A few Washington-related items that came across my radar screen in recent reading:

• Presidential candidate Jon Huntsman says he never considered running for president while in his service as U.S. ambassador to China. I’ll give him the benefit of the doubt on that. But Huntsman notes that he never intended to stay in the previous role for more than two years — and admits that he failed to tell that to President Obama. Oops!
• While many are criticizing the federal health care reform effort for what it tries to do, a former administration official is blasting it for its failure to address a related subject. Former OMB Director Peter Orszag says that as long as doctors follow evidence-based protocols, they should be exempted from medical malpractice suits. "His quote: "Unfortunately, in the health act, this was one of the largest missed opportunities." Anything to help curb the lawsuit mania that grips our country would be a good thing. Can we start over on that reform thing?
• News flash! The U.S. Postal Service is a broken system — and Congress wants to fix it. Ending Saturday delivery and closing more branches are part of the plan, as well as renegotiating collective bargaining agreements. I don’t know the answer, but something must be done sooner rather than later to fix an uncompetitive, costly government-run program.

I’m fortunate to sit on our Wellness Committee here at the Chamber. We develop ways to encourage staff to eat better, exercise more, and take advantage of the state’s wonderful parks. Additionally, the Chamber now houses the Wellness Council of Indiana, which is doing great things under the leadership of Chuck Gillespie. But some businesses out there may be hesitant to invest time and resources into staff wellness. This article from Media Health Leaders may help you see the benefits:

If employers entice and incentivize employees to take better care of themselves, by losing weight, quitting smoking, exercising, etc., then the healthier life style will result in lower medical costs, which will be reflected in lower health insurance premiums, and other costs associated with employer-based health plans.

It’s a remarkably simple theory. Until recently, however, it’s been just that: theory. It’s been difficult to consistently demonstrate savings generated by wellness programs. As the wellness movement matures, however, more studies prove they are a worthy return on investment.

Highmark Inc., the Pittsburgh-based health insurers, have published the findings of a four-year study which found that healthcare costs rose at a 15% slower rate among wellness participants who were offered a consistent and comprehensive wellness program over several years, when compared with employees in a control group who did not participate in wellness programs.

The study of select Highmark employer group wellness programs showed that the savings per participant was $332 a year, when compared with the control group of nonparticipants. Actually, the savings could be considerably higher, says Jennifer Grana, a director at Highmark, because the study does not factor in the cost of lost productivity and absenteeism due to health issues.

The U.S. Chamber recently released findings from a small business survey. A few interesting findings:

• 55% of respondents cited economic uncertainty as their greatest hiring obstacle.
• 35% said Washington uncertainty impacted growth.
• 35% cited too little revenue as their greatest obstacle. 
• Two of the top issues of concern are America’s debt and the health care law. Eighty percent of respondents said America’s debt and deficit have a negative impact on their business, and 72% said the health care law has made hiring more difficult.
• By a 73% to 17% margin, respondents said that the business climate of the last two years has hindered their growth. Respondents were split in how they view the next two years, with 38% believing the climate will improve, 37% believing that it will worsen and the remainder uncertain.

According to a CareerCast.com report, choose a career related to health care rather than the media if you want to reduce stress on the job. Remember, that’s their findings, not mine. Not sure how much to put into the analysis, but here are the rankings:

The criteria used by CareerCast.com researchers include 11 different factors that invoke stress. Each factor was assigned a range of points, and a high score was given if it was a major part of the job, while fewer points were given if it wasn’t normally required.

The most stressful job was found to be commerical airline pilot, but four of the top 10 were media related.

CareerCast.com’s Highest Stress Professions:

Commercial Airline Pilot
Public Relations Executive
Corporate Executive, Senior
Photojournalist
Newscaster
Advertising Account Executive
Architect
Stockbroker
Emergency Medical Technician
Real Estate Agent
 

Audiologist, a practitioner who assesses and treats hearing disorders, is ranked as the nation’s least stressful profession, according to the new report. More than half of the 10 least stressful professions are in the health care field.

CareerCast.com’s Lowest Stress Professions:

Audiologist
Dietitian
Software Engineer
Computer Programmer
Dental Hygienist
Speech Pathologist
Philosopher
Mathematician
Occupational Therapist
Chiropractor
 

Looks like the business community received some good news Tuesday. The 1099 tax form that would have drowned businesses in even more paperwork was rejected by the Senate. CNN has the story:

The Senate voted Tuesday to repeal a part of the health care reform law that would require businesses to file a 1099 tax form with the government for every purchase they make over $600.

The requirement was designed to fight tax fraud and raise money for the health care reform plan Democrats passed last year. But it quickly became unpopular with both parties when businesses complained it would be too burdensome.

