Practice variation links

Some tidying up of older but still interesting info about regional variation in healthcare:

The Dartmouth Atlas study in Acrobat:
http://www.dartmouthatlas.org/atlases/2006_Atlas_Exec_Summary.pdf

And an op-ed piece from Dr. Goodman about utilization/variation:
http://www.nytimes.com/2006/07/10/opinion/10goodman.html?ex=1156046400&en=2960abf359ef20a7&ei=5070

An article about 'off the chart' utilization of angioplasties in Elyria, Ohio:
http://www.nytimes.com/2006/08/18/business/18stent.html?hp&ex=1155960000&en=b81be5f43f98a99b&ei=5094&partner=homepage

And a lecture Jack Wennberg talking about Atlas:
http://www.dartmouthatlas.org/atlases/NYAM_Lecture.pdf

Cheers,
Chris

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2006 Kaiser/HRET Employer Health Benefits Survey - Kaiser Family Foundation

2006 Kaiser/HRET Employer Health Benefits Survey - Kaiser Family Foundation:
"This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including changes in premiums, employee contributions, cost-sharing policies, and other relevant information. This year the survey also documented the prevalence of high-deductible health plans associated with a savings option, including the percentage of employers offering these plan types and the percentage of workers covered by them. "

"The average cost of premiums for single coverage in 2006 is $354 per month or $4,242 per year. This figure includes both the worker and employer contribution. The average cost of premiums for family coverage is $957 per month or $11,480 per year (Exhibit 1.10)."
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So, if you have a family and make $57K, your premium, on average is 20% of your Wages! If you're single and earning $42K, you're on easy street, as only 10% of your compensation is healthcare...The new "lucky duckies"?

And check out this table (1.13): watch the numbers left to right and top to bottom. Wow.

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"As with premium increases, there is also a great deal of variation in premiums across workers and firms: 10% of covered workers work in firms that have single premiums of $250 or less per month, while 22% have single premiums greater than $400 per month (Exhibit 1.13)."
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Cheers,

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MAPLight.org | Money and Politics: Illuminating the Connection

MAPLight.org Money and Politics: Illuminating the Connection: "MAPLight.org brings together campaign contributions and how legislators vote, providing an unprecedented window into the connections between money and politics."

h/t to Mr. Pogue:

From the Desk of David Pogue, New York Times,

Following the Money Trail Online

By DAVID POGUE

Published: May 24, 2007

The first step to solving a problem is recognizing that you have one.

That's what I keep telling myself, anyway, to avoid becoming depressed by Maplight.org.

It's a new Web site with a very simple mission: to correlate lawmakers' voting records with the money they've accepted from special-interest groups.

All of this is public information. All of it has been available for decades. Other sites, including OpenSecrets.org, expose who's giving how much to whom. But nobody has ever revealed the relationship between money given and votes cast to quite such a startling effect....

All I can say is, "Let the games begin!"

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Amy Ridenour's National Center Blog: Universal Health Care: Universally Bad

Amy Ridenour's National Center Blog: Universal Health Care: Universally Bad

I think trying to bring the most horror stories to the table is not a fruitful way to move the debate on single-payer vs. the status quo forward. Besides, the horror stories attributed to other nation's systems are trivial compared to the stories about our own. On top of this, once you add the population based problems with our system, there really is no comparison.

I say this as a physician who has always looked favorably on single-payer after a medical school experience in England. Yes, that system had lots of problems, but nowhere near as pervasive nor unfair as our own. As the years have gone by, I have seen so many heart breaking (and infuriating!) situations with our own system, my view has gone from simply favorable to my current view: it is really not acceptable to maintain the status quo.

I am not alone. I am involved in organized medicine on the state level. When I started in 2002 in this capacity, I think the current was then 10-1 (or 2) against single payer. i think that is now perhaps 10 to 3 or 4. Now, mind you, these are leading physicians in my state. These are those who used to be very reliably against anything that smacked of single payer.

I think there are many currents that are drawing physicians along. The injustice of the system that we see every day wears us down. The waste in a system managed by not-for-profit-in-name-only insurers and the true for-profit health plans, pharmaceutical and equipment companies and on and on is unconscionable. The loss of control over the patient-physician relationship could not possibly be worse under the most draconian socialized system, let alone a simple single-payer system. The pay differential among specialists is causing strain. The cost of the system is clearly becoming unsustainable.

There are more, but you get the idea.

Cheers,

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Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care

Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care: from The Commonwealth Fund

"Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. The 2007 edition includes data from the six countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care."

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The Danger in Drug Kickbacks - New York Times

The Danger in Drug Kickbacks - New York Times

The explosion in the use of three anti-anemia drugs to treat cancer and kidney patients illustrates much that is wrong in the American pharmaceutical marketplace.

With any luck, the advisory panel’s concerns should cause many oncologists to think twice before dispensing the anti-anemia drugs. But the surest way to slow the overprescribing is to stop the rebates. Federal laws already bar drug companies from paying doctors to prescribe medicines in pill form. That prohibition should be extended to injected and intravenous medicines.

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Doctors Reap Millions for Anemia Drugs - New York Times

Doctors Reap Millions for Anemia Drugs - New York Times: "Two of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. "

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JS Online: For $600, a lesson in health care economics

JS Online: For $600, a lesson in health care economics

If we insist on expensive scans, if each hospital feels it must buy its own machine to compete, what can we possibly do about costs?

One option is to buy three machines and advertise scans for $600 a pop, making it up on volume.

Jim Stoll is going this route...

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Corporate Democrats Escalate Attack on Single Payer

corporatedems050807: "CORPORATE CRIME REPORTER
Corporate Democrats Escalate Attack on Single Payer
21 Corporate Crime Reporter 20, May 8, 2007"

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Scientific American: We're Number Two: Canada Has as Good or Better Health Care than the U.S.

Scientific American: We're Number Two: Canada Has as Good or Better Health Care than the U.S.: "Despite spending half what the U.S. does on health care, Canada doesn't appear to be any worse at looking after the health of its citizens

By Christopher Mims

The relative merits of the U.S. versus Canadian health care systems are often cast in terms of anecdotes... "

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