Here are several smart stories on cancer screening, aggregated by Kaiser Health News that offer some new insights on the preventive tests.

One medical journal suggests that patients and doctors are split when it comes to new mammogram guidelines that recommend women get routine screens every two years starting at age 50, rather than annual tests beginning at 40. On the other hand, patients appear amenable to screening for colorectal cancer, for example, if the tests are easier for them to endure. The Associated Press reports:

“Nearly half the people who need potentially lifesaving checks for the nation’s No. 2 cancer killer — colorectal cancer — miss them. … But what if you opened your mailbox one day to find an at-home test kit, no doctor’s appointment needed? The dreaded colonoscopy may get the most attention but a cheap, old-fashioned stool test works, too.” And, when Kaiser Permanente chose to mail such test kits “to patients due for a colon check, its screening rates jumped well above the national average. Now specialists are looking to Kaiser and the Veterans Affairs health system, another program that stresses stool-tests, for clues to what might encourage more people to get screened for a cancer that can be prevented, not just treated, if only early signs of trouble are spotted in time” (Neergaard, 2/15).

Jon Kingsdale, executive director of the Mass. Health Insurance Connector Authority, tells The Washington Post that there isn’t enough “political will” in most states to carry out health care reform. Still, the paper reports, with national reform in limbo, attention is turning to the states, and debate is raging on which approaches to reform really work best. Reporter Alec MacGillis writes:

Advocates of a state-by-state approach are invoking welfare reform, which originated in the states, and education, an area in which the federal government goads states to improve but lets them choose their own approaches. Imposing national health-care reform, they argue, ignores local variations in health-care markets and politics.

“Let’s let the states come up with the solutions,” said Missouri state Senate President Charlie Shields (R). “There’s a lot of solutions out there, but the solutions vary state by state.”

Supporters of a national approach counter that relying on states would mean accepting the status quo for years to come. A state-by-state approach makes it harder to rein in health costs with systemwide reforms. And cash-strapped states are in no position to launch new initiatives. Shields acknowledges that Missouri won’t be expanding insurance coverage to more people anytime soon, saying, “Other than just doing the right thing, there’s not much incentive financially to do that right now.”

Another problem is that “successful” reform appears to be largely subjective. The Post notes, for instance, that, “Texas Gov. Rick Perry lauds his state’s health-care system, even though the state has the highest uninsured rate in the nation.”

The Boston Globe reports on a bill introduced by Gov. Deval Patrick that would give the administration sweeping authority to hold down health care costs by vetoing charges set by hospitals, doctors, insurers and other providers that are deemed excessive.

The proposal, which aims to ease the financial burden of small businesses and their workers, is laid out in a 40-page bill, according to the Globe, that seeks to give “the insurance commissioner the power to essentially cap health care price increases” to make medical care more affordable.

Rates hospitals and other health providers charge insurers would be “presumptively disapproved as excessive’’ if they increased faster than the level of medical inflation, and they could be rejected after a public hearing.

Similarly, for health insurance plans sold to employers with 50 or fewer workers, premium increases that exceed one and a half times the level of medical inflation would be considered excessive and could be turned down.

The legislation would also impose a two-year moratorium on lawmakers’ mandating any new health benefits that must be covered by insurance plans, a practice that employers have said drives up their health insurance premiums. Small businesses have been hit with double-digit rate increases in recent years.

With a growing awareness that medical patients are being exposed to increasing amounts of unnecessary radiation, the FDA announced that it will ramp up oversight of several forms of radiation including CT scans, according to a roundup of related stories from Kaiser Health News. Here are some details:

“The amount of radiation Americans are exposed to from medical imaging has dramatically increased over the past 20 years,” a senior FDA official said, according to HealthDay News/Business Week. The FDA hopes to minimize risk – including radiation-related cancers – by ensuring procedures are justified and that minimum necessary doses of radiation are delivered. HealthDay reports, “While the extent of the cancer risk is a topic of debate, most experts agree that exposure to unnecessary radiation from these devices should be reduced” (Reinberg, 2/9).

An analysis in Sunday’s Boston Globe reveals that GOP gubernatorial candidate Charlie Baker is making the most of his deep roots in the health care industry: in a 7-month period, Baker’s campaign has received more than $122,000 from contributors with direct ties to Harvard Pilgrim Health Care, where he formerly served as chief executive officer.

The Globe analysis of Baker’s health care-related campaign contributions also found:

This includes not only $43,000 in contributions from Harvard Pilgrim’s employees, directors, and affiliated companies, but also a broad array of vendors: its accountants, auditing firm, advertising agency, information technology providers, and consultants.

In total, Baker has raised at least $263,000 from employees of health-care providers, other insurers, and related businesses in the health-care sector. That’s about 10 percent of the $2.57 million he has raised overall.

