Monthly Archives: December 2012

‘ClearHealthCosts’ Sorts Out Bewildering Health Prices

(Image: ClearHealthCost)

If you’re uninsured or have a high deductible health plan, you’ve likely experienced the frustration of trying to figure out how much a specific medical procedure might cost you.

Start up ClearHealthCosts is trying to help. Former New York Times journalist Jeanne Pinder hatched the idea on the simple premise that “somehow you could bring transparency to the health care marketplace,” as she told me today in an interview.

The site launched with price comparisons across 30 common procedures in New York and then (lucky for those in the Bay Area) added San Francisco. Let’s pick a simple lower back MRI without dye. I searched within 25 miles of San Francisco, and the range was $500 on the low end to $1945 on the high end. If you’re paying out of pocket, that’s a whopping $1,445 savings to you.

In this case, the main driver of the big cost difference appeared to be whether the MRI would be done in a hospital (more overhead) or a clinic. Continue reading

Quick Read: Dirty Medical Needles Infect Thousands Across the US

Investigation finds 150,000 unsafe injections in last 10 years, leading to 49 disease outbreaks. These are entirely preventable disease outbreaks. USA Today profiles two people who were infected with hepatitis C and have endured lengthy treatments, one woman while simultaneously being treated for cancer.

As drug-resistant superbugs and increasingly virulent viruses menace the medical world, patients face a threat that was supposed to die with the advent of the disposable syringe 150 years ago: dirty needles.

Read more at:

Quick Read: Jack Klugman’s Secret, Lifesaving Legacy

ICYMI from yesterday’s Washington Post: back in the early 1980s the Orphan Drug Act was stalled in Congress. Jack Klugman’s brother, a screenwriter, suffered from a rare cancer and ultimately wrote two episodes of Quincy devoted to the topic. California representative Henry Waxman invited Klugman to testify before Congress. As the Post reports, Klugman played an “instrumental role” in the passage of the bill.

The actor Jack Klugman died on Christmas Eve at age 90. Klugman was best known for his roles as the unkempt sportswriter in “The Odd Couple” and as the crusading medical examiner on “Quincy, M.E.” the wildly popular 1980s medical drama.

Read more at:

5 Things to Watch in Health Care in 2013

By Dan Diamond, California Healthline

Supporters demonstrate in favor of the Affordable Care Act on June 28, 2012 when the U.S. Supreme Court issued its ruling on the health care overhaul. (SEIU International: Flickr)

It was easy to predict the big health care issues for 2012. This year, it's murkier. (SEIU International: Flickr)

“Prediction is indispensable to our lives,” forecaster extraordinaire Nate Silver writes in his new book, “The Signal and the Noise.” Every day, whether wearing a raincoat to work or setting aside funds for future spending, “we are making a forecast about how the future will proceed — and how our plans will affect the odds for a favorable outcome.”

But in health care, the mix of ever-shifting technologies, laws, competitive landscape — and more — means that many patients’ lives (and industry dollars) rest on whether providers and regulators can make the right bets. And some years, the industry’s direction is relatively easy to predict.

For example, last year — when “Road to Reform” did a similar forecasting exercise — the 2012 signposts were clear: March’s Supreme Court case; the November election.

What’s coming in 2013 is definitely murkier, though several major developments await in the months ahead. Here are five broader trends that industry observers are watching.

1. Premium Growth

The Affordable Care Act was supposed to help tamp down health care costs, and some supporters have suggested (possibly prematurely) that the law has been responsible for a slowdown in health spending growth. But average Americans haven’t seen much of a difference yet. A new analysis released in mid-December found that workers’ spending on premiums swelled by 74% between 2003 and 2011.

And while the ACA contains measures to control premiums — like new rules on insurer oversight and administrative spending — observers don’t expect any immediate relief. “Hold onto your hat,” consultant Robert Laszewski warns. Having spoken with a number of insurers in the individual and small group markets, Laszewski says to “expect a 30% to 40% increase in the baseline cost of individual health insurance to account for the new premium taxes, reinsurance costs, benefit mandate increases, and underwriting reforms.”

2. Employer Decisions

One of the most significant industry questions post-ACA: Will employers continue to provide traditional health benefits for their workers, drop coverage or adopt new models in hopes of controlling spending? Continue reading

The Gun Lobby’s Favorite Part of the Health Law

By Jay Hancock, Kaiser Health News

(Image: Kaiser Health News)

Did you know the Affordable Care Act stands up for gun rights?  The “Protection of Second Amendment Gun Rights” section (page 19 in this PDF) says the health law’s wellness programs can’t require participants to give information about guns in the house. It also keeps the Department of Health and Human Services from collecting data on gun use and stops insurance companies from denying coverage or raising premiums on members because of gun use.

The Newtown massacre renews the controversy about whether gun violence is a public health issue. Should health authorities view guns in the same category as pneumonia and car crashes? The debate has been going on for years, with epidemiologists arguing firearms can kill just as many as a bad flu season and gun-rights advocates viewing any attention from public health officials as a step toward gun confiscation — the beginning of the end of the Second Amendment.

The ACA language was included at the request of Nevada Democrat Sen. Harry Reid, the Senate majority leader and a gun rights supporter. Reid’s office did not respond to a request for comment, nor did the National Rifle Association.

Public health scholars criticize the measure because they say it keeps doctors and nurses from doing their jobs.  While the law doesn’t ban doctors from asking about guns, it places limits on what information they can record. The fear is physicians will avoid the topic altogether, inhibiting a full conversation about firearms hazards. Continue reading

A Public Health Approach to Gun Violence

So now we’ve heard from the NRA which asserts that we need to put armed police in every school, then adding, “The only thing that stops a bad guy with a gun is a good guy with a gun.”

