The GOP’s Health Policy Cynics

Michael Millenson

First published 3/7/11 on Kaiser Health News

The health care community is discovering to its shock and dismay that it’s not simply traditional Republican conservatives who have taken control of the House of Representatives, it’s a new group of cynics.

Conservatives, like liberals, have a more-or-less coherent set of ideas. They use political power to push preferred policies, whether related to health care, housing or a hundred other possible issues. William F. Buckley Jr., one of the fathers of modern American conservatism, “had a way of … making conservatism a holistic view of life not narrowed to the playing fields of ideology alone,” as one admirer put it.

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Health IT’s Future: A Tale of Three Watsons


First published 2/15/11 on The Doctor Weighs In

If you want to see the future of health information technology, take a look at the dueling visions of two Thomas Watsons that are on display this month in a game show and a trade show. The juxtaposition unintentionally demonstrates what doctors and patients will be doing together and also what they can do separately.

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Why Aren’t the Uninsured Protesting in the Streets Like the Egyptians?


Originally published 2/1/11 on Forbes

Maybe the uninsured could learn something from Egyptians and the Arab street. At a time when landmark health reform granting most of the uninsured access to medical care for the first time in their lives is being seriously threatened, protests by the uninsured themselves are nowhere to be seen.

In 2009, a staggering 51 million Americans from every walk of life and every corner of the nation had no health insurance. The Urban Institute estimates that 400 of them die each week due to lack of access to care. However, instead of pouring into the streets to protest when an activist judge calls the health reform law unconstitutional or conservative ideologues threaten to cut off funding, the uninsured leave the loudest push-back to (well-insured) political partisans.

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Fixing the Failure At Physician Compare


Originally published 1/28/11 on Kaiser Health News

The launch of Medicare’s Physician Compare website at year-end should have been a watershed event in the long campaign for health care transparency and patient empowerment. Instead – and it pains me to write this – Physician Compare is a case study in how the interests of the average citizen can be shunted aside by indifferent government, lazy journalists and solipsistic special interests. That remains true despite all of those involved being Good People Trying To Do The Right Thing.

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No Outrage, No Story In Dead Patients


Originally published on 12/22/10 on Kaiser Health News

A good story involves drama and conflict. A federal judge with Republican ties nixing a Democratic president’s signature achievement in ensuring access to care for all is a great story. One, two, even three reports about hospitals avoidably (if inadvertently) killing tens of thousands of Americans annually once they have the insurance that ensures them access to care apparently has little, if any, drama at all.

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A New Health System Data Collaborative Asks “What Really Works”

For decades, it has been clear that the clinical trial, as important as it is, is not the only way to prove that a particular approach works. As Jeanne Lenzer and Shannon Brownlee described this past weekend, many interventions are in use that have relatively little data supporting their efficacy.

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Why We Still Kill Patients: Invisibility, Inertia, And Income


Originally Published 12/6/10 on the Health Affairs Blog here.

DESCRIPTIONA recent front-page article [1] in the New York Times conveyed grim news about patient safety. The first large-scale study [2] of hospital safety in a decade concluded that care has not gotten significantly safer since the Institute of Medicine’s 1999 estimate [3] of up to 98,000 preventable deaths and 1 million preventable injuries annually.

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Cheer Up, It’s Not Just Us with Problems


Although we in health care often complain that system reforms are delayed, diluted or derailed by the forces of inertia and incrementalism, we are hardly alone in our frustration. Would-be reformers elsewhere suffer similar setbacks, even when the need for change is painfully obvious.

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