Author Archives

Matthew Holt

Obama’s Health Plan Under the Microscope and Through a Fair Lens

Oct 3, 2008• 5

By MAGGIE MAHAR

Each presidential candidate offers a blueprint for health care reform. Neither can expect to see his plan enacted whole—legislators will leave their fingerprints all over any proposal. And, if truth be told, neither plan is perfect. Each proposal is blinkered in its own way; each ignores just how difficult true reform will be. I very much doubt that national health insurance will become a reality in the next year.

That said, I believe that we can take steps toward reform in 2009 if we begin thinking clearly—and honestly—about exactly what it is that we want and what it will cost. To that end, I believe that in-depth analysis of each candidate’s proposal can help underline the core ideological differences between conservatives, libertarians and progressives, and highlight the economic realities that any reform plan will have to face.

Recently, opponents of each plan have offered their critiques in Health Affairs (here and here) and supporters have defended their favorites here and here. Inevitably, many readers found the critiques too partisan. At the same time, they complained that rebuttals from the home team “read more like a stump speech with details glossed over and facts overlooked.”

Help for newly unemployed to decipher COBRA options

Oct 3, 2008• 2

By Sarah Arnquist

The downturn in the economy, means lots of newly unemployed individuals will be asking what happens with their health insurance.

There are a number of online resources to help them understand their options under COBRA. Here are a few:

eHealthInsurance launched a new initiative, www.COBRAlearning.com,
to education consumers about COBRA and alternatives health insurance
for the newly unemployed. Accompanying the launch, was a survey (paid
for by ehealthinsurance) that found many consumers don’t know what
COBRA is or what their options are after losing employment.

Besides having a cheezy name, bWell-Informed Health Plan Forecaster says it offers "vendor-neutral educational and personal underwriting tools" for those Americans who are in the position of having "the freedom, yet responsibility, to choose their own health care."

Here, also are government and nonprofit options. The Department of Labor explains COBRA coverage here. The American Cancer Society also has a page intended to explain COBRA coverage.

The invisible hand and capitalistic sustainability

Oct 2, 2008• 4

By Scott Shreve Scott_shreeve

I, along with everyone else, have been walking around hollow-eyed given the speed of the recent financial meltdown. One-hundred-year old firms disappearing in a weekend, markets roiling with every bit of news, experts clamoring about the greatest calamity ever in the recorded history of finance, and politicians actually working weekends to attempt to rescue the largest and most important financial system in the world.

This is serious business.

I have also been amazed at the Governments response to nationalize “key” companies – AIG, Fanny/Freddie, and probably a few others before it is all through. Several people have made the connection between the nationalization of financial companies with the potential nationalization of the health care systems. Actually the wealth-health connection is probably stronger than you think. Just as the current financial mess is related to the “toxic” subprime debt on the books of the eviscerated companies, hospitals are also being laden with “toxic” debt from consumers who are also leaving them holding the bag on their bad debt.

Health Care and the Broader Economic Crisis

Oct 2, 2008• 9

By Brian Klepper

Over at HealthLeaders, Dr. Richard Reece and I have an article, Will Primary Care Be Re-Empowered By An Ailing Economy?, arguing that the turmoil in the larger US economy – and particularly the tightening of credit – is going to significantly enhance the pressures on purchasers and industry players, and grease the wheels of meaningful change throughout health care.

Consider, for example, the fact that most hospitals and health systems
have remained in the black only as a result of investment income. Many
lose money on operations. How will health systems remain afloat if the
returns on their investments are diminished?

Then there was the Wall Street Journal story
a couple weeks ago in which Vanessa Fuhrmans described significant
drops in office visits, filled prescriptions, elective surgeries as
consumers cope with the economic downturn. That was before the big
crashes that began a few weeks ago.

Around the Web in 60 Seconds (Or Less)

Oct 2, 2008• 2

A computer and one expert are as effective at spotting breast cancer as the two experts who usually used to read mammograms in the UK, according to a New England Journal of Medicine study. The BBC reports that these results may help the NHS expand mammagraphy to more women without placing greater demand on the existing workforce.

Wal-Mart is the first of eight Dossia members to offer its employees a personal health record.

