Maine Likely To Repeal Health Care Reform

You know how the rest of the country looks to Massachusetts to see how health care reform might play out nationally? (Latest example: PBS this week.) Well, now, the rest of the country may soon start looking to Maine to see how a repeal of health care reform might play out nationally.

Maine’s new governor-elect is Paul LePage, a colorful Republican who knew homelessness and deprivation as the oldest of 18 children in a poor Maine family, but went on to become a successful businessman and mayor.

During his campaign, he pledged to “repeal and replace” the state’s groundbreaking 2003 health care reform, “Dirigo Health.” (Dirigo means “I lead” and is the state’s motto.) He called it a “costly failure” and said it had “cost taxpayers more than $160 million to cover just 3,400 uninsured Mainers,” a charge the reform’s backers contest.

Now, it’s looking like Dirigo Health “may be one of the first casualties of the Republican landslide in state capitals,” reports Stateline, a news Website on state politics funded by the Pew Charitable Trusts. Continue reading

Daily Rounds: Money Fueled Alcohol Tax Repeal; Surprising Shift On Gene Patents; Biogen Cuts; Election Effects On Health Reform

Money fuels repeal of alcohol tax – The Boston Globe “The alcohol industry, which contributed the vast majority of the nearly $2.5 million to the Vote Yes on One Committee, far outspent the opposition. Beer giant Anheuser-Busch contributed $88,110, and the Beer Distributors of Massachusetts gave nearly $300,000. The Committee Against Repeal of the Alcohol Tax didn’t even raise $200,000, according to the latest finance reports filed with the state.” (Boston Globe)

Feds Surprise Biotech Industry With Gene Patent Rule : NPR “The Justice Department is proposing to overturn 30 years of legal precedent by sharply limiting patents on genes. The government surprised just about everyone who follows this issue when it suggested this change of policy in a court filing last week.” (

Biogen to ax 650 workers – The giant Weston-based biotechnology firm said it expects to see a total savings of $300 million due to a combination of moves, including shutting down offices in Waltham, Wellesley and San Diego. The company also said it will nix its cardiovascular and cancer-treatment research programs. (Boston Herald)

And about those midterm elections:

Medical News: Obama Will Consider ACA Modifications – in Washington-Watch, Reform from MedPage Today But, he continued, “If the Republicans have ideas on how to improve our healthcare system, if they want to suggest modifications that would deliver faster and more effective reform, I’m happy to consider some of those ideas.” (

Voters oust half of House Democrats who opposed health-care law “Did Democrats dig their own graves by passing the unpopular health-care bill last year? That remains uncertain: The midterm elections Tuesday provided zero clarity on this often-debated question.” (The Washington Post)

To Save Money, Save the Health Care Act – “If the newly elected representatives and senators are truly concerned about rising health care costs, they should work to deploy the law’s cost-containment measures fully rather than try to repeal them.” (The New York Times)

Election’s Effects On Health Care Reform: New Harvard Public Health Forum Webcast

What comes next? After today’s election, that is, for health care reform? Experts will try to answer that question in a Harvard Webcast this Friday at 1:30.

We don’t normally post calendar events, but this one marks the “soft launch” of a high-profile new Harvard institution that aims to become a forum on some of the most burning topics in public health.

In fact, it’s called “The Forum at Harvard School of Public Health,” and you can learn more about it here. In brief, it’s meant to be “an exchange focused on health issues and controversies of current concern to decision-makers around the world.”

Says the forum’s director, Robin Herman: The Harvard School of Public Health has built a state-of-the-art broadcast facility for webcasts and videoconferences in its main building and plans to have live (and on-demand) webcasts around compelling health issues that require immediate decision-making.

The next Forum event will be its “official ceremonial launch” and is scheduled for Dec. 9 with philanthropist Ted Turner in conversation with Dean Julio Frenk on how to meet UN development goals for global health.

