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<channel>
	<title>John Goodman's Health Policy Blog</title>
	
	<link>http://healthblog.ncpa.org</link>
	<description>Health Care Policy and Reform Insights | NCPA</description>
	<lastBuildDate>Fri, 25 May 2012 19:30:47 +0000</lastBuildDate>
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		<title>Small Business Tax Credit Not Worth the Effort</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/Tyb4Itw587g/</link>
		<comments>http://healthblog.ncpa.org/small-business-tax-credit-not-worth-the-effort/#comments</comments>
		<pubDate>Fri, 25 May 2012 19:30:47 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Science and Other News]]></category>
		<category><![CDATA[ObamaCare]]></category>
		<category><![CDATA[tax]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25616</guid>
		<description><![CDATA[This is from Chris Jacobs: In addition, the GAO report found that bureaucracy was deterring firms from applying for the small business credit, particularly given that the credit itself was &#8220;insubstantial&#8221; for most firms. The report notes that claiming the credit requires &#8220;15 calculations, 11 of which are based on seven worksheets, some of which [...]]]></description>
			<content:encoded><![CDATA[<p>This is from <a href="http://healthblog.ncpa.org/wp-content/uploads/2012/05/Small-Business-Tax-Credit-Not-Worth-the-Effort-.pdf">Chris Jacobs</a>:<strong></strong></p>
<p style="padding-left: 30px;">In addition, the <a href="http://www.gao.gov/assets/600/590832.pdf">GAO report</a> found that bureaucracy was deterring firms from applying for the small business credit, particularly given that the credit itself was &#8220;insubstantial&#8221; for most firms. The report notes that claiming the credit requires &#8220;<em>15 calculations, 11 of which are based on seven worksheets, some of which request multiple columns of information</em>.&#8221; Furthermore, &#8220;tax preparers told us it could take their clients <em>from 2 to 8 hours or possibly longer to gather the necessary information</em> to calculate the credit and that the tax preparers spent, in general, <em>3 to 5 hours calculating the credit</em>.&#8221; All of which raises an obvious question: What small business owner wants to – or is even able to – spend a full working day gathering paperwork to claim a credit that may amount to a few thousand dollars at best?</p>
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		<item>
		<title>Should You Be Able to Sell Your Kidney?</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/jIZpdv4EOG8/</link>
		<comments>http://healthblog.ncpa.org/should-you-be-able-to-sell-your-kidney/#comments</comments>
		<pubDate>Fri, 25 May 2012 17:30:02 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Science and Other News]]></category>
		<category><![CDATA[Health Care Access]]></category>
		<category><![CDATA[Health Care Costs]]></category>
		<category><![CDATA[health care quality]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25613</guid>
		<description><![CDATA[Here are some wimpy poll results: Federal law bans payments for organs. But given the need, we wondered what Americans thought about compensation for three kinds of donations that can be made while people are alive: kidneys, bone marrow and a portion of liver big enough to help someone whose liver is failing. So we [...]]]></description>
			<content:encoded><![CDATA[<p>Here are some wimpy poll results:</p>
<p style="padding-left: 30px;">Federal law bans payments for organs. But given the need, we wondered what Americans thought about compensation for three kinds of donations that can be made while people are alive: kidneys, bone marrow and a portion of liver big enough to help someone whose liver is failing.</p>
<p style="padding-left: 30px;">So we asked 3,000 adults across the country as part of the NPR-Thomson Reuters Health Poll, and here&#8217;s what they told us.</p>
<p style="padding-left: 30px;">If compensation took the form of credits for health care needs, about 60 percent of Americans would support it. Tax credits and tuition reimbursement were viewed favorably by 46 percent and 42 percent, respectively. Cash for organs was seen as OK by 41 percent of respondents.</p>
<p><a href="http://www.npr.org/blogs/health/2012/05/16/152498553/poll-americans-show-support-for-compensation-of-organ-donors">NPR report</a>.</p>
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		<slash:comments>5</slash:comments>
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		<item>
		<title>Drug Stores Better at Detecting Counterfeit Drugs than Government</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/JmBxcvobneY/</link>
		<comments>http://healthblog.ncpa.org/drug-stores-better-at-detecting-counterfeit-drugs-than-government/#comments</comments>
		<pubDate>Fri, 25 May 2012 15:30:53 +0000</pubDate>
		<dc:creator>Devon Herrick</dc:creator>
				<category><![CDATA[Health Care Quality]]></category>
		<category><![CDATA[drugs]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25610</guid>
