Thursday

Good morning!  I am thoroughly exhausted from interviewing while trying to stay on top of the rest of my work.  Hard decision, hiring a staff attorney, but I'm narrowing things down.  I hope.  In the meantime, I've had little time to keep up on current events during the day, so let's see what we have this morning.

My favorite!  A NY Times quiz!  So we have here a woman with diabetes whose eye doctor saw an abnormality on an exam and sent her to a specialist.  She had no real symptoms, but a bit of a medical history which you can read in the Times.  They've given us very little to go on this time.  Apparently, the specialist asked her one question that she'd never been asked before and that led to her diagnosis.  The challenge?  What question did the doctor ask her?  I have no clue, but I can't wait to find out!

The politics of health care will affect the upcoming elections -- not just the presidential elections, but races all over the country.  We know that two conservative Democrats in Pennsylvania who voted against reform already lost their seats in primary fights.  Politico analyzes 5 key races.  This comes amidst news that, once again, the United States spends an astronomical amount of money on health care when compared with other countries -- about $8000 per person. 

Medicare accountable care organizations (ACOs) may dramatically transform healthcare.  Instead of seeing one doctor who gets paid for each service he/she provides, in an ACO, you have a team of doctors who work together and get paid a lump sum to care for your health needs, with the amount of the payment tied to health outcomes.  The idea is to pay for value rather than volume.  So interesting -- the potential to make a better system is very real.

A new Republican report says that large employers can save a bundle if they stop offering health insurance, shifting people to buying coverage on the Exchange.  However, every indicator is that they won't stop offering coverage.  It certainly hasn't happened in Massachusetts.  Offering health insurance provides some tax advantages, and it helps ensure a healthy work force.  In my opinion, it also inspires loyalty.

Over 100 people have been charged with Medicare fraud on a grand scale, with money laundering and kickbacks and the whole deal.  The fraud was valued at $452 million.  This doesn't save the federal budget, but it's a start. Under health reform, Medicare and Medicaid fraud prosecutions have become priority.  One place we can all agree we should be trying to control costs is fraud and waste.  Indeed, a bipartisan group of Senators has asked health care providers to help root out fraud.  It's great that the feds are taking this seriously and rooting out this kind of fraud and exploitation. 

A new study shows that the US has as many premature births as developing countries.  Although we do better in keeping those babies alive, why aren't we doing a better job of caring for pregnant moms so they don't give birth prematurely?  The explanation is that we have a combination of teen pregnancies and pregnancies in women over age 35, especially if they have in vitro fertilization followed by implantation of twins or triplets.

Finally -- but I hope you're still reading because you shouldn't miss this -- the miraculous Atul Gawande has written an 8 page paper summarizing the 200 year history of surgery.  Anything he writes is worth reading -- this piece shows his sense of humor as well as his brilliance.

And that's it for this morning.  Have a great day!  Jennifer