Tuesday, March 13, 2012

Tuesday Tidbits

Good morning! Tuesday is the big health news day, so let's get right to it:

Conservative House GOPers would like to renege on the deal they made over the debt limit and reduce spending below the levels that were agreed upon. The Senate will stick with the agreement, so anything the House does won't become law. Just another fight for the cameras. But underlying all of this is a fight over the future of Medicare. The conservatives want to privatize it, which hurts seniors and enriches insurance companies. What a horrid idea.

Yesterday, the Obama Administration released the final regulations on Exchanges -- marketplaces where you'll shop for and buy insurance starting in 2014. They're over 600 pages long, so please excuse me for not having read them cover to cover yet. The feds are requiring at least one consumer representative on the Exchange Board -- ARE YOU LISTENING CONNECTICUT? Under the rules, states will have more flexibility, as well as more help in setting up Exchanges. But realistically, what can the feds do to states that don't comply with the law? There will be a federal Exchange that will operate in states that don't set up their own. But in the end, the punishment of states who don't comply with the law will be chaos among consumers and the health care sector as a whole.

The health reform law will bring a few changes in 2012. Starting in August, well-woman visits. Consumers will start getting rebates if their insurer did not spend at least 80 or 85 percent of premium dollars on health care. Beginning September, the summary of benefits and coverage -- new "labels" for insurance that will allow you to comparison shop and know what you're getting. The doughnut hole in the Medicare drug plan will continue to shrink.

We are beginning to see Accountable Care Organizations at work. For example, take Advocate Health Care in the Chicago area. They are stepping up chronic disease management and care coordination while reducing costs. Fingers crossed.

As you know (if you read this blog), the GOP is trying to eliminate the independent payment advisory board (IPAB), which is the panel that is supposed to separate out the treatments that work and those that don't, but that are very expensive. They propose to pay for it with a cap on medical malpractice awards -- and that has the trial lawyers very upset.

Things adult medicine can learn from pediatrics. Some of my favorite IBD docs are the pediatricians. I've often wished I could go to see one of them and get treated with good humor and fun. Indeed, my friend Athos Bousvaros uses a comic book he wrote to teach kids about Crohn's disease.

Patients taking sleep meds are twice as likely to die as those who don't. I'm quite certain this would not be true for me. If I didn't take meds, I'd never sleep and I'd go totally mad. And besides, the study doesn't establish that sleep meds CAUSE death -- just that there's an association. Meanwhile, antipsychotic drugs are becoming more popular among patients with NO mental illness. And red meat also is associated with premature death.

Why doctors are leaving private practice to become hospital staff.

Steps patients can take to avoid hospital readmissions. Schedule your follow up visit. Fill your prescriptions right away. Get written discharge instructions and stick to them. These may seem obvious, but they aren't automatic. So make the effort and save yourself some extra hospital time.

What to do if your elderly parent is showing signs of dementia but she won't let you participate in her health care decisions. There is no substitute for a power of attorney for financial decisions, a health care power of attorney, and a living will. Everyone should have these documents.

Here's a really great video that summarizes all sides in the battle being waged in Texas to eliminate women's health care.

Surgery for epilepsy is thought of as a last resort, but this new study suggests perhaps it shouldn't be.

A rave review of a book by a patient paralyzed by Guillian Barre syndrome. I think I need to buy this one.

The mild winter is likely to bring a harsh allergy season.

Due to a budget fight, there is a toilet paper shortage in Trenton, New Jersey. This may seem insignificant to you, but try living with inflammatory bowel disease with no toilet paper. Perhaps Governor Christie should spend less time explaining why a student who argued with him is and idiot and resolve this mess before it becomes -- well -- an even bigger mess.

And that, my friends, is the health news on this Tuesday morning. Have a great day! Jennifer

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