Mark Herzlich, Boston College All American linebacker and now New York Giants rookie, believes that positive thinking played an important part in his successful battle "to beat bone cancer" and return to football. World-renowned cyclist and cancer advocate Lance Armstrong credits not only topnotch medical care but also positive thinking in his overcoming testicular cancer. Armstrong stated on CBS Sunday Morning, "You can't deny the fact that a person with a positive and optimistic attitude does a lot better." Like the vast majority of individuals polled on whether or not the positive thinking can influence cancer outcomes, I believed/wanted to believe that positive thinking would be correlated with better survival data. But the weight of evidence does not support the thesis that optimistic attitude trumps the Big C, or even influences oncology outcomes.
Americans’ girth is growing at an alarming rate. Many are too sedentary, too stressed, suffering from insomnia, making bad food choices. The drumbeat of “We need a culture of health versus a sickness culture” is a refrain that we now often hear and that I have espoused.
I was just looking at the website of Newtek Business Services (www.thesba.com/), which also goes by the name of The Small Business Authority. It sells financial and administrative services to small businesses. I found more evidence that the public doesn’t have a clue about what’s going on in health care. This is goofy stuff, folks, so I'll have some fun with it.
"You Can't Outrun Your Past"........ The title of a slide in a grand rounds presentation by Dr. David Kountz, senior VP for medical and academic affairs at Jersey Shore Medical Center and professor of medicine, UMDNJ-Robert Wood Johnson Medical School. The subtext is that the impact of being black in our society confers incremental risk across a range of cardiovascular and cardiometabolic conditions irrespective of socioeconomic status.
There has been a lot of discussion of the Food and Drug Administration’s decision to revoke approval for the use of Avastin in metastatic breast cancer. Most of it takes at face value FDA Commissioner Margaret A. Hamburg’s 69- page decision in which she claims that the “objective” evidence of benefit did not exist to support approval relative to the serious side effects of the drug.
A recent conversation reminded me of the forgotten population in health care — the non-utilizers. I was speaking with a physician leader in Lancaster, Pa., about his program that emulates the good work of Dr. Jeff Brenner and his team in Camden, N.J., that has targeted the 1 percent of patients responsible for 30 percent of the cost.
I was amused and somewhat unsettled when I heard of Kaggle, a company with a novel approach to data analysis. As I understand it, Kaggle is a middleman between companies that have large amounts of data and are looking for certain kinds of analysis and the people or companies that can provide that analysis. But with a twist.
Three times during the past month a friend has asked for advice regarding his/her personal health care or that of a family member out of frustration and concern stemming from not receiving clear communication/information about the health problem(s). This scenario is all too common.
The Affordable Care Act codified the worksite wellness exemption to the federal medical underwriting provisions in the group health plan market. This means companies are allowed to use an “outcomes-based” incentive model that provides financial rewards for those who satisfy a prescribed health standard such as a BMI of less than 30 or who meet a “reasonable alternative standard” or obtain a waiver from their physician. What some see as “rewards” others view as penalties or surcharges and, given the absence of evidence to confirm the role of such incentives in actually improving population health, the new provisions have unleashed a debate about the ethics and putative effectiveness of the new provisions.
When an employer group shifts from one health plan to another, why not allow them to take their claims data to the next health plan? That way, the new plan would gain immediate knowledge of the specific disease burden faced by its new members and be able to act accordingly vis-à-vis care management programs and other interventions. As it stands now, the new plan would have to wait many months and even then would lack the history that the earlier plan no longer needs. And when the new plan “finds out" about a member's condition, it might be due to a claim for an event that could have been prevented had the carrier had access to the earlier data.
Here’s how the system would work. When a group signs up with a carrier, it could reserve the right to have its data transferred if it changes carriers. Obviously, it wouldn’t be able to “see” its own patient-identified data any more than it does now, but the data would accompany the change of carriers.