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Feb. 8, 2013

Rabbi Berel Wein: Lofty ideals must be followed with grounded applications

Clifford D. May: Letter from the West Bank
Steve Rothaus: Judge OKs plan for gay man, lesbian couple to be on girl's birth certificate
Gloria Goodale: States consider drone bans: Overreaction or crucial for privacy rights?
Environmental Nutrition Editors: Don't buy the aloe vera juice hype
Michael Craig Miller, M.D.: Harvard Experts: Regular exercise pumps up memory, too
Erik Lacitis: Vanity plates: Some take too much license
The Kosher Gourmet by Susie Middleton: Broccoflower, Carrot and Leek Ragout with Thyme, Orange and Tapenade is a delightful and satisfying melange of veggies, herbs and aromatics
Feb. 6, 2013

Nara Schoenberg: The other in-law problem

Frank J. Gaffney Jr. : A see-no-jihadist for the CIA
Kristen Chick: Ahmadinejad visits Cairo: How sect tempers Islamist ties between Egypt, Iran
Roger Simon: Ed Koch's lucky corner
Heron Marquez Estrada: Robot-building sports on a roll
Patrick G. Dean, M.D.: Mayo Clinic Medical Edge: How to restore body's ability to secrete insulin
Sharon Palmer, R.D.: 3 prostate-protecting diet tips
The Kosher Gourmet by Emma Christensen 7 principles for to help you make the best soup ever in a slow cooker
Feb. 4, 2013

Jonathan Tobin: Can Jewish Groups Speak Out on Hagel?

David Wren: Findings of government study, released 3 days before Newtown shooting, at odds with gun-control crusaders
Kristen Chick: Tahrir becomes terrifying, tainted
Curtis Tate and Greg Gordon: US keeps building new highways while letting old ones crumble
David G. Savage: Supreme Court to hear case on arrests, DNA
Harvard Health Letters: Neck and shoulder pain? Know what it means and what to do
Andrea N. Giancoli, M.P.H., R.D.: Eat your way to preventing age-related muscle loss
The Kosher Gourmet by Diane Rossen Worthington Baked Pears in Red Wine and Port Wine Glaze: A festive winter dessert
Feb. 1, 2013

Rabbi Dr. Tzvi Hersh Weinreb: Redemption

Clifford D. May Home, bloody, home
Christa Case Bryant andNicholas Blanford Why despite Syria's allies warning of retaliation for Israeli airstrikes, the threats are likely hollow
Rick Armon, Ed Meyer and Phil Trexler Ex-police captain cleared by DNA test is freed after nearly 15 years
Harvard Health Letters: Could it by your thyroid?
Sharon Palmer, R.D.: When 'healthy food' isn't
Sue Zeidler: Coke ad racist? Arab-American groups want to yank Super Bowl ad (INCLUDES VIDEO)
The Kosher Gourmet by Nealey Dozier The secret of this soup is the garnish
January 30, 2013

Allan Chernoff: Celebrating 'Back from the Dead Day'

America isn't a religious country? Don't tell Superbowl fans!
Mark Clayton Cybercrime takedown!
Germany remembers Hitler rise to power
Israel salutes U. N. --- with the one finger salute
Sharon Palmer, R.D.: Get cookin' with heart-healthy fats
Ballot riles Guinness World Records
The Kosher Gourmet by Elizabeth Passarella Potato, Squash and Goat Cheese Gratin
January 28, 2013

Nancy Youssef: And Democracy for all? Two years on, Egypt remains in state of chaos

Fred Weir: Putin: West is fomenting jihadi 'blowback'
Meredith Cohn: Implantable pain disk may help those with cancer
Michael Craig Miller, M.D. : Ask the Harvard Experts: Are there drugs to help control binge eating?
David Ovalle Use of controversial 'brain mapping' technology stymied
Jane Stancill: Professor's logic class has 180,000 friends
David Clark Scott Lego Racism?
The Kosher Gourmet by Mario Batali The celebrated chef introduces us to PANZEROTTI PUGLIESI, cheese-stuffed pastry from Italy's south


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

The ‘HealthStat’ Seduction

By Jonah Goldberg


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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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