Intrepid THCB intern Tiffany Huang will be live-blogging The Economist‘s Innovation conference at Berkeley today and tomorrow. Of particular interest to THCB readers might be tomorrow’s panel on “The End of Health Care As We Know It”, which has speakers Clayton Christensen and Michael Porter from the Harvard Business School, as well as the CEOs of Kaiser, the California Healthcare Foundation, and Proteus Biomedical. The event opens at 12:30 pm today. Check out their blog here!
Health 2.0 in Hungary? Yes, We Can!
By MATTHEW HOLT
Gábor Gyarmati has been running health care web sites in Hungary for longer than you might imagine. I suspect that many of you reading this don’t know much about Hungary and those of you who went to high school in America probably can’t find it on the map (stop it—you cynical Brit!), but what’s going on there is very interesting. Gábor will be presenting at Health 2.0 Europe on April 6–7 in Paris, but I did an IM interview with him last week to give you a preview.
Matthew Holt says: Gabor, you’ve been working in online health for several years doing market research and running consumer and physician websites. Can you tell me how you got started?
Gábor says: We have started our health and pharmaceutical research company, Szinapszis in 1998 that was the first of its kind in Hungary. We collected a lot of information about our market, patients, physicians, about their health and prescription choices. We found about 5 years ago that a “new media”, the Internet, appeared as a communication tool in healthcare and pharma marketing but at that time it was extremely weak, only a few physicians used it and less than 10 percent of the patients but we saw a very strong and fast increase in it. As our other companies did marketing communication projects, we knew that we have to this new tool as well although it is not known enough.Continue reading…
The Reinvention of Social Progress
I watched C-Span through the entire voting process on Sunday night. Socialism? Tyranny? The Republican hyperbole was unhinged from reality.
Democratic claims that the health care reform marked a major milestone in domestic policy were closer to the truth. But billing the legislation as comparable to the advent of Social Security in the 1930s or Medicare and Medicaid in the 1960s simply isn’t accurate.
Why do I say that?Continue reading…
What’s Next With Health Care (And Why This Process Was Madness)
What’s Next With Health Care (And Why This Process Was Madness)
By MARIAN WANG
Sometimes things are a little clearer in retrospect. Now that health care reform has passed in the House, it seems there are two main questions in people’s minds:
- What’s next?
- Why, procedurally, was the legislative process so confusing and painful to watch?
Let’s answer that second question first. To help do that, we’ve drawn up some helpful infographics.
Exhibit A – How, originally, we thought health care legislation would play out procedurally. This is typically how proposed legislation is melded between the two houses.
Exhibit B – How things would’ve worked under “deem and pass [1],” or a self-executing rule. After questions were raised about the constitutionality of “deem and pass,” the House ended up not going that route.
Exhibit C – How it looks like it’s going to happen, after all.
In that last graphic, the yellow marker (5) is where we’re currently at. President Obama reportedly will sign the Senate bill on Tuesday [2], which means that part of health care legislation is law. The House-passed reconcilliation portion, consisting of 153 pages of “fixes” to the Senate bill (compare the two bills with our side-by-side comparison app [3]), will then move to the Senate (6), and if it passes, on to presidential sign-off (7).
As for the “What’s next” question, Kaiser Health News has a good list [4] of some of the provisions that will take effect in 2010. Most of the bigger changes that will affect millions don’t go into effect in 2014.
Marian Wang blogs for the ProPublica news service. This post first appeared on the ProPublica blog. You can write Marian Ma*********@********ca.org.
Rearranging Chairs
I have been asked by patients, readers, family members, and by fellow bloggers what I think about the bill passed by the House of Regurgitants Representatives yesterday. I resent this. I have tried hard to remain neutral as possible, finding equal cause to point and sneer at both conservatives and liberals. It’s much more fun to watch the kids fight than it is to figure out which one is to blame.
But given the enormous pressure put on me by these people, as well as threatening phone calls from Oprah and Dr. Oz, I will give my “radical moderate” view of the HC bill. My perspective is, of course, that of a primary care physician who will deal with the aftermath of this in a way very few talking heads on TV can understand. The business of HC is my business, literally. So, reluctantly, I take leave of the critic’s chair and take on the position where I will be a target for any rotten fruit thrown.Continue reading…
The big question for what’s next
By MATTHEW HOLT
It’s the morning after the big night. Soon all melodrama of the past 14 months will be forgotten, particularly the last 6 weeks (for which the current narrative is that Nancy Pelosi brought health care reform back from the ashes with an assist from Angela Braly and Anthem Blue Cross). In the end the current bill is probably better than the version that would have come from a 60 vote Senate win after conference as the abuses of the Cornhusker kickback and more would still be there. Given that the sticking points at the end were more about the irrelevancy of abortion than anything else, the more mainstream Democrats might be wondering whether this wasn’t a better way to do things in the first place, and therefore whether they couldn’t have got a public option through if the 51 vote reconciliation process was adopted earlier in the bill’s life.