		<description><![CDATA[American Enterprise Institute scholar, Roger Bate, tested the quality of the antibiotic drug, Ciprofloxacin, purchased in 18 low-to-middle income countries.  Of the 1,437 samples tested, more than half were either substandard (9.88%) or counterfeit (41.5%). Counterfeit drugs both failed a visual test and contained no active ingredient. By comparison, substandard drugs are those that passed [...]]]></description>
			<content:encoded><![CDATA[<p>American Enterprise Institute scholar, Roger Bate, <a href="http://papers.nber.org/papers/w18073">tested the quality</a> of the antibiotic drug, Ciprofloxacin, purchased in 18 low-to-middle income countries.  Of the 1,437 samples tested, more than half were either substandard (9.88%) or counterfeit (41.5%). Counterfeit drugs both failed a visual test and contained no active ingredient. By comparison, substandard drugs are those that passed a visual test but contained less than 80% of the stated active ingredient in lab tests.</p>
<p>Bate&#8217;s team found that product registration – that is, registering a drug product with the local government – was associated with higher quality than non-registered drugs. However, a better indicator a drug was not counterfeit was its availability at chain drug stores. In an attempt to maintain a good reputation, chain drug stores policed their suppliers and were better able to keep their inventory free of counterfeits than were local government regulations.</p>
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		<slash:comments>3</slash:comments>
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		<item>
		<title>Unskilled Labor, and Other News</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/kriYam1dclw/</link>
		<comments>http://healthblog.ncpa.org/unskilled-labor-and-other-news/#comments</comments>
		<pubDate>Fri, 25 May 2012 13:20:24 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Interesting Links]]></category>
		<category><![CDATA[heart disease]]></category>
		<category><![CDATA[ObamaCare]]></category>
		<category><![CDATA[tax]]></category>
		<category><![CDATA[unemployment]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25607</guid>
		<description><![CDATA[Why don&#8217;t the unemployed have the skills that employers want? $20 billion of your tax dollars to promote ObamaCare. Study: 96% of chain restaurant entrees exceed USDA limits. &#8220;Good cholesterol&#8221; not so good: It doesn&#8217;t lower your risk of heart disease.]]></description>
			<content:encoded><![CDATA[<p><a href="http://economix.blogs.nytimes.com/2012/05/21/the-case-of-the-missing-skills/">Why don&#8217;t the unemployed have the skills that employers want?</a></p>
<p><a href="http://news.investors.com/article/612384/201205221858/obama-spends-taxpayer-money-to-hype-obamacare-.htm">$20 billion of your tax dollars to promote ObamaCare.</a></p>
<p><a href="http://www.usatoday.com/NEWS/usaedition/2012-05-17-notsohealthy-meals_ST_U.htm">Study: 96% of chain restaurant entrees exceed USDA limits.</a></p>
<p><a href="http://www.nytimes.com/2012/05/17/health/research/hdl-good-cholesterol-found-not-to-cut-heart-risk.html">&#8220;Good cholesterol&#8221; not so good: It doesn&#8217;t lower your risk of heart disease.</a></p>
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		<title>Cancer Study Authors Respond to Critics</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/xPEu91_Hwfs/</link>
		<comments>http://healthblog.ncpa.org/cancer-study-authors-respond-to-critics/#comments</comments>
		<pubDate>Thu, 24 May 2012 19:30:38 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Health Care Costs]]></category>
		<category><![CDATA[cancer]]></category>
		<category><![CDATA[health care quality]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25604</guid>
		<description><![CDATA[In a recent Health Affairs paper, we documented that the United States has a significant survival advantage over much of Europe when it comes to cancer: 1.8 years for those diagnosed during our study window. Furthermore, we showed over a 17-year period that this gap had widened, not narrowed, and that this widening was more valuable than traditional [...]]]></description>
			<content:encoded><![CDATA[<p style="padding-left: 30px;">In <a href="http://content.healthaffairs.org/content/31/4/667.abstract">a recent <em>Health Affairs</em> paper</a>, we documented that the United States has a significant survival advantage over much of Europe when it comes to cancer: 1.8 years for those diagnosed during our study window. Furthermore, we showed over a 17-year period that this gap had widened, not narrowed, and that this widening was more valuable than traditional health valuation approaches suggest. As a result, we argued that the additional spending in the United States was &#8216;worth it.&#8217;</p>
<p style="padding-left: 30px;"> These results have generated a lot of controversy, and even some criticism. We understand the controversy given the impression that U.S. health care spending is too high. However, we find the criticism both irrelevant and misguided, both qualitatively and quantitatively.</p>
<p>More on cancer care in the United States and Europe at the <a href="http://healthaffairs.org/blog/2012/05/14/when-epidemiology-goes-astray-valuing-cancer-care-in-the-united-states-and-europe/"><em>Health Affairs</em> blog</a>.</p>
