HEALTH REFORM: Back to the Blogger To-Do List....

(Reposting to fix a typo in a Brendan Borrell's name)

A few good reads from this week that we didn't have time to blog about (some travel, two magazine deadlines and Halloween costumes to prepare) but still wanted to share:

Reuters Health, under the relatively new direction of Ivan Oransky, has an investigative piece by Brendan Borrell looking at some of the intrigue and controversy surrounding a couple that has to a certain extent become the face of the growing medical tourism industry.

Kaiser Health News' Julie Appleby (expanding on and explaining some fine analysis by the Center on Budget and Policy Priorities) raises some concerns about affordability under the Finance Bill.  She writes:

Proponents of the Senate Finance Committee's health care bill say the legislation will limit the amount that lower- and middle-income people must pay for health insurance to a maximum of 12 percent of their incomes.

But there's a catch: The fine print shows that, over time, the premium costs could rise well beyond those caps. That's because the cost of coverage would shift from a percentage of income to a percentage of the premium, no matter how high the premiums go.

Because premiums generally rise faster than wages, consumers getting subsidies would pay a larger percentage of their incomes toward premiums over time. But the provision means slower-growing subsidy costs for the government.

 

 

 

 

Unclear whether this will be changed in the final legislation.

Tim Jost at Health Affairs blog has a pretty incisive summary of the hot points of the House bill. And the inimitable David Rogers at Politico has a terrific interview with Nancy Pelosi channelling the Rolling Stones (sort of).

On the ever-simmering health IT front -- The Wall Street Journal earlier this week recapped some of the achievements of the VA in adapting health information technology -- and updated us on some of the recent steps to coordinate that information with records of care outside of the VA; (hat tip to our colleague Phil Longman) . Quality expert Bob Wachter (who believes health IT is absolutely essential but who is aware of Health IT pitfalls as well as its promises)  has some cautionary tales about what can and does go wrong.

Both Drew Altman at Kaiser Family Foundation (whom one needs to be very very very kind to in October given his Red Sox sensitivies) and Don Berwick of IHI (in a speech blogged by Paul Levy at Beth Israel) talk about system redesign as a way of addressing the cost-coverage conundrum. Drew writing about quality curve-benders providing a third way (the others being the Regulators and the Marketeers) and Don stressing the "moral imperative" of coverage underscores what we've been saying about increasing overlap and coordination in various health care camps to a more unified and entwined efforts to address cost-coverage and quality as three sides of the same coin (we know that doesn't quite add up but you get the point). We'll take a long time to get there. But this legislation takes a bigger leap forward than many imagined.

Lastly, check out David Broder on opt-in,opt-out and federalism and liberalism. (Hat tip to Politico who got to the Post op-ed page hours before we did...)