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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: i-node who wrote (464875)	3/19/2009 12:32:51 AM
From: Joe NYC	Read Replies (1) \| Respond to of 1573925

Medco CEO Wants Health Fed to Set Treatment Rules for Doctors By Sarah Rubenstein Dave Snow, CEO of the big pharmacy-benefits manager Medco, is making the rounds to tout his ideas on health reform, the topic of the day with Barack Obama about to take to oath of office. Snow stopped by Health Blog HQ and told us he likes an idea that HHS nominee Tom Daschle has been kicking around: a Federal Reserve for the health-care system. Snow said the time has come for doctors to follow set protocols on how to treat patients, and to be paid based on whether they do it. Basically, ‘If X, then do Y,’ and ‘If Y, then do Z,’ sort of stuff. Snow concedes the public doesn’t trust the private sector to come up with these kinds of rules. So he wants some smart folks to get together in an “apolitical” body like the Fed, and do it themselves. “I’m fine with this big, national board creating this standard,” Snow says. Doctors often bristle at the idea of these sorts of rulebooks, because they argue the rules don’t take into account the nuances and intangibles of caring for individual patients. Plus, they think insurers basically use such rules as excuses not to pay for things. “I have no patience for a doctor who says, ‘I’m above it all, I don’t want to practice cookbook medicine,’” Snow says. Too many doctors, he says, just don’t keep up with the science. For instance, Medco last March asked 1,000 doctors who prescribe the potent blood-thinner Coumadin about a genetic test that the FDA has endorsed to keep patients from getting dangerous, excessive doses. Only three of them had heard of the test, he says. Snow does offer a carrot to make this approach more attractive to docs. He says doctors shouldn’t be held accountable legally if they follow the protocol and their patients have bad outcomes. That’s what he calls tort reform. To read more about Snow’s views on health reform, click here blogs.wsj.com