(Foreword: This editorial was written as the August 24th edition of the "Health Wonk Review," a biweekly compilation of freelance healthcare writers.)

The Merriam-Webster dictionary defines a wonk as "a person preoccupied with arcane details or procedures in a specialized field." The unflattering synonym is "nerd."

While the connotation of that word is, of course, not deserved, healthcare writers do form a unique group. Healthcare—with its sometimes circuitous terminology and an industry structure that resembles no other—certainly qualifies as a specialized field. Only by strict attention to detail can we move our understanding of the field "a little farther down the line."¹

With that, The Lucidicus Project presents the Health Wonk Review for August 24, 2006. The Health Wonk Review is a biweekly compendium of health policy writings, some submitted by the authors and others culled by the host. Many topics are represented, including health policy, infrastructure, insurance, technology, managed care, and others. Contributors also take turns hosting the Review, and The Lucidicus project has offered to host this issue. The Lucidicus Project, for those who have not visited this website before, is a Boston-based undertaking whose mission is to help medical students understand the moral and economic case for capitalism, particularly as it applies to medicine.

Inclusion below does not necessarily indicate agreement with the author's claims. Nor does exclusion necessarily indicate disagreement. The annotations are intended to be neutral; this review is merely a snapshot of who is writing about what in the amateur sphere:

1) Julie Ferguson of Workers Comp Insider points her readers to an article by Jon Coppelman entitled "BLS Stats on Dying at Work: Spin Control in the Graveyard." The author takes issue with recently-released statistics relating to the number of deaths on the job. Mr. Coppelman contends that virtually all workplace fatalities are preventable, and criticizes the Bush administration for "reducing government's role to the bare minimum."

2) David Williams of the Health Business Blog ponders—unseriously, we hope—"Instead of paying young couples to have children in the vain hope of increasing the ratio of workers to retirees, why not pay older people to move to countries where healthcare is cheaper?" Mr. Williams notes that even if governments continued to pay the full cost of health care, there would be a large, immediate savings, and that it could be more economically efficient than paying for kids to be born.

3) An unsigned policy digest by the National Center for Policy Analysis echoes the recent editorial in Investor's Business Daily regarding California's new drug discount deal. From the digest: "Price controls, whether on food, energy or medication, never work out as they are supposed to.... There will be shortages of whatever good or service the government tags with price ceilings. It's an elementary law of economics: Supplies fall when prices fall."

4) Dmitriy M. Kruglyak of The Medical Blog Network reports from an event on the future of mobile healthcare. He writes, "Don Jones, Qualcomm's VP of Healthcare lays out the goalposts for what applications are likely to gain traction." Mr. Jones notes that cell phones are cheap, globally available, and near-ubiquitious. Such an infrastructure could be useful in some forms of healthcare delivery, for instance through the use of text messaging applications.

5) Joe Paduda of Managed Care Matters asks "Why would anyone want to buy a healthcare company?" Mr. Paduda looks at the pros and cons associated with the potential $21 billion buyout of the Hospital Corporation of America (HCA) by founder Thomas Frist Jr. and a group of investors.

6) Jack Mason of HealthNex examines the concept of Independent Health Record Banks, a method for managing medical records that has bubbled up from IBM's Innovation Jam, a collaborative think tank type of forum between IBM employees, business partners, and others. This innovation, as claimed by IBM, could be a win-win for both healthcare providers and insurers.

7) Doctors Todd West and Pat Conrad from Doctors for Freedom take a look at a bill proposed by physician Michael Burgess (Rep, R-TX) called the Medicare Physician Payment Reform and Quality Improvement Act of 2006. They write: "This bill is lauded by the AMA as one that would end the Ouji-board voodoo of the infamous Sustainable Growth Rate formula.  This formula, which is nearly incomprehensible to the rational mind, instituted in Medicare law the procedure that increased public demand for doctor visits in one year would result in decreased payments to doctors in the following year."

8) Jason Shafrin at Healthcare Economist examines a recent example of the "Adverse Selection Death Spiral" at work in the recent demise of PacAdvantage, an insurance pooling company for 6000 small and medium sized businesses in California. Back in June 2006, Mr. Shafrin mentioned Cutler and Zeckhauser's 1997 paper which discussed this concept in the context of Harvard's employee health insurance plans.

9) Vreni Gurd of Wellness Tips claims that "processed foods are taking over our supermarkets and our diets and wreaking havoc with our health." Expressing his criticism of the food industry, he writes that, "The food industry knows how to market their products in a way that makes the consumer believe they are healthier than the real food alternative.  Learn to recognize processed food and replace those food products with food that will actually nourish you." In another article, Mr. Gurd also asks whether going to bed too late can make you fatter than you otherwise would be. "Our cells are very sensitive to light and dark, causing our hormones to respond accordingly.  When we stay up late at night with the lights on, our bodies are fooled into thinking it's day, resulting in an inappropriate hormone response that leads to fat deposition."

10) Fard Johnmar of Envisioning 2.0 discusses the advantages of full disclosure when it comes to the pharmaceutical industry and its support of clinical trial research. Mr. Johnmar argues that full disclosure is in the rational self-interest of pharmaceutical companies, since the communication and trust that it bolsters can in the long run help to increase sales.

11) Referencing figures from MedSolutions, a radiology management solutions vendor, Henry Stern of InsureBlog suggests that "radiology services could be the next big battleground in the fight to reign in health care costs."

12) Jim Walter of HR Web Cafe discusses a recent survey on the high cost of absenteeism to U.S. businesses, noting that personal illness accounts for just 35 percent of unscheduled absences. Mr. Walter offers four recommendations to help employers fix this "leaking bucket," including measuring the lost time with a dedicated software tool or even just a simple spreadsheet.

12) Rita Schwab of MSSP Nexus interviews Carole La Pine, Director of the Credentialing Department at Saint Joseph Mercy Health System in Ann Arbor, MI, and President-Elect of the National Association Medical Staff Services. In her interview, Ms. La Pine sketches the important role that MSSPs play in healthcare quality. To bolster this, she strongly encourages medical staff and administrative healthcare leaders to consider what Medical Staff Professionals (MSPs) actually do. She also hopes that Human Resource Departments, Medical Staff leaders, and hospital executives will develop a greater awareness of their roles in the clinical environment.

____

¹Apologies to Johnny Cash, "Folsom Prison Blues," At Folsom Prison. Columbia Records, 1968.

©2005-2010 The Lucidicus Project, all content unless otherwise noted.