Apologies to faithful THCB readers. The crunch continues (yesterday was the first day I’ve skipped in quite a while) and I can’t spend much time today writing up the blog, but there are lots of interesting pieces for me to point you towards. So please go take a look at these.
- There is a great interview from Bob Galvin at GE with Don Berwick, the doyen of healthcare quality improvement in Health Affairs. You owe it to yourself to take the 10 minutes to read the whole thing, but as the abstract says "Donald Berwick, founder of the Institute for Healthcare Improvement, supports performance incentives for hospitals and health systems. But expresses skepticism about the value of pay-for-performance schemes for individual doctors and nurses and emphatically condemns increased patient cost sharing as an appropriate tool for increasing the efficiency of the health care system." Berwick thinks that money isn’t enough and that a national move to transparency and individual accountability will inspire the correct response from ego-driven providers. Fascinating stuff, most of which rings true for me.
- On the pharma side, the NY Times reports that 10 big pharmas are joining the Together Rx Program and are adding their prescription drugs at low cost to the generics already in the program. Methinks all that criticism is working. Meanwhile Forbes has an excellent pair of articles–one on reforming the FDA, particularly pointing out its underfunding in the wake of the explosion of new pharma products out there, and one an interview with Marcia Angell in which she predicts that big pharma will become simply marketing machines (which is what some of us think they already are!).
- The token moderate Democrat on the NY Times Op-Ed page, Nicholas Kristoff, decries the state of health care for the poor noting that we are now below Cuba in terms of infant mortality. There are some counter arguments to this (in terms of our efforts to keep low weight babies alive that don’t get counted as full term deliveries elsewhere), but overall it is a condemnation of the outreach the care system does for poor mothers. Kristoff’s article Health Care? Ask Cuba notes that "In every year since 1958, America’s infant mortality rate improved, or at least held steady. But in 2002, it got worse: 7 babies died for each thousand live births, while that rate was 6.8 deaths the year before." It’s not pleasant reading.
- Finally, the latest spending numbers are out — and getting reported more quickly these days. It used to be that you had to wait for a couple of years but CMS released the new numbers for 2003 yesterday, only 12 months after the year ended. And although overall growth moderated a little to 7%, it’s still in the zone of where it’s been for several years now. Here’s the full CMS article in Health Affairs and here’s the Boston Herald‘s take on it. In days of yore I got pretty buried in those numbers as part of a 10 Year Forecast I co-authored back in the late 1990s. The way they are put together is interesting, and what they say is also interesting, so I’ll add a deeper explanation to my to-write list.
For now happy reading and I’ll see you tomorrow.