The Health Shopper

The huge news from WalMart that they are expanding the number of $4 generic drugs they offer is, of course, a huge benefit to holders of high deductible health plans. Many insurance companies offer generic drugs for a copay much higher than $4. The development is another example of a drop in drug price inflation that's benefiting health care consumers.

A Consumers Union study released this week finds that hospitals in Maryland and Virginia do wildly different jobs at preventing in-hospital infections which afflict as many as 2 million people annually and kill close to 100,000. In other words some hospitals excel and others fail at preventing the infections that are now the fourth leading cause of death in the United States.

What’s so troubling about hospital infections is that three in four infections could be prevented through better sanitation including hand washing, and through more stringent adherence to antibiotic guidelines. While the best hospitals in Virginia and Maryland follow appropriate antibiotic protocol—such as administering an antibiotic an hour before surgery—with nearly every patient, the worst offenders only followed protocol in one out of two or even one out of four patients, according to the Consumers Union analysis. This protocol, according to the Washington Post can be as effective as hand-washing at preventing infection.

The Consumers Union is using the study as part of a larger campaign to require hospitals to begin publicly reporting hospital infection rates, in addition to available data on preventive antibiotic protocol adherence. In the meantime, consumers can check out local hospital performance on infection prevention here.

Some interesting stories on women and the health care system have appeared recently. MarketWatch asks "Are health insurers penalizing women?" in this piece on high deductible health plans and how maternity benefits can make them cost more for women.

Meanwhile, the Wall Street Journal ran this article on a federal legal loophole that ensares some breast cancer patients. "Under the little-known law passed by Congress in 2000, uninsured women under age 65 who are diagnosed with breast or cervical cancer can have their treatment covered by Medicaid, the government-funded health program for the poor, even if they don't meet all of its eligibility criteria. But the law gives states an escape hatch. Rather than provide coverage to all comers, states can choose to cover only those diagnosed at clinics that get funding from a federal cancer-detection program." The story covers the oddysey of one woman who went to the wrong hospital. In addition to exposing cracks in federal health care laws, the story also re-emphasizes how critical it is to carry insurance.

The New York Times reports that the inflation of prescription drugs is slowing. We can thank greater use of generic drugs, and maybe programs like the one from Humana that encourages members to make the switch to generics.

Working as an editor at Vimo, I’m very familiar with the argument in favor of MinuteClinics. In fact, I just finished editing an upcoming Vimo Report on the subject of in-store, doctor-less clinics that are gaining popularity in the Southeast and Midwest. But I also just had an experience that reminded me of the importance of going to a doctor – no matter how inconvenient it may be.

It all started with a swim. Followed by a blocked ear that didn’t go away for nearly a week. It’s something you’d think could be fixed by a nurse at a place like a MinuteClinic, given that I didn't apparently have the brainpower to fix it myself. But, as it turned out, it was swimmer’s ear, something I didn’t know adults could get. The doctor told me I needed antibiotics or I could get a serious infection. I still haven't been billed for the price of the visit (I have a CDHC plan from work) but the antibiotics were $90. Ouch.

Had a MinuteClinic been in town, it might have been tempting to go. But my visit was another lesson in why I won't be heading to retail clinics, even for apparently minor problems. This problem seemed minor, but the doctor figured out it could actually become something major – and required $90 worth of antibiotics (ouch, again).

In the end, when you’re dealing with your own health, I figure it’s important to go somewhere a doctor is on staff. A good one at that. Presumably, had I gone to a retail clinic, I would have been referred to a doctor anyway – nullifying the convenience of going to the clinic in the first place.

While retail clinic patients are reportedly very satisfied with the service they’re getting, it will be interesting to watch the impact of these clinics in the coming years. The comparison to fast food is going to be an inevitable one. Retail clinics are fast and convenient, but are they as healthy? Only time will tell. Myself, I plan to stick with gourmet.

