The holidays are upon us, and we all know what that means for health issues — besides higher sugar and alcohol intake. That’s right, healthcare reform house parties! Check out the message from HHS Secretary nominee Tom Daschle below, and learn more about hosting or attending a healthcare community discussion over the holidays.

Meanwhile, four issues dominating discussions around the web this week are the future of the FDA, the new Nursing Home Compare rating system and web site, physicians and health IT, and of course, healthcare reform issues.

At the Center for Medicine in the Public Interest DrugWonks blog, Peter Pitts shared his recommendations for reforming the Food and Drug Administration:

I was honored when the Obama FDA transition team called and asked for my advice on how the incoming administration could make the agency a more robust and forward-looking regulatory instrument.
…
My suggested areas of focus are

1. A strong, science-based FDA
2. The Reagan/Udall Foundation — a Partnership of Unequals
3. Clarity vs. Ambiguity
4. Information Management
5. Food Safety and Security
6. Risk Communications
7. The Drug Label and the “Safe Use” of Drugs

…
There are, obviously, many, many other important issues … and I look forward to working with the transition team to ensure that the new commissioner can hit the ground running… And kudos to the Obama transition team for reaching out to a wide variety of groups.

On his Pharmalot blog, Ed Silverman wrote about a coalition of health groups that just “joined the heated lobbying battle over the next FDA commish” with a letter to HHS Secretary nominee Tom Daschle advocating for “a person familiar with the industry”:

The newly formed FDA Commissioner Coalition is made up of 34 patient and research organizations, most of which receive funding from drugmakers, the paper writes. The coalition’s letter to Daschle didn’t name any candidates but argues the next commissioner should make decisions free from “pressure from elected and appointed officials and from the news media.”

The move comes after weeks of speculation that the list of potential nominees… [who] have been outspoken in criticizing drugmakers over various products and practices.
…
In contrast to such public profiles, the coalition’s letter says relationships with industry should be viewed as a “positive qualification” for candidates, not as a black mark. A spokesman for Friends of Cancer Research, which signed the letter, says the coalition wants to reflect concerns of its members and didn’t coordinate its statements with drugmakers.

Jane Akre outlined some reactions to the new Nursing Home Compare system that the Centers for Medicare and Medicaid Services (CMS) launched on Thursday:

We use the five-star rating system when choosing a hotel — why not a nursing home? That’s the theory behind a new rating system proposed by the Centers for Medicare and Medicaid Services.
…
“From a consumer viewpoint, it’s not stringent enough,” says Alice Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform… The National Association of State Long-Term Care Ombudsman Programs (NASOP), a nonprofit comprised of ombudsmen representing their state programs, commends the new system. “We are very supportive of giving consumers information to select a nursing home and to monitor the home’s performance,” said Beverley Laubert, the association president in a statement. “And we urge consumers and their families to seek an understanding of how the ratings are derived and to use the ratings in conjunction with other resources.”

On the Covering Health blog, Pia Christiansen overviewed the new system further:

The ratings system is intended to be easier for consumers to use, as well as incorporating more data that has not been used in the past. According to The Bakersfield Californian, “The new rating tool will use federal data to score each facility’s performance in three areas: health inspections, staffing and quality measures.”

On his Musings on Aging blog, Anthony Cirillo had high praise for the five-star system:

The rating system is based on information from the last three years of surveys and complaints, staffing information collected at survey and quality measures. It is one more tool to use to assess care.

It is anticipated that approximately 20 percent of the facilities will receive five stars, 70 percent will have two, three or four stars and the remaining 10 percent will be assigned the lowest rating of one star.
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Keep in mind that nursing home care is something we don’t like to think about and don’t want. But some of us WILL need it… So better prepared than sorry. Do your homework now for future reference.

On the WSJ Health Blog, Sarah Rubenstein covered a development for primary care physicians this week:

These days, the name of the game for getting government money is arguing that your well-being is vital to the nation’s economic recovery. Enter primary care doctors, hat in hand.

American College of Physicians President Jeffrey Harris sent a letter yesterday to HHS nominee Tom Daschle asking that the Obama administration’s economic-stimulus package include a 10% pay bonus for all services provided by primary care docs under Medicare for a period of 18 months. The letter also requests that primary care practices, especially small ones, get a piece of the funding pie for health information technology. Obama has pledged to spend billions of dollars on that endeavor.
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Harris also alludes to problems patients have had getting appointments with primary-care doctors in Massachusetts, which has put in place a universal health-coverage plan. “Providing more people with health coverage doesn’t mean they will have good access to care, when there aren’t enough primary care doctors to take care of them,” he writes.

At The Health Care Blog, David Kibbe and Brian Klepper expressed their concerns and hopes for any health IT spending included in the Obama Administration economic stimulus package:

Whether the health IT money is well spent will depend on how it is distributed and what it buys. Most observers suppose that federal health IT investment dollars will be used to help doctors’ offices and hospitals acquire and implement electronic health record systems (EHRs or EMRs)… We agree that some of the federal health IT money should go to purchase EHRs, especially to doctors and hospitals in rural and under-served areas, which otherwise could not afford them.

