Month: December 2009

2009 Homeless Gift Guide

Dec 23, 2009• 4

By DOC GURLEY

Gurley This time of year, no matter what your worldview, religion or culture, it’s hard, as you hurry past the homeless huddled on the street, to not feel like Scrooge. Whether you’re taking your family to the Nutcracker, or pounding the pavement for a job yourself, walking past so many shivering mounds of human misery takes a toll on the psyche. Maybe your kids are tugging on your arm, asking why can’t something be done? Maybe you (like so many of us) just don’t feel comfortable handing out bits, or even wads, of cash. So what can YOU do to make a small difference? Here, folks, is the 3rd Annual Doc Gurley Homeless Gift Guide, with tips for how you too can safely give an affordable, life-saving gift to the neediest among us. Because when it comes to the homeless, that’s when, truly, The Giving Is Easy. And once you see how simple and rewarding it can be to drop a gift with a homeless person, be sure to pass the word along. Email friends, post your efforts on Facebook or MySpace. Put together gifts to have in your car for those awkward moments when you’re waiting at an intersection, staring at a scrawled “anything helps, even a smile” cardboard sign. It will change the whole tenor of your life.

Still feeling reluctant to throw together a homeless gift? Keep in mind that, when it comes to your health, studies show that acts of altruism benefit YOU – your life satisfaction, your overall level of contentment, and even how long you live. If altruism was a drug, it would outsell Viagra.

Why Health Care Reform Is So Difficult in the United States

Dec 22, 2009• 37

By HUMPHREY TAYLOR, Chairman, the Harris Poll, Harris interactive

Humphrey_Taylor_HI Why is it so hard to change the American health care system? And so much easier to change other countries’ systems?

I pondered this question recently while attending the Commonwealth Fund’s International Symposium on Health in Washington where our latest survey comparing primary care in eleven countries was discussed. I heard presentations describing changes that have been, or are being, implemented in England, France, Germany, Norway, Sweden, Switzerland, the Netherlands, Canada, Australia and New Zealand. In some cases, these are fundamental reforms in how medical care is delivered and how providers are reimbursed. Many of these countries can demonstrate real improvements in the quality of care and efficiency in their systems.

Coal in Your Christmas Stocking?

Dec 22, 2009• 7

By ROBERT LASZEWSKI

Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?

Republican Mississippi Governor Haley Barbour had this to say about the Senate bill last week, “This health care plan is like mackerel in the moonlight. Longer that it's out there, the more that it stinks.”

And yesterday, MoveOn said this about the Senate Democratic health care bill in an email to its members, "America needs real health care reform—not a massive giveaway to the insurance companies. Senator Bernie Sanders and other progressives should block this bill until it's fixed."

When Haley Barbour and MoveOn are saying about the same things—this bill should be stopped in its current form albeit for very different reasons—that says a lot.

Enthoven beats up Gawande

Dec 22, 2009• 17

By Matthew Holt

I finally got around to reading Atul Gawande’s New Yorker piece on why the current reform bill mirrors early 20th century agriculture. I learned lots about the role of the Department of Agriculture in teaching farmers what to do. In post-war Britain the radio soap opera The Archers did much the same thing.

I was actually encouraged to remember that in almost every industrialization process, intelligence, leadership, and usually money, from the government was a key factor.

But I felt very uncomfortable with the analogy. First, the incentive for the farmers was to be more productive—even if in the long run productivity meant a relative fall in the price of food and eventually the rise of agri-business decades later. If they did things right there was an immediate market reward. Whereas we know that (from the Virginia Mason and Intermountain examples) increasing quality and productivity in health care leads to negative financial consequences.

Secondly, Gawande seems to be fine with saying that “we don’t know how to be more efficient, productive and effective, so let’s do pilots for years and figure it out.” This is just crap. We’ve both done pilots for decades, and have examples of organizational forms (you know who I mean!) that get it right. It’s just made no sense for most of the health care system to adopt those techniques and organizational forms because they make more money by doing what they’re doing—and government and employers keep paying them.

I was going to write a long piece detailing my complaints blow by blow, but luckily Alain Enthoven has done it for me!

This doesn’t mean I’m against the current bill as I suspect Enthoven is. There is some hope that ACOs and other modern terminology for the types of organization he’s espoused over the years, will arise more quickly from the “pilots” in the bill than Enthoven suspects. But more importantly, I support the bill because the saving money part is the second of my “two rules to judge a bill.” The first and most important rule is

Rule 1 A health care reform bill needs to guarantee that no one should find themselves unable to get care simply because they cannot afford it. Neither should anyone find themselves financially compromised (or worse) because they have received care.

