It’s a good one folks. I know I say that every time, and that’s because it’s true. Go read it!
As of September 2, CVS–the ubiquitous pharmacy / convenience store–has stopped selling tobacco products, including both cigarettes and smokeless tobacco. This is a bold move from the retailer, which is also planning to rebrand itself as “CVS Health” to emphasize its place in the health care delivery chain. I personally applaud the decision, because there are simply no benefits to tobacco use in any form. And it’s also worth noting that this is a move that is financially risky for CVS. At the time that they first announced their plans to make this change, corporate leadership projected a loss of roughly $2 billion in annual revenue stemming not only from the lost sales of tobacco products, but also the sales of other incidental items that individuals in the store to purchase tobacco might have made. You can’t accuse CVS of not putting its money where its mouth is.
Does this lost revenue concern investors? It doesn’t appear so. The day after the shelves were emptied of tobacco, shares of CVS are up by nearly 1%, and over the last 52 weeks, the share price is up by nearly 43%. What has investors so confident? The answer is likely the new direction that CVS Health is taking. Yes, they are a pharmacy, but they aspire to be–and in many cases already are–much more than that. Many CVS locations also contain minute clinics where one can walk-in without an appointment and be seen by a physician assistant or nurse practitioner to receive a diagnosis–and perhaps a prescription–in a short amount of time. They are planning to have approximately 1,500 clinics in operation within the next 2 to 3 years. CVS Health also operates as a pharmacy benefits manager–you might be more familiar with the name Caremark that could be printed on your insurance card. There’s big money in that business too.
So, this looks like good news for the health of the population, and good business for CVS Health and its shareholders, but is it enough? If you’re really in the business of health care, should you be selling sugar-sweetened beverages, candy bars, and potato chips? What about household cleaning products? They can be hazardous to your health. Many of these stores also sell beer, wine, and liquor. The bottom line is: There are a lot of things one can find inside a CVS that aren’t good for your health. Perhaps none of them are as unequivocally bad for you as tobacco, but then again, you can’t buy a six-pack and a frozen pizza at your doctor’s office. So, again, I applaud CVS for their bold move to make tobacco slightly less available, and to aspire to become CVS Health, but I also wonder if they’ve gone far enough in pursuit of that goal. If they really want to be in the business of health, maybe they need to get completely out of the business of everything else.
I’m back, after an August filled with children, swimming, anniversaries and weddings. Two weekends in a row of travel and I’m glad to be home. Which reminds me of a subject I have long wanted to write about: The Medical Home.
Here is how the US Department of Health and Human Services describes The Medical Home (TMH for short): “The medical home model holds promise as a way to improve health care in America by transforming how primary care is organized and delivered. Building on the work of a large and growing community, the Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place but as a model of the organization of primary care that delivers the core functions of primary health care.” AHRQ says that medical homes provide care that is Comprehensive, Patient-Centered, Coordinated, Accessible, and has Quality and Safety measures.
Here’s how the Patient-Centered Primary Collaborative defines TMH: “The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. It is a place where patients are treated with respect, dignity, and compassion, and enable strong and trusting relationships with providers and staff. Above all, the medical home is not a final destination instead, it is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient’s needs.” The collaborative claims improvements in cost, utilization, population health, prevention, access to care, and patient satisfaction.
If all this sounds familiar, that’s because it is essentially a re-wording of the push to control costs by having care channeled through primary care doctors back in the early 2000’s. That initiative, widely implemented, resulted in a lot of jobs for paper pushers but not a lot of cost savings. In fact, the idea of a medical home has been around since at least 1967, especially in the field of pediatrics. I am not against the concept; the goals are all laudable. The problem is that “home” means different things to different people.
The Medical Parasite Host: If you live in a rural area, your medical home likely consists of one guy, or girl. That MD or NP does everything. That person is your home.
The Medical Grass Hut: In this home, everybody sits on the dirt floor and shares everything. This happens in poor communities where a visit to the doctor takes all day and everyone hangs out in the waiting room with their kids and grandparents, sharing two overworked doctors and a medical student. You pay with chickens or potatoes.
The Medical Motel Room: This is where you stop in for some low-quality, one-the-go health care. Like stand-alone clinics, urgent care centers, and pharmacies. It’s quick, it’s cheap, and no one knows you were there.
