For those of you who believe in Open Source at LinuxWorld  in San Francisco on Aug 15 there is a Healthcare Day. Sometime THCB commenter and contributor Fred Trotter is on at 2pm running a panel on innovation.

Health Wonk Review is up at Tim Gee’s excellent Medical Connectivity Consulting. The next HWR is going to be here at THCB on August 10 so hurry over to Dimitriy’s The Medical Blog Network to submit…

Yup I’ll remind you in advance

Most Beneficiaries Enrolled in Medicare Rx Benefit Satisfied With Drug Plan, Nearly Two in 10 Experienced Major Problem, Study Finds

or if you prefer

Poll shows 80% of those enrolled in Medicare drug plan satisfied

So go ahead and guess which headline came from a non-profit foundation’s news service and which one was from the inhouse newsletter for the trade group for health plans, which of course run the biggest Medicare PDP (Part D plans).

So when is a series of problems not a problem? Apparently if you don’t care much about consumer problems.

34%, of seniors who have used their drug plans have experienced what they perceived as problems, including 18% who described them as "major" problems and 16% who described them as "minor" problems. The experiences cited as problems included having unexpected costs, not being able to fill a prescription at the pharmacy, not receiving an enrollment card and having to change medications because a prescription is not covered. Ninety percent of seniors who experienced minor problems and 55% who experienced major problems feel the issues were resolved satisfactorily. (my emphasis)

So by my math 9% of Part D recipients have had major unresolved problems. Most consumer companies would freak out if they had that level of unsatisfied customers.

But don’t worry, for the $600 billion over 9 years (or whatever mythical number we’re now being quoted is the cost of Part D) that the taxpayer is spending, we’re sure saving all those recipients lots of cash right? Well not quite all—in fact not even most!

Of seniors who have used their Medicare drug plans, 46% say they are saving money on prescription drug costs, while 34% say they are paying about the same as before the drug benefit and 17% say they are paying more.

Oh well, at least the people who the bill was designed to help are benefiting. On Tuesday the NY Times told us that:

The summer revival in the pharmaceutical industry continued as Merck and Schering-Plough, two major American drug makers, reported second-quarter profits yesterday that were well ahead of analysts’ expectations. Medicare Part D, which offers prescription coverage for people over 65, is fueling the profits, as drug makers benefit from new prescriptions and somewhat higher prices for medicines, Wall Street analysts say. The number of prescriptions has risen 3 percent this year, and growth accelerated in June to more than 5 percent, according to a report from Merrill Lynch. Eventually, Part D could fuel a political reaction if prices continue to rise, but analysts expect the industry’s influence in Washington will delay any changes for years.

And the taxpayer isn’t getting screwed any more than they were going to be already in Part D are they? Well there’s this little nugget too

Overall prescriptions are also increasing, according to data from Citigroup and Merrill Lynch. For the year, total prescriptions in the United States are up about 3 percent, but they accelerated in June, rising 5.4 percent over the previous June. Drug makers have also increased prices for many popular drugs and are paying rebates to the private insurers who run the Medicare Part D program that are lower than the 15 percent rebates they paid to Medicaid.

Well at least the market is working—of course Adam Smith might not notice this as being the kind of free market he was thinking about.

Now that we’ve let Pat Salber be so nice to Kaiser, Gadlfy reminds me about a couple of things.

First a lost laptop apparently filched out of Oakland HQ with a mere 160,000 patients’ details on it. They were fined $200K by Dept of Managed Care for putting 150 names on the Internet, so proportionally this one should come in around the gross national product of Belgium!

And then much more dirt about the kidney transplant disaster–including the reason that the story broke. The whistleblower went to the press and the authorities including the LA Times. It was the LA Times series on Kaiser’s kidney transplant program that made the brown stuff hit the whirling metal thing. And what’s worse is that they still have not have had the no-holds barred public enquiry that they ought to allow and that I called for when it happened—mostly (according to Chris Rauber in the SF Business Times) apparently out of fear that it’ll upset the Permanente Group.

I half expect several commenters to (again) question how Robbie Pearl’s father really died. But the point is that the EMR KP is introducing is capable of massively improving care quality. But it’s a necessary but not sufficient condition.

Meanwhile, there are also allegations that the non-profit guys (Blue Shield and Kaiser) are joining the real schlockmeister behavior of retroactively cancelling patient policies—the ones that Wellpoint’s Blue Cross unit is in hot water for doing. No examples about KP, although there is one for Blue Shield, who’s underwriting is pretty tough these days.

So as everything in health care, there are two sides to the story. It would be very nice if KP made more of an effort to be open about this–I still think a full external inquiry into the Kidney transplant fiasco would be much better for them (and for health care as a whole) than us all having to read the tea-leaves via the unfair dismisall case….but the politics of KP as a whole are very delicate and I understand why they won’t do it. I don’t agree with that policy but I understand its genesis

Pat Salber writes The Doctor Weighs In. She is a doc, an ex-med director at California blue shield, and a Kaiser Permanente member. And she loves them. This is why, and it’s quite an advertorial for Kaiser and an indictment of how everyone else does it. So if this becomes the standard, and people find out about it (and with $80m of advertising budget a year behind it, they will find out) can the rest of the US system compete?

You and I might have thought that Continua was a sensible business led approach to get medical devices and remote monitoring systems operating together. But looking at this photo of Intel’s Dave Whitlinger who runs the Continua Health Alliance over at Tim Gee’s blog, maybe more sinister forces from far below are at work?

(Yes, I’m kidding)

Health Care Policy, Innovation and Renewal is a pretty interesting new blog from a hopsital system strategy exec, who appears to have something of a social conscience—if that’s not a contradiction in terms! Doesn’t seem to be updated all that often but every post I read is thought provoking (wish that I could say that for THCB!). It’ll be interesting to see its development

Apparently the SEC is understood to be examining suspicious option trades in the run-up to the HCA leveraged buyout. Which does give me the thought, can’t Bill Frist leave well enough alone?

Change of Shift, the nurses compendium is up.

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