This is from Jim Frogue's testimony to the House Energy and Commerce Committee.

Medicaid patient encounter data is sometimes available to researchers, but not to the general public.  That's too bad.  Taxpayers should know where their money goes.  In one state:

• Only 17% of Medicaid women over age 50 were given an annual mammogram. (Many doctors think the number should be 100%)
   
• Less than half the children received well child checkups.
   
• One beneficiary visited hospital emergency rooms 405 times in three years-more than once every three days.

This blog is fast becoming the go-to site on obesity.  Perhaps that's because I have a new Assistant who is really into healthy lifestyles.  Previous posts are here and here.  What's new:

• Los Angeles is considering banning all new fast-food restaurants in a 32-mile area that is home to its fattest residents. But since there are already 400 restaurants that will be grandfathered in the zone, there is little danger of extreme withdrawal symptoms [link].

• More serious is New York City (home of nanny Mayor Bloomberg), which is banning transfats in restaurants. Going forward, you will have to buy your own lard in the grocery store.

• Neil Trautwein says the National Restaurant Association (which represents fast food outlets) doesn't want you to be fat [link]. It does want you to buy their food, however.

• My daughter Kara is an investor in fast food restaurants. Her advice: If you are going to succumb anyway, try Popeye's, Burger King and Taco Bell-preferably in the Southeast.

• To live longer, eat 30% less. At least this works for mice. [link]

A new paper by Frank Lichtenberg says new cardiovascular drugs increased spending on drugs by $24 per capita over a ten-year period, but reduced hospital costs by $89-for a net savings of $65 for every man, woman and child in the country.  Also, people live longer as a result.

A second paper, using Australian data, finds that newer drugs increased life expectancy by 1.23 years for a cost of $10,585 per year of extra life.  (In the cost/benefit business, this is considered a very good return.)

Hat tip to Jason Shafrim, who has a very good blog.

Your ancestors did. Drinking water posed the risk of cholera, dysentery and other diseases.  Drinking beer kept them alive.  And they passed their beer-drinking genes on to you.  That's the thesis of Steven Johnson's book, The Ghost Map.  See George Will's take on this [here].

It was good enough for Isaac.  It was good enough for Jacob.  It was good enough for….

HSA Consulting Services will host a surprisingly affordable webinar on the latest IRS guidance on Health Savings Accounts on Wednesday, July 23 at 12:00pm ET.  The webinar will last 90 minutes.  One can sign up for the webinar at any of the following websites: http://www.hsaed.com/, http://www.hsaseminar.com/ and http://www.hsaclearing.com/.

Once a year, says the American Cancer Society.  Every year or two, says the Preventive Services Task Force.  Every two or three years, says the American Geriatrics Society.  Nonsense, say others.  "You don't start screening at birth and you don't continue until death," says a critic.  NYT story here.

First, the good news.  Cardiologists with stent patients were invited to make cost-reducing improvements in the way they practice medicine and share in the financial savings they generated.  A study finds the physicians engaged in bulk buying and switched to more efficient devices-saving an average of $17,000 per year per physician (shared 50/50 with the hospital).  Extended nationwide, this behavior would save $195 million.

Now for the bad news.  If other doctors try this, they will be breaking the law.  In fact, they could go to jail!

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Everyone knows that hospitals lose money treating the uninsured. But do they really?

• One California hospital charged uninsured patients $10,150 per day and collected $7,815. Its actual costs: $2,036.
• Another California hospital charged the uninsured $11,098 per day and collected $8,535. Its actual costs: $2,172.

In both cases, the hospitals not only made money on the uninsured, they collected a whopping four times what the care really cost to deliver.

These examples are from a fascinating new book, America's Health Care Crisis Solved, by Pat Rooney and Dan Perrin. It's a must-read for anyone interested in health policy.

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Georgia has become the second state to allow employers' (untaxed) funds to be used to purchase individually owned, personal and portable health insurance for employees.  It's part of a new health reform that promotes wider insurance coverage with HSA and HRA products.  See Ron Bachman's report here.

Opponents of private health insurance often praise Medicare for its low administrative costs.  Yet, according to Scott Gottlieb in a WSJ editorial, Medicare has only 20 doctors and 40 clinicians on staff at any one time.  To match such private plans as Aetna and United Health, Medicare would need 4,500 clinicians.

Private plans use trained people to determine on a case-by-case basis what products and services should be covered.  The result:  better care, more personalized service and better access for appeals by patients.

Barack Obama and Hillary Clinton want insurers to be forced to accept all enrollees for the same premium—regardless of health condition.  The result: health plans will run away from high-cost patients and underprovide to them if they do enroll.  By contrast, the Medicare Advantage program pays more for high-cost patients.  The result:  health plans actively compete for the chronically ill and have enrolled more than a million of them in "special needs" plans.  So what does Congress want to do about it?  Kill the program, of course (see WSJ article here).

Roy Ramthun will be hosting an HSA webinar on Wednesday, June 25th at 12:00 noon ET (11:00 am CT, 10:00 am MT, 9:00 am PT) to explain the new IRS guidance on IRA-to-HSA rollovers and account funding issues.  There will be an opportunity for Q&A as well.

To register and reserve your Webinar seat now, go here.

