Kennedy on the Hill

Ailing Sen. Ted Kennedy made an appearance on Capitol Hill Tuesday to sit in on confirmation hearings for Kathleen Sebelius, the nominee for Secretary of Health and Human Services. Now, Kennedy said, he knows the medical system not just as a policymaker, but as a patient:

“Over the past ten months, I’ve seen our health care system up close.

I’ve benefited from the best of medicine. But we have too many uninsured Americans. We have sickness care and not health care. We have too much paperwork and bureaucracy. Costs are out of control. But today we have an opportunity like never before to reform health care.”

The The Boston Globe has video.

While he was at it, Kennedy introduced a bill to “overhaul” the National Cancer Act.

And the New York Times reports that Kennedy’s “keeping the heat on” the push for health reform.

You go, Senator.

Getting from “Eureka!” to the exit deal

Scientists and investors met at Harvard Medical School Tuesday to talk about the market for potential new drugs and devices. Some were even optimistic.

Sponsored by the Massachusetts Technology Transfer Center, the “Early-Stage Life Sciences Technology Conference,” in organizers’ words:

“…offers an opportunity for research institutions and recently formed Massachusetts companies to present their life sciences technologies to an audience of angel investors, venture capitalists and corporate investors.”

So doctors who usually present to fellow researchers — not VCs — had 10 minutes to pitch their inventions. Among their offerings: A potential artificial retina, a new system to shrink tonsils and a device to accurately deliver drugs to the brain. The scientists came from a range of area hospitals and schools, including Dana Farber Cancer Center, Boston College, MIT and McLean Hospital.

First, several funders and company reps discussed whether investors have the nerve to go with high-risk technology in an economy without much tolerance for risk. The panel included representatives of Partners Innovation Fund, the Small Business Innovation Research program at the National Cancer Institutes and Woburn-based Claros Diagnostics.

Aaron Sandoski, managing director of Norwich Ventures, said a number of companies are looking at early stage technology — a trend he called “a shift in mindset.” But, Sandoski added, inventions that are closer to going to market are also still popular with VCs.

“They can invest with much less risk and on much better terms,” he said.

Not everyone was confident about the current market for fledgling life science discoveries. Some speakers suggested scientists stick close to their incubators for a few more months and see where the economy goes.

MTTC Director Abigail Barrow said the annual meeting drew more people than last year. But she thinks some inventors with good ideas still have a tough time finding sponsors.

“The really early stage, proof-of-concept money is really hard to get,” Barrows said.

Appropriate care or gaming the numbers?

The push to link payment to quality of care entered the ethically questionable zone on Wednesday. The Globe reported on how doctors are responding to the publication of one quality measure — mortality rates:

“Public reporting of hospital death rates may be pushing Massachusetts cardiac specialists to treat some very sick heart patients less aggressively, sparking a debate among health officials and doctors over whether patients are being spared unnecessary and costly end-of-life treatment or denied procedures that might save their lives…

Cardiologists at Mass. General, who have prided themselves on placing stents in the sickest of the sick, said they have stopped performing such high-wire acts on some patients, particularly those with advanced cancer who could die within weeks…

State health officials applaud this more conservative approach, saying that doing procedures on patients with scant hope of recovery wastes money and exposes them to unnecessary care and pain.

But cardiologists say decisions about who should undergo angioplasty are frequently not so clear-cut.”

Conservative opponents of the Obama health reform approach argue that evidence-based medicine leads to rationing. They are going to have a big time with this story.

Is this the medical equivalent of getting D students to drop out of school to raise the MCAS scores? Or is it good medicine to spare a dying cancer patient a useless angioplasty? Comparative effectiveness will sort it all out for us, they say. More about that here from the Alliance for Health Reform.

Also, a study in this week’s Journal of the American Medical Assn. compares mortality with another common quality measure and finds a mismatch.

Double-dipping pharmacies: Some want their drug stores to stop selling information to drug companies.

Consumer advocates testified at the Statehouse this week in support of a bill they say will keep drug stores from selling information about prescriptions to drug and device companies:

“This legislation is necessary to stop companies like CVS Caremark from using prescription data for marketing purposes, which threatens our healthcare system and privacy,”

said Jasmin Weaver of Change to Win (PDF), a union coalition, in a statement released the day of the hearing.

The hearing itself didn’t seem to generate much news coverage, but this bill is part of a national battle over medical records privacy. This Washington Post story pretty much covers it:

“In letters, testimony, meetings with lawmakers and media teleconferences, industry lobbyists have argued that some of the provisions Congress is considering would impede health research, might prevent pharmacists from sending out refill reminders, could restrict doctors from finding out about a patient’s risk of dangerous drug interactions, and might force hospitals to spend billions of dollars to retrofit computer systems and still not be in full compliance…

Consumer advocates assert that the health industry is already reaping billions by gathering, mining and marketing personal health data and is mainly worried that the privacy provisions would threaten that income stream.”

Mass Connector’s starring role

The Mass Connector continues to be fodder for the health reform debate. From PBS, Frontline’s March 31 “Sick in America” program covers it in a segment called “Change is Coming.”

This week’s National Journal “Experts Blog” also takes on mandated health insurance.

As usual, the state plan takes it from both sides. One consumer advocate said the plan is not true reform because there was no effort to control cost. A commenter from the U.S. Chamber of Commerce describes it as “an effort to lock in payers, to force employers to pay more into the system, and to force the young who opted out to subsidize the costs of others.” He also blames it for rising costs and provider shortages. Makes the connector sound like the El Nino of health reform — a bit of a reach.

There’s more by Tinker Ready over at Boston Health News.