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.

Health Affairs is all about IT

Mar 10, 2009• 6

By Matthew Holt

Most of the Health care geek squad is in DC as I write, at a press conference conducted by Health Affairs which has an entire issue out today about IT in health care. Here’s the table of contents. And for those of you who don’t have a subscription, well here are four articles for free including those from David Brailer and John Halamka.

As you might guess KP’s HealthConnect is featured prominently with academic articles about the impact of its installation on physicians & the system (office visits down 25%) and patients (they love it).

There’s lots and lots more, including an article that makes stars of nerdy docs Jay Parkinson, Danny Sands and Ted Eytan—if “star” is the right word for this rarefied environment. (Oh, and somehow Bob Coffield got in there too!) My early tweetings on that one (which is the only one I’ve read so far) were captured and blogged by e-Patient Dave. Converting tweets into a blog post and making it make sense may be the new art form. Be warned that despite the words “Facebook & Twitter” in the title, this is about using Health 2.0 tools for patient to physician communication not about the social networking side of Health 2.0. Still I guess there’s room for another article in the next Health Affairs about that.

Reform? Marginal, I fear…

Mar 3, 2009• 36

By Matthew Holt

Today’s news is that there is now a double header running health care with the addition of the
(notably all-female) team of Sebelius & DeParle joining Orzsag, Zeke Emmanuel and a host of others with influence on the health care policy tiller. We await a CMS leader, and probably multiple other appointments quickly down through the ranks.

However, I remain convinced that not much is going to happen, and that even if Obama’s “plan” gets enacted, it’s a limited reform that is not the big bang we need to do the job.

Thankfully rather than me having to explain why, Bob Laszewski (who makes me feel like an inadequate noobie every time I read his stuff) details the problems over at Health Affairs blog. The Bob L summary?

Obama’s team has not aggressively gone after the hard cost problems as part of Medicare & Medicaid, preferring to trifle around the edges with modest cuts
For the (these days relatively modest!) $120 billion a year the reforms are going to cost it’s only looking to the health care system to pony up around half of it—the rest (c. $65bn a year) will come from the taxpayer.
The details of the plan are being left to the Congress which means that it’ll be watered down.

As I said in the looooong comment thread on Maggie Mahar’s piece on THCB yesterday—BTW Maggie’s comment on her own piece may be the longest comment I have ever seen on any blog!—there’s no reason that the rest of the economy should contribute more to the health care system. As John McCain might say (albeit with disapproval), we need to redistribute the wealth within the system.

Musings on Integrating Care at the IOM

Feb 26, 2009• 5

By Matthew Holt

So I’m in
DC figuring out how the East coast medical policy elite tries to change the world. While the rest of DC is buzzing about Obama’s speech and budget, The Institute of Medicine is having a conference on Integrative Medicine. But most people think it should be called integrative health.

What is integrative health, you ask? Good question.

The majority of the panelists are mainstream health care players like Bill Novelli (AARP), George Halvorson, (Kaiser Permanente), Ralph Snyderman, (Duke). They’re talking about integrating coordinated allopathic health care and information across an individual’s personal health plan. Snyderman, said we need to move from “find it, fix it” to a “personal health plan”. Halvorson said (surprise, surprise) that we need electronic health data on every patient, and to not just replicate the current silos of care in our new data strategy. Novelli went straight at the environmental factors—smoking, fast food et al. And to not ignore them. Mehmet Oz (he of the Oprah show) said that

Disruption breaking out over at Scott Shreeve’s place

Feb 21, 2009• 2

Clayton Christensen's publisher is pressing me to read The Innovators Prescription and then interview him. Sadly I haven’t had the time to pay the book the attention it deserves. Messrs Kuraitis & Kibbe already did a review on THCB and probably said what I’d say, which was that like several other Harvard Business School profs, they got the problem right but the solution wrong. I’m on record from a couple of years back saying that Christensen’s guns are aimed in the wrong direction.

But to be fair my criticisms are pre-publication. Scott Shreeve has a great interview with Christensen’s co-author Jason Hwang (the late Jerome Grossman is also a co-author). and in this interview several of the incentive issues which concern those of us who understand how innovation gets stopped in health care, are addressed. Well worth reading.

