Tuesday Tidbits

The Wall Street Journal reports about a study published in the AMA Journal finding that

About 600,000 angioplasty procedures, which almost always involve placement of a tiny metal tube called a stent, are done in the U.S. each year [at an average cost of $20,000 per procedure]. Roughly 70% of these procedures are performed on patients suffering symptoms of a heart attack and aren't medically controversial. But the remainder are done on stable patients who are suffering mild symptoms or no symptoms at all. Of those, 50% are deemed appropriate, 38% uncertain and 12% inappropriate, the report says.
"One in eight is probably higher than we would like," said Paul Chan, a cardiologist at Saint Luke's Mid America Heart and Vascular Institute, Kansas City, Mo., and the study's lead author.

The good news is that the cardiologists are studying their own practice patterns in order to improve them.

Because the FEHBlog adheres to Dirty Harry's dictate, "a good man knows his limitations," he has decided not to delve into the Avastin or Chantix controversies, but they are worth noting..

The AMA News (whose website is refreshed on Mondays) reports on the AMA legislative body's views on health care reform.

Issue: The federal government is working to define what it will call essential health care benefits that must be covered by plans for sale in the state-based health insurance exchanges.

Proposed action: Rather than recommend a list of specific benefits, reaffirm existing policy stating that the coverage offered by the Federal Employee Health Benefits Program should be used as a "reference" when identifying whether a plan offers meaningful coverage for adults. [Adopted]

Yeah FEHBP!

The AMA News also reports on a Goldman Sachs investors conference that many health insurance executives attended.

Aetna's President, CEO and Chair Mark Bertolini, speaking at the conference, said the economy is succeeding where insurers have not: cutting costs. "As much as we like to say we do really good work, as a company and as an industry, a good majority -- more than half -- of the decrease in utilization is associated with externalities versus what we're doing." In early 2011, he said, the company saw members return to doctors -- normal for the winter cold and flu season -- but not fill the prescriptions doctors wrote for them. He said that was probably because they couldn't afford the out-of-pocket drug costs. "That's an unusual trend," he said.

Interesting observation.