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Category: Matthew Holt

Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site and hosts the #THCBGang and #HealthInTwoPoint00 video shows/podcasts. He was co-founder of the Health 2.0 Conference and now also does advisory work mostly for health tech startups at his consulting firm SMACK.health.

HIMSS Parties, and a little more

Next week the health IT world descends on Atlanta which means a lot of chat, lots of meetings and lots of parties. You’ll be seeing the results of my interviews on THCB next week.

But meanwhile more importantly—the party schedule. So far I’m signed up on Monday for the MEDecision party (mostly because it’s in the aquarium), the HISTalkparty (in which you try to spot the mysterious MrHISTalk and Inga) at Max Lagers. I’ll likely be wearing a sash.

For Tuesday night I’ve been asked to give a special shout out to the FierceHealthIT party. Apparently this one will be huge but there’s room for more. It’s at the World of Coca-Cola, and I'm not sure if you have to bring your own rum. Sign up here

Finally, there’s a new party on Tuesday called HITMen which has an interesting group of cats & dogs on its host committee….although probably only worth going after the palavah is over (unless you like sitting through award ceremonies).

Of course there’s a large chance that I’ll miss all of these but there are two sessions I won’t be missing.

Monday at 2pm in room C201 I’ll be one of the bloggers to meet in the Meet the Bloggers session. It’ll be a good chance for me to argue in public with Val Jones.

And Tuesday at 1pm the ever wonderful Jane Sarasohn-Kahn and I will be presenting on Health 2.0 & Participatory Medicine in Georgia Ballroom 1.

This does all assume I can get out of France despite the air traffic controllers strike! Hope to see you in Atlanta.

Who does PhRMA need next? Robin Strongin thinks she knows

I met Billy Tauzin last summer in Aspen and you couldn’t help but love the guy. He had that amazing Louisiana charm, and was helping PhRMA walk a tightrope between being the bad guys, and giving away the store. Whether or not like Paul Krugman you’re appalled at his old school N’Awlins sense of ethics, he was clearly able to cross lines and get PhRMA to a place it hadn’t been before.

But now that reform is receding from likelihood, where does big pharma need to go now that Billy jumped (or was pushed)? At the Disruptive Women in Health Care blog, Robin Strongin suggests that pharma needs to get out of its box and really embrace the new type of patient—and appoint a leader who is on the technological cutting edge.

A new campaign against childhood obesity

There are intractable long-term problems and then there’s America’s waistlines. And in particular there’s the issue of childhood obesity. I shudder to think what we can do about it, and recently interviewed Alan Greene on the topic of changing eating habits for children.

Earlier this week First Lady Michelle Obama kicked off a campaign to try to end childhood obesity within a generation. The campaign is called “Let’s Move

One of the point people behind the campaign is Kaiser Permanente’s SVP of Community Outreach Raymond Baxter. KP has joined with several foundations (including the Nemours, the Robert Wood Johnson Foundation, The California Endowment, the WK Kellogg Foundation, and Alliance for a Healthier Generation) and they’re working on an extremely ambitious program called the Partnership for a Healthier America.

How ambitious? And can it be done? I spoke to Raymond yesterday to find out. Here’s the interview

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Apparently the public perceives a problem

I think health care reform is dead. And the proposed reform was relatively inconsequential anyway, as it would have left in place Medicare as is, Medicaid as is but bigger, employment-based health insurance, and fee-for-service medicine. And with Scotty Brown winning in Massachusetts, and harsh political winds stripping off the Blue Dog votes from the House Democratic majority, it seems that there’s no hope. In that context Obama’s not entirely spirited defense and offer to have a parlay on TV in a couple of weeks doesn’t sound like a recipe for action.

But apparently the public is less happy with nothing than it might appear are politicians. Today’s Washington Post/ABC Poll claims that two-thirds of the population think that we should keep trying—including 56% of the independents who the Dems feared they had lost and even a sizable minority of those claiming to be from the do-nothing party.

Wapo

Will this poll make any difference? I doubt it, but stranger things have happened. And it does confirm that although Americans may not like the bill or agree on any solution, they know that the health care system is a big problem.

Wellpoint’s wasted opportunity

Sometimes with something so egregious gets written that, even if it’s in the Wall Street Journal, you have to notice it. Angela Braly, the CEO of Wellpoint—compensation a hair under $10m in 2009—ought to be happy, even though Joseph Rago in the WSJ is surprised about that. It looks like the health reform bill which put much of Wellpoint’s highly profitable individual and small group business at risk is dead, and this week Wellpoint started putting up rates between 35% and 80% in the California market (where it’s Anthem Blue Cross).

