Irrelevant small states with no people in them that exist by an accident of history are chronically over-represented in this country — both in the electoral college and most obviously in the Senate. And those states are much more conservative than metro areas where people actually live, which means that even if they send Democrats to DC, they’re not exactly raging Trotskyites.
Hence we get Max Baucus, representing less than 1 million people, or one-sixth of an average state’s population, pushing moderate reform and saying that single-payer is a political non-starter. He’s right, but it’s only because of the political structure that guarantees him his power. If San Francisco, which has roughly the same population as Montana, sent a Senator to Congress I think the result would be somewhat different.
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.
Univita is a new play from a strong executive team led by former Anthem CEO Ben Lytle. Post Anthem, Lytle and his son Hugh founded Axia, a wellness company, and sold it to DM industry giant (albeit a small giant among dwarves), Healthways.
Now they’ve bought Enurgi which has established a platform for caregivers to manage in-home care over the web. (FD, Enurgi was founded by my friend Chiara Bell). Scraped straight from Univita’s website, here’s what they say they’re going to do:
Those of you paying attention for the past few days might have noticed on the one hand a sense of optimism and unity as Barrack H. Obama, somewhat somberly, began his presidency.
Meanwhile, over the past few weeks the fur has been flying among the electrons on THCB while some very knowledgeable and opinionated health care wonks and geeks have been battling it out about what exactly we should be doing in terms of federal health care IT spending.
Previously in the long running retroactive insurance cancellation story I’d accused Steve Poizner (yes, the only Republican I’ve ever voted for and) California state insurance commissioner of being a bit soft. Now he really needs calling out.
Saint Lisa Girion reports in the LA Times today that to make up for cancelling 678 policies, Blue Shield, yes the warm cuddly pro-universal care loving non-profit insurer that’s not Wellpoint, has to reinstate them. Which means they have to reinstate the policies and pay the bills that they’d previously decided not to pay.
Now Blue Shield has been the most aggressive of all the insurers in the state in claiming that it had the right to retroactively cancel policies. Most of the others settled ages before. Meanwhile Poizner last year said this about Blue Shield:
Michael Lewis has returned from writing about Jim Clark, technology, baseball and football to his first
topic; finance. (Liars Poker is still the best book about Wall Street ever) His two part piece with hedge fund manager David Einhorn this weekend in the NY Times is one of the best things I’ve seen on the current financial crisis and what to do about it.
It’s called The End of the Financial World as We Know It and How to Repair a Broken Financial World. (I recommend reading them both straight through). And yes, Lewis wants more transparency and more regulation.
Paul Krugman estimated last month that the share of GDP going to the financial sector increased from 5% of GDP to 8% of GDP over the past 30 years or so. What did exactly we get for the extra 3% of the economy that was extracted by Wall Street? The answer is pretty evident. And of course lots of other sectors of society, generally inhabited by people earning significantly less money, have suffered pretty directly as a result.
Of course, there’s another sector of the economy that’s increased its share of the GDP by an even greater amount in roughly the same time period (from about 9% to about 17%). No prizes for guessing which one.
Anyone care to justify what value that sector has provided?
Like legions of other wonks when I discovered that Tom Daschle was going to be Obama’s point guy on health care, I sent off for a copy of his book Critical. It’s a fast and easy read, but in its examination of the problem it doesn’t add much to superior books on what’s wrong with health care (much of the first section reads like an undergrad’s attempt to summarize Jonathan Cohn’s Sick) and there are some pretty weak logic flows and basic editing throughout (he refers to the book Uninsured in America on p155 as though it’s already been introduced before it actually gets introduced on p161). But ignoring all that, what does Daschle suggest we actually do?
First, he promotes himself as a scholar of failed attempts at health reform past, and of course a witness to the most recent attempt.
Thanks for reading THCB this year. Thanks to to all the authors who we’ve featured and thanks to John and Sarah for keeping the train on the tracks. And thanks to all who commented and made THCB a great place for educated debate about health care issues.
We’ll be posting a little over the next week with some forecasts for 2009–-which is shaping up to be an interesting year in health policy at least. And there’ll be a new look for THCB early in 2009 too.
But for now enjoy the holiday!
I’m in Tahoe where there was 2 foot of powder last night, which I’ll be heading out to enjoy on my snowboard soon!
Last year US Preventive Medicine (USPM) caused a little splash with some full page ads in the Wall Street Journal proclaiming itself the future of preventative care. Since then the company, which has raised a significant chunk of private capital, has been diversifying into various aspects of prevention–including what looks more like disease management.
About a year ago USPM acquired Fred Goldstein’s company Specialty Disease Management Services. And since then it’s been marketing The Prevention Plan to employers–including a recent deal with AON–and also putting out a very neat online service that was shown at Health 2.0 in October.
Prevention is getting some lofty rhetoric, including Prez2Be Obama suggesting that it’s a major key to cutting health care costs. But many people in health care think that it doesn’t have an ROI. Fred disagrees and told me why in a wide-ranging conversation about the company, the concept of prevention and whether it’s really the wave of the future. Click here to listen