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Disgusting, and another reason why marriage needs to be re-defined

Tara Parker-Pope reveals two cases where discrimination kept a partner, and in one case the dying woman’s children, away from their loved one while they were dying in hospital.

One hospital involved is Jackson Memorial in Miami, a massive recipient of Federal dollars. In 1965 then un-integrated hospitals in the south were forced by the Federal government to take black patients as part of the new Medicare program. It’s high time that an executive order was made by Obama that hospitals receiving Federal dollars immediately change their visitation policies in this respect.

But beyond that, those bigots (including the ones who have commented on THCB) who continue to maintain that not changing the legal definition of marriage doesn’t hurt anyone should consider the stories of the people Tara reports about, and they should feel very guilty.

Health Care Leaders Say Obama Overstated Their Promise to Control Costs

Capital

That was the headline in Thursday’s New York Times regarding Monday’s promise by health care  stakeholders to reduce spending by $2 trillion.

A couple of snipets from the Times article:

Hospitals and insurance companies said Thursday that President Obama had substantially overstated their promise earlier this week to reduce the growth of health spending.

“There’s been a lot of misunderstanding that has caused a lot of consternation among our members,” said Richard J. Umbdenstock, the president of the American Hospital Association. “I’ve spent the better part of the last three days trying to deal with it.”

One of the lobbyists, Karen M. Ignagni, president of America’s Health Insurance Plans, said the savings would “ramp up” gradually as the growth of health spending slowed.

Right after the $2 trillion announcement I posted:

Don’t also assume that the American Medical Association (AMA) really represents doctors—I don’t think anyone or anything really represents doctors. If the AMA makes a commitment that actually means sacrifice among the docs you will see just what I mean—especially if the national association folks do a deal with the insurers “on behalf” of all the docs back home requiring real sacrifice. To some degree, you can say the same for the thousands of hospitals out there.

If these stakeholders don’t deliver $2 trillion in something Orszag can take to the bank will the Democratic response be a “public health plan?” Watch the fireworks.

Someone dug themselves one heck of a hole yesterday.

Is it the stakeholders that now have to do in a few weeks what no one has done in decades of pondering this dilemma—make a tangible, measurable, and enforceable offer that cuts real money? If you think coming up with $2 trillion was a big deal actually figuring out the mechanism to carry it off will be a dramatically bigger challenge.

Was it the Obama administration that just raised expectations exponentially trusting these guys can actually deliver something measurable? Or, is the Obama administration just setting them up?

Or was the Obama administration just setting them up?

When those stakeholders walked into the White House on Monday they never intended to make more than a vague promise. When they walked out it was to headlines that they would make “scoreable” proposals by June 1st.

They also had some very angry constituents across the country wondering just what kind of deal they were doing.

They never had $2 trillion and now they have one big problem!

As one insider told me this week, “They got smoked!”

Reconciliation — or War?

Reconciliation. It’s an odd word for something that could precipitate a knock-down, drag-out fight in Congress, but the process that Senate Democrats agreed last week to adopt if health care reform legislation isn’t passed by October 15 was originally intended to reconcile differences among House and Senate budget bills.  What the process does is to replace the usual Senate requirement of a three-fifths majority—needed to end a filibuster, but also consistent with Senate traditions of compromise—by a simple majority.

So, with the Democrats having decided on an aggressive approach (Republican Senator Michael Enzi has called it “like a declaration of war”), what are the implications for the reform legislative process (beyond making Congressional Republicans mad)?

First, is October 15 an absolute drop dead date?

The answer is, not quite. Not only does the reconciliation process provide for up to twenty hours of debate (which could move the deadline out by just two or three days), but Senate Democratic leaders might prefer to continue negotiations on a reform bill if they felt they were close to the magic sixty votes.  This would require the vote of at least one Republican, as well as the only Independent (Joe Liebermann), but would allow Democrats to claim bi-partisan support—even if only a little.

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Calendar: Project HealthDesign

The Robert Wood Johnson Foundation (RWJF) has announced a new call for
proposals for Project HealthDesign: Rethinking the Power and Potential
of Personal Health Records, a $10-million national program to stimulate
innovations in personal health information technology.  Project
HealthDesign will host the second of its informational web seminars for
potential applicants on
May 7th.  For more information and to register: http://www.projecthealthdesign.org

Community: SharpBrains Releases 2009 Market Report

SharpBrains is pleased to announce the release of The State of the Brain Fitness Software Market 2009 report, their second annual comprehensive market analysis of the US market for computerized cognitive assessment and training tools.  Designed for decision-makers at healthcare, insurance, research, public policy, investment and technology organizations this report contains important information concerning developments in the brain fitness and cognitive health space.

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Octomum gives Kaiser a bellyache

First KP somehow gets landed with the Octomum, whom they most surely didn’t provided with the IVF in the first place. My assumption is that the multiple birth cost them into the middling 6 figures.

Now because a rogue employee released some of the Octomum’s records, they get hit with another $250K fine! I felt KP made a little too much fuss at the time about their services (the press conference crowing about the birth was a little much). But this is now an example of good deeds getting multiply punished….

SharpBrains Releases 2009 Market Report

SharpBrains is pleased to announce the release of The State of the Brain Fitness Software Market 2009 report,
their second annual comprehensive market analysis of the US market for
computerized cognitive assessment and training tools.  Designed for
decision-makers at healthcare, insurance, research, public policy,
investment and technology organizations this report contains important
information concerning developments in the brain fitness and cognitive
health space.

