The Wall Street Journal reports this morning that President Obama in his speech tonight will renew his support for including a public plan option in health care reform. He will also endorse an individual mandate, which could cost uncurrently uninsured families as much as $3,800 a year for health insurance.
Meanwhile, recent polling suggests the public is still in the president’s corner on the public plan. This from today’s New York Times:
After weeks filled with seemingly ominous portents for Mr. Obama’s ambitions, there is evidence that public opinion remains basically supportive of him. Despite intense controversy over the “public option,” a government-backed insurance plan that would compete with the private sector, a CBS poll at the end of August found that 60 percent of Americans still support the idea, down from 66 percent in July. And half the respondents to the poll said Mr. Obama had better ideas on health care than Republicans, down from 55 percent.
TR Reid is a former foreign correspondent with the Washington Post. He spent two years (partly funded by the Kaiser Family Foundation) looking at health care systems across the world and has been featured heavily in many media venues lately asking the simple question, if everywhere else can cover everyone at half the cost, how do they do it? I had a great and not too long interview with him last week.
His book is called The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care and here's an interview he did as part of Frontline's Sick Around The World.
Funnily enough I'm posting this from Barcelona, Spain where hopefully I won't have to use the healthcare system unless I get carried away with the late night Sangria…
Seniors care about death panels (apparently) but they usually really care about drug prices and costs. Part of the political rationale for the Republicans passing Medicare drug coverage in 2003 was to deny the Democrats the ability to bundle seniors’ desire for drug coverage with a universal coverage bill. So far the Republicans have to say the least muddied the waters as to whether universal coverage is a good thing for Medicare recipients—or at least the ones that don’t care about their kids or grand-kids.
But there’s one minor trick. The deal with big Pharma that’s part of HR 3200 cuts the donut hole in half. That’s real money for seniors.
And when the cuts to Medicare Advantage become apparent, that donut hole is going to affect many more seniors who now are getting good benefits from Medicare Advantage and are pretty unaware about what’s about to happen to those benefits, according to this recent Silverlink/Suffolk University poll. (Hint, many Advantage plans will get much less generous).
In that case, knowing that there is something in the bill that helps them might change some seniors’ minds. Right now the Silverlink/Suffolk poll does not make happy reading for the Administration:
The survey also polled Medicare recipients on healthcare reform. Despite high levels of satisfaction and relatively strong amounts of optimism, nearly half of Medicare recipients polled (48%) say they do not believe the Obama administration is looking out for their best interests when it comes to healthcare reform. The remaining are split, with 28% believing the administration is looking out for them and 24% unsure.
I don’t use THCB much to point out what good we all can do—I keep that for my year-end letter—but my favorite charity (Saigon’s Childrens Charity) is at its financial year end and just sent me the reports for the kids I support. I’ve asked people who want to talk to me in the past to “buy a kid a bike.” And as it’s late on a Friday and I’m about to go out and take my wife to dinner, I thought you might all think about alternate uses for the $100 I’m about to spend (Yes, she’s a cheap date). Here’s what $100 buys for a very, very poor kid in Vietnam (and because of the recession donations are off this year, so they need more help).
I’ve been meaning for a while to put up a common sense post that points out that if we don’t do reform now, we’ll end up with cost at close to $30K per family as opposed to the $15K as they are now, and in turn that will mean 80–100 million uninsured as opposed to 50–60 million we have now, and of course the end result will be a health care industry that looks like General Motors.
But luckily Joe Paduda just wrote the post for me and added a date—go read at Managed Care Matters.
Which just leads to one conclusion. The health care industry had better buckle down with the Blue Dogs, put more on the table, and get something passed that they can live with now. AND in addition, they need to figure out some way to stop the loony fringe at the town halls and listening to Rush Limbaugh from making the next best alternative be doing nothing—which is what they want.
Otherwise the conversation they’ll be having with the President and the Chinese central bank in 2016 will be very, very unpleasant.
Tonight the documentary based on Maggie Mahar’s book Money-Driven Medicine is on Bill Moyers’ show on PBS.
