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Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries
"Blog Watch" offers readers a roundup of health policy-related blog posts.Bloggers are tentatively reacting to a report and blog post released by the Congressional Budget Office that summarizes the agency"s approach to estimating the cost of any health overhaul bills. At issue is how CBO will count different stipulations of legislation -- like an individual mandate or a public plan -- and whether their conclusions will result in a heftier price tag. Douglas Elmendorf explained on the Director"s Blog: "In CBO"s view, the key consideration is whether a proposal would be making health insurance an essentially governmental program, tightly controlled by the federal government with little choice available to those who offer and buy health insurance -- or whether the system would provide significant flexibility in terms of the types, prices, and number of private-sector sellers of insurance available to people. The former -- a governmental program -- belongs in the federal budget (including all premiums paid by individuals and firms to private insurers), but the latter -- a largely private-sector system -- does not." Janet Adamy of the Wall Street Journal"s Washington Wire notes that the report doesn"t address the cost estimates of the scenarios. Alan Katz on his Health Care Reform Blog concludes, "the message is clear: the looser government"s hand grips the new health care system the smaller its budgetary impact." Liberal bloggers had a variety of reactions -- some found the report too vague, while others saw it as good news. The New Republic"s Jonathan Cohn says, "you may need a Talmudic scholar to figure out what those implications are." Cohn continues, "Other passages in the briefing are [similarly] vexing and, for what it"s worth, the reactions I"ve gotten from insiders familiar with the report have ranged from sighs of relief to statements not suitable for a family blog." Ezra Klein agrees the report lacks specificity, but says, "Even so, I"m cheered by the simple existence of this ruling. The fact that CBO is explaining its thinking before legislation arrives [is] yet more evidence that CBO appears, insofar as it can, to be trying to help out on health reform. ... That"s an important change from past years." Interesting Elsewhere:

In Synaptic Process Protein 'Tweek' Rare But Critical
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America"s chain restaurants are making Americans fatter and sicker say consumer watchdog Center for Science in the Public Interest (CSPI) who
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Simulating The Pandemic Disease Airport Screening System

Four major US national laboratories have worked together to develop a computer model to help airport authorities screen passengers for pandemic influenza. The tool can help estimate false negatives, people with influenza who slip through the screening process, and so assess the risk of infected passengers unknowingly spreading disease across the nation. Robert Brigantic, and colleagues at the Pacific Northwest National Laboratory, in Richland, Washington, and teams at Oak Ridge National Laboratory, Tennessee, Lawrence Berkeley National Laboratory, California, and Los Alamos National Laboratory, New Mexico, report details of their simulations in the current issue of the International Journal of Risk Assessment and Management. When there is a confirmed human outbreak of a pandemic influenza virus overseas, the US National Strategy for Pandemic Influenza calls for screening of passengers scheduled to fly into the US at international airports, en route screening and arrival screening at US ports-of-entry. However, the efficacy of screening procedures is not known and so Brigantic and colleagues have built a computer model, a simulation of US airport entry screening that combines epidemiology with knowledge about evolving disease states and conditions of passengers over time. They have tested their simulation under different pandemic scenarios and carried out an analysis of the impact of alternative mitigative, diagnostic and quarantine measures that can be used. Their results could help decision makers plan for the res needed at the port-of-entry airports, anticipate possible developments during a pandemic, and devise appropriate courses of action to prevent the spread of disease through the US. "The simulation work is easily adaptable to model other types of outbreaks, to include non-influenza virus type outbreaks or disease spread," says Brigantic. The researchers conclude that there are several key factors that could reduce the risk of a pandemic influenza spreading widely in the US. First, if possible passengers should be screened before they board a plane bound for the US. Second, passengers presenting symptoms on arrival should be tested for the pandemic influenza virus and potential quarantine. The authorities should be aware that passengers may infect each other before and during their flight and that any screening program is likely to increase delays and queues. Finally, the team suggests that advances are now needed in diagnostics for infection to automate and speed up confirmation. Robert Brigantic Inderscience Publishers


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