1) NEJM: “Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs.”

My take: A must-read for Hillary and Obama every politician, who pin their cost-cutting hopes on preventive medicine. It isn’t going to work. Cost cutting means keeping people out of the emergency room and denying tests that are not evidence-based. A more effective approach would come from funding a strong primary care foundation and instituting a national comparative effectiveness program.

2) Rhode Island comes up with a refreshing approach to health reform: address costs first, then access.

My take: They get it right. Massachusetts misguidedly promised access before drowning in costs. Rhode Island is taking the far more sensible approach:

The strategies include emphasizing primary care over emergency care, managing treatment of people with chronic diseases, and paying doctors to keep patients healthier. The proposal would also establish a massive database of healthcare treatments, outcomes, and costs designed to point the way to better care at lower costs.

If costs are addressed, access will follow. Bravo.

3) One out of three infants born in Massachusetts in 2006 were delivered by Caesarean section, the highest proportion ever.

My take: Blame John Edwards the multi-million dollar cerebral palsy cases trumpeted prominently by the media. Obstetricians read the same newspaper and TV stories that we do. In difficult births, life-altering decisions need to be made in seconds. Don’t tell me that the latest cerebral palsy verdicts aren’t a factor in an OB’s decision to go with a C-section. After all, it’s just your career on the line.