Daily Rounds: Drug For ‘Emotional Incontinence’; Health Reform Repeal?; Early Autism Therapy; Medicare Nursing Home Ruling; Medical Pot Docs

New Drug Approved For Emotional Incontinence : NPR The Food and Drug Administration has approved the first drug that could help people like Bailey who suffer from PBA. PBA is caused when disease or injury creates a malfunction in the brain circuits involved in expressing emotion. (

Health care repeal unlikely for GOP – The Boston Globe “Republicans are also aware that though the health care overhaul is unpopular, its component parts are quite popular. Simply repealing the entire act sounds better than allowing insurers to discriminate against children with preexisting conditions, or bringing back the days of lifetime limits on coverage, or telling insurers they do not have to cover dependents up to age 26.” (Boston Globe)

Autism Therapy Beginning at 6 Months – The treatment is based on a daily therapy, the Early Start Denver Model, that is based on games and pretend play. It has been shown in randomized trials to significantly improve I.Q., language and social skills in toddlers with autism, and researchers say it has even greater potential if it can be started earlier. (The New York Times)

Medicare Coverage Standards Are Too Strict, Courts Find – Two federal courts have ruled that the Obama administration is using overly strict standards to determine whether older Americans are entitled to Medicare coverage of skilled nursing home care and home health care. (The New York Times)

Medical marijuana doctors help make pot available in California – Fourteen years since Californians passed the first-in-the-nation medical marijuana law, pot is not just for the sick. Hundreds of medical marijuana doctors, operating without official scrutiny, have helped make it available to nearly anyone who wants it. (USA Today)

Dr. Tim’s Top Ten Health Reform Points

There’s something about Dr. Tim Johnson, the longtime ABC medical correspondent. You trust him. If he wrote you a prescription, you’d fill it. These days, he’s writing a prescription for the entire country, trying to cure the health care system of its spiraling costs. (He’s currently scheduled to appear Nov. 8 on WBUR’s “On Point.”)
As mentioned here, he has a new e-book out, “The Truth About Getting Sick in America.” He kindly consented to distill the whole thing down into its ten most essential points:

1) The US spends more than twice as much per person on health care as the average of all other industrialized countries ($7538 vs.$3060 in 2008) BUT we get no better outcomes AND we are the only industrialized country without universal insurance coverage.

2) For example, the five-year survival rates for 17 cancers are virtually the same in the US and Canada even though we spend almost twice as much per person ($7538 vs. $4079 in 2008).

3) And even within our own country, there are enormous differences in expenditures (adjusted for cost of living) with no difference in outcomes. For example, in Medicare spending in 2006: over $14,000 per person in Miami vs. under $6000 per person in Salem, OR.

4) One of the major factors encouraging this high spending without better outcomes is our “fee for service” payment system that basically says to doctors, hospitals, drug and device companies: the more you do or sell, the more you make. In other words our payment system incentivizes health care providers to do more whether or not it makes any difference in outcome.
Continue reading

Fix Health Care In 77 Words Or 57 Pages

They don’t waste words.

In a letter to The New York Times, Dr. Arnold S. Relman, former chief of the New England Journal of Medicine, sums up his fixes for the health care system in a concise 77 (yes, I counted) words, including these:

To straighten out our dysfunctional malpractice system we need two separate systems: a no-fault insurance system to compensate plaintiffs and expert professional panels to determine misconduct by providers.

To control costs and improve care, we need to reform the organization and payment of medical practice along the lines suggested by recent proposals for “accountable care organizations,” and we need to replace fee-for-service with global payment (a fee per patient or medical episode). Multispecialty group practice should be the medical organization model of the future.

Not quite so brief, but still stunningly succinct, is a new manifesto just out from Dr. Timothy Johnson, longtime medical correspondent for ABC News. It is titled “The Truth About Getting Sick in America: The Real Problems with Health Care and What We Can Do,” and is just out as an e-book from Hyperion.

Always a great explainer, he packs it with fascinating facts (Median annal income for family practitioner: $176,000; median income for neurosurgeon: $609,000), frightening truths and dire predictions.

