National health care spending grew at its lowest rate in nearly a decade in 2007, largely as a result of slower spending on prescription drugs, according to a report by government analysts published today in the new January/February 2009 issue of Health Affairs. The analysts from the National Health Statistics Group in the CMS Office of the Actuary report that health care spending grew 6.1 percent in 2007, down slightly from 6.7 percent in 2006 and the slowest rate of growth since 1998. Overall, health care spending reached $2.2 trillion, or $7,421 per person.

Health care and the economy. Health spending growth overall outpaced the slowing economy and consumed a larger portion of gross domestic product in 2007, reaching 16.2 percent, up from 16 percent in 2006. Although prescription drug spending slowed significantly in 2007, reaching its lowest rate of growth in 45 years, most other health care services grew at about the same rate or faster from 2006 to 2007, the government said. Writing in today’s New York Times, Robert Pear noted: “In recessions, when the economy contracts, health spending usually continues to increase. So federal economists and statisticians said that health spending probably accounted for an even larger share of the nation’s economic output in 2008.”

Prescription drugs. The slowdown in the rate of growth for prescription drug spending contributed to more than half of the overall deceleration of growth in national health spending. Spending for prescription drugs grew 4.9 percent in 2007 to $227.5 billion, down from 8.6 percent in 2006, and the slowest rate of growth since 1963. “A tough time to be in be in the drug business,” noted today’s Wall Street Journal Health Blog. Read the rest of this entry »

On Saturday, President-elect Barack Obama highlighted health information technology as part of his plan to improve the economy and health system. In his weekly address, Obama said: “To save not only jobs, but money and lives, we will update and computerize our health care system to cut red tape, prevent medical mistakes, and help reduce health care costs by billions of dollars each year.”

As the National Journal’s Tech Dose Daily reported, Obama is scheduled to meet next week with leaders from both parties to discuss his plan. Health IT wonks eagerly noted the attention. On The Health Care Blog, David Kibbe and Brian Klepper offer an updated “Open Letter” to the Obama Administration on Health IT today.

Amidst the enthusiasm, readers may well ask how these “billions of dollars” of savings will be achieved. Many of the cost estimates build on the RAND Health IT project that estimated fully implemented electronic medical records could save the U.S. health system $81 billion per year [free access article]. Another early estimate by Jan Walker and colleagues at Partners HealthCare placed the value of “electronic health care information exchange and interoperability between providers (hospitals and medical group practices) and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers” at $77.8 billion per year [free access article].

Some analysts, questioned the estimates saying, “it ain’t necessarily so.” Read the rest of this entry »

As we close out 2008, here is a look back at the Health Affairs Blog posts that attracted the most readers this year. Analysis of health reform plans from the presidential candidates and a look ahead to policy options under an Obama Administration garnered the most attention. If you missed any of these posts, happy reading. Best wishes to all in the New Year!

1. Obama’s Health Policy Options: 3 Scenarios
   by Jeff Goldsmith
2. Covering The Uninsured: Cheap At Twice the Price
   by Henry Aaron
3. Indiana: Health Care Reform Amidst Colliding Values
   by Mitchell Roob and Seema Verma
4. U.S. Worst At Beating Death From Preventable Illness
   by Jane Hiebert-White
5. The McCain Critique: Out Of Touch And Short Of Ideas
   by David Cutler
6. Health Plan Scoring That Runs Out Of Bounds
   by Tom Miller
7. Minority Health Legislation In The 110^th Congress
   by Dora Hughes
8. Medical Homes And Medical ‘Home Runs’?
   by Arnold Milstein
9. McCain, Obama Health Plans Critiqued
   by Jane Hiebert-White
10. Obama And Health Policy: Campaign Successes And Governing Plans
    by John Iglehart

Ever since an 18-year-old New York woman died tragically in 1984 under the care of medical residents who—in the view of her family—were overworked and undersupervised, the subject of the duty hours of physician trainees has simmered in the academic medical community and, on occasion, among public policymakers. Now, as the consequence of a new study by the Institute of Medicine (IOM), these issues will reemerge in a robust fashion again, and the leading questions will focus on how to ensure patient safety while maintaining rigorous training programs.

The IOM study was requested by four members of Congress—all of whom are senior members of the House Energy and Commerce Committee—as part of the panel’s investigation into preventable medical errors.  They are Chairman John Dingell (D-MI), ranking Republican Joe Barton of Texas, Rep. Bart Stupak (D-MI), and Rep. Ed Whitfield (R-KY). In a letter (dated March 29, 2007), the representatives directed the Agency for Healthcare Research and Quality (AHRQ) to contract with the IOM to study “medical errors associated with physician and resident work schedules.”

