Senator Max Baucus says he hopes to have a bi-partisan health care reform bill ready by June or July. Baucus, who chairs the Senate Finance committee, briefed reporters this morning at an event arranged by the Kaiser Family Foundation. He described strong momentum…saying “the stars are aligned,” “its time to move from first steps to giant steps” and “the conversation is going great guns.” Baucus says if Congress fails the problem will cripple many families by 2016. Here’s a summary of key remarks.

Baucus says reforming the health care delivery system will drive the bill. Here he includes shifting payment to reward the quality of services delivered, not the volume. The Senator says he might propose bundling payments…or including all the costs of a specific surgery, for example in one payment. He also mentioned boosting the primary care system (although he doesn’t know how he would pay for this) and studying the effectiveness of one treatment as compared to another here. Baucus does not recommend tying the data to costs just yet…he says that’s too much for the first phase.

The Senator was asked how he’ll bring Republicans on board when the talk so far seems in opposition to sweeping health care reform. Read more…

Researchers at Brigham and Women’s Hospital have found a reason why night-shift workers often have higher rates of obesity, diabetes, and other health problems.

The research shows that when people sleep during the day and eat at night, their internal body clocks are thrown out of whack.

That can affect blood sugar levels and hormones that control appetite. And that can lead to weight gain or worse, according to Brigham and Women’s Frank Scheer.

“The exciting part of our study,” says Scheer, “is that we could explain so many of the different diseases that are observed in shift work — obesity and diabetes and also cardiovascular risk, and also an increase in blood pressure.”

Scheer says night-shift workers should be screened frequently for these problems. The findings appear online in the Proceedings of the National Academy of Sciences.

Patients looking to save money on their prescriptions are increasingly putting pills under the knife or, to be safe, a pill splitter. They are cutting pills at the suggestion of friends, their doctor or in some cases their insurance company. This latest way to game the pharmaceutical industry leaves many patients and providers asking what the system has come to.

(text of story follows)
You may have heard about older or low income patients who cut their blood pressure or cholesterol medications in half because they can’t afford a full dose. This story is about pill splitting with a different twist. A growing number of patients are asking their physicians to double their prescription dose from 20 to 40 milligrams of say Lipitor. Patients then cut each pill in half so that each half is now the prescribed strength. They get double the number of tablets for the same price

ROBERT LEBOW: People have kind of stumbled on the idea. It’s a small way of fighting back and economizing.

Robert Lebow, a primary care doctor in Southbridge, says this method works because the price of many prescriptions is the same whether you’re buying 20 or 40 or 80 milligram tablets. Read more…