The Medical Project: Better than a grass hut. It still takes all day to see a doctor, but now you have bathrooms.
The Medical Apartment: Here you get your own doctor. Until your employer changes your insurance coverage. Then you move and find another doctor. It works as long as your medical problems fit in the back of a Ford Escort.
The Medical Single Family Home: Its nice, its comfortable, its stable, you’re insured. You have to drive into the city for your comprehensive, patient-centered, coordinated, accessible, quality healthcare, run by a healthcare conglomerate, but you have a car. Or know someone who does.
The Medical Mansion: You get all the care you want, when you want it. It’ll cost you, but it’s worth it because you don’t have to wait like everyone else.
The Medical Estate: The doctors come to your house. With MRI machines in trailers.
The Medical Home is a nice idea, and it works well in areas of the country where people are insured and have reliable transportation to centers that provide all the services TMH promises, that is, people in the middle. Rich people can buy their homes. Poor people either have low-quality homes provided for them or have no home at all. They drag their health problems with them from place to place, staying in motel rooms when they can, visiting the grass hut when they can’t. The ACA is trying to get everyone into at least an apartment. Even if it’s in a bad neighborhood.
A few months ago, while flipping through an issue of Christianity Today magazine, I came across an interesting full-page advertisement. Usually, I’m more interested in the articles on theology and the ads for new books from contemporary pastors, but this time the ad that I noticed was for a company that was advertising the Christian alternative to health insurance. I read the ad fully, and then ventured onto the web to find out more about this company, what exactly it was offering, and how it was supposed to work. I learned a lot. In fact, I learned about the existence of something in U.S. health care that I never learned about during 8 years of graduate school and postdoctoral training in health policy. As it turns out, there are a number of these “faith-based insurance alternatives.” Among the largest nationally are Medi-Share, Christian Healthcare Ministries, Liberty HealthShare, and Samaritan Ministries. While there may be some slight differences between the various organizations, they all work in basically the same way, so for simplicity’s sake, I’ll just give you the broad overview.
The idea is simple: You sign up for membership, then you pick a plan level, and you pay the corresponding monthly membership fee. You receive a membership card that you can show to your provider, which may entitle you to a discount on services rendered. Then, if and when you get sick and incur a charge from a health care provider, you pay the bill and submit paperwork to the medical sharing organization, which will pay a portion of your costs using the monthly fees paid by other members. Before you are eligible to have a portion of your costs covered by the program, you must first have paid out of your own pocket what is typically called your “annual household portion” in addition to your monthly membership fee. That’s basically all there is to it.
If that sounds a lot like insurance to you, it should. After all, I could rewrite the preceding paragraph like this: You enroll in a plan and pay a monthly premium. You receive an insurance card that you show to your provider, and your insurance company has likely negotiated a contract for discounted services with providers in your network. If you get sick and incur a charge from your health care provider, you or they submit the bill to your insurance company, which will pay a portion of your costs using the premiums collected from other beneficiaries. Before you are eligible to have a portion of your costs covered by the program, you must first have met your deductible, the amount that you are required to pay out of your own pocket in addition to your monthly premium.
But these plans make a point of telling you that they are not insurance. That’s an important point–and it’s very true. Here are some of the key differences. First: Membership. It used to be that health insurance plans could discriminate a lot more on the basis of health conditions–either charging you a much higher premium or denying you coverage altogether. Under the Affordable Care Act, that has changed. You can no longer be denied health insurance coverage because of a pre-existing condition. However, membership in one of the “faith-based insurance alternatives” requires that you be a Christian. The way that these organizations define that, you cannot use tobacco or illegal drugs, must adhere to biblical principals regarding alcohol use, and must attend worship services regularly. While I think that all of those are very good things, it is important to take into account that just by excluding tobacco users, the plans are engaging in cream-skimming–that is only allowing the healthiest people to enroll. One firm even says you qualify if you “are healthy and live a healthy lifestyle.”
Second, these plans are not regulated by State Departments of Insurance. In fact, they are explicitly carved out as an exception in the Affordable Care Act. If you belong to a “faith-based insurance alternative” you are exempt from the individual mandate to obtain health insurance and you are not subject to the penalty for failing to buy coverage. So, this is an attractive option for people who are just anti-ObamaCare, as well as people with moral objections to things like abortion and contraception that they feel they are supporting by paying premiums to insurance companies whose plan benefits cover those goods and services. While I may not necessarily agree, I don’t have any issue with this.
