health policy


Globe’s Kay Lazar Wins Health Reporting Prize

The Boston Globe's Kay Lazar on YouTube

Yay, Kay! The Boston Globe’s Kay Lazar has just won first place in beat reporting from the Association of Health Care Journalists for her coverage of health policy and aging.

I have just one quibble with the association’s prize: It’s a bit late. She should also have won for her amazing 2009 story on the partial face transplant at Brigham and Women’s, precursor to this week’s news of a full face transplant. That article is, annoyingly, not available for free anymore on, but it’s worth the archive fee to read her beautiful account of Joseph Helfgot, the son of Auschwitz survivors who donated his organs to help others.

The Globe features Kay’s prize-winning stories here, and they include these headlines:
Antipsychotic drug use for dementia patients is questioned
Short-term customers boosting health costs
A family struggles with Alzheimer’s
Medicaid contracts with UMass Medical School unit scrutinized
Mass. aims to cut drug overuse for dementia

New Cigarette Warning Labels: Death, Disease, Burning Skin

Some of the new warning labels the FDA is considering for cigarettes

If these graphics don’t give smokers pause, nothing will.

The New York Times reports that the U.S. Food and Drug Administration is proposing a series of graphic new warning labels be placed on cigarette packs, with bold messages, like “Smoking Can Kill you,” and “Cigarettes Cause Cancer,” and horrifying pictures depicting the many ravages of smoking.

Designed to cover half of a pack’s surface area, the new labels are intended to spur smokers to quit by providing graphic reminders of tobacco’s dangers. The labels are required under a law passed last year that gave the Food and Drug Administration the power to regulate tobacco products for the first time.

The proposed labels include pictures of a man smoking from a tracheostomy tube inserted into his throat; a diseased lung; and a woman holding a baby in a smoke-filled room. The proposals stayed away from some of the more gruesome labels used in other countries, where pictures of blackened teeth and diseased mouths are common.

Cost Hike: Levy Blames Insurers For Lack Of Efficiency, Insurers Fight Back

Paul Levy, the perpetually newsworthy CEO of Beth Israel Deaconess Medical Center, makes a crisp argument today blogging about the rising cost of health care.

Levy says while insurers often whine about the “underlying rise in medical costs” as the key driver of higher health insurance premiums, there is, in fact, another critical culprit: outsized administrative expenses racked up by the major health insurers, on average about 9.3 percent annually.

Levy’s Exhibit A is a February 2010 report issued by the state Division of Health Care Finance and Policy on premium levels and trends in the private insurance market:

“How can this be the case?” Levy wonders. “In other financial services industries, unit costs of transactions have gone down, not up. What is it about health care that suggests the opposite should be the case?”

Not to be outdone, the Massachusetts Association of Health Plans gave me a fairly lengthy response. Touche:

Reducing administrative expenses in health care is important and efforts are underway, but those costs are not what is driving health plan premiums. More to the point, talking about administrative costs distracts from focusing on the the major cost driver, which is escalating medical expense. Continue reading

Money Can’t Buy You (A Longer) Life

Despite lavish spending on health care in the U.S., our life expectancy rates are falling behind other countries

Here’s a shocking fact: despite the United States’ exorbitant spending on health care, our life expectancy rates are slipping behind other countries, according to a new study published in Health Affairs by Columbia University researchers. Our life expectancy is lagging when compared to other rich countries, yes, but also in comparison to poorer nations like Costa Rica, Singapore and Chile. I’m told Cuba could be next.

In the past, we’ve targeted the usual villians: Americans are fatter, we smoke more, we have more homicides, more car accidents and more minorities — and all these factors conspire to pull down our life expectancy ranking.

Well, according to Peter Muennig, assistant professor of health policy at the Mailman School of Public Health at Columbia, and the study’s lead author, the true culprit is “none of the above.”

He says that smoking and homicides have declined in the period researchers were studying, 1975-2005, and traffic deaths are fairly constant. More Americans were actually obese 30 years ago, and over that time, other countries have caught up, weight-wise. The U.S. immigrant population, which has a higher-than-average life expectancy (amazing fact: Asian women in Bergen country, New Jersey have an average life expectancy of 88!) more than offset the generally lower life expectancy of African-Americans.

So what gives?

Apparently, Dear Reader, it is our top-of-the-line, $2 trillion health care system that is killing us before our time.

“The unnecessary care Americans are getting is potentially driving up costs and affecting our longevity,” Mr. Muennig says. “Unnecessary care is very likely the culprit.”

What he’s saying is that a fee-for-service payment system so heavily reliant on specialists tends to work like this: one uneeded test leads to an unecessary procedure; that procedure causes an infection, and that leads to a hospital admission.

“Our health care costs are sapping our federal expenditures,” Mr Muennig says. “And this is taking money away from all social programs,” some that could actually improve health, like transportation, education and others.