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Given the success of the coverage expansion, Massachusetts policymakers are turning to the next phase of health reform - reigning in health care costs.

I've contributed a lot to this discussion.  Perhaps I've been obssessive.  I'm concerned about the state of healthcare in this country, though.  I'm upset about the rampant myths and lies being tossed around about healthcare reform.  I'm concerned about all the lazy thinking we citizens are exhibiting. Misinformation, misunderstandings, bias, prejudice, narrowly self-interested polemics, anger, manipulations, and nastiness are badly hurting the process (and probable outcome) of healthcare reform debates and efforts. I can't NOT write long, detailed comments when I read stuff that's...well...WHACK!

Sepsis. Hospital-acquired infection. Deadly.

The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system - and with improved outcomes. We asked them about their secret to success.\n\nMayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there's no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.\n\nIf Mayo can do it, why can't everyone else? The AARP believes that the potential is there for most communities to have excellent care - we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It's a big job and will take some investment, but we have many opportunities to do a better job than we're doing today.

*In West Chester, Community Volunteers in Medicine treated 332 patients in February, up 26% from February 2008. The cost of care was up 21%. At the same time, the clinic was about $100,000 behind in fundraising for its $1.8 million annual budget. *Ohio's 40 free clinics treated 56,000 uninsured patients in 2008, up from 43,000 in 2007. Marjorie Frazier, executive director of the Ohio Association of Free Clinics, expects the number to increase in 2009. In January, one clinic in Cleveland closed because it lacked funding. Ohio, one of the few states that helps pay for free clinics' operations, is cutting funding. Its two-year allocation for 2008 and 2009 was $2.1 million; for 2010 and 2011, proposed funding is $1.5 million. *California's 800 community health centers saw increases of up to 20% in uninsured patients in the past six months. The state, facing a $42 billion budget shortfall, is eliminating payments for some services for poor adults, including dental care. As a result, the centers will lay off 1,000 dentists and other staff, leaving as many as 400,000 people without dental care, says Chris Patterson, spokesman for the California Primary Care Association.

If the uninsured were a political lobbying group, they'd have more members than AARP. The National Mall couldn't hold them if they decided to march on Washington. But going without health insurance is still seen as a personal issue...The grass-roots group Health Care for America Now plans to bring as many as 15,000 people to Washington this year to lobby Congress for guaranteed coverage.

Workers, 20-30% of whom are uninsured, and an even larger percentage of whom are underinsured, continue to pay the bill for others to get coverage; their payroll taxes help support Medicare for the elderly, Medicaid for the disabled, for children of low-income parents, and those living in poverty.

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