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Month: October 2008

Judging States By the Health of Their Children

The Robert Wood Johnson Foundation’s Commission to Build a Healthier America has just released a report that reveals the degree to which a child’s health is determined by the hand he draws when he is born.

The report, which is titled “America’s Health Starts With Healthy Children: How Do States Compare?” confirms what we have written in other Health Beat posts.

While having or not having health insurance is important, poverty will have an even greater influence on an individual’s health. As Commission Co-Chair and former Congressional Budget Office director Alice M. Rivlin puts it, “This report shows us just how much a child’s health is shaped by the environment in which he or she lives.”

Moreover, the report reveals that it is not only the poor who are molded by their environment. “In nearly every state, children in middle-income families also experience shortfalls in health when compared with those in higher income families. And these differences in children’s health by income can be seen across racial or ethnic groups”  says the report, which is based on  research  done at the University of California at San Francisco’s Center on Social Disparities in Health. Ultimately, this study highlights “the unrealized health potential possible if all children had the same opportunities for health as those in the best-off families.”Continue reading…

We knew the Swedes hated the Bush Adminstration, but…

…we never suspected that they hated it to this extent.

After giving Al Gore the Peace Prize a couple of years back, today Paul Krugman wins the Nobel Prize for Economics.

They say the prize is for his work on international trade, but it must be partially for his columns in the New York Times since 1999 skewering the Bush Adminsitration on economics, war, healthcare, and just about everything! Congrats, Paul.

Let’s get real about the economy and health care

I just got a call from a reporter at one of the major news organizations to talk about the chances for health care reform.

We both commented on the almost surreal environment we are all in. I’m not sure if my friends and neighbors are in denial or just numbed by the recent cascade of events in the financial world. Up on the Hill and in the presidential campaigns it’s business as usual when it comes to extending the Bush tax cuts, spending on alternative energy, or the imperative to do health care reform.

The reality is we are now headed down an unavoidable slope into a recession. The only question is how bad. Today, Dr. Phil told his audience to stop spending money, get their credit card debt paid off, and hold cash–"Cash is king." They are and they will.

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Dissecting the Revolution Health-Waterfront Media merger

Like many of you, I was surprised to hear the news that Revolution Health would merge with Waterfront Media, the operator of Everyday Health Network. In this email interview, Mark Bard, president of Manhattan Research, shares his thoughts on the deal and its implications.

David Williams: When Steve Case launched the Revolution Health website last year he said, “While Revolution Health will be a journey over many years to come, we are excited today to launch a site that is the cornerstone of our efforts to revolutionize healthcare.” Now it seems like he’s throwing in the towel on the online business and keeping the rest of the company separate. What’s going on?

Mark Bard: This recent move by Revolution Health highlights the challenges in building a health site and achieving critical mass that appeals to both consumers using the site and advertisers investing in the channel. Like a number of industries today, there is the potential for significant value creation at the two ends of the size scale. You can be on top as one of the largest sites with scale or you can become a highly targeted site with a unique and engaged audience.

This move allows Revolution Health to achieve critical mass and deliver a combined network with the Waterfront team. The harsh reality is that building out a health site today takes more than just funding. It requires the ability to meet the needs of two customer segments – the consumer and the advertiser.


David E. Williams
is co-founder of MedPharma
Partners LLC
, strategy consultant in technology enabled health care services, pharma,  biotech, and medical
devices. Formerly with BCG and LEK.

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W(h)ither thy health benefits?

The headlines read that CFOs are having trouble accessing credit.

What will that mean for health benefits?

A survey of American CFOs and comptrollers from Grant Thornton has found that over half of CFOs have seen credit costs increase. 2/3 find credit harder to come-by than in 2007.

One in two CFOs think the U.S. economy will remain the same over the next 6 months.

The No. 1 pricing pressure concern is employee benefits — 55% are most concerned about benefits, including health and pensions.

In the short term — six months out — 23% of employers expect their headcount to decrease.

Jane’s Hot Points: Getting credit flowing is Job 1 for the Treasury Secretary (separate from stock market woes). Even with the possible infusion of cash into the U.S. market (with similar moves by European and G7 banks under consideration), the credit crisis won’t be reversed immediately. CFOs anticipate the pricing pressures plaguing their daily businesses will persist for at least six months.

As health benefit designs return to their drawing boards, we can expect two impacts: (1) some employers forced to drop the health benefit; and (2), further erosion of the benefit, in the form of insureds bearing more costs.