The easy solution would be to spend most of the health IT funds on EHRs… But the easy solution would not be the right one… important as EHRs are, at this point there are far better ways to invest in health IT for the doctor’s office and hospital.
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We believe that the Obama administration could leverage IT spending in similarly inexpensive ways. Smaller, incremental steps would likely impact a larger number of medical practices in the short-term, benefiting patients while limiting the disruption to doctors. Here are three suggestions:

1. Referral Management.
   …
2. Patient Communications.
   …
3. Infrastructure Build-Up and Maintenance.

(Check out the complete post for more details on these three suggestions.)

Commenting on the ongoing healthcare reform debate in and out of Congress, Ezra Klein noted:

If you’re looking for the coming fault line on the left of health care politics, keep an eye on what happens to the public insurance option in the health reform bill. Access to a public insurer is a big deal for progressives and conservatives alike. It’s important to progressives because they believe a public insurer — which is to say, an insurer that’s not concerned with the profit motive — could offer better coverage at lower cost, and in doing, attract more customers and pave the way to something closer to a single payer system. It’s important to conservatives for the exact same reason. The only difference is that progressives think this a very good thing that cannot be sacrificed while conservatives think this a very bad thing that cannot be allowed.

On that note, at The New Atlantis: Diagnosis blog, James Capretta commented on the upcoming “battle… fought over the so-called ‘public insurance option’” for which the Obama campaign advocated:

Many Democrats, including Senate Finance Committee Chairman Max Baucus, want to give workers the option to enroll in a public insurance plan modeled on Medicare. Proponents of this idea say they only want a fair competition with private insurance offerings, but the reality is that a public insurance plan would open a backdoor to a single-payer system. Public insurance plans always set fees for services well below market rates and thus shift costs to other payers who must negotiate, not dictate, rates with doctors and hospitals.
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Some more moderate advocates of Democratic-leaning reform try to downplay the significance of the public insurance option, suggesting it might be discarded to get a deal. Perhaps. But the Obama framework really doesn’t work without it either because the Democratic approach to reform is entirely dependent on governmental price controls to hold spending in down. Jettisoning the public insurance option, absent a real marketplace, would drive the costs of Obamacare even higher.

Also looking ahead at 2009 healthcare legislation possibilities, Joseph Paduda warned against “inflated expectations”:

I’ve been rather negative about the chances we’ll see major health care reform next year. That doesn’t mean the new Congress and President won’t address significant issues — expect major efforts to change physician reimbursement, enable HHS Sec-to-be Daschle to negotiate with big pharma, slash the Medicare Advantage subsidy, invest in Health IT and expand SCHIP coverage. These are really really big issues…

We’re moving in the right direction, there is significant momentum, and focus is on the right areas. What we don’t need is a pell-mell rush to pass universal coverage and worry about costs later.

There’s an old adage — if you don’t have time to do it right in the first place, what makes you think you’ll have time to fix it later? If we screw it up on the front end, we’ll have zero political capital to clean up our mess.

Finally, getting into (one part of) the spirit of the season on the Let’s Talk Health Care blog, Charlie Baker asks (and answers), “what could health care and [the Bowl Championship Series] possibly have in common?”:

This year, when there are still two undefeated teams, and a host of teams with one loss (most of which occurred against one another), the idea of a two-team showdown based on computational statistics seems simply nuts. But the keepers of the BCS flame have their reasons for retaining the status quo, and they have the power and the juice to keep things just the way they are. Their rationale — to anyone looking at this from the outside in — seems pretty skimpy… the folks who participate in and benefit from the current arrangement don’t want to change it, and as long as the fans, the alumni, the TV networks, and the schools themselves continue to show up and participate every year, moving away from the status quo is simply not going to happen.

Which brings me to health care. Anyone looking at health care from the outside in would have to conclude that it needs to be reformed. And the commentary from the various analysts, experts and overseers on this question is quite familiar… And yet here we are, twenty years or so into this conversation, and it still works under more or less the same terms it’s always worked under. Why? Well, in some ways, it’s a lot like the BCS. As long as everyone who pays for, manages and participates in the current system likes it better than something they either don’t know or don’t understand, it’s unlikely that major change will occur.

Maybe major health care reform will happen at about the same time [as] Divisin I college football… Seems if we can do one, we can simply apply the lessons learned from that to do the other.

Related posts:

1. Blog Roundup: The jury's still out on comparative effectiveness and the stimulus, but at least we know coffee is good for our health
2. Blog Roundup: The Economic Stimulus Bills and Health Care
3. Blog Roundup: President Obama's budget plan for health care reform
4. Blog Roundup: Daschle, HHS, and American Heart Month
5. Multimedia Roundup: Health Care Policy

This entry was posted on Friday, December 19th, 2008 at 10:48 am and is filed under Access, Caregiving, Consumer Health Care, Cost, HIT/Health Gaming, Medicaid, Medicare, Policy, Politics, Roundup, Technology. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.