- Image by FatMandy via Flickr
Highlights of the important and the interesting from the world of health care:
Health lobbying broke records in ’09: No single issue in any year on record has drawn as much lobbying money as health care did last year, the New York Times reports. The total stands at $648 million–and the that’s not even a final tally, according to the Center for Responsive Politics. The number is almost certain to climb since the Center has not yet processed about 20 percent of the year-end lobbying reports that were recently filed. Leading the way–and also breaking all industry records–was the pharmaceuticals industry, which accounted for $245 million of that total.
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While it’s easy for health overhaul proponents to demonize lobbying and lobbyists, it’s important to remember that a significant chunk of that lobbying money, though we can’t be sure how much, was spent in support of overhaul, such as the drug industry’s revival of the old Harry and Louise TV ads. Of course, it’s not as if these groups lobbied for the overhaul out of the goodness of their hearts. Plenty of corporations stand to gain new sources of revenue should overhaul efforts succeed, though that’s very much in doubt.
HCA owners cash-in big time: The private-equity owners of HCA Inc., the nation’s largest hospital system, will pay themselves a gargantuan $1.75 billion dividend after a “stellar” financial 2009, the Wall Street Journal reports. Good times all around if you work for Kohlberg Kravis Roberts & Co., Bain Capital Partners and Merrill Lynch Global Private Equity, or HCA co-founders the Frist family. That group in 2006 bought the hospital system for $21.3 billion, paying about $5.5 billion of that amount in cash and borrowing the rest.
These sorts of obscene payouts were all the rage in the middle of the last decade during the private-equity boom, then died out the last couple years, but now appear on their way back, the Journal reports. For example, consulting firm Booz Allen Hamilton raised money last month to help fund a $550 million payout to the Carlyle Group LLC, the private-equity firm that bought it last May for $2.5 billion. To learn more about how private equity firms can engorge themselves with questionable payouts while running a company into the ground and leaving its rank-and-file employees without jobs, read the New York Times’ excellent piece on Simmons Bedding Company from last year.
Taking a look behind hospital pricing in Massachusetts: A report recently released by the state government of Massachusetts shows that some hospitals charge private insurers twice as much as others for the same procedures. Maybe that’s because the higher-charging hospitals provide twice the quality of care, or treat sicker patients? Not quite, the Wall Street Journal reports. It’s all about the bargaining power, and that power often stems from factors like size, geographic location, “brand name,” and specialty service lines offered. Assuming that insurers pass these costs on to their customers, it seems like a gross injustice to patients, who are forced to pay double the price for care that’s as good as what they could’ve obtained for half the cost. Looks like yet another area where the free market fails miserably when it comes to health care.
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Why doctors are reluctant to discuss end-of-life care: The ridiculousness of the Palin-inspired “death panels” controversy brought to light a serious subject–end of life discussions between doctors and patients. KevinMD tackles the subject and notes a recent study that revealed that many doctors fail to heed guidelines that call for the discussions to be held when a patient has about a year to live. According to the study’s authors, reasons include doctors’ lack of comfort in engaging in such discussions. “It’s easier to say, ‘Let’s try another round of chemotherapy,’ instead of having a heart-to-heart discussion.”
KevinMD identifies another culprit: the U.S. health system’s reliance on the notoriously inefficient fee-for-service system.
Time is simply not valued within our fee for service-based health system. … The fact that doctors practice in a system that discourages lengthy office visits, it’s no wonder that more are shying away from this imperative issue.