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Selected news articles which highlight important policy issues.

News: Weekly Archives

News for the week of 02-01-2006

The Domestic Agenda: On Education and Health, Costly Plans Face Hurdles
The New York Times, 2-1-06

Editorís Notes:

As many observers have noted, the Presidentís State of the Union speech didnít contain any revolutionary new health care policies. But the importance of his speech lies in the fact that the President continues to push for an incremental revolution in how Americans access our health care system.

Mr. Bush proposed incentives to encourage the use of health savings accounts as an alternative to traditional insurance. The White House says such accounts make consumers more attentive to the cost of the services they use.
Under current law, people can make tax-deductible contributions to such accounts for routine medical expenses, provided they also buy high-deductible insurance policies to cover catastrophic costs. The Republican majority in the House will almost certainly support efforts to expand the use of health savings accounts, and Senate Republicans may also go along.

"The more people adopt H.S.A.'s for their health care coverage, the more market forces will work to reduce costs," said Representative Eric Cantor of Virginia, the chief deputy Republican whip.

U.S. health care spending has a lot in common with the other shibboleth of American politics, education. In both these sectors, costs routinely outstrip inflation by substantial margins, and consumers are largely subject to the whims of third-party payers (i.e., the government and employers). At the same time, critics of market forces in these areas deride choice as something that only the rich can afford to have.

This is both ironic and untrue. When a health insurer bargains for services and prices, it negotiates with employers, not employees. When the teachersí unions bargain for wages and work conditions they go to politicians, not parents. As a result, in both cases consumersí preferences are largely marginalized.

HSAs are the first crack in the wall of government or employer-provided health insurance. By asking consumers to pay more routine costs, they help to reduce unnecessary spending and empower consumers to bargain with providers. HSAs are a wedge in the door for market forces and will encourage more innovation in health care delivery.

[permanent link]

A Gender Difference in Heart Disease; Variant in Women Called Hard to Detect
Washington Post, 2-1-06

Editorís Notes:

As Sally Satel points out in this weekís Spotlight article, health outcomes (for lung cancer, for instance) can vary between different racial or ethnic groups for a variety of reasons, including health literacy, education, or even genetic predisposition.

This article illustrates how heart disease can manifest itself differently in some women than it does in men. It is a fascinating window into how new diagnostic technologies can challenge conventional wisdom and help to personalize medical treatment.

Many women suffer from a form of heart disease that is fundamentally different from the type that strikes most men and is easily missed by standard tests, researchers reported yesterday.
Instead of developing obvious blockages in the arteries supplying blood to the heart, these women accumulate plaque more evenly inside the major arteries and in smaller blood vessels, the researchers found. In other cases, their arteries fail to expand properly or go into spasm, often at times of physical or emotional stress. Ö
The findings may help explain why some women suddenly have heart attacks even though their arteries look clear, in some cases leading doctors to send them home without treatment or refer them to psychiatrists. Their symptoms are often unusual: Instead of the classic crushing chest pain, sweating and shortness of breath, they often complain of vague symptoms - fatigue, an upset stomach, or pain in the jaw or shoulders.

This study illustrates the challenges facing physicians when the same disease manifests itself in radically different forms in different patients. Men with heart disease, for instance, may complain of sharp chest pains; women with vague fatigue or joint pain. The bottom line is that no matter how technologically sophisticated medicine may become, its best practitioners will always have to be equal parts Socrates and Sherlock Holmes.

[permanent link]



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