Third, these plans do not offer typical benefits that most health insurers do. For instance, you may not have coverage for things like rehab for drug and alcohol abuse. You may not be able to get reimbursed for birth control, depending on the plan you choose. Even some types of important preventive care (e.g., mammograms and colonoscopies) often aren’t covered. Of course, proponents of these plans are likely to stress that that’s precisely the point (see the point above), and that’s fine, but it’s an important thing to know when you’re shopping for health coverage.
The fourth–and biggest–difference, as I see it, is that these plans that look so much like insurance, are really no assurance of insurance at all. As the Alliance of Health Care Sharing Ministries makes extremely clear, “Health Care Sharing Ministries do not assume any risk or guarantee the payment of any medical bill.” That means you pay them money every month and hope that things work out, but have little legal recourse if they do not. Related to that, there have also been financial scandals and court cases against some of these organizations, so potential members need to be just as careful with these programs as they would be with any other financial decision.
In light of these important differences, what do I think of these “faith-based insurance alternatives?” Well, I think that Christians should take care of their bodies, and that we are called to love our neighbors as ourselves. In that respect, many aspects of these “faith-based insurance alternatives” are clearly on the right track. But who is my neighbor? The parable of the Good Samaritan presents that everyone in need is our neighbor, even when we disagree with or are different from them. Even if they use tobacco products. Or illegal drugs. Or don’t regularly attend a worship service. This doesn’t mean that we condone these things, but we are to love even our enemies, and do good to those who persecute us, not alienate them. So I don’t necessarily agree with the restrictions placed on membership in these programs. It feels a bit like only letting people we deem to be “good” enter the doors of the church. But it is the sick who need a physician, not those who are well. Of course, in pointing out some of the perceived limitations with these “faith-based insurance alternatives,” I certainly don’t hope to imply that insurance companies are somehow occupying the moral high ground, because I don’t believe they are. On the contrary, I’m not sure that there is a moral high ground in U.S. health care financing these days. But I would encourage us to think broadly about who we consider our neighbors and how we care for them, and to engage with “faith-based insurance alternatives” with a keen understanding of the fact that they have many redeeming qualities, but that they are not–by their own admission and design–in the business of insurance.
In the new app-driven health economy, ease of use of IT for providers and patients is a must. Equally important is a sound technical approach and business plan for application creators looking for success, sustainability, and a large market for their innovations. Under the leadership of Boston Children’s Hospital’s Drs. Kenneth Mandl, Isaac Kohane, Joshua Mandel and an advisory committee that includes former U.S. Chief Technology Officer Aneesh Chopra, Harvard Business School professor and notable author Clayton Christensen, and Eli Lilly’s director of Clinical Open Innovation Thomas Krohn, the new SMART (Substitutable Medical Apps & Reusable Technology) Platform aims to revolutionize the way providers and patients use applications to improve access to and quality of care. SMART apps are agnostic to the underlying electronic health record (EHR) or other IT platform. Like iPhone or Android apps, SMART apps are substitutable and can be readily added or deleted from EHRs.
Swapping Technology In Real Time
The SMART team has focused on enabling the property of substitutability in health IT through an application programming interface (API). This essentially allows innovators and developers who write an app to run it anywhere, and lets end users of health IT customize their systems with these substitutable apps.
“The opportunity is to create an ‘app store’ to extend the capabilities of EHRs,” says Dr. Ken Mandl of Boston Children’s Informatics Program . According to him, the trick to SMART is that the software developer doesn’t need to know anything about the underlying system just the format of data presented by the API, which will not change.
He makes an analogy to the original iPhones that used cellular towers to triangulate a user’s GPS, but shifted with the present day satellite GPS. When they did so, iPhone apps kept on working. The app developers did not need to know how the underlying system measured geo-coordinates. Similarly, SMART apps don’t need to know which electronic health record or pharmacy information system is in use at any given hospital. Instead, SMART app developers, like those developers for iPhone apps, simply use the original library to make upgrades and change out necessary components.
