The Health Shopper

Health and health care are complex issues. Like Vimo.com, there are a number of other resources out there trying to make it a little easier to understand. The following ten blogs – listed in alphabetical order – each address a unique set of topics and issues. Together, they provide a fairly comprehensive view of what’s going on in health care today.

Health Affairs Blog. An offshoot of the academic journal Health Affairs, the Health Affairs Blog publishes daily on issues in health care and policy. Posts are written by a variety of guest contributors, including politicians, health policy experts, and Health Affairs staff.

Recent topics: the individual health insurance mandate, hospital safety, chronic disease and prevention

The Health Care Blog. An independent blog managed by a core staff and written by a number of contributors, the Health Care Blog’s tagline is “Everything you always wanted to know about the health care system. But were afraid to ask.”

Recent topics: pay-for-performance, patient-provider communication, the Affordable Care Act

Healthcare Economist. Written by economist and researcher Jason Shafrin, Healthcare Economist focuses on the health insurance market, health policy and economics, and Medicare research. Occasional posts are personal.

Recent topics: employer health benefits, physician quality and training, nursing home care

Julie’s Health Club. Hosted by the Chicago Tribune, Julie’s Health Club is written by journalist Julie Deardorff. It focuses on a variety of personal health issues, including holistic approaches to health, the environment and sustainable living, and child health. The blog also hosts occasional live chats on specific topics.

Recent topics: health benefits of yogurt, tooth decay, weightlifting and cancer

KevinMD.com. Managed by primary care physician Kevin Pho and featuring guest posts from additional contributors, KevinMD.com provides commentary on health and medical news. The blog also includes weekly roundups of its own posts and daily roundups of top health stories.

Recent topics: electronic medical records, healthcare reform, medical education

Managed Care Matters. Since 2004, health consultant Joseph Paduda’s blog Managed Care Matters has covered issues in managed care, health care cost containment, policy, and health research.

Recent topics: hospital care costs, the individual health insurance mandate, workers’ compensation

Paging Dr. Gupta. Paging Dr. Gupta is written by CNN Chief Medical Correspondent Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen, and additional Medical Unit staff. The blog focuses on health news and medical trends and provides commentary and analysis.

Recent topics: patient privacy, mercury dental fillings, nutrition for vegetarians

Shots. Written by the science staff at National Public Radio (NPR) and updated several times per day, Shots covers recent news about health and medicine.

Recent topics: cholera vaccination in Haiti, health care reform, bone marrow donation

Wall Street Journal Health Blog. Written by health reporter Katherine Hobson, with contributions from staff at WSJ and Dow Jones Newswires, the Health Blog offers news and analysis multiple times per day on health and the business of health.

Recent topics: chronic fatigue syndrome, antidepressants and the elderly, FDA approval of drugs

Well. Hosted by the New York Times and written by columnist Tara Parker-Pope, Well focuses on healthy living and medical research. The blog also features commentary on other New York Times articles and a weekly set of healthy recipes.

Recent topics: fashion’s effect on health, patient amenities in hospitals, cholesterol and Alzheimer’s disease

Los Angeles Times consumer affairs reporter David Lazarus has written an informative primer on some of the key differences between drugs and dietary supplements such as vitamins. The key difference: Unlike pharmaceutical drugs, which must go through rigorous testing to prove their safety and effectiveness, supplements don't undergo any scrutiny unless complaints about their safety start to pile up. 

And pile up they have, at least in a couple cases. In the past month, the CEO of Enzyte-which offered "natural enhancement for men"-was sentenced to 25 years in prison "for bilking customers out of $100 million." The manufacturer of Airborne-a common herbal supplement that individuals take to ward off colds-has paid $30 million in fines for making unsubstantiated claims.  And a recent study in the Journal of the American Medical Association found that supplements with the chemical Ayurvedic can lead to dangerously high levels of metals in the bloodstream.

A new clinical trial has found that Vytorin, a cholesterol drug with $5 billion in annual revenue taken by 3 million Americans, doesn't lower heart disease risk but may increase cancer risk. The limited good news from the trial is that, according to Business Week, is that the increase in cancer risk has not been proven conclusively, and since there is no clear cause for an increase in cancer risk and other trials have not shown similar results, it is possible that the results were ultimately a fluke.

Still, not good news.  A few months ago, the leading professional group for cardiologists recommended against prescribing Vytorin, though some patients are still on the drug.  Definitive proof about the drug's effectiveness is expected in 2012.

