Too often, those who oppose health care reform say that while there may well be waste in our health care system, it’s hard to say where it is. One man’s waste is another man’s effective treatment. Many tests and surgeries may be controversial, but who is to say for sure what is unnecessary?

The truth is that we have stacks of medical evidence showing that many procedures and products are of little or no value to many patients who receive them.  These treatments may be useful to patients who fit a particular medical profile: women between the ages of 50 and 70, for instance, or patients suffering from left main coronary artery disease. In these cases, health care reformers agree: patients should receive the treatment. 

But typically a much larger group of patients are subjected to a procedure that provides no benefit. Thus, they are subjected to risk without gain. Keep in mind that one hundred thousand people die each year from complications of surgery—far more than die in car crashes. And some of those surgeries were unnecessary.

In a recent post on The Health Care Blog (THCB) (www.healthcareblog.com)  Dr. George Lundberg, former editor-in-chief of the Journal of the American Medical Association,  wrote about seven areas where we have enough comparative effectiveness research to know that a great many patients are being over-treated. Lundberg, who is now president and chair of The Lundberg Institute suggests that we could begin to rein in health care spending NOW –if doctors  take “a good hard look” at the evidence (and “in the mirror”), and share medical evidence with patients about benefits and risks when discussing options for treatment. (For more on “Shared Decision-Making” see this Health Beat post)

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Health Wonk Review, a round-up of some of the best posts in the Healthcare blogosphere over the last two weeks, is now up on Health Business Blog, hosted by David Williams here:.
http://www.healthbusinessblog.com/?p=2556
http://www.healthbusinessblog.com/

Just a few highlights:

The Robert Wood Johnson Foundation presents a users’ guide to health reform. Key assertion: if we improve efficiency in health care we can avoid cost/coverage tradeoffs

Managed Care Matters offers the top ten misconceptions about health reform. Reason #2: “A public plan would crush private insurers and we’d all end up covered by the public plan,:

Heath Care Renewal thinks hospital Group Purchasing Organizations (GPOs) are acting more like Group Kickback Organizations. As Williams points out, Roy Poses, the editor of Health Care Renewal has  written about this problem “as far back as 2005, but now investigators are taking an interest”  This is very good news.

To find links to these, and other top posts, go to
http://www.healthbusinessblog.com/?p=2556
http://www.healthbusinessblog.com/

Below, a response to novelist Jane Smiley that I am publishing on the Huffington Post tomorrow.  Earlier this week, Smiley posted on Huffington expressing her dismay that President Obama seems to be folding on health-care reform. I don’t blame her for coming to the conclusion: this is what the mainstream media has been telling her. My response begins:

An Open Letter to Jane Smiley: Please Don’t Believe Everything You Read

            (The Media Is Not Always a Reliable Narrator )

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The pharmaceutical industry has been settling into its “good guy” role in recent days; first committing to $80 billion in cost savings over ten years to help defray the cost of health reform and then forking over $150 million to finance an ad campaign championing the administration’s plan. (Of course there was that slight fall from grace when it looked as if, in exchange, PhRMA had secured guarantees that Medicare would not be able to negotiate drug prices…click here for Maggie’s take on that.)

But what else can the industry do to help burnish its image with the American people? How about finally consenting to some common-sense limits on the barrage of prescription drug ads confronting consumers every time they turn on the TV or open a magazine? While a complete ban is probably not possible (in part because such a ban might violate the First Amendment) how about making prescription drug ads a lot more educational and a lot less like a hard sell for a new BMW?

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Media Matter has done a nice job of rounding up and debunking 14 of the most common myths about healthcare reform here.  You may find it useful when talking to friends and relatives.

I doubt it.  Progressives are in the middle of a long negotiation with conservatives that will end in  conference committee late this fall, where politicians will merge the Senate and House versions of the bills, hammering out the differences. We know that the House bill contains a strong public sector plan. It seems likely that the Senate plan will offer, at best, a weak public sector alternative. What will happen then? 

No one knows. But as I have suggested in the past, conference is what matters. Whatever compromises Senator Max Baucus does or doesn’t make in the Senate Finance Committee’s version of the bill may not, in the end, be that important. 

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   DVDs Available for Sale Online This Week

As regular readers know, Academy-award-winning documentary film producer Alex Gibney (Enron: the Smartest Guys in the Room, and Taxi to the Dark Side) has made a 90-minute documentary based on my book, Money-Driven Medicine. 

Moyers and the film’s director, Andy Fredericks, have cut the film down to 56 minutes so that Moyers can show a preview of excerpts from the film on  Bill  Moyers' Journal, Friday, August 28 (Check local listings for the exact time.) 

 For those who would like to see the whole 90-minute film, DVD’s will become available for sale this week (Thursday, August 20).  

Institutional Use & House Parties

Screen the DVD in community dialogs, classes, staff trainings, policy forums, 'brown bag' lunches and conferences.  Arrange "house parties" for friends and neighbors to discuss what ordinary citizens can do.   Institutions can buy the DVD by going to this site http://www.newsreel.org/nav/title.asp?tc=CN0225  or by calling 877-811-7495. DVDs will begin shipping this week, August 20.

For High Schools, Public Libraries, HBCUS and Qualifying Community Organizations, or anyone who wants to organize a brown bag lunch or “house party” the price is $49.95.

For Colleges, Corporations, and Gov’t Agencies, the price is $195.000

Individual Use

Individuals can rent a digital version of the film for home use at Newsreel.org/Amazon anytime after August 28 for $2.99

What People Are Saying About the Film

“Money-Driven Medicine is one of the strongest documentaries I have seen in years and could not be more timely.  The more people who see and talk about it, the more likely we are to get serious and true health care reform.”—Bill Moyers

“Few Americans appreciate how the health care system is gamed against physicians’ professional commitment to focus only on their patients’ best interests.  This outstanding film helps us all understand why reform is essential.”
– Elliott S. Fisher, MD, Director
Dartmouth Center for Health Policy Research
Principal Investigator, Dartmouth Atlas Project

(Disclosure—I’m not making money on the sale or rental of DVDs or any showings of the film. I just want to get the word out there—mm.)

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The media has been paying too much attention to the lies about health care reform that the conservatives have been circulating. Perhaps this is understandable: they are Big Lies, colorful canards, horrifying rumors. But they are simply, totally wrong—made up out of whole cloth.

The job of the media is not to repeat rumors, but to present facts—so that the public can draw rational conclusions from empirical evidence. Today, the New York T.imes ran an Op-ed signed by Drs. Atul Gawande, Donald Berwick Elliott Fisher and Mark McClellan that does just that. http://www.nytimes.com/2009/08/13/opinion/13gawande.html?pagewanted=1&_r=1&hp The four tell the story of ten U.S. communities that have managed to do what progressives claim health care reform can do: “change how care is delivered so that it is both less expensive and more effective.”  We don’t have to ration care. We don’t have to raise taxes for the middle-class or the upper-middle class. We may need modest tax hikes for the very wealthy to seed healthcare reform. But structural changes in our health care system can ultimately provide the savings needed to offer high quality, affordable care to everyone.

Last night, the Lehrer Report made the same point: http://www.pbs.org/newshour/indepth_coverage/health/healthreform/  We already know how to lift the quality of care while reducing costs.  This is not a theory dreamed up by ivory-tower academic physicians. It is a fact.

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Business Week has just published an excellent piece exploring the pros and cons of Amgen’s new drug for osteoporosis.  It illustrates how drug-makers—and Wall Street investors—view new products.  It also demonstrates why government regulators should begin  taking a close look at pricey “me-too” drugs before committing billions of tax-payer dollars to pay for those new products.

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