Sections: Personal News / Job Listings / Fellowships and Internships / Education, Training & Professional Opportunities / Conferences and Meetings / Calls for Papers / Grants Awarded / Grants Available / Organization News / Publications

New this week, 18 March 2008:

Personal News

Mar 18, 2008

Nancy Krieger, M.S., Ph.D., Professor of Society, Human Development, and Health, Harvard School of Public Health. Associate Director, Harvard Center for Society and Health and Co-Director, Interdisciplinary Concentration on Women, Gender and Health. 10th Annual William T. Small, Jr. Keynote Lecture: The Science and Epidemiology of Racism and Health in the United States: An Ecosocial Perspective. University of North Carolina at Chapel Hill School of Public Health Minority Student Caucus. 29th Annual Minority Health Conference February 29, 2008. Webcast

*   *   *

Mar 18, 2008

Each Saturday Healthcare Update News Service offers a video presentation by a national expert in health policy and practice. This week we feature the following keynote presentation from the 2007 Quality Colloquium, Video.

*   *   *

Mar 18, 2008

James C. Robinson, Ph.D., who became editor-in-chief of Health Affairs last September, has decided to return to the University of California, Berkeley, where he holds the Kaiser Permanente Distinguished Professorship of Health Economics in the School of Public Health. Robinson will step down as Health Affairs editor on July 1, 2008. The journal's founding editor, John K. Iglehart, will lead a national search for a replacement and serve as interim editor should a new editor-in-chief not be identified before Robinson's departure.

*   *   *

Mar 18, 2008

Donald M. Berwick and Madge Kaplan, What's The Ethics Of That? A Conversation With Thomas O. Pyle. Health Affairs, January/February 2008. Thomas O. Pyle served in the top echelons of the Harvard Community Health Plan (HCHP) for nineteen years. In that time, HCHP became the largest health maintenance organization (HMO) in New England, and its reputation for innovation and entrepreneurship rose to the top ranks of the industry. HCHP pioneered the automated medical record, nurse practitioners, quality measurement, and sophisticated disease management. In this interview, Berwick and the Institute for Healthcare Improvement's Madge Kaplan explore Pyle's background, his interpretation of HCHP's evolution and eventual transition to a much different organization, and his recommendations for the future. At the time of this interview, Tom was suffering from advanced pancreatic cancer, from which he died ten weeks later, 18 July 2007. Abstract.

Job Listings

Jan 22, 2008

The Institute for Pharmacogenomics and Individualized Therapy at the University of North Carolina at Chapel Hill invites applications for a full-time research-track position (Research Associate or Research Full Professor) in the area of pharmacogenomics-related translational research and health policy. The successful candidate will develop and maintain strong relationships with interdisciplinary translational research teams, as well as mentor graduate students and postdoctoral fellows and contribute to the Institute's mission to employ an interdisciplinary approach to tailor therapies and enable the delivery of individualized medical practice. This position is designed to support the conduct of multidisciplinary research on clinical and policy issues that are critical to the appropriate translation of pharmacogenomic technologies into clinical practice. Full Job Listing.

*   *   *

Jan 22, 2008

The American Society for Gastrointestinal Endoscopy seeks a Manager, Health Policy & Grassroots Advocacy to support the work of the Health and Public Policy Committee. To develop, implement and coordinate health policy, related projects, products and campaigns designed to identify and address legislative and regulatory issues impacting the use of endoscopy in patient care. Develop and manage ASGE's grassroots advocacy network. Educate ASGE member physicians and their office staff regarding ASGE's advocacy agenda, legislative and regulatory initiatives, and laws impacting the practice of endoscopy. Full Job Listing.

Fellowships and Internships

Jan 29, 2008

Kaiser.edu maintains a continuously updated Policy Fellowships database that summarizes and links to more than 200 fellowships and internships in health policy and related fields. The database includes fellowships located across the United States that are available to undergraduates, graduate students, and professionals. Searches can be performed based on educational level, geographic location, whether the opportunity is paid or unpaid, or by keyword.