To see the latest Vimo Report on the subject of convenient care clinics click here

Sen. Hillary Clinton on Monday announced the details of her health care proposal for the 2008 campaign. Her plan differs substantially from her failed 1990s efforts, according to the Los Angeles Times. Instead of forcing people into government-run groups to get health care, her plan uses individual mandates—similar to the requirements in Massachusetts—to require individuals to obtain insurance through an employer or to purchase it from a private company. The plan will also require that employers with more than 25 workers offer insurance or pay into a general federal fund, and it will help subsidize costs for businesses with fewer than 25 employees by providing tax breaks to those that offer insurance.

Democratic reaction has been largely positive. Jonathan Cohn, writing in The New Republic argues that Clinton’s plan will dramatically reduce the number of uninsured Americans while maintaining individual choice.

In contrast, the Institute for Policy Innovation’s Peter Ferrara claims that Clinton’s plan is a back-door route to government run insurance, less choice and rationed care.

To read more about her plan, you can also visit her website here.

On Friday, 20/20's John Stossel will investigate Canada's health care system, and even present an interview with Michael Moore on the subject. A preview of the show can be seen here. In it, Stossel shows a "lottery" held in Canada, where the lucky winner gets to see a family doctor. While health care is free in Canada, wait lines are long and doctors are difficult to find. Check out your local TV listings to watch the entire hour-long show, entitled "Whose Body Is It Anyway? Sick in America."

It seems like every month or so a new everyday product or substance is found by a group of researchers to help fight cancer. The latest is the tangerine peel.

At the British Pharmaceutical Conference held in Manchester, Leicester School of Pharmacy announced they had discovered that human cancer cells were destroyed by were destroyed by a compound contained in tangerine peel, Salvestrol Q40.

Like a lot of this research, an article about it often comes with a disclaimer: "[T]he research was still in its early days and many tests will be needed before reaching the clinical trial stage, which could take between five and seven years."

Meanwhile, vitamin D is being touted as another potential cancer fighter. Research conducted by Dr. Philippe Autier and published this week in the journal Archives of Internal Medicine studied 57,000 patients in 18 trials involving vitamin D. "Over an average of nearly six years, those who took vitamin D had a 7 percent lower risk of death from all causes than those who did not."

While Michael Moore toured Cuba and Canada in his documentary “Sicko,” he failed to visit one place that some observers say is the ideal model for a future U.S. health care system: Holland. As reported in a great feature in the Wall Street Journal this month: “The Netherlands is using competition and a small dose of regulation to pursue what many in the U.S. hunger to achieve: health insurance for everyone, coupled with a tighter lid on costs. Since a new system took effect here last year, cost growth is projected to fall this year to about 3% after inflation from 4.5% in 2006. Waiting lists are shrinking, and private health insurers are coming up with innovative ways to care for the sick.” And inflation for drug prices dropped from 9 percent a decade ago to 2.6 percent in 2006, according to the WSJ.

The Dutch system requires every citizen to buy insurance and every insurer to provide a policy to everyone that applies. The focus is on individual health insurance – something that is already on the rise in the U.S. Because individuals are responsible for obtaining their own insurance, they're more conscious of the price of health care.

In America, some people do fall through the cracks – "uninsurables" as they're called in the industry. Under the new system in Holland, no one can be turned away for a policy. If someone can't afford the premiums, the state jumps in to help. This system does seem like an interesting model for the U.S. – and is certainly superior to the socialist model promoted by Moore. Government mandates designed to curb costs have always led to long lines. When the Netherlands initially attempted something like the socialist model in the late 1990s, the long lines led to a backlash. "'Dead on the waiting list,' read one cover story of Vrij Nederland, a weekly magazine that, like other Dutch media, relentlessly criticized the country's health system."

America's current dependence on employer-sponsored health plans is leaving many people in the cold because: 1) It encourages rampant health care inflation; 2) Many individuals and families that find themselves without employer-sponsored insurance simply aren't buying insurance for themselves, even when they can afford it. The Dutch model would certainly address those problems.

The Kaiser Family Foundation published some interesting statistics today on health insurance inflation. Premiums rose 6.1 percent his year, far below the 7.7 percent increase of 2006. It was the smallest rise since 1999. It's good news, of course, but the reducing inflation rate is the result of more health care costs being passed on to the consumer.