Author Archives

Matthew Holt

Two big deals in Health 2.0

Oct 2, 2009

By Matthew Holt

John Halamka writes about the small but important meeting this week at Harvard Medical School hosted by Zak Kohane and Ken Mandl. Because of the impending arrival of about 1,000 of my best friends next week at Health 2.0, I couldn’t go to that meeting. But it may be very important in putting the “cats and dogs” together to think about ways for new platforms with players like Halamka and David Kibbe (who have not been on the same side of these issues) both taking part.

Meanwhile, yesterday Microsoft released My Health Info. I got a quick preview and it’s essentially a layer over HealthVault that allows both Microsoft and others to build widgets that can be arranged on sites like MSN Health (and presumably many more to come) which directly connect with the individual’s data in HealthVault. It essentially is the cool user interface that HealthVault has been missing and it’s more evidence of Microsoft’s serious intentions in consumer health care.

If you’re at Health 2.0 next week you’ll see Microsoft’s My Health Info and hear much, much more about what David Kibbe is calling Clinical Groupware, and also many demonstrations about we’re starting to call “unplatforms”.

While health reform is arguing about multiple amendments in Baucus’ committee and making some of us despair, the tech world is showing some real promise.

Money-Driven Medicine film now downloadable

Oct 1, 2009• 3

By Matthew Holt

If you want to watch the documentary Money Driven Medicine based on Maggie Mahar’s book, it’s now available for free download at moneydrivenmedicine.org (the DVD is also available for purchase). The free download is part of an ongoing “Watch-In! For America’s Health” — a national viewing party organized in conjunction with the Consumers Union.

Carrot or Stick? Should Patient Decision Aids Be Rewarded or Required?

Oct 1, 2009• 6

By DON KEMPER

Don kemper

Should we incent or require providers to prescribe patient decision aids?
Should we incent or require consumers to use patient decision aids?

Over-treatment is the most celebrated cause of runaway health care costs, but we shouldn’t blame the doctors. The fee-for-service system sets them up for over-treatment. First, they have been taught that offering all possible cures to every patient is good medicine. Second, malpractice law pushes them toward offering more testing and services, not less. And third, they generally get paid more when they do more. It’s hard to buck a triple-threat system like that without a little help from the patient. Fortunately, it’s not that hard for patients to provide that difference.Continue reading…

Can Social Media Save Healthcare Reform?

Oct 1, 2009• 2

By DANIEL PALESTRANT, MD

Daniel Palestrant is the Founder & CEO of Sermo, the largest online physician community, and a friend of THCB’s from the Health 2.0 world. Lately Dan has been seen on cable TV representing the 110K+ Sermo members in the health reform debate—including a very public break-up with Sermo’s former partners at the AMA, which has endorsed the House 3200 bill. I’ve been asking Dan, if his members’ don’t want the House bill, what do they want? This is the piece he sent me in reply—Matthew Holt

Speaking at Fortune’s Brainstorm Technology Conference last month, longtime healthcare reform advocate, Howard Dean pointed out that the “dirty secret” of social media is that it can put a whole lot of politicians out of business because it allows the truth to bubble up. For the sake of healthcare reform, let’s hope he is right.

True healthcare reform has no chance of occurring with the current political topography. As the general public tries to make sense of the 1,000+ page version of the bill and President Obama distances himself from Howard Dean’s raison d’etre, the public option, two things are becoming increasingly clear:

1. There is very little actual healthcare reform going on.

2 The insurance companies look like they will win, no matter what, especially if you believe the cover of the most recent Business Week “The Health Insurers Have Already Won”.

At Sermo.com we seem to be seeing Governor Dean’s prediction come true.

The Health 2.0 Accelerator is really gunning it…

Oct 1, 2009• 2

By MATTHEW HOLT

The Health 2.0 Accelerator was a glimmer in the eye of Commerce.net’s Marty Tenenbaum late in 2007. But under the dedicated leadership of Julie Murchinson and Aaron Apodaca, something quite remarkable is happening. The Accelerator is an industry consortium, mostly made up of very small Health 2.0 companies who are just getting started in their own young lives. But working together they’re integrating data and services in a way that’s going to make consumers’ use of online health tools very different from the patchwork we see today.

And the effort is getting attention. Today Kaiser Permanente announced that it was joining the Accelerator, moving alongside Sage and Catholic Healthcare West as corporate members. And in the wings is a major health care data player, who’s going to be adding their seal of approval next week.

What’s happening here is the evolution of an ecosystem—an ecosystem where innovation on the web and in mobile Health 2.0 is now finding ways to present itself to consumers and healthcare organizations in new ways.

I don’t want to let the cat out of the bag completely, but I think that anyone who’s interested in seeing the evolution of Health 2.0 and the evolution of health care consumer technology will be fascinated by what around a dozen Health 2.0 Accelerator members are going to show—together—at the tools panel at the Health 2.0 Conference next week.