Education, Training & Professional Opportunities

Mar 18, 2008

The Kaiser Family Foundation hosts a live webcast, "Immigration and Health Care: What are the Policy Choices?," at 3 p.m. ET on Wednesday, March 12 as part of an ongoing series of interactive webcasts about health and health care disparities in the U.S. A panel of experts will discuss the influence that immigration policies have on federal and state decisions about access to health care and coverage. Marsha Lillie-Blanton, Dr.P.H., senior adviser on Race/Ethnicity & Health Care at the Kaiser Family Foundation will moderate the discussion with Tom Perez, M.P.P., J.D., secretary of the Maryland Department of Labor, Licensing and Regulation and former director of the Office for Civil Rights at the Department of Health and Human Services; Leighton Ku, M.P.H., Ph.D., professor of health policy at the George Washington University School of Public Health & Health Services; and Steven Camarota, Ph.D., director of research at the Center for Immigration Studies. The recorded webcast will be available online at http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2517>.

*   *   *

Feb 12, 2008

KaiserEDU.org invites undergraduate and graduate-level students in all disciplines to submit an original essay for the web site's annual competition. Students are asked to submit entries by March 17th. For more details visit the website: http://www.kaiseredu.org/essay/essaycontest2008.asp.

Conferences and Meetings

Jan 29, 2008

The Public Health Advocacy Institute (PHAI) and Public Health Law & Policy (PHLP) is hosting the Fifth Conference on Public Health, Law, & Obesity on September 19-21 2008. This conference will be sponsored by The Public Health Advocacy Institute (PHAI) and Public Health Law & Policy (PHLP) & held on Sept 19 - 21st, 2008 at Northeastern University School of Law. At the conference "advocates, public health practitioners, legal scholars, researchers, and policy makers are invited to come together to discuss the current legal approaches to the obesity epidemic. The conference will help stakeholders collaborate in developing a public health legal strategy." For more details, go to http://www.phaionline.org/projects/obesity-project/fifth-conference-on-public-health-law-obesity/.

Calls for Papers

Feb 12, 2008

TuftScope, the Interdisciplinary Journal of Health, Ethics, & Policy, is now accepting submissions for its Spring 2008 issue. TuftScope accepts original articles on government health policy, public and community health, bioethical matters, medical education, research in the mentioned fields, and other various issues dealing with the science and art of medicine and health or our country's healthcare system. Articles and editorials are accepted. Articles can be 2000 - 3000 words in length, editorials can be 1000 - 1500 words in length. Contact tuftscope@gmail.com or visit http://ase.tufts.edu/tuftscope for more information.

Grants Awarded

Grants Available

Jan 29, 2008

The Robert Wood Johnson Foundation Investigator Awards in Health Policy Research program supports highly qualified individuals to undertake broad studies of America's most challenging policy issues in health and health care. Grants of up to $335,000 are awarded to investigators from a variety of disciplines for innovative research projects that have national policy relevance.

Applications are welcomed from investigators in the fields of anthropology, business, demography, economics, engineering, ethics, genetics, health and social policy, health services research, history, journalism, law, medicine, nursing, political science, psychology, public health, science policy, social work, sociology and others. Complete instructions on how to apply can be found in the Call for Applications (pdf).

Key Dates:

*March 26, 2008 (5 p.m. ET)-Deadline for receipt of letters of intent (by mail only).
*June 13, 2008-Applicants will be notified by mail if selected to submit a full proposal.
*July 29, 2008-Deadline for receipt of full proposals.
*December 15, 2008 -Notification of acceptance mailed.
*March 1-September 1, 2009-Acceptable start dates for projects.

Organization News

Feb 12, 2008

Kaiser Commission on Medicaid and Uninsured. Medicaid: Overview and Impact of New Regulations. Washington, DC: KCMU, Issue Brief prepared by Robin Rudowitz, January 2008. In the past year the Bush Administration has moved forward with significant changes to the Medicaid program via rule-making. Taken together, six new regulations could result in an estimated $12 billion reduction in federal Medicaid spending over the next five years according to the regulatory impact statements prepared by Centers for Medicare and Medicaid Services. This brief focuses on the six new regulations that have been the source of considerable controversy and explains current policy, the proposed regulatory changes as well as the impact and issues with these changes. Full text (pdf)

