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Matthew Holt

As I Was Saying…

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By Eric Novack

As can be read in my response to Jane’s touting the wonderful results of the non-study published in the Annals of Internal Medicine recently (and well noted by the much maligned on THCB, but usually correct Greg Scandlen), the media will attempt to skew reporting in favor of nationalized, government-run, bureaucrat-controlled, special interest-driven, health care.

To wit, the April 09,2008, release from Rasmussen : headline: 29% Favor National Health Insurance Overseen by Federal Government.

Guess how many opposed? 39%

Should the headline have been 39% Opposed to National Health Insurance?

Let’s look at the ‘topline’ data : The most interesting: 46% believe quality would DECREASE under a national health insurance system. Should that have been the headline instead? A quick note on literature, for those who have read my comment to Jane here A difference here is that Rasmussen does not purport to be scientific literature— it is clearly a poll… and though they interview 1000 adults, they could be wrong (though the 15% uninsured reflects national average- just one of many possible factors, so it does not make this poll ‘correct’).” Have we clearly ‘crossed the tipping point’ against a nationalized, government-run, bureaucrat-controlled, special interest- driven, health care system, Jane?

John McCain: Never a Day Without Government Health Insurance

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By Sarah Arnquist

Oie_399px_john_mccain_mackinac_islaPresumptive Republican presidential nominee Sen. John McCain (Ariz.) emphasizes freedom, personal choice
and responsibility when promoting his plan to reform America’s health care system. He’s not calling for an incremental approach but "nothing short of a complete reform of the culture of our health system and the way we pay for it will suffice."

This post isn’t a play-by-play of McCain’s health care proposal.

Visit his Web site to read those talking points. Or read Bob Laszewski’s detailed analysis on THCB.

This is an examination of his biography to point out that the man who wants to reduce state-regulated health insurance and hard-won consumer protections has never spent a day of his life outside the cozy blankets of publicy-sponsored government health coverage.

Continue reading…

When You Go to an ER and There’s No One There to Take Care of You

• 4

By MAGGIE MAHAR

Recently, I’ve been reading less-well known health care blogs—and finding some provocative stories.

Below, Edwin Leap–who is a physician and a blogger–tells a story about trying to find a specialist for a very sick child in the middle of the night.

Let me preface Dr. Leap’s story by explaining that, in the past, specialists who had “privileges” at a hospital (to treat patients there and to use the hospital’s very expensive equipment and operating rooms) were routinely “on call” to treat emergency patients. But these days, more and more entrepreneurial doctors are refusing to fulfill what was once seen as a traditional duty—unless they are paid.

In Money-Driven Medicine, I quote the chief operating officer of a rural community hospital who recalls a conversation with a young doctor who walked into his office and informed him that he would no longer be willing to be on call for the ER. When the doctor had signed on with the hospital, he, like all of the other physicians, had agreed to be available to treat ER patients one week a month. Typically that might mean coming into the ER two or three times during that week. But now, he explained, he wanted to spend more time at home with his children. He was not willing to continue answering the calls unless the hospital would pay him $80,000 a year.Continue reading…

Health 2.0 Unconference NL

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The first European Health 2.0 Unconference is happening this Saturday in Amsterdam, and we have a location folks! We’ll be brainstorming, cloudtagging, liveblogging and all that jazz. What is our (Dutch) definition of Health 2.0? Come, define, share at the first Health 2.0 Unconference in Europe. The Health 2.0 Unconference NL has 4 amazing sponsors and a great crowd of healthcare, media, social networking, web, communications/marketing, and creative types. Thanks to The Decision Group, KNMP (Royal Dutch Pharmaceutical Foundation), Twynstra Gudde, and Bubble Foundry for getting this off the ground in just 3 weeks.

Continue reading…

Health 1.0h. . .Geez, This Is a Mess

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By Craig Stoltz

Stoltz 

A family member just had surgery, but don’t worry, this isn’t about that.

I want to share just one observation from the experience:  Between the decision to have surgery and the moment scalpel touched flesh, the patient’s medical history was taken four times. None of these documents contains identical information.

Medical History 1. At the specialist’s office, forms were filled out in the waiting room, then completed and annotated during the in-office consult. The primary care physician’s record was not provided or asked for. We didn’t have the records from previous episodes of the medical issue in question–this all came up suddenly, and. . .we couldn’t find them.

But the hospital said they’d faxed the latest ER report, didn’t they? Can’t find it here.

Medical History 2. The day before surgery, a hospital prep nurse
called and created a new medical history by phone. My wife was there,
so she was able to correct and change some details. One of these
details was. . .the correct name of the earlier diagnosis, at least as
far as my wife could remember. I had it wrong the first time. My bad.

Continue reading…

Most Doctors Want A National Health Plan

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By Jane Sarasohn-Kahn

Six in ten U.S. physicians support a national health plan to achieve universal coverage.