But no matter, we’s got what we’s got. For now. And whatever happens I can’t see any way that this gets overturned—especially when people figure out what’s in the bill. More likely the subsidies get sweetened, and the holes in the coverage get filled.
So it’s almost time to turn our attention away from payment reform, to delivery reform. Now every time in the past that we’ve had reform or something approaching it, those organizations who have shaped themselves to operate in an environment that rewards cost-effective innovation have ended up losing their financial shirts. You can go back to Friendly Hills in the 1990s, or look at Intermountain and Virginia Mason more recently. (Which is why I’ve been ranting at Michael Porter & Elizabeth Teisberg for years)
Now as Maggie Mahar has trumpeted, there appear to be some serious provisions for pilots in Medicare payment and eventually changes to overall Medicare reimbursement. Ideas like accountable care organizations and more should start to become reality. But of course, these concepts will need considerable change on the provider side before they become reality.
So the big question for the health care system going forward is, if providers start making the changes that will promote more cost-effective care, will they be rewarded or will they be hung out to dry?
“I Am Not Bound To Win. But I Am Bound To Be True.”
By
So many said it would never happen. But now, on Sunday, March 21, 2010, it appears that reformers have the votes. Rep. Bart Stupak, the leader of the anti-abortion hold-outs, has announced that he will vote “yes.” – under the agreement, President Barack Obama will sign an executive order ensuring that no federal funding will go to pay for abortion under the health reform plan. This really doesn’t change anything. Stupak got nothing except face-time on television.
At last, Congress is about to take the first step toward transforming what we euphemistically call our health care “system.” In the years ahead, the laissez-faire chaos that puts profits ahead of people will be regulated, with an eye to providing affordable, evidence-based, patient-centered care for all.
Over the last three years, I have predicted that Medicare reform would pave the way for health care reform, and this bill makes that possible. Under the legislation, Congress will no longer be in a position to thwart Medicare’s efforts to rein in spending by eliminating waste. Not everyone is happy about this. Over at Politico.com former Republican Senator Bill Frist and former Democratic Senator John Breaux register their protest in a column titled “Keep Medicare in Congress’ Hands.”Continue reading…
Healthcare 2015
“This gets back to the fundamental lesson of political survival that Bill Clinton taught me, which is if you make it about the American people’s lives instead of your life, you’re going to be okay.” — Paul Begala
It’s March, 2015. Healthcare reform has now been active for over five years with the majority of reforms kicking in as of January 1, 2014. Several amendments have been proposed and passed in the interim period including the All-Payer Act normalizing reimbursement rates for hospitals between Medicare, Medicaid and private insurance.
The American Family Practice Reimbursement Act promulgated minimum reimbursement levels for primary care providers acting as part of accountable care organizations and included a package of incentives for medical graduates and nurse practitioners to practice primary care. A particular emphasis was paid to establishing federally qualified health centers in urban and rural areas where Medicaid statistics reveal high rates of chronic illness and minimal levels of compliance with requisite preventive care to arrest the erosion of chronically unstable patients into catastrophic illness.Continue reading…
The Tale of the Fancy Sea Creatures and the Pipes
By
Once upon a time there was a land on the ocean. The people lived off of the food from the ocean and were very happy. But as they grew bigger, they had a problem: they made a lot of waste! Yuk! Nobody likes waste. What could they do about all of this that stuff that nobody liked?
Some said that they should find a way to make less waste. They said that the people of the land were not smart and should be making less waste. But most of the people in the land didn’t like to change what they were doing. It’s hard to change. So they built a large pipe that pumped the waste into the ocean.
The land was clean again and the people were happy!Continue reading…
The Vote is 6pm EST
By MATTHEW HOLT
Just a quick note that the vote on the Health care reform bill is at 6pm EST tonight. It looks like the Stupak 6 (the anti-abortion Dems) have been persuaded that a Yes vote will be OK because Obama will issue an executive order later confirming the Hyde amendment which already bans Federal funding for abortions. So a small stupid policy stays in place so we can have a big social program pass.
But it’s certainly not confirmed that 216 is in the bag. I’m off skiing, so watch Jon Cohn on The Treatment and @jcohntnr on Twitter as I assume he’ paying attention!
