Tuesday, October 30, 2012

The Health Wonk Review: An Example of the Facts, Education and Spin Behind the Lingering Debate on Obamacare and Health Reform

Modern political discourse
The Disease Management Care Blog had a Hurricane Sandy choice: either a) leave day before that early A.M. hospital procedure and stay with friends who live close by, or b) stay at home and make the long trip in the wind and the rain to the hospital that same morning.  The DMCB spouse turned to repetitive education to help the DMCB make the right choice.

Does that learning tactic underlie Obamacare supporter Maggie Mahar's approach to the latest Health Wonk Review?  That's what the DMCB thought when it read Maggie's posting.

To help the thousands of health reform realists who make up the DMCB readership, Hurricane Maggie repetitively retreads the cost-control talking points from reform architect Peter Orszag, surgeon Golden Boy Atul Gawande and the White House Office of Management and Budget  Rest assured, says Maggie, if you selectively counter the DMCB's fiction with facts, you'll realize Washington DC's solutions are the right choice.

The DMCB isn't too sure about that.

Maggie doesn't argue health care costs aren't rising, only that the increases are less than widely claimed.  She credits Obamacare.  The Disease Management Care Blog agrees that cost trends are moderating, but it also credits a lackluster economy.

Maggie says be of good cheer, because the increased costs are delivering correspondingly better value for the health care dollar. The DMCB says value remains an inexact science that is ill-suited to simplistic nostrums and blunt force laws and regulations. The latest examples of this conundrum include mammograms and annual check ups.  There are plenty of others like this.

Maggie points to Massachusetts's Atul Gawande's brimming optimism about Massachusetts leading the way with risk and performance contracting as a cost-control panacea.  The DMCB awaits the arrival of hard macroeconomic outcomes data that proves the experiment works.  It also points out that the Bay State's recently passed cost control legislation speaks volumes on what that state's leaders really think about the savings-success of Romneycare.

Last but not least, not everyone on the blue side of political spectrum shares Maggie's optimism.

By the way, the DMCB has received a cost estimate from the unnamed hospital mentioned above. That institution is the flagship part of a nationally recognized integrated delivery system that is a basis for much of Maggie Mahar's enthusiasm. The DMCB's planned procedure coupled with OR charges and an overnight stay will result in charges, prior to discounts and contracted rates, in excess of $100,000.

For those of us with a lingering doubt that our political class's health reform sound-bites, nostrums, talking points and pronouncements will cut through all those inconvenient facts, the DMCB recommends this catchy tune.  You'll feel a lot better:

Image from Wikipedia