*   *   *

Feb 12, 2008

KaiserEDU.org presents a new narrated slide tutorial on health care and the 2008 election by Claudia Deane, associate director of public opinion and media research at the Kaiser Family Foundation. The tutorial uses Kaiser's regular surveys taken throughout the campaign to examine public concerns about health care affordability, views on different policy approaches, trends in which issues the public wants presidential candidates to talk about, and how views vary by party identification. KaiserEDU.org is an online resource for faculty and students from the Kaiser Family Foundation. Tutorial

Publications

Mar 18, 2008

Newt Gingrich, Ph.D., Richard Boxer, M.D., and Byron Brooks, M.D., Telephone Medical Consults Answer the Call for Accessible, Affordable and Convenient Healthcare, Center for Health Transformation, 02/08. "This report examines the role of telemedicine and specifically the telephone cross coverage model to deliver a practical, easy-to-implement and cost-effective solution to all adults - wherever they are located and regardless of their insurance coverage. The knowledge and skills gained in telemedicine programs are impacting routine care for non-emergency medical problems with telephone medical consults gaining momentum largely the result of consumer receptivity and cost-savings. Currently, more than 1.5 million Americans have access to this option with significant growth projected as more employers, health plans and other benefits payers recognize the opportunity for improving access to quality care and reducing expenditures." Full Report (pdf)

*   *   *

Mar 18, 2008

Robert E. Moffit, Ph.D, Medicare Advantage: The Case for Protecting Patient Choice, Heritage Foundation WebMemo #1836. March 6, 2008. "The estimated 4 percent profit margins of Medicare Advantage plans are considerably below the profit margins for most major industries... officials at the CMS estimate that Medicare beneficiaries are, on average, getting additional benefits in the program worth more than $90 per month, or $1,100 per year... Empirical analysis shows that low-income and minority beneficiaries have disproportionately enrolled in Medicare Advantage plans, taking advantage of the lower cost-sharing and richer benefits." WebMemo

*   *   *

Mar 18, 2008

NPR and Kaiser at the Harvard School of Public Health, NPR/Kaiser/Harvard Survey: The Public on Requiring Individuals to Have Health Insurance, 2/29/2008. A new survey conducted jointly by NPR and public opinion researchers at Kaiser and the Harvard School of Public Health examines how the public views different approaches for expanding health coverage, including provisions that would require all individuals to purchase insurance or parents to obtain coverage for their children. The survey looks at whether or not the public supports such provisions, the major reasons behind their views, and how opinions differ among Democrats, Republicans and independents. This survey is part of a series of projects about health-related issues by NPR, Kaiser, and the Harvard School of Public Health. Representatives of the three organizations worked together to develop the survey questionnaire and to analyze the results, with NPR maintaining editorial control over its broadcasts on the results. Survey Results

*   *   *

Mar 18, 2008

The Kaiser Family Foundation, Kaiser Health Tracking Poll: Election 2008 - March 2008, Public Opinion and Media Research Program, 3/7/2008. The March Kaiser Health Tracking Poll: Election 2008 looks at where health care will fit in the ongoing presidential campaign now that economic concerns are rising. It finds that health care plays a role in two ways: as an independent issue, and as part of the voters' growing concerns about the economy. Among registered voters, health care ranks third as an issue that they want presidential candidates to discuss during the campaign - named by 28 percent of voters, behind the economy (45 percent, double the level in December) and Iraq (32 percent). When asked about the most important economic concern facing their families, one in four voters cited the general issue of rising prices. Behind this general concern, the cost of health care is one of a number of more specific economic worries cited by similar shares of votes: high taxes (13 percent), the price of gasoline (11 percent), the cost of health care (10 percent), and problems with getting a good-paying job or a raise in pay (9 percent). The March survey - the sixth in a series - also takes a closer look at political independents and those who name health care as one of the most important issues in their vote for president. Full Results

