Diet and Nutrition. Natural Health, and Healthy Living

This April 6–7, the Health 2.0 Europe conference will feature the many ways in whichWeb 2.0 tools are providing innovative solutions to, amongst others, our fundamental need for self-expression, known more recently as “user-generated content”.

Several panels will refer to these issues, but we will focus in this post on the Hospital and Payers’ panel. Payers want to ensure that their patients are being oriented to good care. Hospitals want to know that they are being considered “justly”.The Health 2.0 panel will include demonstrations byGuide Santé (France) and Patient Opinion (UK), both web 2.0 sites created by physicians concerned by patient satisfaction with hospitals and clinics. Payerslike the UK NHSand Big-Direkt from Germany will participate in the conversation and Big-Direkt will also demo their new online tools.

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Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Checklist Manifesto is one such book.

In this short, deceptively simple volume, Atul (who I count as both friend and inspiration) discusses the history of “the lowly checklist,” the impact of checklists on various industries, how he came to understand the value of checklists to medical care, and what makes a useful checklist. Most of this content could have been written by a thoughtful healthcare journalist. But Atul put his interest in checklists to practical use, spearheading a WHO initiative to test a checklist-based “safe surgery” program in 8 diverse hospitals around the world, an effort that saved hundreds of lives. His description of this program forms the core of the book.

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According to the headlines, 10 percent of Americans are unemployed. The truth is that closer to 17 percent of the population cannot find full-time work; this number includes workers who have become discouraged and have given up looking for work as well as those who have settled for part-time jobs because they cannot find the full-time employment that they need.

The situation is not going to change anytime soon. As Princeton economist Paul Krugman recently warned: “We are facing mass unemployment — unemployment that will blight the lives of millions of Americans for years to come.”

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The last time the US Senate held a vote on Christmas eve, it was 1895. In that one, lawmakers said it was OK for former Confederate army soldiers to serve in the military. The vote was hailed as a milestone in the slow national reconciliation following the Civil War.

No one was talking about national reconciliation following last week’s Christmas Eve Senate vote on health care reform. A bill was passed with unanimous support by Democrats, against the wishes of 40 resolute, disdainful Republicans.

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Right now, American health care information technology is undergoing two enormous leaps. First, it is moving onto Web-based and mobile platforms - which are less expensive and facilitate information exchange - and away from client-server enterprise-centric technologies, which are more expensive and have limited interoperability. In addition, more EHR development activity is headed into the cloud, driven by large consumer-based firms with the technological depth to take it there. Both these trends will facilitate greater openness, lower user cost, improved ease of use, and faster adoption of EHRs.

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Ezra Klein haspublishedanengaging seriesofinterviewsregarding the filibuster, and the prospects and shape of reform for the Senate’s much maligned rule of procedure. The prospects for reformdon’t look particularly bright. And as we come to reckon with one of the final products of the filibuster floor, the Senate’s health reform bill, we may want to take a moment to consider the filibuster itself– this need for 60 votes.

Kleinwrites

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It's Christmas Eve and the Senate just passed a major health reform bill. Personally I think the reforms in it are relatively minor, but the passage of the bill itself is a screaming big deal. When I say minor, what I mean is that we’re leaving in place the inefficient employment-based health benefits system, and we’re expanding insurance mostly by putting more people into the separate but equal Medicaid program.

But this bill is a statement, and an important one.

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For a Broadway stage, the set is simple and spare – a long, white leather couch, a handful of wooden tables and chairs. No ornamentation is needed; the stories being told on the stage are what command the audience’s attention. Let Me Down Easy is health reform as poignant, funny and gripping theater.

A supermodel compares the high-powered physicians a cosmetics company gets her after she signs a lucrative contract to the doctors she had access to during her working-class childhood. A middle-aged woman emotionally refuses dialysis because of the terrible injuries her daughter sustained while undergoing dialysis when a hospital’s mistake left her covered in blood. And a cancer patient hospitalized with a post-chemotherapy fever describes being told not to take it personally that her chart has been lost: “that happens here quite a bit.”

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So today’s news is that the gang of ten have come up with something. (If you haven’t been following along, the gang of ten are the five “liberal” Democrats and the five DINOs asked by Harry Reid to come up with something to break the deadlock and get some type of compromise that will pass the Senate). More details are here from Brian Beutler at TPM

So it might vanish like a Clinton-eratrial balloon, or it might be a stayer, but the core of the new concept is to allow the 55–64 crowd to buy into Medicare, and to ask/allow/mandatea non-profit insurer(s) to provide a substitute public option. Exactly what the second point means is unclear to me. It may be to be some collapsing of Kent Conrad’s notion of the cooperative with an extension of the Federal Employees’ Plan (presumably minus the for-profit carriers) and somehow cramming that into the exchange. Of course providing something like the choice among private plans that Federal Employees now get was at the heart of Ron Wyden’s plan. We’ll see if it can last a couple of days scrutiny, or the wrath of the House Democrats.

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Readers know of my yearlong pessimism over our getting a trillion dollar health care bill in 2009.
With the historic passage of the House bill, are we now on our way to a big health care bill in 2009—or even by early 2010?

Clearly, Democrats desperately want to pass a bill. Given their compromise over abortion and the neutering of the public option in the House legislation—things most liberals said they would never agree to—it is clear the Democratic leadership will take any deal they can get.
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