to caring for our fellow Americans and all that?

Well, it's not in health reform, at least according to the GOP, which is already plotting full repeal of health reform if they take the White House and Congress next year. Your kid staying on your policy to age 26? Gone. The elimination of pre-existing condition exclusions for kids? Gone. The elimination of pre-existing condition exclusions for everyone in 2014? Gone before it happened. Health reform has already done some real good. You ready to give it up?

Here's what happens to people who can't access health care. Can you really read this and turn your back?

Medicare releases hospital patient safety ratings.

A doctor charts the path of HIV/AIDS back to 1900. Fascinating.

And is colon cancer linked to a particular bacteria not normally found in the colon?

With the CLASS Act all but dead, we revisit the issue of long-term care insurance and the fact that most of us have no way of paying for long-term care at the end of our lives. I think one of the reasons we don't think about long-term care is that we -- doctors and patients -- aren't very good at handling death. We simply aren't very good at dealing with the process of dying.

But the bruhaha around the CLASS Act is sort of confusing. The Administration says the long-term care plan is unworkable -- but they don't want to repeal it. The GOP of course would repeal any part of health reform they could. I think the issue is that the CLASS Act was projected to save $86 billion, so without it, the federal deficit increases by $86 billion. If the Administration didn't want to repeal it, though, why did they announce its demise?

How to pick a good therapist and good therapy for you.

Have you gotten your flu shot yet? I'm not kidding.

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