This is exactly what developers like Justin Cranford in Raleigh, North Carolina say are ideal for functionality. “In the iPhone, the library is written by Apple, and that internal code changes, but the commands I call to build apps just pull those changes in without me ever knowing. Think about how Tinder pulls in Facebook photos and triangulates your location through the phone.” Or, as Ken Mandl quipped, “I don’t imagine that each time the creators of Angry Birds wanted to add a bird they had to fly to Cupertino for a meeting with the Apple technical team.”
This method, known as abstraction, allows technologies to be swapped out and improved inside the walls of hospitals, clinics and other care facilities. A natural extension of which might be the ability to share these substitutions and updates with patients, allowing them access not only to their data, but community and population trends inside the hospital and out – which is most important to advisors like Thomas Krohn from Eli Lilly. According to him, “I’m at the table because the pace of transformation is too slow. Measures are poor, the timeline is slow and the apps are not presently scalable. This is the real opportunity,” he believes, “to allow innovation at the point of care.”
Clayton Christensen adds, “Modularized hardware and software are what make this unique. That element will determine the winners and losers.” When comparing it to his writing in The Innovator’s Prescription, he contends, “SMART fits the pattern of a successful business idea because the architecture is closed, proprietary and independent.”
Health Reformations Make SMART Possible
In addition to the creative ideas and established models that SMART is built upon, significant changes to the health system and technology in the United States have made advances such as this possible. Three specific incidences have had a particularly large effect on SMART.
First, the opening of health data has allowed payers, providers and patients access to new information. According to Aneesh Chopra, “The more data that is made available to consumers, the more ways data can be utilized and repurposed.” Although the Centers for Medicare and Medicaid Services (CMS) has not opened all of their data to the public, giving away payment information has opened many new doors for using payment information to better inform everyone in the health ecosystem.
Second, the digitization of health care has allowed for patient information to not only be collected, but to be used. By releasing patient information, our former CTO Mr. Chopra, who has a background in health, technology and policy believes that a patient revolution is on the horizon. He contends that the ultimate way to empower patients is to give them their own data to take beyond the four walls of the hospital or institution, and that means they can also use SMART in real time.
Third, payment reform in America is shifting us from a fee-for-service to an outcomes and value-based health system. Although there are significant flaws to the system, the mental shift for providers means that patient-centered care, outcomes and overall “value” will have new importance. The SMART team has faith that as payment reform occurs, their substitutable applications will not only create better care in facilities, but more informed providers and more engaged patients .
SMART Advisors And Partners
The advisors that have come together to make SMART a reality really are a who’s who of the health industry. In addition to the former White House CTO, universities and professors of note and the largest provider health systems, there has also been buy in from key technology companies, pharma, investors and consultants.
The list of advisors includes, but is not limited to:
- The Advisory Board Company
- Centers for Medicare & Medicaid Service (CMS)
- England National Health Service (NHS)
- Eli Lilly
- Hospital Corporation of America (HCA)
- Canadian Institutes of Health Research
The strategic input by this team of advisors makes it almost impossible to fail. Additionally, the SMART Platform is already funded by a $15M grant from the Office of the National Coordinator for Health Information Technology (ONC) .
However, in the coming months it will be interesting to everyone in the health space to see how successful the platform is and just how substitutable the apps are. As we all know, apps have to work with providers and patients, if they are going to work for providers and patients.
Infographics and visualizations are hugely popular in all cultures, and there is unlimited opportunity to use them in a complex field like health care. However, 15 seconds is all the time an online article has to capture a reader according to data from Tony Haile of Chartbeat. The data also suggests that people don’t read content on the web the way we think they do, as much as visualize it. Health visualizations then, like media, only have mere seconds to get a patient engaged. With such great opportunity for improving health literacy, patient activation and outcomes, better health visualization must be easily digestible, and must engage the reader’s emotions instantly. What BuzzFeed does in the media space, we might find useful for health, too. According to Devin Gross, CEO of Emmi Solutions, “Images, voice and text are all important parts of creating rich, emotional content that is relevant to individuals experiences. The goal is to bring real interconnectivity to the health space.”
A Picture Is Worth A Thousand Words
Pictures can give a patient a complete concept in seconds, where words alone often fall short. Tell a patient, “Don’t eat that next piece of cake, because excessive consumption of cholesterol increases the risk of heart disease and stroke”, and they will either ignore you or hear “Don’t eat cake, it kills you”. That’s neither true, nor encouraging. Visual cues can explain the opportunity for improvement in a more informative, fun and intriguing way.