California will become the first state to require restaurants to post calorie information on menus. Will consumers think twice before ordering that 2,000-calorie fettuccine alfredo?

A judge ordered Medtronic and Boston Scientific to pay Johnson & Johnson $1.2 billion in a lawsuit over patent infringement on a stent. It’s quite the time to have to deal with the 10-year-old lawsuit.

700 billion reasons to read Health Wonk Review

Oct 2, 2008

It’s up over at Healthcare Economist. Go check it out. It’s filled with thoughful commentary about the economy, bailout and health care.

X2HN event calling for speakers

Oct 2, 2008

By THCB Staff

What do high stakes poker, smart women and health care have to do with each other? The Third Annual Xscape conference coming up in February will combine all three in Las Vegas to promote and support women health care executives.

The conference is put on by the X2 healthcare network, and they’re looking for additional speakers.

Indu Subaiya, co-founder of the Health 2.0 Conference and Accelerator, will give the keynote address, bringing attendees up to speed on new health care players in technology and how Health 2.0 is empowering consumers.

KevinMD turns into raving socialist…

Oct 1, 2008• 6

By Matthew Holt

Well not quite, but in his op-ed at USA Today Kevin talks about why it’s a problem for the US not to have wide deployment of EMRs, and notes that it’s the wrong incentives that are to blame—docs have to pay but others reap the rewards. So in Kevin’s words:

One needs to look at the Department of Veterans Affairs for an optimal model. All of the VA’s primary care physicians, specialists and hospital-based doctors across the country use the same electronic record system. It has played a significant role in the reduction of medical errors, optimization of cost efficiency, and attainment of high scores in preventive care measures.

Kevin’s usually criticizing me for being the wooly lefty, but I could be pardoned for thinking that he’s suggesting that we junk the current US system in favor of rolling all docs and patients into the VA. I wouldn’t suggest that but far be it from me to tell Kev that he’s wrong!

Will tighter credit slow medical technology innovation?

Oct 1, 2008• 4

By Jane Sarasohn-Kahn

Medical technology is one of the most innovative sectors in the U.S. economy. The market is fueled by aging populations, expanding chronic conditions, and a forecasted growth in demand for companion diagnostics to use in concert with personalized, targeted therapies.

In its detailed update, Pulse of the industry: US medical technology report 2008, Ernst & Young describes the industry, its opportunities and challenges.

In summary: U.S. med-tech still leads the world, but the larger economy could compromise both the U.S. lead in the sector as well as health innovations.

Do gamers make better surgeons?

Oct 1, 2008• 1

By Sean Neill Videogame

Something I had not seen before coming to the U.S. was robotic surgery, even though some UK centres do offer it.

Leonardo da Vinci has had many attributes associated with his name, but what would he think of being eponymously associated with prostate surgery?

da Vinci surgery uses advanced invasive robotics to perform procedures such as hysterectomies, prostatectomies and even mitral valve surgery. The manufacturers claim many advantages from decreased blood loss to the sparing of nerves. It is a shock to walk into a room where the patient appears to have been grasped by a giant mechanical spider, with the legs moving within the patient’s abdomen. The surgeon is nowhere to be seen and if you ask the nurse she will point to a figure hunched behind a box in the corner of the room. Peak behind and you will see a magnificently magnified view from within the patient abdomen from positions you would never see in an open procedure. The surgeon appears to be playing an advanced musical device as the instruments are directed from within.

If you watch a game junky play on their PC, PlayStation or Xbox, the manual dexterity and eye-hand co-ordination is something to behold. So will the next generation of gaming computer nerds be the da Vinci surgeons of the future. A study in 2007 suggests that this may be so. Researchers found that doctors who spent at least three hours a week playing video games made about 37 percent fewer mistakes in laparoscopic surgery and performed the task 27 percent faster than their counterparts who did not play video games.

Even though I am not a surgeon will this evidence be enough to convince my wife of our latest purchase?

Sean Neill is a South African-born, British-trained anesthesiologist, who
recently relocated to Midwestern USA. He blogs regularly at OnMedica about his cross-cultural experience, frequently pointing out oddities of American health care.