In the meanwhile kudos to Julie and Aaron, to Erick & Linda von Schweber from PHARMASurveyor who’ve been founding board members and have driven the technical process, to the folks from Sage who were great early supporters and to the more than 100 people and companies who’ve been supporting the Accelerator.

They’ve all made a real difference. And it’s just beginning.

I was largely in favor of Swiss-style health care…

Oct 1, 2009• 2

By Matthew Holt

until I found out that the people who the NY Times says are really in favor of it are Bill O’Reilly and Regina Herzlinger…

Actually I’m kidding. I knew Regi says she likes it, and Maggie Mahar ripped her position—(Herzlinger’s position being that she espouses a version of the Swiss system for the US)—to shreds a while back. But would Herzlinger really want to live in a world where there was no easy money to be made trading in the stock of health insurers who are defrauding state governments? But I’ve got to say that Herzlinger and O’Reilly make a interesting couple.…pass the falafel.

Health Reform and Medicare: Part I

Sep 30, 2009• 12

By THOMAS L. GREANEY

Here’s a pop quiz on health reform: Which prominent Republican said the following:

And if you don’t [oppose this health care legislation] and if I don’t do it, one of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.

OK, it’s a trick question: the answer is Ronald Reagan, paid spokesman for the American Medical Association’s Women’s Auxiliary, speaking in 1961 against the bill that ultimately emerged as Medicare. (A recording of his “coffee klatch” talk, “Ronald Reagan Speaks Out Against Socialized Medicine,” is here.

Although what political scientist Jonathan Oberlander has termed “a politics of consensus” lasted for some thirty years after Medicare’s enactment, bipartisanship broke down in 1995 when Newt Gingrich targeted Medicare for cuts of 30% and urged privatization using managed care. By the lights of conservative Republicans, severe cuts in traditional Medicare would encourage flight to managed care alternatives, so that, in the famous phrase of Newt Gingrich, Medicare would “wither on the vine.” (1 St. Louis U.J. Health L. & Pol’y 5-43 (2007), Abstract). Although President Clinton used the Republicans’ Medicare reform to his own benefit (polls showed that his defense of Medicare helped him secure re-election), ultimately much of the Republicans’ agenda for reform was adopted in 2003. Since then Republicans have not relented in their criticism of the program– with some in leadership positions even questioning the government’s role in health care for seniors. (See Rachel Maddow’s cable television show featuring a parade of video clips of Republicans bashing Medicare, including former Speaker DeLay –echoed by Representative Roy Blunt–asserting that “Medicare shouldn’t be a government program”).

Swine flu, uninsurance and not-so fondly remembering the teenage years

Sep 30, 2009• 5

By Matthew Holt

We get sent lots of rants to our tips line, most of which we ignore in an amused jaundiced way. But this one I found very amusing. I’m not sure it’s 100% accurate, but it is very funny and essentially details something that we know happens every day. So to have some fun with how to buy individual insurance in California, head over to this post on a blog usually concerned with selling you credit cards.

By the way, a close colleague of mine trying to buy a short-term stop-gap policy while her husband changed jobs got a very similar “we’re not selling you insurance and we’re not telling you why” just last week.

Don’t forget that virtually any form of the bills in Congress outlaws these shenanigans.

Medicare Policy Might Discourage Proper Care for Hospital-Acquired Infections

Sep 29, 2009• 7

By MAYA SEQUEIRA

Medicare’s recent policy of refusing to pay hospitals’ additional costs to treat hospital-acquired infections fails to adequately incentivize prevention and proper treatment of these complications, associated with 99,000 deaths annually. A recent analysis by Peter McNair and colleagues in the journal Health Affairs suggests that, in the entire state of California, only 11 hospitalizations complicated by infection would have received lower reimbursement as a result of the policy if it had been in place in 2006.The Medicare policy focuses on infections that have low mortality, such as catheter-associated urinary tract infections, and infections that affect few people, such as mediastinitis after CABG surgery. This means that the vast majority of severe hospital-acquired infections remain completely unregulated.

To Change Health Care, Change Diabetes.

Sep 29, 2009• 14

By DANA HAZA

As we work to change health care in America, we must recognize the need to dramatically change diabetes. Twenty-four million Americans have diabetes at a cost to our nation of an estimated $218 billion for diabetes and pre-diabetes, according to a series of studies recently published in Population Health Management. Imagine the effects diabetes will have on our health and economy in the future if we don’t take action now. The prevalence and economic burden of undiagnosed and pre-diabetes make the case for the importance of policies that promote early diagnosis and prevention. About 25 percent of Americans with diabetes aren’t even aware they have the disease. And, those with undiagnosed diabetes result in $18 billion in health expenses, or $2,864 per person each year, according to one of the studies mentioned above.