I'm excited to announce that I have also just released a Spanish version of my HSA guide — Manual de sentido común Cuentas de Ahorros para la Salud — which is intended to help individuals and families for whom Spanish is their primary language to better understand Health Savings Accounts, how the HSA-qualified health plans that make people eligible for Health Savings Accounts compare to traditional health insurance, and how to determine whether a Health Savings Account is right for them.  The guide is a direct translation of my updated version in English, The Common Sense Guide to HSAs, released recently.  This guide should help Spanish-speaking family members and relatives feel more comfortable with the terminology and issues as well as advantages that HSAs present.

You may download a copy of the Spanish language guide for a fee at http://hsaed.com/ my website devoted to educating consumers about Health Savings Accounts.  The English version is also available for free on this site. http://hsaed.com/hsa_guide_book

You may also be interested in signing up for a one hour HSA webinar I will be hosting on Wednesday, June 25th at 12:00 noon ET (11:00 am CT, 10:00 am MT, 9:00 am PT) to explain the new IRS guidance on IRA-to-HSA rollovers and account funding issues.  The webinar will provide an opportunity for Q&A as well.
 
The cost of the webinar will be $35.  To sign up visit HSAed.com For those that attend the webinar, the Spanish version of my guide book will be sent to you free of charge.

You can fill the gap once, but only once. See details here from the Life and Health Insurance News.

This is a heads up from Tyler Cowen.

Three years of medical school in Tanzania results in only a 1 percentage point increase in the probability of a correct diagnosis. In Paraguay, the amount of time a doctor spends with a patient has nothing to do with the severity of the patient's illness.

This is from "The Quality of Medical Advice in Low-Income Countries," by Jishnu Das, Jeffrey Hammer, and Kenneth Leonard, in the Spring 2008 issue of the Journal of Economic Perspectives.

Contradicting an earlier Dutch study, a new study finds that overweight people have higher lifetime health care costs after all.  So instead of getting a lifetime discount on their private health insurance and Medicare premiums, the obese should pay a bit more.  But not that much more.  Just eyeballing it, I would assess the fat tax at $300 per excess pound over a lifetime. That's less than 2 cents per excess pound per day of adult life — roughly the cost of an M & M.      

See my previous FYI.

Bad news….Very bad news….Bad, that is, if your name is Hillary or Barack or Newt or if you work for the Commonwealth Fund or if you are one of the innumerable health policy wonks who think that health spending can be controlled without choices, without markets, without competition, without any pain whatsoever - other than installing a few computers.

According to a Congressional Budget Office (CBO) report, health information technology by itself is unlikely to produce the significant cost savings projected by economic analysts and policymakers.  This is a blow to:

• Hillary Clinton, who is counting on $50 billion in annual savings from health information technology (IT) and similar reforms to pay almost half the cost of her health reforms.
• Barack Obama, whose health advisors expect between $120 billion and $200 billion of savings.
• All other candidates for office this year who were counting on an IT fix to create a health care free lunch.

Last week, Pete Stark chaired a Bash-Health-Savings-Accounts hearing.  In a nod toward balance, the committee agreed to hear from one (and only one) witness who had any real world experience with actual HSAs.  Jim Frogue from the Center for Health Transformation reports as a comment.

Get ready.  Somewhere between 2016 and 2020, health entitlements, Social Security, debt service and national defense will consume the entire federal budget.  There will be nothing left for education, environment, highways - not even enough to pay the telephone clerk at the White House.

This is from a Gene Steuerle/Randall Bovbjerg article in Health Affairs. [gated, but has summary]

People in fair or poor health who have health insurance are less likely to drop or lose coverage if they have individual insurance than if they have small-group insurance, according to a study by Mark Pauly and Robert Lieberthal of Wharton. This finding, by the way, is stunning. It is the opposite of what all your friends and colleagues think.

The number of people traveling the globe for medical treatment is lower than commonly assumed, but there remains potential for huge growth in the industry, according to a gated study by consulting firm McKinsey & Co.

You do. A Commonwealth study finds that "on average, hospitals passed on 78% of the costs of all injuries and 70% of the costs of negligent injuries to outside payers."

House Oversight and Government Reform Committee Chairman Henry Waxman (D-CA) and House Ways & Means Health Subcommittee Chairman Pete Stark (D-CA) chose to release a report they requested from the General Accountability Office on the same day as the AHIP survey was released, even though the report was delivered to the Chairmen on April 1.  The Chairmen's press release, seeking to throw cold water on the otherwise solid numbers from AHIP, says the report shows that HSAs are used more often as a tax shelter by wealthy individuals rather than as a mechanism to help working families obtain needed health care.

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America's Health Insurance Plans (AHIP) just released its 4^th annual survey of Health Savings Account plans.  As of January, 2008, more than 6.1 million Americans are covered by Health Savings Account (HSA) insurance plans, a 35 percent increase over last year and almost double the number in 2006.

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The FDA says they are.  Lots of patients say otherwise.  Here's a Wall Street Journal article about a generic that releases 34% of the drug in the first two hours compared to 8% for the brand name drug.  Four times the impact is apparently too much for some patients and there have been lots of complaints.  Bottomline:  people shouldn't be forced to choose one over the other.  But patients should pay the full costs and reap the full financial benefits of the choices they make.  

An ounce of prevention may have been worth a pound of cure in households down through the ages, but in the world of health economics the adage, alas, is not true….

Even when prevention greatly reduces future cases of a particular illness, overall cost to the health-care system typically goes up when lots of disease-preventing strategies are put into practice. This is usually true whether treating the preventable diseases is cheap or expensive.

This is from an article in the Washington Post.