On Monday, Medicare (and Medicaid) turn 45. And to celebrate, the government will be touting its annual open enrollment. Well, okay, the feds will also be throwing in a plug for government’s role in health reform and what benefits are in store for those who were spring chickens when Medicare became law. Who better to message than the avuncular Andy Griffith?

Clearly targeted at those seniors who still think “death panels” are an essential creation of the Obama plan for reform, the ad — which begins airing in some markets today — will mostly focus on the benefits for seniors inherent in standalone or the program’s supplemental plans under reform. There will be no mention, however, of the major way the new reform law will maintain Medicare solvency well into the next couple of decades: trimming the fat from Medicare Advantage payouts from plans which originally saw benefit under the George W. Bush administration’s 2003 Medicare Modernization Act. | LINK

Medicare Advantage flourished in the second George W Bush administration, creating new siphons of revenue for third parties in a rampantly robust healthcare marketplace. Although choices for plans presented to potential beneficiaries were touted as beneficial and desirable, confusion over eligibility and extent of coverage made participation mildly risky for seniors who felt traditional coverage was inadequate for certain services even Medigap plans couldn’t provide. Within the scope of the Obama reform law, MA plans will have to increase quality assurance parameters to remain viable.

Are the majority of MA beneficiaries getting that quality currently?

According to a recent survey commissioned by a public policy group, about one-quarter of beneficiaries were enrolled in plans that received either four- or five-star quality indicators. Metrics were very broad and covered everything from telephone customer service to follow up on beneficiary preventive medical services those plans explicitly underwrote. As payment to private insurers begins a new era tied to quality, numbers like these are sure to improve. | LINK

The Cochrane Collaboration, an international body which evaluates published medical trials, has interesting insights into the nature of the results of compilations of study data in trials done all over the world. A brand new Cochrane review upholds the clinical suspicions which physicians and healthcare lobbyists know only too well: that studies with positive results are more likely to see the light of publication, reach publication sooner, saturate the media easier, and influence healthcare policy more effortlessly.

So-called negative studies (those which conclude results which may refute established medical dogma or anecdotal belief) were seriously hampered by what the researchers/evaluators termed as “publication bias”. Many involved in shaping healthcare delivery policy in this country know how important a trial with a positive result is as it applies to high powered Washington lobbying; this issue will become much more important as the Obama administration has pledged “transparency” (a word it uses front and center on its official White House blog, describing it as one of its innate characteristics) with respect to all policy matters.

Just as many have cried out that healthcare policy was over politicized and favored Pharma and Big Insurance in the Bush administration, time will tell if Barack Obama is pressured by those same critics to renounce policies which have their genesis in findings like those provided by Cochrane. | LINK

Although his quest to “fix the healthcare system” currently has as much of a pie-in-the-sky altruism and idealism about it as — say, ending the Iraq War — there is much the future President Barack Obama can do on the issue of healthcare delivery immediately upon swearing in office in January. At the top of the list is revisiting the current President George W. Bush-led legislation involving the so-called “conscience rule”, which gives healthcare providers an out when faced with the possibility of performing procedures or prescribing medicines (notably, those treatments involving family planning) that might not square with their moral beliefs. Obama et al. promise to prioritize dismantling of this healthcare legislative piece, initially by allowing the Democratic controlled Congress to hamper its implementation. | LINK

• FDA requires warnings about suicidality risk with certain popular anticonvulsants.
• Physician in key role in Medicare scam gets 30 years.
• Healthcare providers’ “conscience rule” to take effect, courtesy George W. Bush.
• Editorial: Barack Obama must not “bow to” the demands of abortion rights supporters.
• The state of Utah gets ready to overhaul its healthcare delivery systems.

A healthcare imprimatur of sorts for the outgoing Bush Administration?  The current lame-duck president’s ‘Patients’ Right of Conscience’ regulation, which proposes that healthcare providers may withhold services based upon their moral beliefs, would probably do more to hurt patients than help — even those religious conservative patients who are the regulation’s intended targets.  Unsurprisingly, the major medical associations have swiftly come out against such proposed actions, citing patient safety — especially in emergency cases. Read the rest of this entry »