*   *   *

Mar 18, 2008

Janice L. Cooper, Towards Better Behavioral Health for Children, Youth and their Families Financing that Supports Knowledge. Unclaimed Children Revisited - Working Paper no. 3, January 2008. Towards Better Behavioral Health for Children, Youth and Their Families: Financing That Supports Knowledge provides an overview of sources of funding (and their policy roots) that underwrite children's behavioral health services, illuminating the flaws and prospects of various policy choices. The working paper is the third in a series titled Unclaimed Children Revisited produced by the National Center for Children in Poverty. Although the paper focuses on public funding for mental health and on substance abuse services within the behavioral health arena, it also addresses related funding in education, child welfare, and juvenile justice. Topics include an overview of children's behavioral services, an overview of federal behavioral health funding streams and their impact, fiscal innovation in states and local communities, and challenges and opportunities. The authors conclude the paper with recommendations for policy actions to create and sustain a supportive federal and state fiscal environment. The paper is available at Full Report (pdf)

Originally published in MCH Alert March 7, 2008 2008 National Center for Education in Maternal and Child Health and Georgetown University. Reprinted with permission.

*   *   *

Mar 18, 2008

U.S. Department of Health and Human Services, The National Survey of Children with Special Health Care Needs Chartbook 2005-2006. Rockville, Maryland: U.S. Department of Health and Human Services, 2008.The National Survey of Children with Special Health Care Needs Chartbook 2005-2006 highlights major findings on the prevalence of special health care needs among children, both nationally and within each state, and on access to and satisfaction with health care among children with special health care needs (CSHCN) and their families. The survey, sponsored by the Maternal and Child Health Bureau and carried out by the National Center for Health Statistics, provides information about six core outcomes used to measure progress toward the Healthy People 2010 objectives to increase the proportion of states that have integrated service systems for CSHCN. The chartbook is available at http://mchb.hrsa.gov/cshcn05/index.htm.

Originally published in MCH Alert March 7, 2008 2008 National Center for Education in Maternal and Child Health and Georgetown University. Reprinted with permission.

*   *   *

Mar 18, 2008

Disparities: Expanding The Focus is the title of the March-April issue of Health Affairs, which will be released on Tuesday, March 11. The issue, supported by the Robert Wood Johnson Foundation, looks beyond the health care system to key social determinants of health such as neighborhoods and education. The issue also touches on oral health - an area often neglected in health policy discussions - by exploring the problems minorities face in accessing dental care. Home page

*   *   *

Mar 18, 2008

Robert A. Berenson, From Politics To Policy: A New Payment Approach In Medicare Advantage, Health Affairs Web Exclusive, March 4, 2008. While the Medicare Advantage program's future remains contentious politically, the Medicare Payment Advisory Commission's (MedPAC's) recommended policy of financial neutrality at the local level between private plans and traditional Medicare ignores local market dynamics in important ways. An analysis correlating plan bids against traditional Medicare's local spending levels likely would provide an alternative method of setting benchmarks, by producing a blend of local and national rates. A result would be that the rural and lower-cost urban "floor counties" would have benchmarks below currently inflated levels but above what financial neutrality at the local level-MedPAC's approach-would produce. Full Text.

*   *   *

Mar 18, 2008

Mary Beth Landrum, Ellen R. Meara, Amitabh Chandra, Edward Guadagnoli, and Nancy L. Keating, Is Spending More Always Wasteful? The Appropriateness Of Care And Outcomes Among Colorectal Cancer Patients, Health Affairs, January/February 2008. 27(1): 159-168. Increased area-level medical spending is not correlated with improved patient outcomes or quality, thereby supporting the case for spending reductions in high-spending regions. However, all additional spending need not be wasteful. Examining the care of patients with colorectal cancer, we show that high-spending regions are more likely than other regions to use recommended care but are also more likely to use discretionary and nonrecommended care, the latter of which has adverse outcomes for patients. Our results show that instead of cutting spending, policies designed to target services to patients most likely to benefit could increase the value of medical spending.

