Health Care Reform Articles-June 3, 2012

Let’s (Not) Get Physicals

By ELISABETH ROSENTHAL

FOR decades, scientific research has shown that annual physical exams — and many of the screening tests that routinely accompany them — are in many ways pointless or (worse) dangerous, because they can lead to unneeded procedures. The last few years have produced a steady stream of new evidence against the utility of popular tests:

Prostate specific antigen blood tests to detect prostate cancer? No longer recommended by the United States Preventive Services Task Force.

Routine EKGs? No use.

Yearly Pap smears? Nope. (Every three years.)

So why do Americans, nearly alone on the planet, remain so devoted to the ritual physical exam and to all of these tests, and why do so many doctors continue to provide them? Indeed, the last decade has seen a boom in what hospitals and health care companies call “executive physicals” — batteries of screening exams for apparently healthy people, purporting to ferret out hidden disease with the zeal of Homeland Security officers searching for terrorists.

http://www.nytimes.com/2012/06/03/sunday-review/lets-not-get-physicals.html?pagewanted=2&ref=global-home&pagewanted=print

Oregon's Medicaid Experiment Represents A 'Defining Moment'

The things that Amy Vance does for James Prasad are pretty simple: She calls doctors with him, organizes his meds, and helps him keep tabs on his blood pressure, blood sugar and weight.

These simple things — and the relationship between a health coach like Vance and a chronically ill Medicaid patient like Prasad — are a big part of a $2 billion health care experiment in Oregon.

Gov. John Kitzhaber, a Democrat and a former emergency room doctor, has convinced the federal government that he has a way to make Medicaid treatment better, and cheaper, by completely changing the way the sickest people in Oregon get health care.

http://www.npr.org/blogs/health/2012/05/30/153982708/oregons-medicaid-experiment-represents-a-defining-moment

The perils of health care price controls

By Steven Syre

http://www.bostonglobe.com/business/2012/05/31/the-perils-health-care-price-controls/EkSTx07ZLKe5xUEvzbwjZO/story.html

Treating You Better for Less

There is some good news about the overly costly, underperforming American health care system. A growing number of hospitals, doctors, employers and health insurers are finding ways to reduce the cost of delivering medical care while maintaining or improving quality. If enough providers adopt their already proven techniques, this grass-roots movement could transform the entire system in ways that will benefit all Americans.

It is a measure of how dysfunctional the system has become that these successful experiments — based on medical sense, sound research and efficiencies — seem so revolutionary. Here are some that deserve a close look from the rest of the industry and from Washington:

http://www.nytimes.com/2012/06/03/opinion/sunday/treating-you-better-for-less.html?emc=tnt&tntemail1=y&pagewanted=print

Trade Deals For Cheap Drugs In Developing Nations Stalled By U.S.

WASHINGTON -- A change of heart from the Obama administration may pave the way to a groundbreaking global deal to provide lifesaving medications to developing nations. But hardline American opposition to a related treaty has delayed talks to lower the price of AIDS drugs and other critical medications in poor countries.

For most of last week, global medical experts balked at the American position in both negotiations. In talks at the United Nations' World Intellectual Property Organization, 34 nonprofits including Oxfam and Doctors Without Borders wrote a letter criticizing American resistance to new standards that would lower the cost of medications in developing nations, calling the U.S. position "shameful."

Many of the same the groups were alarmed by another set of negotiations occuring simultaneously at the World Health Organization, where the Obama administration attempted to prevent the creation of a new global fund to finance research for new drugs combating diseases that are rampant in poor countries. At the World Intellectual Property Organization, "the U.S. government was opposing access to existing medicines, while at WHO they were opposing access to future medicines by blocking a process to develop innovative drugs," said Judit Rius, U.S. manager of Doctors Without Borders Access Campaign.

http://www.huffingtonpost.com/2012/05/29/trade-deals-cheap-drugs-us_n_1554314.html?view=print&comm_ref=false

U.S. Trade Position Protecting High Drug Prices Blasted By U.N. Agencies

WASHINGTON -- Two major United Nations organizations warned world leaders on Thursday to avoid restrictive free trade agreements that may threaten public health, amplifying international pressure against President Barack Obama's controversial Trans-Pacific Partnership deal.

A report issued by the U.N. Development Program and the anti-AIDS UNAIDS detailed a host of drug financing policies and intellectual property standards that inflate the price of medications, and urged governments to reject such terms in trade negotiations. By granting pharmaceutical companies long-term monopolies on lifesaving medications, the U.N. groups noted, poor citizens are denied lifesaving treatments.

http://www.huffingtonpost.com/2012/06/01/us-trade-drug-prices-un_n_1560481.html?view=print&comm_ref=false

The future of medicine

Squeezing out the doctor

The role of physicians at the centre of health care is under pressure

Jun 2nd 2012 | BANGALORE AND FRAMINGHAM 

IN A windowless room on a quiet street in Framingham, outside Boston, Rob Goudswaard and his colleagues are trying to unpick the knottiest problem in health care: how to look after an ageing and thus sickening population efficiently. The walls are plastered with photographs of typical patients—here a man who exercises occasionally, there a woman with many chronic ailments. Big sheets of paper chart each patient’s course from the hospital back to a comfortable life at home, with divergent lines showing all the problems that might arise and ways to handle them. To map the many paths to health in this way Mr Goudswaard’s team interviewed a lot of patients and nurses.

http://www.economist.com/node/21556227