However, to use visualizations successfully – to engage and grab the attention of both the well and the ill – requires really understanding people. But if done appropriately, real improvements to public health might be possible. As David Spiegelhalter, Professor at Cambridge University in public understanding of risk says, “Often, numbers do not speak for themselves. They are part of narrative, and so there are no correct or objective ways of communicating them as text.”
At London’s recent WIRED Health conference, speakers made heavy use of data visualization to communicate the benefits of using certain technologies in health care and wellbeing. Although that was to an audience of medical professionals, entrepreneurs and media, data and charts could have been replaced with a wholly different narrative and disseminate the same story if need be for a lay audience.
Data visualization is not for everyone though. A crucial mistake in health would be to identify patients as one cohort – especially when they are a group of people suffering the same affliction. Therefore, Infographics and interactive visuals are one piece of the overall patient engagement goal.
Psychology Of A Patient
In a recent Business Insider post, columnist Milo Yiannopoulos asked why data journalism doesn’t always work; at least, not for most people who aren’t “data nerds.” He contends that news providers have forgotten that ordinary people are moved by pleasure and displeasure rather than spreadsheets. This is why money, sex appeal and humor all play major roles in media.
Ironically, many in the health space also seem to forget that patients are also people, and raw stats just won’t cut it. Health communicators must innovate to tell compelling, visual stories beyond the numbers. Or, as Emmi Solutions CEO says, “The dynamic of any relationship and subsequent health-related action come from feeling like you’ve been getting advice from a trusted friend. Learning in a friendly and meaningful way is really an extension of a relationship built on trust.”
Any communication professional will tell you, all people are different. Personality gurus Myers-Briggs split us into 16 broad personality types, describing how people perceive the world and make decisions. Based on analyses such as Myers-Briggs, we know that some people prefer the written word while others will want credible datasets to work through. Older people tend to have the time to want to do their own research and younger people tend to have no problem trading time for simplicity. But as a whole, almost all humans have a desire to connect with and relate to other people.
Many charities understand this well, such as Cancer Research UK, which collaborates with good PR agencies to tell trusted stories that tug at heartstrings. Yiannopoulos says that these stories get the most attention in the media because by the end, tears – whether from laughter or pain – are dripping onto the page.
Engage, Play, and Interact
The JBS3 risk calculator, developed by David Spiegelhalter and Mike Pearson at Cambridge University, is a tool to help visually communicate the risk of cardiovascular diseases and the benefits of interventions, whether lifestyle or pharmacological. It’s a good example of how to create engagement through instant feedback. Feedback is important because it contributes to the motivation and the emotional bond between data, good advice, understanding and future decision-making.
In a doctor’s office, the physician can use tools like this to tell a better story to their patients. Providers can more easily illustrate the potential of a different lifestyle choice, and the impact of behavioral changes. It further gives the patient choices, options and a vision of incremental benefit rather than black-and-white outcomes.
US-based Emmi Solutions is a company that provides multi-modal engagement tools that relay personalized, visually oriented health information throughout the entire care continuum, from prevention to surgery to self-care. Using teams of visual and graphic artists, voice artists, script writers and patient focus groups, the company creates content that, in theory, simplifies complex medical information to provide people with information that they can easily understand and respond to.
This idea also allows providers to have more meaningful conversations during notoriously short visits and better explain in-person what is happening, as well as send them home with reference material that they can interact with on their device of choice and when they’re ready to learn. Their results from over 12 years of being in operation prove that this approach does get people engaged and taking action.
On the academic front, the Robert Wood Johnson Foundation (RWJF) and the University of Michigan Center for Health Communications Research have joined forces for “Visualizing Health,” a project examining how data visualization for risk behavior can be applied. Their premise is that people need to be able to understand and respond to multiple types of health risk information.
According to the RWJF report, once people have information they can understand, they set goals, recognize that risk exists, judge whether the level of risk is acceptable or not, and use that to make a decision among options. As we grow, around the world, to better understand the learning preferences and human behavior that influences comprehension and decision-making, the ability of presentation could have significant impacts on public health. By creating educational materials that allow people to interact in ways that make sense to them, we empower them.