But the WSJ quotes her as calling health reform a “wasted opportunity”. Funnily enough Wellpoint and the trade association it funds, AHIP, were on both sides of the debate. Pushing Congress to give it 30 million more customers as part of the bill, and then surreptitiously funding the Chamber of Commerce to oppose health reform (and putting pressure on the Blue Dogs, and the DINOs in the Senate) when some of the terms of the House Bill started to look less favorable (85% Med loss ratios limits among them).

I’d had some semi-decent hopes for Braly and her team.

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Uwe and Heritage agree: we need a tax-funded universal pool

When you’re at a party and someone explains to you that they just read a great article in the NY Times explaining why Peggy Noonan doesn’t understand basic math, and you know that they’re referring to Uwe Reinhardt, then you’re over-wonked. That’s surely my condition

Here’s what Uwe said—you can’t just ban medical underwriting as Noonan suggested, because the individual insurance market will collapse. Both the history of New Jersey (and Washington state) in the 1990s, and in current Massachusetts where people can buy insurance or pay a lesser fine, show that healthy people won’t buy insurance until they need it.

The answer is to force everyone into a universal insurance pool

But of course, that means younger and healthier people will likely pay more. For the good folks from Heritage writing on the WSJ Opinion page this is an outrage. Using their complex model they came up with the amazing analysis that if you give uninsured younger people with no health condition the choice of paying a smaller fine or a higher premium—surprise surprise—most will pay the fine. And of course that’s exactly what’s happened in Massachusetts.

The problem is of course that most younger people who have no insurance are in low wage jobs, They therefore place a much higher value on receiving money now than forgoing it to later stave of a potential risk of catastrophe from having no insurance

So we deal with this in a very sensible way in the rest of society’s transactions.

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A vote for single payer, austerity-style

I spent summer 1984 in Boston and generally found it an oppressively hot place. I’ve spent a few winter days there and found it an oppressively cold place. I’ve always thought that, given the absence of passport controls, if you lived there and could move to California and didn’t, you were probably crazy. And yesterday the residents of that fair state proved me right.

As I said earlier this week, it now appears that health care reform is dead. I just can’t see a scenario in which there are 60 votes to pass anything. I also don’t see the Dems having the cojones to go to reconciliation or to cram the current Senate bill through the House quickly. Instead (as Bob Laszewski says below) the moderate Dems will run for their lives away from health insurance reform—although I just don’t understand what Bob thinks “reform” would have meant if it had really required 6–10 Republican Senators.

So my prediction is that we end up with nothing.

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Thinking the unthinkable–no Health Care bill?

Matthew Holt

After a resounding Democratic Presidential election win, a terrible recession, and a bruising year of politics, it would be just like America that a crazy election result torpedoes the health care reform bill. It would be the first Republican Senator win in 43 years in Massachusetts, a state that’s bluer than blue, and the actual seat being elected on Tuesday hasn’t been won by a Republican since 1947!

But it’s becoming more and more possible, and the latest polls are all over the map.

Let’s play out what happens if we go back to a 59–41 Senate. The current Senate rules basically allow the minority to shut down proceedings. Harry Reid has in fact performed miracles to keep Lieberman, Nelson and some of the rest on board. Obama, Reid & Pelosi are now working the deal out with the unions and all the rest to make sure that what’s a pretty slim majority in the House will essentially accept the Senate bill—with some sop to the unions on the “Excise tax”. There are some other technicalities about the Exchange et al, but in the end we have a fair idea of what’s going to be the result.

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Why health insurance reform really matters

Just occasionally we get a really heartfelt comment on THCB that is passionate and rational, and reminds us why for all the bile spewed about the topic the essential part of the health care bill—making insurance available to everyone—is really important. This comment from CF Mother was left on my post “Thinking the unthinkable” on Friday. And of course, this could happen to anyone—including you. And frankly the Democrats need to do a better job explaining this—Matthew Holt

Questions for those who do not support health care reform:

Twenty years ago our cheery toddler was diagnosed with cystic fibrosis. Afraid, we dug into the medical research to understand the disease that threatened his future. We healed through optimism, roused by the news eight days after his diagnosis that the gene that causes CF had been found, opening the door toward a cure. We knew that our heroes, the researchers and his doctors, would continue to find ways to protect his future. We were no longer afraid of CF.

The fear that woke me in the night was of losing our health insurance because our son was on every insurer’s no-fly list. While my husband’s profession was periodically roiled by layoffs, he decided against the security of opening his own firm because the cost of carrying coverage for our eldest son was too high, the thread on which his health care dangled too slight.

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