The report this year expands to 150+ pages, and has added several new chapters:- Results from a market survey with 2,000+ respondents (decision-makers and early adopters)
– A proprietary Market & Research Momentum Matrix to categorize 21 key vendors into four categories
– 10 Research Executive Briefs written by leading scientists at prominent research labs
– An analysis of the level of clinical validation per product and cognitive domain

This insightful report will be available through direct purchase at a reduced rate for THCB readers strating May 7th, 2009.

UPDATE from the FRESH-Thinking Capstone Conference

Fuchs

In the same week that the Obama Administration has stated its commitment to overhauling the health  care system, the FRESH-Thinking Capstone Conference adjourned yesterday morning to discuss next steps in health care reform. The event is a cross-section of health care experts—academics, practitioners, economists, industry insiders—devoted to fixing the health care system.

The morning began with Stanford Health Policy core faculty member Victor Fuchs welcoming the hundred plus attendees. Fuchs is co-director of the FRESH-Thinking Project with Ezekiel Emanuel. Emanuel stepped down from the Project to join the Obama Administration earlier this year. The Project has spent the past years considering all aspects of health care reform, and this conference is the capstone event of the group's findings. The morning talks look at the cost side of reform.

The first morning speaker was John B. Shoven, Director of the Stanford Institute for Economic Policy Research (SIEPR), who queried the crowd "is it possible to put health care on a diet?" Shoven's focus was on universal coverage and how it can be paid for. After discussing the logistics of who the uninsured are and the current taxation approach, he disavowed the crowd of two giant universal health care reform myths: shared responsibility and the middle class not having to shoulder health care costs. Shoven's take aways were "it's not necessarily that we should have new value added tax. It's that we should have a dedicated tax … We should not separate the benefits from the costs."

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Should Health Care Standards be Open Source?

Recently there has been some chatter on Twitter about health standards and open
source, so I thought I would write a little commentary on the topic.

Anyone who knows me well, knows that I am huge fan of Linux and open
source.  This is perhaps why I get so frustrated with the US health
care industry and its general lack of interoperability.  I could use
many standards as an example, however, for this discussion I’m using
the ASTM Continuity of Care Record (CCR) as an example.  Now I’m not
picking on the CCR. The format is XML (good), and while there is always
room for improvement, I think the general structure is reasonable and
workable.  I’d also point out that David Kibbe and Steven Waldren, two
keep champions for the CCR, have always been nice and helpful any time
I’ve asked a question on the list serve. I’m using the CCR as example
just because the barrier to access is so low ($100).  Much of the
following is summarized from an inquiry I made to the CCR list serve
about a year ago.

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The Chronic Pain Educational Educational Workshop in Berkeley, CA – July 19th, 2009

In the spirit of Health 2.0 and User Generated health Care we are proud to announce:

“The Chronic Pain Educational Educational Workshop"
July 19th, 2009 – 12:00P.M – 7:00P.M – Reception 7:00P.M – 8:00P.M

Chronic pain is the 21st century’s invisible handicap, a humanitarian crisis of epidemic proportions.

Chronic pain holds back individuals, families often whole communities from their full potential.

We believe effective chronic pain prevention and treatment is possible;
it comes through education and our goal is just to do that: to raise
awareness and educate on the issues related to chronic pain. That way
individuals and their families can make educated decisions on how to
manage their chronic pain, reclaim their lives and be able to
participate and contribute to their families and communities not longer
being devastated by daily burden of chronic pain.

The event is designed to educate and fundraise on issues related to
chronic pain and to benefit "The Chronic Pain Educational Documentary
Series."
During the event there will be informational booths with educational
material available to attendees, informational sessions and a silent
action.  Food and beverages will be available.
Massage therapists will be available during the event for free chair massages.

Companies and individuals are welcome to sponsor and/or attend the event.
For more information or press releases please inquire via e-mai; at Ch******************@***il.com

Op-Ed: Leave it to Darwin?

Roger collierI’ve been reading some of the testimony on delivery system reforms from the House Ways and Means  Committee meeting earlier this month, in particular the lengthy statements from MedPAC Chairman Glenn Hackbarth and Urban Institute Senior Fellow Dr. Robert Berenson.  Hackbarth and Berenson are each distinguished health care figures, and their remarks are worth careful study. Together, they paint an all too familiar gloomy picture of a system whose costs are out of control, in which quality is often poor, and where there is little correlation between expenditures and outcomes. Few would disagree with the causes that they identify: payment structures that reward volume, lack of coordination among providers, an overemphasis on specialty care, and a system that seems more often driven by supply than demand. The two sets of testimony include several very important recommendations, like more emphasis on public health, dissemination of comparative effectiveness information, and higher payments for primary care (although several years will elapse before this makes a real impact on physician career choices).

Other testimony proposals, however, especially those focused on
Medicare, carry the risk of distracting us from more important changes.
Chronic care coordination (including the medical home model) has not
yet convincingly been demonstrated to cut costs. Accountable care
organizations (this year’s buzz-phrase) require more willingness to
cooperate than many providers have so far shown. Bundled
hospitalization payments make good sense but require the same kind of
willingness to cooperate. Tying payments to quality introduces
questions of data interpretation and validity of guidelines.  

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