The latest edition of Health Wonk Review is up, hosted by D. Brad Wright of Wright on Health. There wasnโ€™t a dominant healthcare issue in the newspapers this fortnight, so top healthcare bloggers tackled a diverse array of interesting subjects.

HWR highlights John Goodmanโ€™s discussion of the emptiness of Obamacareโ€™s promise to allow Americans to keep their health plans if they like them. But the most interesting posts from Goodmanโ€™s blog were Linda Gormanโ€™s brief entry on erroneous payouts by the Medicaid systemโ€”for example, an error rate of 77% in 2009 in Coloradoโ€”and Goodmanโ€™s must-read discussion of the concept of health insurance.

Goodman argues that people should pay out-of-pocket for care โ€œwhen patients can exercise discretion; when patients should exercise discretion; and when the amount of money is not large.โ€ He goes on to point out that Obamacare requires people to purchase insurance based on the opposite premise: where the patient can and should have discretion (such as with preventive care), all costs will be paid by the insurer; whereas in cases where the patient has not chosen his condition (e.g., getting hit by a truck), he will get stuck with high out-of-pocket costs.

Austin Frakt does his usual job of honestly assessing the challenges of health care reform from the liberal perspective. This time, he takes on Obamacareโ€™s cuts to the Medicare Advantage program. He concludes: โ€œIn the long run, thereโ€™s no getting around the fact that Advantage plans will shrink in generosity and availability. Anything else would defy a fundamental law of economics that also happens to be a fundamental law of politics: you get what you pay for.โ€ There was a case to be made for taking on the Medicare Advantage subsidies. (For the opposite view, see one of the Wall Street Journalโ€™s many editorials on the topic.) Either way, itโ€™s a shame those funds couldnโ€™t have been used for deficit reduction.

Chris Fleming of Health Affairsโ€™ blog discusses the June issue of the magazine and an accompanying panel discussion in Washington on the subject of โ€œbending the cost curve.โ€ The panelists were optimistic about the impact of electronic medical records, and of stimulating more โ€œintegrated careโ€โ€”a healthcare catchphrase for combining health insurance, doctors, and hospitals under one roof (and thereby aligning everyoneโ€™s incentives). Other panelists, like former CBO director Douglas Holtz-Eakin, were pessimistic about Obamacareโ€™s fiscal acrobatics.

Peggy Salvatore of Healthcare Talent Transformation feels โ€œoverwhelmedโ€ by the governmentโ€™s directives on the implementation of healthcare information technology. She also writes that private-practice oncologists are on the ropes: โ€œThe outlook is grim, quite frankly, for oncologists who are practicing in private medical offices. Thereโ€™s just no money in it anymore, and reimbursement doesnโ€™t cover their costs. They arenโ€™t the only specialty that is feeling the pinch, but the financial pain is particularly acute in oncology.โ€

David Williams of Health Business Blog makes some excellent points about a recent New England Journal of Medicine op-ed about comparative-effectiveness research. (Comparative-effectiveness research seeks to compare two different approaches to treating a disease, in an effort to see which approach is more cost-effective. The 2009 stimulus law included substantial funding for such research, which some conservatives see as a prelude to pharmaceutical price controls.) While the authors of the op-ed point out a number of logistical difficulties in such research, Williams correctly notes that there are additional problems, because the example they useโ€”a trial of Avastin against Lucentis in a form of blindness called age-related macular degenerationโ€”is a unique situation and not generalizable to other cost-effectiveness questions.

InsureBlog is one of the best blogs for knowledgeable discussion of the health insurance industry. There, Henry Stern investigates the demise of nHealth, a Virginia-based provider of consumer-driven health plans. He concludes that, while the company attempted to blame its failures upon the โ€œconsiderable uncertaintiesโ€ caused by Obamacare, its problems were more likely to have been caused by a more conventional business failure: under-capitalization.

Rich Elmore of Health Technology News interviews Rick Jackson, CEO of Jackson Healthcare, who conducted a Gallup survey suggesting that โ€œ$650-850 billion per yearโ€ could be saved from the healthcare system by tort reform.

Richard Fogoros, author of the intriguing Covert Rationing Blog, has a thoughtful piece on the debate about whether or not relationships between doctors and the pharmaceutical and medical-device industries are a conflict of interest.

Jason Shafrin of Healthcare Economist reviews the healthcare systems of Canada, France, Germany, Italy, Japan, Sweden, andโ€ฆRwanda as a way of garnering lessons for American health reform.

Finally, Louise Norris of Colorado Health Insurance Insider notes a recent interview of Barbara Bush (George W. Bushโ€™s daughter, not his mother) by Fox News Sunday, in which Ms. Bush says sheโ€™s โ€œgladโ€ that Obamacare passed, and that โ€œhealth care is a right.โ€