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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.

A little HIMSS housekeeping

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By MATTHEW HOLT

Today till Weds I’ll be at HIMSS in Atlanta. You can see me at the Bloggers panel at 3pm Monday, or more importantly at the talk Jane Sarasohn-Kahn & I are giving on Health 2.0 & Participatory Medicine at 1pm on Tuesday in Georgia Ballroom 1.

I’ll also be wondering around with the trusty flipcam, so expect to see a few schedules and not so scheduled interviews up on THCB too. And you can always follow my twitter feed http://twitter.com/boltyboy If you want to meet me, best bet is to DM or follow my social schedule here although with Jetlag waking me up at 4am not sure how long I’ll last tonight!

Interspersed in all of that tech stuff, THCB will roll on as usual. I’ll let you know in 3 days time if the tech sector in health care has made more progress since last year than their political cousins!

Bentley & Stanton: Two UK docs talk about Health 2.0

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By Matthew Holt

Last week in London I met with two of the brightest lights in the UK’s community of physicians looking at Health 2.0. Annabel Bentley is the medical director and head of informatics at Bupa, the UK-based non-profit health insurer, which owns Health Dialog amongst many other activities, and is also a sponsor of the upcoming Health 2.0 Europe conference. Emma Stanton is a psychiatrist, round-the-world yachtswoman, and has just spent two years on assignment working with Sir Liam Donaldson the Chief Medical Officer in the UK, and is on her way to a Harkness fellowship in the US working with Don Berwick & Eliot Fisher. Not bad company!

Both will be speaking at Health 2.0 Europe on April 6–7 in Paris (and you should come too, you can register here!) and both of them gave me some gems about why they think Health 2.0 is important in this brief interview—captured in the glamorous location of the Bupa canteen.

HIMSS Parties, and a little more

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By Matthew Holt

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

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By MATTHEW HOLT

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

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By Matthew HoltFirst Lady Michelle Obama at the kickoff of her campaign against obesity this week

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

Continue reading…

Wellpoint and Their “39%” Rate Increase

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By MATTHEW HOLT

Wellpoint is getting killed in the press over a “39%” rate increase for their individual health insurance block in California.

HHS Secretary Sebelius has pointed to the Wellpoint individual rate increases demanding an explanation. The President even brought it up in his interview on Sunday. At a time Democrats are fond of calling insurance executives “villains” this story just adds more fuel to the fire.

No less than five reporters  called me the day the story broke asking me to explain it all.

Falling back on my industry experience it is probable:

  • The “39%” headline is anecdotally the biggest increase the press has found—the average is probably less albeit in the high 20% range.
  • This is likely driven by a combination of increasing medical cost trend, a bad economy, and anti-selection as healthier people disproportionately drop their coverage leaving a sicker group in the pool.
  • The rate increase is probably “defensible,” at least actuarially, based upon the actual experience in that block.

When the day is done this probably says more about why systemic health care reform is so critical than about any one company’s behavior. Last week we heard national health care spending skyrocketed to 17.3% of the economy. This is a real life example of what that macroeconomic statistic really means.

Continue reading…

Apparently the public perceives a problem

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By Matthew Holt

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

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By Matthew Holt

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.

Continue reading…

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

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By Matthew Holt

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.

Continue reading…

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