It sounds good, but as Josh Sugarmann of the Violence Policy Center said today in a statement, that’s been tried already — and it didn’t work. “There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.”

And if you’re thinking that having a gun protects you from guns, think again. After all, Rachel Davis, Managing Director of the Prevention Institute points out, in Newtown, Adam Lanza first killed his mother, a gun enthusiast. “The first victim of this shooting was a gun owner who was not able to stop this from happening,” Davis says. “The problem of guns is they raise the risk of lethality.”

We are a society that craves simple solutions, yet violence is a complex problem. That doesn’t mean nothing can be done. While Davis favors an assault weapons ban, she says that’s only one piece of a comprehensive approach. “Another piece,” she adds, “is addressing mental health needs — that includes access to high quality mental health services, reducing the trauma people are exposed to and then addressing the trauma.”

Mass shootings in Newtown understandably capture widespread media attention, but remember that children are murdered every day by firearms. In 2010, according to CDC numbers, 1,260 children up to age 18 were killed by someone who used a gun. That’s more than three children every day — or 21 children in the week since Newtown.

Davis argues for broad community-based prevention programs. Davis points to “GRYD” — the Gang Reduction Youth Development program which has been in place for several years in Los Angeles. GRYD is multi-pronged. “It’s not one single thing,” Davis says, “but a combination of strategies and efforts that are coordinated in the neighborhoods that are most affected by violence.”

For example, in LA’s successful Summer Night Lights program, parks are open after dark — prime gang-activity time — with free food and extra programs. Families flock there.

And it’s effective. Here are some statistics from the Summer Night Lights website:

(Image from Summer Night Lights website)

Continue reading

Blue Shield CEO: Challenge, Opportunity in 2013 and Beyond

By Alvin Tran and Sarah Barr, Kaiser Health News

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state — it currently has more than three million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012.

Bodaken’s successor, Paul Markovich (the chief operating officer), may not have an easy time of it. He’ll have to implement provisions of the federal health law while trying to keep costs as low as possible. “That will be the biggest challenge that I think any health plan CEO will face over the next several years,” Bodaken said.

Bodaken’s views on the health law and the current state of the insurance industry were among the many topics during a recent interview with Kaiser Health News. Here are edited excerpts:

Q. Why retire now?

A. One thing I told my board when I first came on, after a decade or so, you need to think about changing your CEO as a policy matter. There is a time for these things for any corporation, for any person. I’ve been doing this for 12 years. I don’t see this retirement as me dropping out of sight.

Q. What do you think insurers will have to contend with as they head to 2014, when the federal health law will fully kick in? Continue reading

How Much is Your Health Data Worth — And Who’s Buying It?

By Aarti Shahani, KQED

Self-tracking devices are going beyond fitness. Scanadu is building a device to record medical vital signs.

Self-tracking devices are going beyond fitness. Scanadu is building a device to record medical vital signs.

Those trying to lose pounds after over-indulging this holiday season can look for help from a slew of monitors that count steps climbed, calories burned, and heart rate. Self-tracking, once a subculture for fitness junkies, is gaining broader appeal for a broader range of health issues.

According to Forrester Research, about three percent of online shoppers say they already use a self-tracking device, and 17 percent say they’re interested in one popular brand.

Tim Chang, a venture capitalist with the Mayfield Fund, is one of the money guys behind self-tracking. Chang raised $9 million for a new kind of tracker, made by Basis, a start up. The device, still a prototype, is “the world’s first very accurate heart rate monitor on just a wrist watch,” he says. “No chest strap, no other device.”

Sensors and bluetooth technologies have become so cheap and sophisticated, they can record more than steps taken and calories burned. Another start-up, Scanadu, is building a handheld device to record systolic blood pressure and blood oxygenation. Scanadu’s Walter De Brouwer says technology enables people to be “citizen doctors.”

If Basis can get its wristwatch/heart rate monitor to market, it will presumably make money from sales. But Chang is hoping for big money from a different place: selling an app that aggregates the monitor’s data and analyzes it for you, the user. Continue reading

Significant Foodborne Illness Outbreaks: A Timeline

The Pew Health Group (as in “Pew Charitable Trusts”) has put together this interactive timeline of 14 widespread foodborne outbreaks that have happened since the FDA Food Safety Modernization Act was passed in 2011. It’s the first major update to the country’s food safety infrastructure more than 70 years. But the Obama Administration has yet to issue proposed rules required to begin implementing the law. This timeline represents just a fraction of all the foodborne illnesses that have occurred since the Act’s passage.

As you click through, keep your eye on “Reported Cases” and remember that most cases are never reported, as journalist Maryn McKenna experienced for herself as she described in her blog, Superbug.

No Evidence of Benefit from Routine Pelvic Exams

Women can add pelvic exams to list of medical tests they may not need as often — or at all



First, let’s review. We’ve been getting a lot of updates to cancer screening tests lately.

Pap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that every three years was equally effective. Most medical groups, including the American Cancer Society, agree on this one.

Then there’s mammography. I think everyone knows the debate around that. Every year or every other year? Starting at 40? or 50? The evidence points to every two years after age 50, although many doctors maintain younger and more often is better.

Women get them annually, even though we “lack data” that they do much for us.

But this latest one — about pelvic exams — caught me by surprise. It turns out there’s really not a whole lot of evidence that doing an annual pelvic exam makes any difference to a healthy woman’s continuing good health. (Again, we’re stressing healthy women. Women having symptoms are definitely candidates for a pelvic exam).

Here’s what the American College of Obstetricians and Gynecologists (ACOG) says about the pelvic exam, after recommending it be done annually: Continue reading