The Environmental Working Group has released a study finding that only a small percentage of commonly used sunscreens adequately protect consumers from sun exposure and potential skin cancers.  According to the study, just 15 percent of available sunscreens meet the group's standards for adequate protection against UVA and UVB rays.  As the San Francisco Chronicle notes, sunscreens that offer inadequate protection can give people a false sense of security against skin cancer-including serious skin cancers such as melanoma-and provoke them to spend more time exposed to sun than they otherwise should.

For the organization's list of the most protective sunscreens, see here.

Over at Freakonomics, health writer Julie Salamon tells the story of a college student who, in response to a high fever, went to an emergency room, was given some Tylenol and charged $1,089.50. Naturally, Salamon points out that $1,000 for a Tylenol seems a bit excessive. In defense of the hospital, prominent doctor and medical blogger Kevin, M.D. argues that the patient wasn't just paying for the Tylenol, but for the doctor's opinion and space in the hospital itself, and that the charge for the space and labor was fair.

Regardless of one's feelings on the matter, it's important to remember that hospitals-particularly emergency room visits-are expensive. As Consumer Reports points out in a new article on managing hospital visits: Save the ER for emergencies. For minor aches and illnesses, it's a better idea to look for an urgent care facility or call the family doctor first.

On the other hand, in a true emergency-such as sudden, severe chest pain, shortness of breath dizzying headaches, major blood loss-get to the hospital as soon as possible.  And don't drive yourself.

Check out the rest of Consumer Reports' advice here.

Business Week has a long feature that suggests that many colleges and universities offer inadequate coverage to their students. Many insurance plans have low caps on insurance reimbursements-for example, Connecticut College enrolls its students in an Aetna sponsored plan that caps its reimbursements at $10,000, while other colleges, such as Ross University, have plans with daily reimbursement limits that don't cover hospital expenses. According to a recent report by the General Accounting Office, more than 50 percent of college students have health plans with benefit limits of $30,000 or less.

Business Week also notes that in many instances, college students and their families are spending nearly as much on these inadequate plans as they would spend buying coverage in the individual market.   

A new study from the Kaiser Family Foundation and the Urban Institute suggests that for every percentage point increase in unemployment, 1.1 million more Americans will lose health coverage. An additional 600,000 children and 400,000 adults, according to the study, will move onto public insurance programs such as Medicaid and S-CHIP, which would cost a total of $3.4 billion in state and federal revenues. The New York Times notes increasing health costs coupled with concerns about the economy is also impacting individuals with health coverage. In a recent poll cited by the Times, 42 percent of adults said that someone in their family had foregone medical treatment due to cost.

The New York Times has an interesting article on some of the challenges that early retirees face in finding health insurance. The article notes that for most people-especially those with no existing medical concerns-"the best, least-expensive option is to buy an individual policy" rather than opt into COBRA coverage through an employer. The story focuses on a couple in their early 60s who decided to leave their jobs before they were eligible for Medicare who were able to find an individual insurance policy for about $400 a month, which was about half the cost of paying for COBRA coverage. The couple did, however, have to spend some time shopping around due to some minor pre-existing medical conditions.

The article also offers another key point for early retirees: When leaving a job, individuals have 60 days to start COBRA coverage-that is, opt to pay to remain on an employer's plan-or else lose the option. As the Times notes, many early retirees may want to opt into COBRA initially until they have found coverage elsewhere.

Consumers paid less for drug co-pays in 2007 than they did in 2006, according to a new study from Express Scripts. Although the decrease in the average co-pay was small, it stemmed from smart consumer behavior. Since 2002, consumers have switched over to generic medications in large numbers, as generic drugs now account for 64 percent of prescriptions, up from 42 percent in 2002. According to Express Scripts, consumers save an average of $15 per prescription when buying generic.  

A couple months ago, we noted that Fair Issac has partnered with Tenet Hospitals and other partners to develop a medical credit score. Today's Wall Street Journal examines the trend of hospitals examining patient finances after billing, which has drawn complaints from consumer rights groups who worry that hospitals will use credit ratings to determine whether or not to provide elective and other non-emergency care. Consumer groups also worry that hospitals could force individuals to tap into credit lines or other assets in order to cover the costs of bills.

Hospital officials, on the other hand, say that they are not using financial information to deny care but to direct charity care to the neediest patients. For example, one woman qualified for charity care knee surgery after providing a detailed financial history to demonstrate that she couldn't afford to pay the bills on her own. At the non-profit hospital Orlando Regional Healthcare, billing staff are classifying patients by likelihood of paying and focusing on getting "moderate risk" patients to pay their bills before they become delinquent.