In particular, the legislators said their interest in the subject “was recently heightened” by a study funded by AHRQ  and published in PLoS Medicine that “found medical errors resulting in adverse events, including death, due to sleep-deprived and over-extended medical residents and interns, substantiating previously held concerns about physician work schedules.” Read the rest of this entry »

Yesterday President-elect Barack Obama nominated Sen. Tom Daschle (D-SD) as his choice for Secretary of Health and Human Services. Additionally, Obama asked Sen. Daschle to lead a new White House Office of Health Reform and nominated Jeanne Lambrew, a senior fellow at the Center for American Progress, as the deputy director of the office. Lambrew has written a book on health reform with Daschle, served in President Clinton’s administration at the Office of Management and Budget, and was an informal adviser on health care to Sen. Hillary Clinton during the campaign. She wrote in Health Affairs with John Podesta on the challenge of extending and improving health coverage [free access article].

Last night, in an interview on the PBS NewsHour with Jim Lehrer, Health Affairs Editor-in-Chief Susan Dentzer noted that the nomination of Daschle to these dual health leadership positions may give policy watchers some indication of where an Obama administration is heading in thinking about health reform:

“I think it tells us a little bit about the substance of the proposal that could likely emerge and also about the process. On the substance, Sen. Daschle has very much been in-sync with the kind of thinking that was evident in the Obama campaign plan on health reform, that is to say around such concepts as shared responsibility, everybody has to pay into the system, employers, individuals, the government….

It also tells us something very important about the process, which is that, unlike what happened during the Clinton health reform, this is not going to be a plan that is cooked up in the White House and brought out and pushed on to Congress. Quite the contrary, it’s going to be a plan that emerges largely from the Congress. We know that key officials in Congress — Sen. Max Baucus, who chairs the Finance Committee, Sen. Ted Kennedy, who chairs the Health, Education, Labor and Pensions Committee — are working together already on a plan…. There’s going to be very, very active engagement.”

Linking Health Reform To Economy. In the press conference announcing the nominations, Obama linked the importance of tackling health reform to the economy, saying: ”If we want to overcome our economic challenges, then we must finally address our health care challenge.” Dentzer elaborated on this point in her NewsHour interview: Read the rest of this entry »

A new edition of the Health Wonk Review posted this week highlights a round-up of health policy bloggers on prospects for reform in an Obama administration, the intersection of health care and the economy, and more. Vince Kuraitis of e-CareManagement Blog, offers a Dragnet-style “just the facts” spin for his turn at hosting the biweekly blog compilation. Also out today, Kaiser Daily Health Report offers its Friday Blog Watch. The Kaiser health blog round-up appears every Tuesday and Friday.

Just after the historic inauguration of President Barack Obama, join health policy makers in Washington, D.C. for the 2009 National Health Policy Conference, co-sponsored by Health Affairs and AcademyHealth.  The event takes place February 2-3, 2009 and will feature senior officials from the Obama Administration and Congress. Other confirmed panels include:

• The impact of health care reform on public programs
• State lessons for health reform
• The impact of health care reform on employers
• How to fund health care reform

Register today to learn where health care reform is headed tomorrow.

If you listen to National Public Radio’s (NPR) “All Things Considered” on Saturday afternoons, recently you heard the voice of Narrative Matters author Nataly Kelly. Her on-air commentary about being a medical interpreter was excerpted from her Narrative Matters essay in the November/December 2008 issue of Health Affairs. For a story of a medical tragedy caused by a hospital not using a professional medical interpreter, read this post on the Health Affairs Blog.

Narrative Matters essays are good listening as well as good reading. You can listen to several other Narrative Matters authors reading from their essays on NPR as well.

Health reform ideas and policy proposals for President-elect Barack Obama to consider topped the most-read list on Health Affairs Blog in November. Jeff Goldsmith lays out three options for how health reform might proceed. John Iglehart looks at the policy process an Obama administration might take. And John Goodman’s recent post has generated heated commenting. Another post of interest with new extended debate between readers and author is Dennis Cotter’s entry on how Medicare should incorporate epoetin into its composite payment rate for end-stage renal disease. Additional comments are always welcome. To stay on top of new postings, sign up for email or RSS feed alerts.

1. Obama’s Health Policy Options: 3 Scenarios
   by Jeff Goldsmith
2. Obama And Health Policy: Campaign Successes And Governing Plans
   by John Iglehart
3. AmeriCares Plan: A McCain-Obama Hybrid Proposal
   by Ron Klar
4. Expanding Primary Care: A Call To Action
   by John Iglehart
5. McCain And Obama Health Plans: An Authors’ Roundtable
   With Mark Pauly, Katherine Swartz, And Gail Wilensky
   by Parmeeth M.S. Atwal
6. Eulogies: Allan Rosenfield, Paul Rogers, And Michelle Mayer
   by Susan Dentzer
7. Indiana: Health Care Reform Amidst Colliding Values
   by Mitchell Roob and Seema Verma
8. The Obama-Romney-McCain Plan
   by John Goodman
9. Health Plan Scoring That Runs Out Of Bounds
   by Thomas Miller
10. Primary Care: Divergent Paths In U.S. And Abroad
    by John Iglehart

Time to catch up on health policy blogging highlights? The latest Health Wonk Review offers a post-election round-up hosted by Louise Norris of The Colorado Health Insurance Insider blog. Earlier, David Harlow of HealthBlawg took a turn at hosting the HWR and highlighted some terrific posts on health spending and the economy.