That is, if the employee happens to land in the 77% who will be lucky enough to keep his

Moving forward on genetic testing

Scott_shreeveThree months ago,
there was a huge hubbub about genetic testing in California. In a
dramatic effort, albeit totally misguided, the California Department of
Health sent “cease and desist
letters to multiple vendors who were offering genetic testing services
directly to the consumers. They were concerned by the cost, the
accuracy, the ability for medical professionals to interpret the
results, and the potential for harm to the consumers. However, with
many technology advances that outpace the regulatory apparatus, this
one was well ahead of its time and when the dusts settles, this type of
testing will become a normal part of your health portfolio.

Need proof?

This week Microsoft, Scripps Health (based in San Diego), Affymetrix and Navigenics
announced they are launching a research study to evaluate the impact of
personal genetic testing. The study will offer genetic scans to up to
10,000 employees, family and friends of Scripps Health system and will
measure changes in participants’ behaviors over a 20-year period.
Participants will be able to save a copy of their genetic information
and analysis in HealthVault, enabling them to retain it for future use
as they continue to manage their health and wellness, whether it is for
preventative or treatment purposes.

From Cease and Desist, to a public announcement from all California
based companies on a landmark longitudinal study with 10,000 people
validating the use of personal genetic information in just over three
months?

Stylin’ and profilin’ Cali Style.

Using clinical decision support to get the right diagnosis the first time

Joseph Britto is co-CEO of Isabel Healthcare, a clinical software vendor that helps clinicians with diagnosis. He practiced medicine in the UK before joining with co-CEO Joseph Maude to start Isabel, named after Joseph’s daughter who was wrongly diagnosed with Chicken Pox and nearly died as a result. Joseph has a personal connection as he was the physician in charge of Isabel’s recovery.

Remember President Bush’s goal, first stated in the 2004 State of the Union message, of giving “every American” his own EMR by 2014?

That goal seems as elusive as ever, especially in light of a recently released study by the The Center for Studying Health System Change which found a discouragingly low rate of EMR adoption among physicians. The new study, released last month, reported that only 29 percent of the hospitals surveyed were actively supporting physician acquisition of EMRs through financial or technical support. This number was disappointing in light of the current government initiative that has relaxed federal rules on physician self-referral and made available hundreds of millions of dollars in various subsidies for EMR adoption by physicians.

Many health policy experts believed that “if you subsidize it, they will come.” While that approach has worked in persuading people to take mass transit, it hasn’t lured many physicians into using EMRs.

Why the reluctance? One reason is cost. On September 25, 2008, the Certification Commission for Healthcare Information Technology (CCHIT) issued a report that reviewed 90 EMR incentive programs (state, federal, private) with a total funding of $700 million available.

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Subliminal health education

You’ve heard of subliminal advertising, but what about subliminal educating for health?

But who’s tried selling health to us where we live, work, and play? What about using ‘mainstream’ TV shows as a public health education tool?

Kaiser Family Foundation’s seeding of Grey’s Anatomy produced some surprising results.

Kaiser worked with the show’s Director of Medical Research to pick health topics based on 3 criteria:

  1. Appropriate for the show
  2. Not well understood by the American public
  3. Topic where learning could be "measured in a straightforward way" in a survey

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Tracking media coverage of health care

You probably haven’t seen a lot of campaign coverage from the health beat these last few week, unless The Health Care Blog is your exclusive source.

The "Financial Crisis," and its predecessor, the troubled "Economy," have obscured the issue that many voters said should be near the top of the agenda back when Hillary Clinton and Mitt Romney were serious contenders and the stock market was inching onward. Look back to the October 2007 Kaiser tracking poll for a recap.Analytics_3

A new tool from LexisNexis Analytics
puts health care media coverage in perspective; based on the charts, media attention hasn’t reflected the public’s call for reform – still the number 3 issue according to over-all voters. The Kaiser polls show 26 percent of independents marking health care as a top issue, up from only 13 percent in August

The Lexis analysis also suggests media scrutiny has focused on McCain’s campaign, which has been the brunt of Obama ads attacking the efficacy of the tax credit strategy. Health care was particularly unpopular with Republican’s last month, reaching "a new low" of 11 percent, Kaiser noted.

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Health care stocks falling, too

Health care stocks are proving that they’re not recession proof as I and others predicted back in April.

Look at these charts
for 10 prominent health care stocks. Every one of them has declined so
much in recent weeks that in terms of relative strength, compared with
the market, they’re oversold. All are down significantly from their
52-week highs and several are making new lows.

Schering Plough (SGP), Novartis (NVS) and Quest Diagnostics (DGX) are still trading slightly above their April lows.

Chart_2

Mylan Labs (MYL), Wellpoint (WLP), Humana (HUM), United Health Group
(UNH), Aetna (AET), Universal Health (UHS) and LifePoint (LPNT) are all
trading below their April lows, if not at their lows for the year. (FD: I own none of these stocks.)

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