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Meet the iPAB!

Jan 13, 2012• 10

By D. Brad Wright

Contrary to the title, the IPAB is not a new Apple product. Rather, it is the “Independent Payment Advisory Board” created by the Affordable Care Act to solve the problem of ever-increasing Medicare spending.

In people’s worst nightmares, the IPAB is a death panel that will make decisions about how to ration health care for the elderly and disabled. Images of 15 people sitting in a room handing out death sentences flash through the minds of the anti-government crowd.

Nothing could be further from the truth, as the IPAB has no authority to limit benefits, increase beneficiaries’ out-of-pocket costs, or otherwise alter the Medicare program in any way that would “ration” care.

So what can the IPAB actually do to promote slower spending growth in Medicare?

They can suggest legislation, that’s what. Legislation that, for example, would reduce or alter the way in which payments are made to providers. It’s debatable if the recommendations from IPAB will work to actually control spending. What’s not up for debate is whether action will be taken, and that’s what I’m most pleased about.Continue reading…

A Constitutional Right not to Be Bankrupted

Jan 13, 2012• 6

By Frank Pasquale

Those challenging the ACA in court profess deep concern about government forcing citizens to buy insurance or pay a fine. The fundamental harm here is monetary; it’s about being required to purchase insurance, not to use it (or to get any medical care at all).

If the Court agrees with them, why can’t there be a parallel monetary right not to be bankrupted by health care costs? In the 1973 case San Antonio School District v. Rodriguez, the Supreme Court decided, by a 5-4 vote, that children did not have a constitutional right to education. But at that time, at least four justices thought the state was obliged to make a decent education available to all. Why can’t a future Court do the same for health care?

If the current Supreme Court were to declare the ACA unconstitutional, it would need to abandon several landmark precedents. That’s not a problem for the Roberts Court; it’s already jettisoned once-venerable holdings on campaign finance, equal protection, antitrust, and voting rights.

For many Americans in these tough economic times, rights to education, housing, health care, and food are a lot more meaningful than the right to be free of an insurance mandate. We the people can locate these ideals in a Constitution and a Declaration of Independence rich with grand and sweeping language. If the ACA’s opponents can use our nation’s founding texts to undermine the ACA, those who care about meeting basic human needs need to gear up to use them to do quite a bit more.

Bring Back the Public Option

Jan 13, 2012• 108

By Scott Carroll

The way health care is administered in the United States is unsustainable and in need of fundamental reengineering — right? During the 2008 presidential race, the country appeared to be in agreement on this point. But that all changed somewhere, somewhere after the election of a dark-skinned new president with a foreign-sounding name whom even proud Medicare card-carrying Americans were viscerally driven to deride as a socialist.

This was recently reported in The Hill: “The six largest investor-owned health insurance companies saw a 22 percent increase in combined net income in the third quarter, putting them on pace to break profit records for 2010.” The president was castigated by loud little crowds around the country for championing the overwhelmingly popular idea of a publicly funded, public health insurance alternative to challenge the partly publicly funded, private health insurance companies’ assertion that they simply cannot provide their services any cheaper. Rather than groundbreaking legislation, what we got was the president being caricatured on national television, in effigy, as The Joker — and health insurance executives laughed all the way to the bank.

Patients Rating Doctors: Let’s Pay Popular People More!

Jan 13, 2012• 2

By Doc Gurley

My patient only had 20 minutes to wait for the van headed to detox. The people who had worked to get him into a detox program already numbered in the double digits. Sam (not his real name) was the classic public inebriate — he woke on sidewalks with the shakes, vomited blood on a regular basis, had lost most of his teeth, and was such a frequent victim of head trauma that depressions and scars ridged his balding skull.

Over the last week, our substance abuse counselor had daisy-chained together an impressive series of phone calls, blood tests, and clearance forms to line him up for one of our rarely-available detox beds.

Only 20 minutes to go.

But it was 20 minutes too long for him.

How Healthcare’s Embrace of Mobility has Turned Dangerous

Jan 11, 2012• 9

By Eric Lai

No industry has adopted mobility faster than healthcare.

Doctors love their devices. 81% of physicians have smartphones. They also love their apps. 38% of them use medical apps daily. One-third use smartphones or tablets to access electronic medical records today, with another 20% expecting to start using them this year.

