Weekend Potpourri

A Wall Street Journal article attempts to debunk the World Health Organization’s relatively low health care ranking for the United States.  The article points out flaws in the ranking methodology and  the misuse of the ranking to indicate that the US has poor quality care.  Like the number of uninsured, this WHO ranking is often misused by proponents of health care reform.   (WSJ Article)

A Wall Street Journal Editorial reminds us that government has done a particularly bad job at predicting the future costs for new or expanded health programs.  Here’s an example of that outstanding foresight:  in 1965 Congress said Medicare would cost $12 billion in 1990; the actual cost that year was $90 billion.  Whoops.  (WSJ Column)

A Journal of the American Medical Association commentary looks at medical tourism.  (JAMA Abstract)  The commentary notes the rapid growth of this phenomenon, the potential loss of business to providers in the US and the American College of Surgeon’s issuance of a statement warning patients about potential problems with receiving health care overseas.

The New England Journal of Medicine points out the potential for enormous savings by better managing the care of the relatively few patients who account for a substantial part of all health care spending.  Ten percent of patients are responsible for 70% of all spending.  (NEJM Perspective)  The good news is that the high cost of these patients justifies the intensive management interventions necessary to keep them out of hospitals and using health resources efficiently.   The article describes several care management programs designed to improve care and lower costs.  Reducing the spending of this group by even 10-15% would more than pay for expanded access.

The WSJ Personal Journal had an article on October 20, 2009, regarding the increasing use of telemedicine to bring scarce expertise to patients, whether in rural or other underserved areas. 

Unfortunately, in the effort to reduce health costs, we rarely think about the input costs of providers.  The Association for Healthcare Resource and Materials Management, working with the Center for Innovation in Healthcare Logistics, has done a great deal of work on how hospitals and other providers might manage their supply chains better and lower costs.  A recent report summarizes the opportunities.  (CIHL Report) 

Have a great weekend!