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Eight Signs that Wellness and Prevention have become Health Reform Priorities

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Health care reform alone won’t make
America healthier. We’ve seen this basic message as recently as yesterday,
in Ezra Klein’s piece for the American Prospect, “Wealth-Care Reform.”  At the Robert
Wood Johnson Foundation Commission to Build a Healthier America
, we’ve been studying prevention, wellness,
and the broader factors that influence good health for nearly two years. 
And as the health care reform debate has heated up over the last few
weeks, we’ve seen eight signs that health reformers and leaders from
all sectors are starting to get the message that there’s more to health
than health care. 

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The State of Meaningful Use

Is it possible that the State Department is technologically bolder than the HIT Policy Committee?  On Tuesday, that committee convened by the Office of the National Coordinator as required by the American Recovery and Reinvestment Act released some initial recommendations on the definition of meaningful use of HIT.  Then yesterday the New York Times in an above the front page fold article reported that the State Department recognized an internet blogging service could change history–right now.

Compare that report about the State Department to the HIT Policy Committee’s recommended vision for the role of patients and families.  The committee envisions that someone would eventually “provide access for all patients” to populated personal health records and some self-management tools by 2015–about six years from now.  It’s not that this vision is bad; it’s just so underwhelming.  Let’s see–the State Department thinks that the Iranian people might be using Twitter today to regain control of their nation–and in our multi-billion dollar ultimate vision for the patient’s role with health information technology we’re still talking about “providing” a couple of interesting tools to patients by 2015.  Is it me, or are we possibly missing a powerful health reform player here–the consumer?

So, as you can see, I listened to this meeting on “meaningful use” and came away with some distinctly mixed impressions.Continue reading…

Back to the Drawing Board?

Roger collier

The current congressional approach
to health care reform of adding ever more fixes without changing the
underlying system looks increasingly shaky. 

What are the some of the indications? 

  1. The public plan has generated
    enormous opposition—and not just from insurers. Whether anyone believes
    that a Medicare clone would reduce under-65 health care costs or not,
    it is unlikely that a final reform bill will include anything other
    than a weak compromise.

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The Right to Share

Jamie-headshot-casualWe do not live our lives alone. We live our lives in collaboration
with others. We communicate our needs and our goals, and together we
work to achieve them. This is exceptionally true for families and
individuals dealing with illness. Whether you’re dealing with
depression, or pain, or perhaps the fear and stigma of HIV, or the
impairment that comes from MS, Parkinson’s or ALS, what helps us the
most is when those around us reach out and share their support and
advice.

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Interview with Hal Luft, author of Total Cure

6a00d8341c909d53ef0105371fd47b970b-320wi Hal Luft is a veteran policy analyst who's been looking at all aspects of the health care system. He's Professor Emeritus at UCSF and now is director of the Palo Alto Medical Foundation Research Institute.

His recent book Total Cure had a fabulous review from JD Kleinke in Health Affairs and essentially presents a combination of a universal insurance pool for chronic care and hospital care, and choice between independent physicians for routine primary care. It's a mix of universal care, and market solution. In this (long) interview I ask Hal about the idea, and he also goes on to explain how the central core of the idea–a public body that essentially re-routes payments to care delivery teams might well be part of the emerging legislation. Given that (as Robert Samuelson points out in the WaPo today), we haven't seen much of a mechanism for cost containment from the legislation proposed so far, yet all agree that we need one, Luft's ideas are becoming become influential rather quickly.

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THCB alum going gone places

Sarah Arnquist left THCB earlier this year to go work at a newspaper with a slightly higher journalistic profile and somewhat longer history. I'm very proud to tell you that below is a link to Sarah's first byline in The New York Times—even if it’s not typical THCB material!

In Some Swimming Pools, a Nasty Intestinal Parasite, by Sarah Arnquist

Quick Sunday roundup or “OMG I agree with Tyler Cowen”

6a00d8341c909d53ef0105371fd47b970b-320wi I can’t say that I often agree with libertarian Tyler Cowen and I think it’s pretty appalling that the New York Times gives someone with such, as Republicans used to say, “out of the mainstream” views a regular place to air them. Like this column saying that our health care system is better than those of other nations because we’ve got more Nobel prizes for example.

But today in his column Cowen basically says the we should pay for the expansion to the uninsured through reallocating current government spending (mostly on Medicare).

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Designing an Effective Insurance Exchange. Or Not.

Roger collier

If health care reform legislation is passed, it will almost certainly include provisions for Insurance exchanges. Theoretically, these could be key to controlling costs and expanding access to coverage. In practice (and in addition to assumptions about guaranteed issuance, community rating, and the elimination of medical underwriting) these goals will be achieved only if exchange design adheres to some basic principles:

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