Friday News Dump: Wonkbites

by Karan Chhabra

Health news doesn’t stop for oppressive heat, Memorial Day Weekend, or the French Open, and neither will Wonkbites:

  1. Look Ma, No Bankruptcy: Obamacare’s under-26 coverage provision has cut the amount of uninsured young adults showing up at emergency departments, according to a new study in the New England Journal of Medicine. One of the ACA’s most popular provisions, it allows adults to stay on their parents’ insurance plans until they’re 26. To put some numbers around it, in 2011, this meant an increase of $147 million in emergency department costs that were covered by insurance.
  2. Party poopersClostridium difficile (“C. diff”) is a life-threatening infection that can happen to any patient when antibiotics wipe out the normal bugs in their gut. You might’ve heard that fecal transplants are being used experimentally to cure them. What you might not know is that those poop swaps have shown a higher success rate than vancomycin (the heavy-duty antibiotic currently used for C. diff), and that nonetheless the FDA is introducing regulations to make them much more difficult for doctors to provide. The FDA cites safety and quality control as its concerns—but doctors are refusing to provide the procedure and delaying potentially lifesaving care in the process.
  3. Is there magic to the map? Wonks have had a lively debate on a study aiming to debunk research that, according to Jordan Rau, has “influenced a generation of health policy thinking.” The new research attacks a premise advanced by the Dartmouth Institute for Health Policy and Clinical Practice—specifically that arbitrary geographic variation explains much of our healthcare cost burden. Instead, this new work says that Dartmouth’s geographic cost variations were driven primarily by those regions’ underlying health status.
  4. Have it your way—and pay more? A recent study, according to many, has shown that shared decision-making increases healthcare costs. I have to interject with a few reactions:
    1) If you read the methodology, you’d find out what it actually says is that patients who responded to a survey saying they prefer more of a role in their healthcare turned out to have higher lifetime healthcare costs. Cause-and-effect could run the opposite way—those who’ve dealt more with the healthcare system end up preferring more of an active role.
    2) If someone used a stronger methodology to demonstrate that shared decision-making cost more, I’d still support it. Healthcare should provide what patients and families want, not what providers want—and if that costs more, so be it.
    3) That said, conventional wisdom is that more healthcare is better. If more patient-centered care means more healthcare, perhaps the medical establishment and media need to do a better job of showing that more is sometimes better, but not always.
  5. The more you know: Righty? You’re more likely to use your cell phone on your right ear. Lefty? The opposite. Why? Science.

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Karan is a student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.

Follow him on Twitter @KRChhabra or subscribe to the blog.

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One thought on “Friday News Dump: Wonkbites

  1. Jennifer says:

    “Healthcare should provide what patients and families want, not what providers want—and if that costs more, so be it.”
    I am all for patient involvement and shared decisions. But there is a reason why providers are providers, they are expected to direct care, they are expected to have greater knowledge to choose appropriate care, or no care. As you point out next, conventional wisdom is that “more is better”. Increasingly, this is being shown not to be the case, for example in diagnostic imaging.

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