Health Care
Friday, July 18, 2008Preventive Care Still Expensive PolicyBy Joseph D. ColettiCategories: Individual Mandates, Insurance Regulation, Medicaid, Nanny State, North CarolinaIt's always nice to have new research back you up.
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Friday, July 18, 2008State Health Plan BailoutBy Joseph D. ColettiCategories: North CarolinaThe State Health Plan for teachers and state employees in North Carolina has gone from an expected $50 million surplus this year to a $200 million deficit in the last couple weeks. Legislators, on a bipartisan basis, are trying to salvage it by jeopardizing the last fig leaf of fiscal responsiblity in the budget they passed last weeek. Read more on the fiasco here, here, and here. UPDATE: Legislators have decided not to decide and just go home.
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Friday, July 18, 2008Ambulance-chasing for OrgansBy Joseph D. ColettiCategories: Nanny State, New York, North CarolinaI go rounds with my colleague Donna Martinez on the value of creating a market for organs. She likes presumed consent - opting out of donations instead of opting in - which strikes me as coercive. I favor allowing people to sell their organs instead of donating them, she thinks that devalues life. We do agree, however, that a new program she described in a recent column and that could start this year at Bellevue Hospital Center in Lower Manhattan is repulsive and raises questions about when a person is really dead.
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Friday, July 18, 2008No More Protons, Please!By John LaPlanteCategories: Certificates of Need (CON), IllinoisWho can fathom the number and scope of regulations surrounding health care? This morning I read that something called proton therapy is a new form of treatment for cancer. (It's an alternative to or perhaps an enhancement of radiation therapy.) There are five facilities in the country that offer this therapy. Northern Illinois University has permission to start another one, which it says will be finished in March, 2010. In April, the state's health facilities planning board blocked a move by Central DuPage Hospital to build a similar facility. One reason for the denial, perhaps, is that the two centers would be only 6 miles apart. Yet Chicagoland is one of the leading metropolitan areas in the country, so why--if you care about such things--shouldn't two facilities be sustainable? DuPage County, by the way, is in the 25 wealthiest counties in the country, so I expect that residents will demand the best services available--including new treatments. The hospital's proposal is now being championed by 23 state lawmakers, who are pitching an appeal to the state regulatory board. Imagine that your state senator's political power made the difference in the opening of a new medical clinic. That's the prospect of increasing the amount of power that government has over health care.
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Friday, July 18, 2008State Employee BenefitsBy Kalese HammondsCategories: TexasWith almost 560 state employees per 10,000 Texas residents, the increasing cost of health insurance benefits means state lawmakers must allocate considerable funding for these benefits. The state covers the entire cost of the monthly premium for state employees only, and half of the cost of dependent coverage. The monthly premium cost for employee-only coverage has increased from approximately $200 in 1999 to $360 in 2009. While health insurance benefits are an appropriate benefit for state employees, there are things lawmakers can do to help control these costs, such as offering HSAs as an option for state employees.
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Friday, July 18, 2008Can Ignorant Consumers Still Buy Health Care?By John LaPlanteCategories: Medical TourismIs health care so complex that it must be entrusted to experts, such as people in government agencies? The blotter behind Healthcare Manumission says no: "There is indeed an asymmetry of information in medical care. That much is indisputable. There is also an asymmetry of information in law, auto repair, computer technology, and countless other realms where we yield to the wisdom of those we consider experts." And yet we don't expect government to organize an "automobile maintenance organization." Nope, consumers figure their way around in markets all the time--and health care is not excluded.
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Thursday, July 17, 2008The Other Crisis Affecting Health CareBy John LaPlanteJohn Joseph Leppard IV, who blogs at Healthcare Manumission, says there is an insurance affecting health care in America: "'I'm referring to malpractice liability insurance. Although generally considered an issue which affects just the small, "elite" physician community, the current state of malpractice liability insurance has far reaching implications which are significant and consequential to the entire state of the American health care system." Malpractice insurance is a factor, he argues, even though few disputes go so far as to result in an award for the plaintiffs. Defending a charge can cost anywhere from $25,000 to $90,000, and sometimes more, he says. The results of soaring costs: some doctors leave the practice. Others change their ways of providing medicine--and not always to the benefit of anyone.
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Thursday, July 17, 2008A How-To Guide to "Make P4P Pay 4U!"By Peter NelsonIn this week's Journal of the American Medical Association, Drs. Rodney Hayward and David Kent offer doctors "6 EZ Steps to Improving Your Performance," a snappy how-to guide for "winning the pay-for-performance game." (Accessing the article requires a paid subscription.) Mind you, each step is just dripping with sarcasm and actually outlines how present P4P incentives can deter doctors from putting their patients first. Here are their 6 EZ steps:
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Thursday, July 17, 2008Health Care is Not a Right: The Peikoff VideoBy Paul HsiehAmericans For Free Choice in Medicine has found a video of Dr. Leonard Peikoff's 1993 speech, "Health Care Is Not A Right".(Here is the updated 2007 text version.)
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Thursday, July 17, 2008"I'm Proud to Have Killed Off People's Livelihoods"By John LaPlanteCategories: Nanny StateIt may seem strange to oppose a smoking ban on a site dedicated to health care policy, but I'm going to try. The case for smoking bans may seem a slam-dunk. Smoking is bad for human health, though not all who smoke develop cancer or other diseases, and some people develop lung cancer and so forth without ever having lit a cigarette. But there are other important ideals that get trampled in the rush to smoking bans. One is freedom of association, or your ability to patronize or work at an establishment based in part on whether it allows smoking. Another is property rights, or the ability of a business owner to allow acts, legal otherwise, on his property. One smoking ban advocate writing in a Minnesota newspaper, however, says rights be damned: "I am not going to debate what is in the Bill of Rights we all hold so dear." In other words: I don't care what the Bill of Rights says. As a friend of mine puts it, "Some of us, obviously, hold it a little more dearly than others." Smoking bans, prohibitions on trans fats in restaurant foods and health care policies that rely on pay-or-play, individual mandates or at the extreme, outlawing private health insurance, are of the same cloth, trampling personal rights in the name of the public good.
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