The status quo of American health care is unacceptable. What makes it a political nightmare to fix is that what one side really wants is a single payor government system like Medicare and what the other side really wants is to minimize government involvement and let a free market bring about changes naturally. How's that working for us so far?

Pragmatists, including most presidential candidates, occupy the middle ground seeking workable solutions at the risk of loosing their political constituancies. Such is the case in California, where Repubilcan Governor Arnold Schwartzenegger made a deal with Democratic Assembly Speaker Fabian Nuñez to compromise on a health care bill similar to the recently enacted Massachusettes plan. The California bill has passed the House and will face a Senate vote in January 2008. Both men are risking a lot of their political capital to make this happen. We could use more politicians like them.

On the plus side, insurers would no longer be able to reject applicants for pre-existing health conditions. Health insurance in California would be mandatory in 2010 and low income residents would be subsidized. Coverage will be extended to 4 million previously uninsured California residents.

California would get up to $4 billion in federal funds that the state has not previously been able to get its hands on, but there are some significant funding hurdles to overcome. In an effort to end-run a two thirds vote for the establishment of any new taxes, the bill's backers plan to introduce an initiative on the November 2008 ballot asking voters to authorize funding.

The nation is watching to see if California can pull this off. I sure hope we do.

While virtually all doctors (96%) agree that they should report incompetent colleagues, only 45% of them have ever done so. This according to a recently published study by Dr David Blumenthal from the Massachusetts General Hospital, Institute for Health Policy. Results were based on responses from 1,662 family practice, internal medicine, pediatrics, surgery, anesthesiology, and cardiology physicians between November 2003 and June 2004.

Another telling bit of information was that about one third of respondents said they would order unneeded MRI for back pain if a patient asked for it. See recent blog on the cost of unnecessary tests

Walgreens is no longer going to fill prescriptions for these four CVS Caremark plans: ArcelorMittal, Johnson Controls, Progressive Casualty Insurance, and the Wisconsin Education Association Trust managed plans. These plans are available in Ohio, Wisconsin, Illinois, Indiana, and Michigan.

Wallgreens says they can't make money on these four plans, saying "The reimbursement rates are unreasonably low and below-market". Wallgreens is trying to preserve profits while CVS Caremark is trying to lower the cost of health care for its members. In this case, it looks like CVS Caremark stonewalled too long.