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		<item>
		<title>Unhappy Doctors</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/e_DKbaFOwQ4/</link>
		<comments>http://healthblog.ncpa.org/unhappy-doctors/#comments</comments>
		<pubDate>Thu, 24 May 2012 17:30:51 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Physicians]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[health care quality]]></category>
		<category><![CDATA[health policy]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25601</guid>
		<description><![CDATA[According to the survey, only 54% of physicians would choose medicine as a career if they had to make the decision again as opposed to 69% in the previous year. What are the underlying causes of such a precipitous drop in satisfaction? Several of the causes cited can be blamed on federal policies… Adding to [...]]]></description>
			<content:encoded><![CDATA[<p style="padding-left: 30px;">According to the survey, only 54% of physicians would choose medicine as a career if they had to make the decision again as opposed to 69% in the previous year. What are the underlying causes of such a precipitous drop in satisfaction? Several of the causes cited can be blamed on federal policies…</p>
<p style="padding-left: 30px;">Adding to concerns related to reimbursement, physicians continue to pay incredibly expensive malpractice premiums and nearly a quarter of physicians admitted to practicing defensive medicine…</p>
<p style="padding-left: 30px;">Most doctors enter medicine with the thoughts of healing patients on a daily basis, but paperwork can often come between the doctor and the patient. According to the Medscape survey, 33% of physicians spend 10 or more hours per week on administrative activities. The burden will only keep piling on come 2013 when the Physician Sunshine Act is implemented, adding <a href="https://www.federalregister.gov/articles/2011/12/19/2011-32244/medicare-medicaid-childrens-health-insurance-programs-transparency-reports-and-reporting-of#p-264">237,000 paperwork hours</a> by forcing physicians to reveal the minutiae of their relationships with medical supply manufacturers and distributors.</p>
<p>More on <a href="http://americanactionforum.org/topic/dissatisfied-physicians-unsatisfactory-health-care-system">dissatisfied physicians</a> at American Action Forum.</p>
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		<title>Greed</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/AZbBBMPGERI/</link>
		<comments>http://healthblog.ncpa.org/greed/#comments</comments>
		<pubDate>Thu, 24 May 2012 15:30:57 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Health Care Quality]]></category>
		<category><![CDATA[consumer driven health care]]></category>
		<category><![CDATA[doctors]]></category>
		<category><![CDATA[Health Care Access]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25598</guid>
		<description><![CDATA[Greedy doctors. This guy is getting a chemotherapy regimen for colon cancer that we stopped using about 15 years ago. His medical oncologist was practicing the best medicine of the late 1980s, but we were in 2006. The other drugs he was being prescribed were totally unnecessary. But the doctor could get a substantial markup [...]]]></description>
			<content:encoded><![CDATA[<p><strong>Greedy doctors.</strong></p>
<p style="padding-left: 30px;">This guy is getting a chemotherapy regimen for colon cancer that we stopped using about 15 years ago. His medical oncologist was practicing the best medicine of the late 1980s, but we were in 2006. The other drugs he was being prescribed were totally unnecessary. But the doctor could get a substantial markup and make a substantial amount of money by selling them.</p>
<p><strong>Greedy patients.</strong></p>
<p style="padding-left: 30px;">Another patient of mine had early colon cancer. Three doctors had told her she should not get chemotherapy. She decided she wanted it, and she went doctor-shopping until she found a doctor who would give it to her.</p>
<p><strong>Greedy everybody.</strong></p>
<p style="padding-left: 30px;">I blame patients, I blame doctors, I blame hospitals, I blame drug companies, I blame insurance companies.<strong></strong></p>
<p><a href="http://well.blogs.nytimes.com/2012/04/20/how-doctors-and-patients-do-harm/">Interview</a> about Otis Webb Brawley&#8217;s <a href="http://www.amazon.com/How-We-Do-Harm-America/dp/0312672977">&#8220;How We Do Harm: A Doctor Breaks Ranks About Being Sick In America&#8221;</a> (St. Martin&#8217;s Press).</p>
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		<slash:comments>6</slash:comments>
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		<item>
		<title>Employer Pays the Concierge Fee</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/q7VnWtsn6GA/</link>
		<comments>http://healthblog.ncpa.org/employer-pays-the-concierge-fee/#comments</comments>
		<pubDate>Thu, 24 May 2012 13:40:45 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Health Care Access]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25596</guid>