*   *   *

Mar 18, 2008

Sean Keehan, Andrea Sisko, Christopher Truffer, Sheila Smith, Cathy Cowan, John Poisal, M. Kent Clemens, and National Health Expenditure Accounts Projections Team, Health Spending Projections Through 2017: The Baby-Boom Generation Is Coming To Medicare, Health Affairs Web Exclusive, February 26, 2008. The outlook for national health spending calls for continued steady growth. Spending growth is projected to be 6.7 percent in 2007, similar to its rate in 2006. Average annual growth over the projection period is expected to be 6.7 percent. Slower growth in private spending toward the end of the period is expected to be offset by stronger growth in public spending. The health share of gross domestic product (GDP) is expected to increase to 16.3 percent in 2007 and then rise throughout the projection period, reaching 19.5 percent of GDP by 2017. Abstract

*   *   *

Mar 18, 2008

Baris Karapinar and Michelangelo Temmerman, Benefiting from Biotechnology: Pro-Poor IPRs and Public-Private Partnerships (2007). NCCR Trade Regulation Working Paper No. 2007/35. The Green Revolution has contributed to the alleviation of poverty and hunger for hundreds of millions of people, but it remains technically and institutionally limited. It has largely bypassed small farms located in dry agro-ecological regions and its institutional 'top-down' approach was not equipped to address social, economic and environmental variations at the local level. However, with new developments in biotechnology, including genetic engineering, unprecedented possibilities for addressing the needs of smallholders in developing countries have arisen. Yet, there are new challenges too. The new technology is driven by the private sector, which is not attracted to investing in research on developing biotechnology specifically addressing the needs of small farms. Moreover, the accessibility of the existing technologies to small farms is arguably impeded by the intellectual property rights (IPRs) leading to monopoly prices and hindering technology diffusion. In this context, this paper analyzes how IPRs can be domestically tailored within the existing international commitments so as to encourage the development of technologies that favor and are accessible to small-scale farmers in developing countries. In particular, it proposes, for the first time, a special IPRs regime designed for public-private partnerships (PPPs), which would go beyond contractual arrangements and provide a more favorable institutional climate for the development of pro-poor and pro-small-scale biotechnology. Available at SSRN .

*   *   *

Mar 18, 2008

Thaddeus Mason Pope, Reassessing the Judicial Treatment of Medical Futility Cases. Marquette Elder's Advisor, Vol. 9, 2008. Over the past twenty-five years, a significant number of surrogate decision makers have demanded that a health care provider use medical technology to prolong a patient's life beyond the point thought medically appropriate. These surrogates want to continue life-sustaining medical treatment (LSMT) that providers want to stop. While most of these futility disputes are resolved informally inside the hospital, dozens have now been litigated in U.S. courts. Because the judicial treatment of these disputes casts a long, dark shadow on the informal resolution of all the others, it is important to ascertain exactly what guidance these court cases provide.

In assessing the judicial treatment of futility cases, most of the medical, legal, and bioethical literature concludes that courts have generally disfavored providers. But these assessments are based on limited and outdated sets of cases. In this article I offer a comprehensive review of futility cases from 1983 to 2007. Based on this review, I argue that courts have generally neither prohibited nor punished the unilateral refusal of LSMT. Providers have regularly obtained both ex ante permission and ex post forgiveness for stopping LSMT without consent. Available at SSRN .

*   *   *

Mar 18, 2008

Thaddeus Mason Pope, A Definition and Defense of Hard Paternalism: A Conceptual and Normative Analysis of the Restriction of Substantially Autonomous Self-Regarding Conduct, Chapter Five: A New Normative Defense of Hard Paternalism, Doctoral dissertation, 1/25/08. This is the key and final chapter of my doctoral dissertation. Chapters two, three, and four of this dissertation have already been published as free-standing law review articles. This chapter will also soon be published, though in two or three separate articles that link this normative jurisprudential theory to ongoing debates in public health. In this chapter, I offer my own theory of justified hard paternalism. My theory is, as I will explain, a beneficence-based, consequentialist argument. First, because I am not the first to make such an argument, I quickly review other beneficence-based, consequentialist arguments for the justifiability of hard paternalism. I do not systematically evaluate this literature as I did with the consent-based, deontological arguments in article for the UMKC Law Review. Rather, my objective, here, is only to provide some background. Available at SSRN.