And the current bill just about does that….although Maggie Mahar is pretty doubtful, especially for near-seniors in the first few years.

Virtual Medicine: The Lever That Just Might Save Independent Practice

Dec 21, 2009• 11

By RICHARD REECE, MD

Give me a lever long enough, and a prop strong enough, I can single-handedly move the world.

— Archimedes

Independent medical practice in America is in trouble. It is fragmented, with some 900,000 doctors – 300,000 primary care doctors and 600,000 specialists- practicing in disparate settings. These physicians are located in roughly 580, 000 locations. Some are solo, most are in small groups, and many are clustered around 125 academic medical centers, 100 integrated groups, and 5000 community hospitals.

Doctors are not unified – less than 20 percent belong to the AMA. Some 110,000 are members of Sermo – a social networking organization that tends to house dissident physicians. The MGMA is said to represent 300,000 doctors.Continue reading…

Interview with Alan Greene MD, author of “Raising Baby Green”

Dec 21, 2009• 1

One of the most remarkable talks I heard this year wasn’t about health care. It was about food. Of course, food is very, very closely related to health and health is at least tangentially related to health care.

So I invited Alan Greene of drgreene.com (who is a friend and has spoken at a couple of Health 2.0 Conferences) to tell me about the new book, Raising Baby Green. It really is a potential way to change how Americans (and everyone else) eat, and to use the most important years (the ones we can’t remember!) to do it.

Most importantly Alan is starting a viral campaign to get this information into the hands of expectant mothers. For anyone who knows an expectant mum or someone who might be one someday, this book is very important. And the message needs to get out and get mainstream quickly.

Here’s the interview in which Alan explains how to feed kids right, and we do a little plotting in how to get this into mainstream child-raising.

Cool Technology of the Week

Dec 19, 2009• 8

By JOHN HALAMKA

John Halamka is the CIO at Beth Israel Deconess Medical Center and the author of the popular “Life as a Healthcare CIO” blog, where he writes about technology, the business of healthcare and the issues he faces as the leader of the IT department of a major hospital system. He is a frequent contributor to THCB.

I recently wrote a Computerworld Column about Email Overload.

I’m a data oriented guy and was curious to learn detailed statistics about my own Blackberry use. I found a great Blackberry application called “I Love Blackberry” from EarlySail.Continue reading…

Senate Deal on Health Care Bill Done

Dec 19, 2009• 52

By Matthew Holt

As it's a work day for the Senate worth reporting here that Ben Nelson’s vote has been bought for more Medicaid spending for Nebraska and a complex formula for States to opt out of exchanges being able to fund abortions. So presuming there’s no problems in reconciliation we can expect the reform bill to be done relatively soon. Full details on what’s in the new bill on Think Progress’ The Wonk Room.

The netroots left has been complaining loudly over the last couple of days since Lieberman was bought off by dropping the public option and the Medicare buy-in. Howard Dean and Markos of Daily Kos both called for massive changes to the bill, or killing it and the debate between the “sensible left” and the “this is a sellout to insurers” has got a little silly. However, (unless Bernie Sanders pulls fast one) none of the more left wing Senators (Sherrod Brown et al) are going to vote against the bill, so what we see now is what we get.

The real issue will be when the voting public finds out that nothing happens for 3 years.

Kate’s Counterpane

Dec 19, 2009• 1

A wonderful sad and happy story about someone who never thought disease could happen to them. (It’s relatively long and plays in sections or you can go to the original site)

From a system/policy perspective, the role of complementary and allopathic medicine is pretty interesting. But this is a story about a fighter.

Interview with Paul Taylor, renegade hospital CEO

Dec 18, 2009• 4

By Matthew Holt

Paul Taylor is CEO of Ozarks Community Hospital, a teeny 2 hospital system catering to the poor and senior populations in rural Missouri and Arkansas. He thinks that he’s figured out a way to deliver health care at government rates and is incensed that every other hospital claims it can’t make it on what Medicare pays. (That’s they I call him a renegade–I don’t mean that his hospital is called “Renegade”!) He also gets much less from the local Blues than he does from Medicare for the same services.

I wrote about Paul a while back and he sounded like a guy with interesting ideas on how to fix health care. So I called him up to see if he would be a good interview–and he didn’t disappoint!

Paul Taylor