Checking up on Health: August 27, 2013

Health Policy News and Views
Compiled by Benita M. Dodd

Benita Dodd Vice President, Georgia Public Policy Foundation
Benita Dodd
Vice President, Georgia Public Policy Foundation

Self-diagnosis? It can save you a trip to the pediatrician and help ensure that health care resources are used more effectively. It’s the online symptom-checker, available on more than a dozen children’s hospital Web sites. And it’s the brainchild of Dr. Barton Schmitt, medical director of the pediatrics call center at Children’s Hospital Colorado in Aurora. He keeps the symptom-checker platform updated with the latest guidelines from the Centers for Disease Control and Prevention, the Food and Drug Administration and other organizations. In 2009 it was rebuilt as an app. In a survey of users of the platform as it appears on a dozen pediatricians’ Web sites, 94 percent of parents had a positive and 72 percent of respondents said the symptom-checker saved them a call or visit to a physician.

The platform has proven popular among parents. The symptom-checker on the Children’s Hospital Colorado Web site has garnered 336,000 visitors and 438,000 page views in the past year, with 88 percent of them first-time visitors to the hospital’s site. A recent Wall Street Journal article reported that physicians are embracing the approach to make consultations more productive and efficient,.It cited a survey that more than 40 percent of Americans are comfortable using an online symptom-checker

Ten billion pounds later: Britain’s failed nine-year project to develop a national electronic health care record system (HER) will cost the country’s taxpayers 10 billion pounds ($15.5 billion). The National Program for IT, approved by the Department of Health in 2002, was stopped in 2011 after the contracted companies failed to complete the project. One company’s contract was extended through 2017 to avoid litigation, according to a report in the Register newspaper.  A Department of Health official is quoted in the report as saying the government has realized the “weaknesses of a top-down, centrally-imposed IT system.” Meanwhile, back in the USA, the Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible physicans and hospitals “as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.”

Genome sequencing and baby steps: When five of their 10 children were diagnosed with hearing loss and genetic testing didn’t help, the Nadeau family turned to whole-genome sequencing to determine the cause of the hearing loss, the Boston Globe recounts. They also wanted to know whether that loss would worsen as the children got older; the children hear some frequencies but not all. At Partners Laboratory for Molecular Medicine, the family underwent sequencing. One of the first passes at analyzing their sequences turned up 31 changes affecting hearing-linked genes, but none seemed likely to be behind the problem. A separate analysis indicated that the affected children had two copies of a large genetic deletion, and that was the likely cause of their hearing loss. The lab has added the deletion to their hearing loss tests. The parents have some information, “But the question that drove them to testing in the first place remains unanswered; they still do not know whether their children will eventually become deaf,” the Globe reports.

Sometimes it’s stupid to KISS: Making it too easy leads to misperceptions, writes researcher Dan Kobolt at MassGenomics. He says researchers often find themselves trying to explain their fields to non-technical audiences. “Working in human genetics as I do, I’ve found that the average lay person has many preconceived notions about heredity and genetics. Some of them have a basis in truth, but many are inaccurate, if not altogether wrong. These misconceptions are often perpetrated, surprisingly, by our educational systems in their attempts to simplify a field that’s anything but simple. As usual, the media doesn’t help either. They don’t like ‘it’s complicated’ answers.” He cites the example of blue eyes being considered recessive. “The idea that eye color is a simple trait and blue eyes are recessive is one of the oldest human genetics myths. It’s kind of true, in that blue-eyed couples tend to have blue-eyed children, but it’s not entirely true. … the trait is influenced by interaction among at least ten different genes.” This is further complicated by the fact that eye color can change, especially in the first few months of life. The article notes, “The only certainty is uncertainty.” (KISS = Keep it simple, stupid!) Source:

Shades of Oliver Twist: After just one year, some schools around the country are dropping out of the healthier new federal lunch program, complaining that so many students turned up their noses at meals packed with whole grains, fruits and vegetables that the cafeterias were losing money. Federal officials say they don’t have exact numbers but have seen isolated reports of schools cutting ties with the $11 billion National School Lunch Program, which reimburses schools for meals served and gives them access to lower-priced food. Not only don’t they like the food, but these are growing children, and my parental sources say that the food calories just aren’t enough to satisfy many of them. Source: Associated Press

Affordable Care Act

Don’t like Medicaid expansion? You must be heartless. Benjamin Domenich of the Heartland Institute points out that Ohio Governor John Kasich, a Republican, has made his case for Medicaid expansion under the Affordable Care Act: that people who don’t favor expanding Medicaid don’t care about the poor. Domenich calls it “is as leftist a critique of the GOP as one can advance. It views entitlements as the only way to help the downtrodden and seeks to shift the burden from state tax rolls to federal, all based on the assumption that the rug won’t be pulled out from underneath the state in matching funds in the future (as every legislator with a brain anticipates). Even without the anticipated drop in matching funds, Urban Institute figures indicate Kasich’s expansion would necessitate an increased tax burden under future governors of about $3.1 billion by 2022. Kasich’s ‘compassionate’ approach is thus thoroughly fiscally irresponsible, albeit only in a timeline in which Ohio continues to exist.” Neil Young’s profile of Kasich in The Wall Street Journal, meanwhile, is well worth a read.

Quotes of note:

“You have a cough? Go home tonight, eat a whole box of Ex-Lax – tomorrow you’ll be afraid to cough.” – Pearl Williams

“When I told my doctor I couldn’t afford an operation, he offered to touch up my X rays.” – Henry “Henny” Youngman

“My doctor gave me two weeks to live. I hope they’re in August.” – Ronnie Shakes

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