Today, it is my distinct pleasure to host the month’s only issue of the Health Wonk Review. You see, much like Congress, we academics and policy wonks tend to slow down our work considerably in the summer months. And yet, much unlike Congress, even then we are able to get at least something done. Thus, in this “August Recess” edition of the HWR I bring you some wonderful insights into health care spending, Medicare, and the ACA from the best health policy bloggers on the web.
Leading things off, Billy Wynne of the Healthcare Lighthouse blog will get you all caught up on implementation of the Affordable Care Act, with a focus on what happened in July. You usually have to pay for access to this stuff, folks. So, read it while it’s free, and you may be surprised to see that so much work continues on all fronts after the close of open enrollment period 1.0. I guess while Congress is in recess, the executive branch has to keep working, despite all the people outraged by President Obama going on vacation during world crises.
Louise, of the Colorado Health Insurance Insider, takes a look at fixed indemnity health insurance plans. As she says, “There are still a lot of moving parts in the ACA. New regulations are constantly being added to ensure that all of the parts work well, but they don’t all take effect immediately. So while regular major medical health insurance is guaranteed issue now, fixed indemnity plans are still being sold in the individual market–exempt from ACA regulations and quite possibly without the client understanding that the plan is not sufficient to avoid the individual mandate penalty. Far worse than the penalty however, is the possibility that a person could purchase one of these plans thinking that it’s ‘real’ health insurance, and only find out it’s not after incurring a significant claim.” Fortunately, some regulations are on the way for fixed indemnity plans starting January 1, 2015.
In other ACA-related news, it won’t be long before the Marketplaces are available once again for open enrollment. On the Health Affairs blog, authors Jon Kingsdale and Julia Lerche explain how the “one-two punch” of rate shocks from benchmark plan changes and delayed tax refunds could threaten the success of the ACA’s second open enrollment period, and they outline some steps that could address these challenges.
But, if rate shocks are such a big problem, why are we seeing such a significant slowdown in health care spending? Is it the recession still? Are we seeing a real shift towards paying for value rather than volume? To get to the bottom of it, read the Healthcare Economist’s latest post. There, Jason Shafrin explains that between 2000 and 2007, annual health expenditures in the U.S. grew by 6.6% per year. While between 2008 and 2011, the growth rate was only 3.3% per year. Shafrin investigates what is causing the change, and you should read what he has to say.
When it comes to health care spending, one of the first places policymakers turn (when they’re not back home or in the Hamptons for a family commitment), is the Medicare program. And one of the contributing factors is Medicare fraud, which Bob Vineyard writes about at the Insureblog. In his post, Bob points out that in South Florida, Medicare fraud is a bigger business than cocaine. Government’s always talking about reducing fraud, waste, and abuse, but they never seem to get around to doing anything about it, and his post may explain why. Still, the recent Medicare actuaries’ report presents some pretty good news–at least for some–that costs are not growing as rapidly as had been projected. As Joe Paduda, of the blog Managed Care Matters reports, while it is good news for the long-term health of Medicare, the downside is hospitals are going to be looking elsewhere to make up revenue shortfalls–and workers’ comp is a very soft target.
Speaking of workers’ comp, Julie Ferguson, of the Workers Comp Insider, provides HWR with its first Inception-like contribution. Here, within our own best-of-the-best roundup, Julie offers her own research roundup on a variety of topics including variations in costs for MRIs based on price transparency, state policies on provider market power post-ACA, disability risk factors following work-related injuries and more. It’s a roundup within a roundup, people. Don’t miss it.
In the world of pharmaceutical controversy, we have two posts. One from David Williams of the Health Business Blog, who writes about the misguided review of Zohydro ER by Consumer Reports, and another from Roy Poses, who explores the irrationality of spending hundreds of millions of dollars for drugs like Acthar, which are not proven effective, while spending almost nothing on a search for a vaccine for seriously life-threatening illnesses like Ebola. Seems like maybe there are some issues for Congress, the FDA, the NIH, and the CDC to straighten out when our lawmakers return from holiday.
Finally, what is Summer without a little vacation? Tinker Ready of Boston Health News paid a visit to the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain. Check out her post for some gorgeous pictures of one of the oldest medical institutions in Europe. You’ll be transported.
Well, that’s it for this edition. The Health Wonk Review will be back in session in September when David Williams hosts the next edition at the Health Business Blog.