The New York Times reports that President Obama will hold a televised, bi-partisan summit on health care reform at the White House Feb. 25. According to the report:

The president made the announcement in an interview on CBS during the Super Bowl pre-game show. The meeting would mark the first time in the long health care debate that leaders from both sides would be allowed to air their ideas publicly and see if they can find agreement.

Mr. Obama did not say what he was willing to give up in the negotiations or chart a specific legislative strategy for moving a bill through Congress.

“If we can go step by step through a series of these issues and arrive at some agreements, there’s no reason we can’t do this faster than it took last year,” Mr. Obama said in an interview on Sunday afternoon from the White House Library.

Indeed, over the weekend, Obama told Democrats gathered for a DNC meeting, not to simply, “regroup, lick our wounds and try to hang on” during a challenging political season, but to actually press on and find a way to pass health care reform and other programs that would create jobs, according the The Times.

A investigation by Attorney General Martha Coakley finds that doctors and hospitals with the highest clout in the marketplace are paid more by insurers — in some cases twice as much — than their lesser-known counterparts without necessarily providing better care, according to a story in yesterday’s Boston Globe.

Reporters Liz Kowalczyk and Scott Allen write:

The yearlong investigation, set to be released today, found no evidence that the higher pay was a reward for better quality work or for treating sicker patients. In fact, eight of the 10 best-paid hospitals in one insurer’s network were community hospitals, which tend to have less complicated cases than teaching hospitals and do not bear the extra cost of training future physicians.

Coakley’s staff found that payments were most closely tied to market leverage, with the largest hospitals and physician groups, those with brand-name recognition, and those that are geographically isolated able to demand the most money.

In an interview with the Globe, Coakely raises concerns about switching from a “fee-for-service” model to one of “global payments” in order to control costs — a move endorsed by a key state commission last year. The paper says, “Coakley’s investigators found that Massachusetts health care costs, which are growing by 7.5 percent annually, are mostly the result of rising prices, not patients getting more imaging tests, surgery, and other procedures,” which is one of the main justifications for payment reform.

On one point, at least, it’s hard to disagree: President Obama knows how to give a good speech. His State of The Union address last night was punchy, eloquent and touched on the major issues confronting the administration — and the nation — in the coming years. Obama spoke of jobs (good), the bank bailout (bad, but necessary), the war (ending, but not before a ramp-up), and gays in the military (do ask, do tell — soon.)

He also spoke about health care reform, as an economic and moral necessity, and as a problem lawmakers must take on. He urged members of Congress to do something to improve the current system, and not simply “run for the hills,” just because reforming the health industry is messy, complicated and politically more difficult largely due to the election of a Republican senator from Massachusetts.

Kaiser Health News aggregates reaction, and offers an illuminating comparison between Obama’s State of the Union speech and his remarks on health care reform delivered to a joint session of Congress last year.

Ahead of tonight’s State of the Union address NPR has a new poll that brings bad news to Democrats (like they needed more). Mara Liasson reports:

The poll holds plenty of danger signs for the Democrats. In one indicator studied closely by both parties ahead of midterm elections, likely voters chose an unnamed Republican candidate by 5 percentage points over the Democrat on a hypothetical congressional ballot.

And on health care reform, Liasson says, President Obama is particularly vulnerable. Those polled are annoyed on two fronts, she notes: “The survey suggests Democrats are being punished as much for not getting health care done as they are for what’s actually in the bill.”

Still, the notion that after coming so close to passing a health industry overhaul, Democrats are ready to give up, is particularly troubling to many of the president’s constituents, including the New York Times editorial page.

Do you think there’s still hope for national health care reform?

A sense of gallows humor pervaded a national conference on health care reform that is currently underway in Boston.

Dr. Stuart Altman, an economist and professor of national health policy at Brandeis, said after he had a few drinks Tuesday night (Jack Daniels), he quickly switched the topic of his conference talk. The original title, he said, was “After Health Reform, What Next?” But following the results of the special election here this week, and the probable demise of sweeping national reform, Altman changed the talk to “Is It Possible For The U.S. To Control Health Care Costs.” His answer: A resounding “Maybe.” “The pressure,” Altman said, “is really on.”

There were, however, signs of hope. Dr. Don Berwick, president and CEO of the Cambridge-based Institute for Healthcare Improvement, is currently working with Atul Gawande (the surgeon, New Yorker writer and health quality activist) and others to identify regions of the U.S. that actually deliver quality medical care at costs lower than the rest of the nation.

Richard Moore, the state senate chair of the joint committee on health care financing, said Massachusetts is slowly taking steps toward payment reform which should ultimately control the rising cost of health care.

But, as my WBUR colleague Sacha Pfeiffer reports, truly controlling those costs will take years, according to Harriett Stanley, the house chair of the health care financing committee.