For instance, 200 doctors and nurses at Charite Berlin, one of Europe’s largest hospitals, are piloting SAP’s new Electronic Medical Record app on iPad.

The app allows medical providers to trade their clipboards for (electronic) tablets, which present them a clean dashboard that lets them drill down into data such as medical history, medications (and allergies), X-rays and vital signs. It pulls that data down from a speedy SAP Hana in-memory database.

An Interview with Blueprint Health

Jan 11, 2012

By Matthew Holt

Blueprint Health is a specialist health IT incubator that just opened its doors this week and selected its first group of startups who get $20K each and a chance to hang in a nice art gallery in Soho that’s opening officially Thursday (FD Health 2.0′s NY city team will be moving in too). You can read more at Techcrunch and see the HUGE list of mentors here (I was thinking of throwing my hat in the ring until they told me it involved work!). But I wanted to ask Brad Weinberg & Mat Farkash, the founders, what was so special about Blueprint, so Mat told me:

Matthew H: Describe the Blueprint program

Mat Farkash: Blueprint Health is a New York based health-focused accelerator that is a Charter member of the TechStars Network. Blueprint Health kicked off its three-monthWinter program on January 9 in its 12,000 square foot office in SoHo and will also host a summer program in 2012. The program is a heavily mentorship focused, providing teams with access to over 120 mentors, all of whom have experience in the healthcare industry, including many physicians and health providers.

Work Induced Attention Deficit Disorder

Jan 11, 2012• 5

By John Halamka

When you’re in meetings or on phone calls, are you focused in the moment or are you distracted by emails, text messages, or social networking traffic?

When you’re reading a 20 page whitepaper, RFP, or article, can you finish it?

When you’re writing a presentation or article, can you keep your thoughts flowing or are they interrupted by the urge to check your email or mobile device?

Part of the problem is the expectation that we’re all connected 24×7 and should respond in near real time.

Part of the problem is an addiction-like behavior caused by a need to feel connected to other people.

Part of the problem is the pace of change that makes us work two days for every workday – one with scheduled meetings and one with unscheduled electronic messaging.

Do you find that your ability to explore issues in depth has diminished over time because of the need to react to the constant flow of input?

The National Nurse

Jan 11, 2012• 13

By Brian Klepper

On December 15, Rep. Eddie Bernice Johnson (TX-30) introduced HR 3679, The National Nurse Act of 2011.

The legislation, co-led by Rep. Peter King (NY-3), would elevate the existing Chief Nurse Officer of the US Public Health Service, to the National Nurse for Public Health, a new full time leadership position that can focus nationally on health promotion and disease prevention priorities.

Teri Mills, a Certified Nurse Educator at Portland Community College in Oregon and President of the National Nursing Network Organization (NNNO), introduced the idea of a National Nurse in a 2005 NY Times op/ed. Here is an excerpt from that article.

…Nurses are considered the most honest and ethical professionals, according to a recent Gallup poll. It’s the nurse whom the patient trusts to explain the treatment ordered by a doctor. It is the nurse who teaches new parents how to care for their newborn. It is the nurse who explains to the family how to comfort a dying loved one.

Now, I’m not saying that a National Nurse will become a household name immediately. But given all that’s at stake – the health of a nation – it seems to me that we should at least give nurses a try.

Continue reading…

2012: A Year of Huge Uncertainty in Health Care Policy

Jan 10, 2012• 5

By Robert Laszweski

2013 may be the most significant year in health care policy ever.

But we have to get through 2012 first.

Once the 2012 election results are in there will be the very real opportunity to address a long list of health care issues.

If Republicans win, the top of the list will include “repealing and replacing” the Affordable Care Act. If Obama is reelected, but Republicans capture both houses of Congress, we can still expect a serious effort to change the law. Then there is the granddaddy of all problems, the federal debt. The 2012 elections could well prepare the way for entitlement reform—particularly for Medicare and Medicaid. Even if Obama is reelected, the 2013 agenda will include a serious debate about Republican ideas to change Medicare into a premium support system and block grant Medicaid to the states.

If the election is a draw with neither side able to unilaterally move their agenda—likely in the form of Obama still in the White House but facing a Republican Congress, the pressure to deal with the growing costs of Medicare and Medicaid as well as nagging concerns about the implementation of the Affordable Care Act will create an imperative for action in 2013.