Unwrapping early presents, wrapping up ’11 Health Wonk Review series

A sleigh led by a dog.

Hey, the red-nosed reindeer had nothing on this mutt.  Like Rudolph’s maiden voyage with the fat man, this is the Watchdog’s first time hosting the Wonk Review.  So buckle up for a wild ride.



Man, there’s a lot in Santa’s bag:  unbundling the bundle in the jungle, the Bare Naked Ladies, sitting on Santa’s lap (those two weren’t related), anarchy, Newt Gingrich (those last two weren’t necessarily related, either), Mitt’s $10K bet, Occupy health care, some re-gifting (ACOs), and a year’s worth of health care news releases on toenails, zits, ta-tas, head lice, vaginal dryness, etc.

First, the serious stuff:

Jason Shafrain on the Healthcare Economist reviews one proposal from the book, “Bring Market Prices to Medicare” to answer the question, “How can you cut Medicare spending while improving quality?”

On Managed Care Matters, Joe Paduda focuses on Republican efforts to overturn the part of the Affordable Care Act that restricted Medicare payments to new or expanded physician owned facilities.  He concludes asking “What do you want: A ‘free market’ or higher taxes and higher group health premiums?”

No, it’s not the Rumble in the Jungle.  But Bradley Flansbaum delivers the “Bundle in the Jungle” on the Hospitalist Leader blog, on bundling as a method of payment for healthcare services. His punchline:  “The emperor must keep shopping.”

The only music video of the week is delivered by Roy Poses, unwrapping the Bare Naked Ladies to make his point, “It’s All Been Done Before,” If We Only Could Remember What it Was – the AHERF Example.”  His point: ACO’s are once again the rage, but only a few people seem to remember how badly this idea turned out when it was fashionable in the 90s.

A somewhat similar note of déjà vu all over again on David Harlow’s Health Care Law Blog. “We need to put a little bit of the anarchist in each of us to work if we want to achieve meaningful change to our broken health care system,” he writes.

No music video, but a YouTube Popeye cartoon backed up John Goodman’s Health Policy blog post, “Eat-Your-Spinach Budget Reforms.”

Some people write “Dear Santa” letters. But Dr. Kerry Willis writes a “Merry Christmas, Mr. President” letter on the Healthcare Talent Transformation blog. Excerpt: “We do have proven models that have demonstrated a cost savings while increasing the quality of care provided. It’s called the Patient Centered Medical Home. We can reward practices for moving to this model and save money and improve the quality at the same time. We have trials, data and savings demonstrated everywhere the model has been tried. It’s portable, accessible and easy to understand and implement. And it’s being ignored in favor of ACOs where we have no data and no savings and no one is quite sure what they are or how they work.”

Hank Stern’s InsureBlog digs into the Early Retiree Reimbursement Program, including analysis which suggests to him that the program was an expensive “Thank You” to the President’s union supporters.”

On the other mitten, Anthony Wright writes on the Health Access California Blog – “Occupy Health Care!” His synopsis: “While the Occupy movement spotlights dramatic health care and medical debt stories, its main focus is income equality. Yet it’s important to remember how deeply regressive our health care system is… and by definition, how much the Affordable Care Act would do to address inequality.”

Brad Wright gets all math-heavy with “Americans Must Be Bad With Fractions” on his Wright on Health blog. Not really.  Remember:  this is a journalist hosting this week and we’re notoriously math-phobic. He comes down to “our” level, though, when he writes that Americans might as well say “I love crust, cheese, tomato sauce, and pepperoni, but don’t you go putting it all together and trying to shove a slice of pizza down my throat.” He sees the same thing with the public’s views of Congress.

Jaan Sidorov also took into account that a journalist was hosting this week when he submitted, “The New York Times, Newt Gingrich’s Sins and The Merits of Creative Destruction.” Any resemblance between Newt and Santa – or the Pillsbury Dough Boy is unintentional. This post also has its anarchy tones – with Jaan writing: “Let’s face it, who wouldn’t like to figuratively blow up the health care system (particularly Medicare) and start all over again?”

‘Nuff about Newt?  Ready for some Romney?  David Williams writes on the Health Business Blog that Mitt’s $10,000 bet may have struck some as a lot of money, but it’s chump change in health care.

Journalism kudos

Maggie Mahar wrote on Time.com about South Carolina’s governor using her influence to prevent the implementation of federal health care reform — spending federal funds ear-marked for reform to achieve her goal. Mahar credits Charleston Post & Courier reporter Renee Dudley for a superb job in tracking this story.

Journalist Laura Newman wrote on her Patient POV blog, “Terminology Matters: Let’s Not Call it Prostate Cancer” based on the recent NIH State-of-the-Science Conference: Role of Active Surveillance in the Management of Men With Localized Prostate Cancer. It was interesting to see how a journalist and a physician who spoke at that meeting both – independently – focused on some of the policy aspects of this meeting.  Dr. Richard Hoffman wrote: “We must address the unbridled dissemination of new technologies.  Such a daunting effort may require regulatory changes for introducing new technologies, reconsidering how care is reimbursed, creating expectations for documenting clinical effectiveness, and providing counter detailing for the public and patients–who all too often are seduced by the marketing hype that innovation and high-technology equals effective, safe, and necessary care.”

Mixed bag of posts

On the Workers’ Comp Insider, Jon Coppleman examines two court cases that trouble the dreams of claims adjusters: workers with severe injuries whose use of pain medication leads to their deaths.

Louise Norris at the Colorado Health Insurance Insider comments on “HHS Allowing States To Define Essential Benefits In The Exchanges.

On the New Health Dialogue, Joe Colucci called for improved informed consent –  a simplified, human-readable summary of the legal and practical characteristics of a treatment.

Now the silly stuff:

I don’t know how anyone could ever call me a “wonk” after reading all of the stuff above, but I have been called that. About as wonkish as I get is to ask shoppers whether they want to spend their time at the shopping mall sitting on Santa’s lap or testing the local medical center’s robotic surgery system.

Or posting about a year’s worth of health care news releases promoting “Chocolate, seaweed, omega-3, antioxidants, laser toenail fungus treatments, enzyme deficiencies, snoring, anti-aging, cure for cancer, seasonal affective disorder, itching, vaginal dryness, miracle diets, zits, ta-tas, head lice, “uber” nutrients, etc.”


All in a day’s work for Santa’s health care marketing elves.


This concludes a year’s work on the Health Wonk Review.


Rudolph, thanks for letting the Watchdog lead the sleigh on this final ’11 effort.


And now that I’ve done this for the first time, thanks to all who have devoted so much time and effort to make these Reviews look so much better than I did.  Hope Mrs. Claus has a hot toddy ready. 





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December 22, 2011 at 9:01 am

Excellent job, Gary! I really feel the Christmas spirit – you must be dog-tired (sorry, couldn’t resist).

Thanks for hosting, and for including our post!

joe paduda

December 22, 2011 at 10:11 am

Thanks for bringing some much needed humor to what’s been an exhausting year.

I love the “Newt Gingrinch” – Santa linkage – or is that a compare/contrast thing?


December 22, 2011 at 5:41 pm

Great job Gary! Funny and informative – an excellent final HWR for 2011. You definitely earned the hot toddy.