		<description><![CDATA[Becker pays $54 per employee per month to a primary care provider called Qliance. Employees get unlimited doctor visits, 24-hour e-mail access to the medical staff, and same-day or next-day appointments. There is no insurance involved in their primary care: no expensive premiums, no complicated claims, no mysterious denials. More from Bruce Japsen on improving [...]]]></description>
			<content:encoded><![CDATA[<p style="padding-left: 30px;">Becker pays $54 per employee per month to a <a title="In-depth reference and news articles about Choosing a primary care provider." href="http://health.nytimes.com/health/guides/specialtopic/choosing-a-primary-care-provider/overview.html?inline=nyt-classifier">primary care provider</a> called Qliance. Employees get unlimited doctor visits, 24-hour e-mail access to the medical staff, and same-day or next-day appointments. There is no insurance involved in their primary care: no expensive premiums, no complicated claims, no mysterious denials.</p>
<p>More from Bruce Japsen on <a href="http://www.nytimes.com/2012/05/22/health/direct-primary-care-providers-extend-concierge-services.html?_r=3&amp;emc=tnt&amp;tntemail0=y">improving access to physicians</a> in the <em>NYT.</em></p>
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		<slash:comments>10</slash:comments>
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		<item>
		<title>What Sick People Think About the Health Care System</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/b7grBErJado/</link>
		<comments>http://healthblog.ncpa.org/what-sick-people-think-about-the-health-care-system/#comments</comments>
		<pubDate>Wed, 23 May 2012 19:30:05 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Health Care Quality]]></category>
		<category><![CDATA[consumer driven health care]]></category>
		<category><![CDATA[Health Care Access]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25591</guid>
		<description><![CDATA[Poll results: Thirteen percent of sick Americans thought they were given the wrong diagnosis, test, or treatment. About 15% of sick Americans thought they got tests they didn&#8217;t need and 18% thought they didn&#8217;t get the tests they did. More than a quarter of sick Americans thought they were not well managed. Aaron Carroll generally [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.rwjf.org/files/downloads/Cost_Quality%20Summary%20Final20120518.pdf">Poll results</a>:</p>
<p style="padding-left: 30px;">Thirteen percent of sick Americans thought they were given the wrong diagnosis, test, or treatment. About 15% of sick Americans thought they got tests they didn&#8217;t need and 18% thought they didn&#8217;t get the tests they did. More than a quarter of sick Americans thought they were not well managed.</p>
<p><a href="http://theincidentaleconomist.com/wordpress/more-bad-news-on-health-care-costs/">Aaron Carroll</a> generally deploring the results.</p>
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		<item>
		<title>How Community Rating Hurts Those it is Designed to Help</title>
		<link>http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/-r78GyXsWD8/</link>
		<comments>http://healthblog.ncpa.org/how-community-rating-hurts-those-it-is-designed-to-help/#comments</comments>
		<pubDate>Wed, 23 May 2012 17:30:47 +0000</pubDate>
		<dc:creator>John Goodman</dc:creator>
				<category><![CDATA[Health Insurance]]></category>
		<category><![CDATA[Health Care Costs]]></category>
		<category><![CDATA[health policy]]></category>
		<category><![CDATA[insurance]]></category>

		<guid isPermaLink="false">http://healthblog.ncpa.org/?p=25585</guid>
		<description><![CDATA[This illustration comes from Avik Roy: In the first bar, there is a classically underwritten distribution of insurance costs: the 18-year-old pays $800 in premiums, and the 64-year-old pays $4,800: six times as much. Then, in the second bar, 3-to-1 community rating is imposed, which redistributes the cost of premiums. Now, 18-year-olds must pay $1,400 [...]]]></description>
			<content:encoded><![CDATA[<p>This illustration comes from <a href="http://www.forbes.com/sites/aroy/2012/05/21/putting-the-insurance-back-in-health-insurance/">Avik Roy</a>:</p>
<p style="text-align: center;"><a href="http://healthblog.ncpa.org/wp-content/uploads/2012/05/community-ratings.jpg"  rel="lightbox"><img class="aligncenter  wp-image-25586" title="community ratings" src="http://healthblog.ncpa.org/wp-content/uploads/2012/05/community-ratings-300x190.jpg" alt="" width="270" height="171" /></a></p>
<p>In the first bar, there is a classically underwritten distribution of insurance costs: the 18-year-old pays $800 in premiums, and the 64-year-old pays $4,800: six times as much. Then, in the second bar, 3-to-1 community rating is imposed, which redistributes the cost of premiums. Now, 18-year-olds must pay $1,400 for insurance—a 75 percent increase—so that 64-year-olds can pay 13 percent less… after adverse selection, the oldest policyholder <em>ends up paying more</em> than he would have under free-market underwriting: $4,900 instead of $4,800. A government policy aimed at forcing young people to subsidize premiums for the elderly ends up driving up costs for everybody.</p>
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