Health Wonk Review: In Like a Lion

Welcome to Health Wonk Review's In Like a Lion edition, wherein we consider the big questions of the moment.

• It seems clear that March is coming in like a lion in most parts of the country. That much is not up for debate.

Our always incisive health wonks have raised numerous important questions over the past fortnight and have attempted to answer them, for their own satisfaction and yours, gentle reader. As they say, reasonable minds may differ — and you'll see a range of opinions on some of the issues of the day.

So let's take a walk on the wild side and see if we can come up with some answers. Questions on the table include the following:

• What's new in the world of Obamacare implementation, HITECH Act implementation, and our 50 laboratories, the states?
• Is there a law of physics that can limit the fiction quotient in Obamacare press coverage?
• What's the best way for the U.S. to pay for health care expenses?
• What's the connection between Irish-American heritage and the Massachusetts gubernatorial race?
• Why does February only have 28 days (usually)?
• Why promote teamwork and collaboration?
• Is there deep meaning in synchronicity, or is Roy Poses just messing with me?

HITECH, ACA and News From the States

Some of the wonks have been hanging out in Orlando this week at #HIMSS14. Neil Versel interviewed HIMSS President & CEO Steve Lieber before the festivities began. The podcast is up at Meaningful HIT News. They discussed Meaningful Use progress and pitfalls, ICD-10 issues, EHR certification, health IT in context of the Affordable Care Act and the shift away from hospital care. (Neil, I hope you weren't injured at HIMSS this year.)

We have a special submission from some of the federales at HIMSS — Lygeia Ricciardi and Adam Dole of the ONC (Lygeia is Director of the Office of Consumer eHealth) — introducing the Blue Button Connector at HealthIT Buzz. What's that? you may ask.

The Blue Button Connector will be a website that helps consumers and patients to find their own health information online, and will help developers build tools that respond to the readiness of the market. It also will provide links to apps and tools for consumers that use structured electronic health data.

The next round of HIPAA compliance audits will soon be upon us. See my post here at HealthBlawg about the enforcement environment and the need for covered entities and business associates to be prepared.

The push to high tech, and to mobile, is inexorable, but Julie Ferguson of Workers' Comp Insider reminds us that as the demand for wireless surges, so too do the preventable deaths of cell tower workers who are under intense pressure to meet unrelenting deadlines. OSHA calls the rate of fatalities in recent years alarming and has put tower employers on alert that they are expected to comply with worker safety mandates.

Joe Paduda provides an update on what's really happening with Obamacare at Managed Care Matters.

Folks purchasing health insurance on the exchanges need to be sure they understand drug formularies (thanks, Louise Norris, Colorado Health Insurance Insider).

Brad Wright, at Wright on Health, wonders: Transparency in Health Care: Can it Happen? and worries that even with better information, consumers aren't likely to change their behavior much, because health care economics does not operate according to traditional market principles.   

MSM Distorts the ACA

Clearly, more people need to get their news from health wonks . . . .

At HealthInsurance.org, Wendell Potter explains how an NBC News report offers a perfect illustration of media coverage that is giving viewers at best an incomplete look at the effects of health reform on small businesses.

Maggie Mahar writes about how a CBS video misled millions at HealthBeat. She is working to keep us on our toes, BS detectors at the ready, when we encounter MSM stories on health reform.

Follow the Money

Some of the Brookings Institution brain trust write this week about Paying For A Permanent, Or Semi-Permanent, Medicare Physician Payment Fix at the Health Affairs Blog, emphasizing that a plan including "off-sets for physician payment reform that support improvements in care as well as lower costs . . . could assure beneficiaries and other health care providers that these savings are not just payment cuts that must be absorbed, but steps to help reduce spending through reforms that improve care."

John Goodman has his own plan for getting affordable access to care to the folks who need it most. See The Vision Thing on his Health Policy Blog.

Across the pond, Healthcare Economist Jason Shafrin tells us, some nations' health policies with respect to addictions are leading to the distribution of free heroin. (Given the rate of progress in the realm of medical marijuana in this country, it seems safe to assume that free heroin distribution will not begin anytime soon on these shores.)  

The Last Hurrah

March is Irish-American Heritage Month — sure to be celebrated round these parts. The new mayor of Boston, Martin Walsh, is an Irish American who embraces his connection to the people's mayor, James Michael Curley, by using his desk. (Curley, for those of you not familiar with Boston political history, "served four terms as mayor, four terms in Congress, one term as governor, and two terms in jail.")

Those who would be the next governor of Massachusetts are not necessarily Irish, but a fair number of them are health wonks. Whether they are or not, David Williams is putting them to the test, with a few questions on health policy. Check out the first installment of his podcast interview series, featuring Charlie Baker, at the Health Business Blog.

Teamwork and Collaboration

T.S. Eliot opened the The Waste Land with: "April is the cruellest month." This February has been pretty brutal, though.

Have you ever wondered why February only has 28 days (or, at best, 29)? It's because it's the runt of the litter, the last month to be added to the calendar (the Roman calendar originally had only ten months — January and February were late additions and February had to cadge days from other months).

Through short, cold months and long, hot months — health care improvement demands collaborative work. Check out these two posts on the subject: Kelly Beloff's InsureBlog post on the importance and challenges of teamwork in health care delivery and Ken Cohn's Healthcare Collaboration post on physician engagement through collaborative work.

The Anechoic Echo

The first time I hosted Health Wonk Review, almost exactly seven years ago, Roy Poses described the subject matter of his submitted post as anechoic. (Nice ten-dollar word!) Well, he's done it again: he hopes — as we all do — that the story he recounts over at Health Care Renewal of health care delivery gone very, very wrong in rural Texas, with insufficient oversight, is anechoic. (Anechoic? Again? Really, what are the chances?) Roy asks:

In a system so opaque that no one may know even who owns or runs a particular hospital, do we really expect quality care?  True health care reform would start with some elementary increases in transparency, beginning with disclosing who owns, oversees, or manages important health care organizations.

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It's a wrap! Thanks for stopping by, and don't forget to join Brad Wright for the next edition of Health Wonk Review at Wright on Health.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting