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April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review Jan. 25, 2011 / 20 Shevat, 5771

The ‘HealthStat’ Seduction

By Jonah Goldberg




http://www.JewishWorldReview.com | If professional writing were the guild it often appears to be, Atul Gawande would be a scab. A surgeon and professor, Gawande also writes beautifully for the New Yorker about health care.

His latest article, "The Hot Spotters," focuses on what Gawande claims is a revolutionary approach to health care. In Camden, N.J. -- hardly a garden spot in the Garden State -- just 1 percent of the people who used the city's medical facilities accounted for 30 percent of the costs. One patient had 324 hospital admissions in five years, costing insurers $3.5 million.

Another fellow, weighing 560 pounds, with both an alcohol and cocaine problem, spent more time over a three-year period in the hospital than out of it. But thanks to work by a crusading doctor, Jeffrey Brenner, the man was pulled back from the brink, cutting his hospital visits dramatically.

Brenner's theory is that we can save billions by delivering better health care to the sickest people. Brenner was inspired by the CompStat approach used by police in New York City during the 1990s to tackle crime where it is most concentrated. Just as cops got out of their cars and walked a beat in the worst areas, under Brenner's "HealthStat" approach doctors and nurses get out and get involved in the lives of the sickest patients.

Brenner's results are impressive. All it takes is a near-religious dedication to getting involved in the nitty-gritty of patients' lives.

In a similar effort, a clinic formed by Atlantic City's casino workers union and its biggest hospital treats only the patients with the highest medical costs. The clinic often hires health "coaches" from outside the health-care profession, because too many of the professionals have become bureaucratized, trained to say "no" to almost any question.

Gawande recounts how one such coach -- a former Dunkin' Donuts cashier named Jayshree who speaks Gujarati -- helped a seriously ill Indian immigrant get well enough to use a walker instead of a wheelchair. Why did this patient listen to Jayshree after she wouldn't take similar advice about diet and exercise following her first two heart attacks?

"Because she talks like my mother."

A preliminary study found that the Atlantic City effort achieved real cost savings. But it was also lucky, statistically speaking. A single heart transplant for any one of its gravely ill patients would have wiped out all of the savings.

Still, Gawande's enthusiasm is infectious, and so is the passion of professionals like Brenner. Where Gawande falls short is in explaining how all of this justifies "ObamaCare" (apparently he hasn't gotten the memo about not using that term).

Yes, the Patient Protection and Affordable Care Act funds pilot programs like Brenner's, but it also fuels the sort of bureaucracy that even Gawande and Brenner concede strangles innovation. It makes insurance companies into even more sheltered monopolies -- health utilities, in effect -- and appeases many of the political constituencies that stand to lose money from this style of counterinsurgency medicine.

Also, we know that ObamaCare incentivizes corporations to dump their most expensive patients onto public exchanges. Which means taxpayers will pick up a much bigger tab than we were told.

Given these disappointments with the latest cures for the system, perhaps a little skepticism about the ability of "hot-spotting" to make it all work out is in order, too.

But what I find most striking about Gawande's celebration of the community policing model is how at odds it is with any notion of limited government. He is tone deaf to those who might bristle at the idea of medicalizing society.

In Camden, Brenner wants to put social workers in "hot spot" buildings so residents can be coached daily about their diet and exercise and harangued to quit smoking. He cajoled the 560-pound alcoholic drug addict to resume church attendance.

This all sounds fine, from a medical perspective. But citizens are not patients.

Brenner is a private citizen doing heroic work. But if this model were to be nationalized, you would in effect have agents of the government serving as lifestyle coaches and health "mothers." Surely you don't have to be a "tea partier" to find that creepy.

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