To wit: “Within five to ten years, health care costs will be so out of control that we — the public — will demand that the government bail us out. At that point, the easiest and quickest action will be to expand Medicare to cover everyone.”

And that, he suggests, may not be such a bad thing: “In my opinion, there is no way to get costs and quality under control without a strong role for federal government.”

Readers, here’s a mental challenge: How would you fix the health care system in 77 words or less? Write your scrip as a comment, and whoever gets the most “like”s by next Monday wins a nifty WBUR keepsake.

Daily Rounds:Health Law Victory; Staples’ Stemberg On Reform; Medical Device Waste; Alzheimer’s Drugs in Britain; Obesity Costs $73 Billion

Health Care Law Ruled Constitutional – “A federal judge in Michigan on Thursday dismissed one of more than 15 legal challenges to the new health care law, becoming the first to rule that the law is constitutional.” (The New York Times)

Tom Stemberg eyes health-care changes – “Staples Inc. co-founder Tom Stemberg, who has been a partner at venture firm Highland Capital Partners since 2005, recently stopped by the Herald to discuss the importance of improving the health-care system.” (Boston Herald)

The Associated Press: Study: Medical device buying rules waste billions NEW YORK — “A study published Wednesday says hospitals and the federal government could save tens of billions of dollars a year if they changed the way group purchasing organizations — which buy medical supplies in bulk for member hospitals — are compensated.” (

Britain Gives Alzheimer's Drugs A Second Chance : Shots – Health News Blog : NPR “An influential British arbiter of what's worth using in health care — and what isn't — is recommending that the National Health Services in England and Wales loosen restrictions on several Alzheimer's drugs.” (

Medical News: Price Tag of Obesity Put at $73 Billion – in Public Health & Policy, Public Health from MedPage Today “Between excess medical costs and lost workplace productivity, individuals with body mass index values of 30 or more cost the U.S. economy about $73.1 billion annually, researchers said.” (

Federal Overhaul Could Hike Premiums Up To 3% For State’s Largest Employee Group

GIC director Dolores Mitchell

WBUR’s Martha Bebinger reports:

Across the country, health insurers say the Affordable Care Act is pushing up health insurance premium rates. (See this Denver Post story on the picture in Colorado.)  The new law requires, for example, that insurers extend family coverage to children up to age 26 and waive patient charges for preventive tests and visits. Employers in Massachusetts are calculating the cost of these additional benefits as well as more generous coverage established in the federal mental health parity law.

The state’s Group Insurance Commission (GIC), which covers more than 300,000 state employees, dependents and retirees, estimates these changes could increase premiums by as much as 3%.  So is the law just shifting patient costs from one place to another?

GIC director Dolores Mitchell says she hopes the answer is no.  She says she’ll try to reduce the 3% increase through tough negotiations with doctors and hospitals.

“I’m going to be pushing my health plans very hard about not simply passing along provider rate increases as though they were inevitable,” says Mitchell.  “I don’t think they are inevitable.”

Keep in mind that the new benefits and costs will take effect when you renew coverage; for GIC members that’s next July 1st.

Daily Rounds: Criminal Caregivers; Avandia Restrictions; Threat Of Caritas Closures; Health Law Q&A

California has paid scores of criminals to care for vulnerable residents – Including people convicted of rape and assault. (Los Angeles Times)

What the FDA’s Restriction of Avandia Means for Diabetics – TIME Healthland “The restrictions, and the fact that there is a similar drug that has not been associated with the same degree of heart risks, may be the death knell for the once popular medication, which grossed nearly $3 billion worldwide during its peak of popularity in the early 2000s.” (

Caritas warns of 2 hospital closures – The Boston Globe “Caritas Christi Health Care executives have told union negotiators they will shutter St. Elizabeth’s Medical Center in Brighton and Carney Hospital in Dorchester if they can’t close a deal for the six-hospital chain to be bought by a New York private equity firm.”(Boston Globe)

Q&A: Will health law help me now? – Wonderfully clear questions and answers about the federal reform’s immediate effects. (USA Today)