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A 2002 poll among American doctors was updated in 2007 to determine how physicians’ feelings about national health insurance (NHI) may have changed in the 5 year period.

In 2002, 49% favored a national plan. In 2007, 59% supported such a plan.

The chart on the left details findings by physician specialty. Not surprisingly, more generalist doctors favor a national health plan compared to specialists, although there is still support for national insurance by a plurality of specialists and the support has grown over five years.

Psychiatrists, long supporting mental health parity in American health financing, are at the vanguard of NHI support. Pediatricians, emergency doctors, and internists make up the over-50% crowd in support of NHI.

The emergency physicians’ support for NHI has dramatically grown since 2002, probably due to the fact that these clinicians are at the forefront of caring for the uninsured. They see firsthand that uninsurance and underinsurance often drives consumers to the ER. A recent study at Harvard published in Health Affairs found that overcrowding in emergency rooms has led to those with the most urgent conditions being at-risk.

Jane’s Hot Points: Physician support of national health insurance is nothing new. For over twenty years, Physicians for a National Health Program (PNHP) has focused its mission on achieving a single-payer system in the U.S. Today, PNHP has more than 15,000 members throughout the U.S.

That more physicians are joining the ranks of people in search of universal coverage moves the concept way past the tipping point in the U.S.

Why it’s impossible to close a hospital

• 5

By Jane Sarasohn-Kahn

Hospitals are major employers in their local markets; they are often the largest provider of jobs in a community. In its latest TrendWatch report, Beyond Healthcare: The Economic Contribution of Hospitals, the American Hospital Association details the economic impact of hospitals in each of the fifty states.
The bottom-line: hospital employment generates economic ripple effects way beyond the direct jobs provided in health care.
Hospitals
employ more than 5 million people nationwide – making them the
second-largest employer in the private sector – and account for more
than 4% of employment most everywhere. The Department of Labor
calculates that private-sector jobs indirectly generated by hospitals
is one in 10. That’s huge.

As
the chart to the left shows, hospital jobs pay more. That means those
workers generally spend more in their local economy, thus providing
spillover effects to other local employers like dry cleaners, food
establishments, auto repair shops, and other services used by workers
going to-and-from their daily jobs.

These ripple effects happen in at least three ways:
1. Purchasing goods and services from other businesses in the community
2. Providing income for employees, who then spend it in the community; and,
3. Paying wages and salaries, which are subject to federal, state and local taxes.

Jane’s Hot Points:
Always remember that one worker’s income is another one’s cost. For
some communities, the hospital is the local monopsony providing the
lion’s share of meaningful employment.
The
chart on the right from the AHA study illustrates that in many states,
hospitals provide at least 1 in 10 jobs: this is true for Maine, North
Dakota, Pennsylvania, and nearly 1 in 10 for Massachusetts, Michigan,
Missouri, Ohio and West Virginia, among others.

The microeconomy of the hospital is thus a major contributor to the States’ and nation’s macroeconomy.

When
there’s talking of closing hospitals, there’s no doubt why it’s so
tough to do so. Financing hospitals, appropriately, has implications
well beyond "the bed" and the individual patient.

Is Non-Profit Business An Oxymoron?

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By Paul Levy

An April 4 article in the Wall Street Journal, entitled "Nonprofit Hospitals, Once For the Poor, Strike It Rich" has prompted a slew of comments
on wsj.com. I think they are worth reading and do not intend to
summarize them here. Some accused the Journal and the quoted
politicians of grandstanding. Others said the story was right on target.

The
issue of the type and degree of benefits provided by non-profit
hospitals is a legitimate and important one. Our institutions are given
certain privileges by the government, and the government has a right to
supervise our performance in carrying out our public service functions.
Recently, the Massachusetts Attorney General announced a review
of certain of these activities, those relating to community benefits.
This is a healthy step, in that as times change, the standards of
behavior and reporting should likely change, too.

The WSJ’s
story contained examples of non-profit behavior that many will find
excessive. I think some examples chosen are unusual and not reflective
of most hospitals. But I imagine that a detailed review of
Massachusetts hospitals would find some items of a more modest level
that at least some people would find troubling.

Continue reading…

Fourth Annual Games for Health Conference 2008

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May 8-9, 2008 :: Baltimore Convention Center

The Games for Health Conference offers a rich platform for learning, promotion, networking and business development for organizations interested in the intersection between games and health. Topics to be covered include exergaming, medical simulation, interactive messaging, health behavior change, medical informatics, physical therapy and game development.

More than 300 individuals from 100 organizations – academic institutions, government agencies and foundations – are expected to attend.

Also, a pre-conference event on May 7 will offer two workshops: Games Accessibility and Virtual Worlds & Health.  All conference participants will have the chance to interact and play with these games that are improving society.

Web site for registration: www.gamesforhealth.org

Registration is $395 for Thursday, May 8 & Friday, May 9 and the pre-conference workshops on Wednesday, May 7 are $99-$129.

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