Giving doctors monetary rewards for choosing certain technologies has been at the center of strong debate.  Many device manufacturers are against the practice, and it turns out that a lot of Americans don't favor it either. According to a Harris Interactive survey, 67% of Americans think gainsharing should be banned. The participants were asked via telephone whether or not hospitals should be permitted to pay doctors who select less expensive treatments or if the practice should be prohibited. Slightly more than one-quarter (26%) of the people thought hospitals should be able to more forward with gainsharing, while the remaining 7% weren't sure. MD&DI received the information about the survey, which was conducted between September 15 and 19, from AdvaMed today.

The Heart Rhythm Society yesterday finalized its recommendations for reforming policies and guidances of implantable heart devices. Most notably, it suggested FDA stop using the word "recall" in public communications about problems with heart devices, on the theory that consumers believe that a "recalled" device must be removed immediately, which is rarely ever the case. Yesterday FDA issued a statement supporting much of what the society said, including the expansion of its cardiac advisory panel's duties into evaluating postmarket safety and effectiveness issues. But it did not say whether it would drop the "recall" lingo. It should, but only if terminology that appropriately identifies the gravity of the situation can be agreed upon.

The Kaiser Family Foundation released a report yesterday that some will find shocking. It found that the average cost of a family insurance plan is growing twice as fast as inflation, and has doubled since 1999. This is likely to lead to more calls to reduce healthcare costs. But David Leonhardt's column in today's New York Times puts things in a more reasonable perspective. Yes, healthcare costs used to be cheap half a century ago, but back then no one expected much from healthcare, nor for it to make much of an impact on longevity. But today's expensive healthcare, including new medical devices, does have a significant impact on longevity. Of course waste does exist in the system, and we should do our best to eliminate it. But innovation costs money. Would we trade those costs for a shorter lifespan?

Leslie Norwalk, deputy CMS administrator, will take over the top job at CMS on an acting basis, reports CQ.com (registration required). Herb Kuhn, head of the agency's Center for Medicare Management, will move into the number-two position. The moves follow the departure of Mark McClellan, announced earlier this month. Both Norwalk and Kuhn have been mentioned as potential permanent successors to McClellan. Either would be a fine choice, as the agency needs continuity as it works to implement sweeping changes introduced under McClellan's watch.