Meanwhile if you haven’t seen this clip of Oklahoma Republican Senator Tom Coburn seriously suggesting to a completely desperate woman that her neighboors should be the ones helping her look after her husband with a traumatic brain injury, you’ll be illuminated by how out of touch (and that’s putting it very kindly) he and lots of his colleagues are on the real life actual needs of people suffering now as opposed to inciting vitriol from the fringe over vague concerns in the future.
Over the years PhRMA must be getting pretty sick of Univ of Medicine and Denistry of New Jersey Professor Donald Light. He’s made a cottage industry of pissing on the commonly-trumpeted propaganda that only American drug research is effective, and that high prices for drugs in the US cross-subsidize lower prices elsewhere in the world. And in Health Affairs this week he does it again. Essentially Light shows that the added R&D spent in the US compared to Europe doesn’t give much bang for the buck, and that not many breakthrough drugs have been created anyway—something that PhRMA knows all to well as it looks at its shrinking pipelines.
In global NCEs, European research productivity was about the same as U.S. productivity in the first period but increased by 30 percent in the second period (1993-2003), while U.S. research productivity declined 26 percent (Exhibit 3). In first-in-class drugs, European relative innovativeness moved from well behind the United States in the first period to well ahead in the second. These are the most commercially and therapeutically important types of new chemical entities.
Now personally I think that, in an era in which all drug research is pretty much international, the basic premise of the argument about which system does more effective drug research is pretty silly. But of course it’s a one-two punch. And the upper-cut that would leave pharma staggering if it didn’t have control of the microphone is this quote from Light:
Congressional leaders and others concerned about high prices of new patented drugs will be heartened by this analysis, because lower European prices seem to be no deterrent to strong research productivity.20 A previous analysis using industry-based data showed that pharmaceutical companies recover all costs and make a good profit at European prices.21 Europeans are not “free riders” on American patients–another myth promoted by industry that assumes that countries are separate R&D/market silos that should each pay for themselves.
Given that Billy Tauzin at PhRMA has already cut a deal with the Obama Administration (albeit one that seems to be unofficially official), none of this matters very much. But it’s good to see that it might just be possible to reduce the very high margins earned by big Pharma without necessarily ending scientific advancement as we know it.
So in Austin every year they have this SXSW conference. Indu goes every year and raves about it. Last year Jay Drayer from CareFlash put me on a panel (but it didn’t get selected). This year he has a different group. But don’t worry, Feelgoodnow.com has proposed a panel entitled Sick Clicks: The Evolution of Health Online that will feature me and other buds including Susannah Fox, Associate Director of Digital Strategy at the Pew Internet & American Life Project,Catherine Ulbricht, founder of Natural Standard and Jay Parkinson, founder of HelloHealth.com.
The bizarre thing is that SXSW is a democratic event and you have to vote for it. So please go vote for us here. And if you want to vote for Jay Drayer’s motley crue, well they’re here (and they’re pretty damn good too…)
Al Waxman is a healthcare entrepreneur who these days runs the Psilos Group, a venture firm that invests in health care services, health care IT and device and instrumentation companies. Among their better known investments are Active Health Management, Health Hero Network and Definity Health–now all acquired by publicly traded companies. This is a wide ranging conversation about Al’s investment philosophy, his desire to get VCs more involved in health care, his mistrust of politicians and where he thinks health care technology is headed. Here’s the interview.
Al will also be on a panel at Health 2.0 on October 6-7 talking about whether Health 2.0 can make health care more affordable.
Podcast: Play in new window | Download
One of the best local talk shows anywhere is Michael Krasny’s Forum on 88.5 KQED, San Francisco’s establishment NPR station (SF of course has a rebel NPR station KALW which has had me on a couple of times but I’m too scruffy for KQED!).
At 10 am PST Forum has a show about health IT which has Robbie Pearle from the Permanente group and 2/3 of my old HIO project team at IFTF, Joe DeLuca and Jane Sarasohn-Kahn.
You can listen in here