The Senate voted 87-12 for the repeal. The House already approved the bill, so it will go directly to the president, who has not said definitively if he will sign the legislation.

The Obama administration and some congressional Democrats, while favoring the repeal, had opposed the way the Republican-sponsored bill made up for the approximately $22 billion the Congressional Budget Offices says would be lost over the next 10 years to pay for health care reform.

However, multiple sources from both parties said they expect the president to sign the repeal.

An aide to Sen. Mike Johanns, R-Nebraksa, said the senator’s effort to repeal the IRS reporting requirement always was aimed at easing the workload on businesses, not at taking a partisan whack at the controversial health care law.

However, other Republicans said they hope this is the first vote of many that pares back the health care law.

"This is a big win for small businesses," Senate Republican Leader Mitch McConnell said before the vote Tuesday. "Importantly, it’s also the first of what I hope are many successful repeal votes related to the disastrous health spending bill Democrats passed last year."

White House Press Secretary Jay Carney, responding to passage of the legislation, said the administration is "open to working with Republicans and Democrats to improve the health reform law."

"We are pleased Congress has acted to correct a flaw that placed an unnecessary bookkeeping burden on small businesses," Carney said in a written statement. "And the administration remains eager to work with anyone with ideas about how we can make health care better or more affordable for all Americans."

No one is doubting the potential of health information technology, including electronic medical records, to enhance patient care. Progress, however, is needed in many areas, according to a senior researcher with the Center for Studying Health System Change. The New England Journal of Medicine reports:

Health information technology (HIT) holds promise for facilitating vast improvements in care and, ultimately, in the health of Americans,1,2 but achieving that potential remains a daunting task. A recent article in the Los Angeles Times described the new phenomenon of hiring computer-savvy undergraduate “scribes” to take notes for physicians during patient encounters and enter the information into electronic health records (EHRs) — a practice that suggests how far we must go to develop EHRs that clinicians will embrace. Of course, the most highly trained professional in the room need not be the one to enter data into the computer, especially during an emergency, but the perceived need for scribes and providers’ experiences using EHRs3 raise important questions about both the efficiency of care processes and the usability of current EHRs.

Although EHRs laudably provide immediate access to patient data and electronic messaging functions, clinicians have been frustrated by the difficulty of using them to support care delivery and coordination.3 Transforming EHRs into effective clinical tools rather than a means of capturing information primarily for documentation and billing purposes will require progress on multiple fronts.

Clinical processes must evolve so as to improve care and be more responsive to patients’ needs, and HIT’s capabilities must evolve along with them. HIT has particular potential in such areas as coordination of care, workflow efficiency and use of teams, clinical decision support, and population health management — all areas offering glimpses of both the potential and the challenges associated with improved HIT use.

Few providers today, for example, can truly coordinate care — integrating care, in consultation with patients and their relatives and caregivers, across all of a patient’s conditions, needs, clinicians, and health care settings.2-4 Outpatient practices and inpatient facilities lack well-developed processes for exchanging information, both within their own walls and during care transitions. Poor care coordination negatively affects patients — particularly those with multiple chronic conditions who account for an overwhelming proportion of U.S. health care expenditures.

The Florida judge who declared the federal health care reform law unconstitutional "updated" his own ruling yesterday and urged that "the sooner this issue is decided by the Supreme Court, the better off the entire nation will be."

On January 31, 2011, U.S. District Judge Roger Vinson (Pensacola, Florida) determined that the “individual mandate” provision of the Patient Protection and Affordable Care Act (PPACA) is unconstitutional and declared the remainder of the Act void because it was not severable.  The defendants (the Obama administration) filed a motion to clarify with the court, suggesting that there would be adverse consequences from an immediate halt of implementing the Act given that many provisions are now in effect and that several other district court judges have upheld the law.

Yesterday, the judge stated that while his original order “was as clear and unambiguous as it could be, it is possible that the defendants may have perhaps been confused or misunderstood its import.”  He did however, treat the clarification as a stay from his original order and as such granted it.  He conditioned the stay upon the defendants filing their anticipated appeal within seven days of his order, either in the Court of Appeals or with the Supreme Court. He chastised the administration that it had been more than a month since his order and the defendants had not filed their notice of appeal.

Twenty six states, including Indiana, are party to the lawsuit. On Wednesday at the Indiana Statehouse, a joint meeting took place with the House and Senate Insurance and Health Committees. Attorney General Greg Zoeller commented on PPACA and offered his view that in those states that were party to the suit the Act was unenforceable. Those comments do not apply a day later as Judge Vinson’s stay to his original order was granted.