Divided we might get somewhere, but not yet

Feb 20, 2009• 7

By MATTHEW HOLT

The NY Times describes the Republican-less lobbyist meetings with Democrats that are allegedly getting
towards a consensus on an individual mandate as the way to universal health care. Funnily enough some of those same groups (e.g. The Business Roundtable & the NFIB) appear to be lessening their commitment to the worthily named “Divided we Fail” campaign.

And then on the second page of the NY Times article there’s this:

Many businesses, crushed by soaring health costs, say they now support changes in the health care system as a way to control their costs. But in its summary of the recent discussions, Mr. Kennedy’s office said, “There was little consensus on the employers’ role.”

Connecting the dots–Uninsured people are poor!

Feb 20, 2009• 10

By MATTHEW HOLT

A bunch of random articles all hit at once on Wednesday morning. And they win the John Madden award for stating the bleedingly obvious. This is kind of a companion piece to my rant about Friday’s NY Times article on the health industry and its political allies and adversaries sitting down to come to consensus.

Inquiry featured a worthy study. It tried to suggest that high costs “crowd out” health insurance spending.

I’m the Man of the Month, really!

Feb 11, 2009• 1

By Matthew Holt

OK, perhaps not the only man of the month in the whole world, but Missy Krasner from Google Health, who is also a founder of the relatively new Disruptive Women in Health Care blog interviewed little ol’ me.

Grand Rounds

Feb 10, 2009• 7

By Matthew Holt

Welcome to Grand Rounds. It's been quite some time
since THCB hosted the medical blogosphere's major compendium. So sit
back and enjoy a stroll through the gardens of medical and health care
obsession.

It's still a fresh political season, so we start with the wonks:

At TNR's The Treatment blog, Jonathan Cohn gets a top administration official to confirm
that health care will be a "central focus" of the budget proposal Obama
submits in a few weeks, signaling a major commitment to reform even
with Tom Daschle gone. He also runs down some possible successors to
Daschle and decides Howard Dean won't be the man, even though he'd do a great job.

Elsewhere on The Treatment, Harold Pollack says it's bad enough the U.S. opposes successful harm reduction strategies for drug addiction at home. Why do we have to use our clout to discourage other countries, too?

At Health Business Blog David Williams thinks that universal coverage
is a worthy goal, but says that if we get there by enrolling everyone in existing
public and private insurance schemes and maintaining existing levels of
utilization we’ll be doomed.

Jon Cohn: Obsessed with baseball and a hopeless optimist

Feb 9, 2009• 7

By Matthew Holt

Jon thinks that Baseball Teaches Us (something) About Health Care Reform. Replace the star player with a bunch of utility infielders, and we’ll still win the pennant. Don’t worry Jon, Daschle isn’t the only one who came in with high hopes and didn’t make it through the week. So long Luiz Felipe!

But more importantly, unity (for the bailout) is a bust already, less than two full weeks into the Obama Administration with only 3 Republican Senators prepared to buck Rush Limbaugh, and then at a pretty big cost to the President and common sense. As Krugman pointed out today, bipartisanship is a crock, with the Republicans telling Obama to go whistle despite his bail-out package being less in total and way less in degree than a centrist Democrat would want. He left in all those tax cuts to please Republicans and they dissed it anyway.

So what would the Republicans do if serious health reform came up for discussion? I think I know! And if Obama starts with an already watered-down plan, it’ll just get more watered down.

A Question For You Privacy Wonks Out There

Feb 3, 2009• 5

By Matthew Holt

When I read a headline like Privacy advocates hail stimulus bills I immediately wonder which privacy advocates. If it’s Deborah Peel I shudder, as her aim appears to be to shut down any system of electronic health data exchange. But if it’s Deven McGraw, from the Center for Democracy and Technology, I’m pretty encouraged as she (and her organization) seem to be taking the militant moderate path on privacy—putting patients in control of their data but encouraging the benefits of electronic records.

So I’m a little puzzled that they both like the privacy aspects of the stimulus package. Can someone who’s read the bill let us know what’s in there, and why they both like it while providers, payers and pharmacy chains hate it?

CODA: Of course who cares about the patients? Most importantly physicians’ privacy will now be safeguarded—even though it’s only their privacy about what we the taxpayer are giving them as contractors that Consumers Checkbook wanted to violate. I can just see Haliburton’s lawyers ready to cite this one.