*   *   *

Mar 18, 2008

John Holahan and Allison Cook, The U.S. Economy And Changes In Health Insurance Coverage, 2000-2006, Health Affairs Web Exclusive, February 20, 2008. The number of uninsured Americans increased by 3.4 million between 2004 and 2006, despite improving economic conditions. In the first four years of the decade, during a period of economic recession, the number increased by 6.0 million. The dominant factor in both periods was a decline in employer-sponsored insurance coverage. Although the recent decline was less than that experienced from 2000 to 2004, growth in public coverage was small, and the number of uninsured people increased by 1.0 million children and 2.4 million adults. Employer coverage declined most for self-employed or small-firm workers, in the South, and among noncitizens. Abstract.

*   *   *

Feb 12, 2008

Peter Shin, Brad Finnegan, Jessica Sharac and Sara Rosenbaum. Health Centers, An Overview and Analysis of Their Experiences With Private Health Insurance. Washington, DC: KCMU Policy Brief, Publication No. 7738, February 6, 2008.

A new policy brief provides an overview of community health centers, with a particular focus on the relationship between health centers and the private health insurance system. The analysis of 10 years of national data shows that health centers do not receive sufficient reimbursement from private insurers to cover the costs of treating commercially insured patients, challenging their ability to provide access to care for low-income patients. Full text (pdf)

*   *   *

Feb 12, 2008

Kaiser Family Foundation. How Non-Group Health Coverage Varies with Income. Washington, DC: KFF Paper prepared by Paul Jacobs and Gary Claxton. February 2008.

With some federal and state policy makers considering ways to encourage more people to purchase non-group, or individual, health care coverage, an analysis by Kaiser researchers released this week examines how often people at different income levels buy such insurance when they do not have access to benefits through an employer or a public program. The analysis finds that relatively few people at lower incomes purchase non- group coverage, with one in 20 purchasing it among those with incomes at the federal poverty level ($18,660 for a family of four in 2003 dollars). As income increases, the coverage rate grows, though even at four times the poverty level, only about a quarter of individuals without access to alternative coverage purchased non-group coverage. Full text (pdf)

*   *   *

Feb 12, 2008

Linda J. Blumberg, John Holahan. Do Individual Mandates Matter? Washington, DC: Urban Institute. January 29, 2008.

In this brief we conclude that, absent a single payer system, it is not possible to achieve universal coverage without an individual mandate. The evidence is strong that voluntary measures alone would leave large numbers of people uninsured. Voluntary measures would tend to enroll disproportionate numbers of individuals with higher cost health problems, creating high premiums and instability in the insurance pools in which they are enrolled, unless further significant government subsidization is provided. The government would also have difficulty redirecting current spending on the uninsured to offset some of the cost associated with a new program without universal coverage. Full Text (pdf), Summary (html).

*   *   *

Feb 12, 2008

Victoria Craig Bunce and JP Wieske. Health Insurance Mandates in the States 2008. Washington, DC: Council for Affordable Health Insurance, January 31, 2008.

The number of state mandated health benefits continues to grow - to 1,961 nationwide, up from 1,901 last year, according to CAHI's annual list of health insurance mandates in each state. Since 1992, the Council for Affordable Health Insurance staff has tracked the introduction and passage of individual and small group market (i.e. not HMOs, PPOs, or the self-funded large group market) health insurance mandates in every state, but not until 2004 did CAHI make this information available to the public. To corroborate its own findings, CAHI surveys every department of insurance and talk with other industry experts. However:

  • The CAHI counts do not currently differentiate between the individual and small group markets, especially since many states are blurring that traditional distinction by allowing "groups of one" (i.e., one person is considered a group) to be classified as a small group under federal law.
  • Also, CAHI does not differentiate between a benefit that is mandated and one that is only offered.

The report contains a chart of the mandates with information broken down by state into three categories: types of mandated benefits, providers, and covered populations. According to CAHI actuaries, mandated benefits currently increase the cost of coverage from a little less than 20% to more than 50%, depending on the state and the specific legislative language. Minnesota leads the states with 64 mandates, while Idaho has the lowest at 15. Fortunately, there is evidence that some legislators are getting CAHI's message. At least 30 states now require that a mandate's costs be assessed before it is implemented, and at least 10 states provide for mandate-light policies, which allow some individuals to purchase a policy with fewer mandates more tailored to their needs and financial situation. Full report (pdf)