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Category: Health Tech

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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PharmaSecure using SMS to detect counterfeit drugs

In developing countries, (and here too) counterfeit drugs are a mega-big problem. Essentially fraudulently labeled drugs in the supply chain are often not what they say they are, with potentially devastating consequences. But there’s no really easy way for companies to monitor their supply chain. We ran into PharmaSecure as they were getting off the ground last year, and yesterday I met CEO Sarah Hine who showed me how their technology allows the consumer to directly connect with the manufacturer using SMS.

A very innovative use of technology and a very interesting brief interview (complete with demo!). They’ve also just raised a $2m series A round.

The Deer Hunter and healthcare reform

Greg Pawleski sent me this little tale. This is the pull-off SR 61 and Adamsdale Rd in Schuylkill county, Pennsylvania. The deer was hit there. The couch was dumped there previously. Day two, the deer was on the couch.  Day three, the end table and lamp showed up. Day four, the TV and TV stand showed up. The Trooper had to call PENN DOT and wait because of all the people stopping to take pictures.  PAY CLOSE ATTENTION TO THE SIGN.

Deer

The cardboard caption in front of the deer on the couch reads:Sorry Hunters.  Obama ruined healthcare.  We can’t afford to have injured hunters on our conscience.  Stayed home. Sorry. The deer.”

My personal start of year letter…

….is up over on my barely used personal blog. It’s a record of an email I send out about charities and causes I support (with a little bit of news about me and mine). If you’re interested it’s here

The five things to pay attention to in 2010

There’s no doubt that despite my thoughts that Obama wouldn’t (and shouldn’t) have pushed health reform in 2009, it was a very big year for health care. Death panels, public options et al—one hundred thousand visits to THCB in August don’t lie.

So what should you look for next?

  1. The finish is the start: It looks like some version of the Senate bill will be a done deal by sometime late January. That means that there’s about two years of health care industry players figuring out what it all means. The biggest two questions are; what will the types of plan sold in the exchanges look like? (high deductible with some preventive care thrown in is most likely), and what will the cuts and changes in Medicare payment actually look like in practice? (More of the same or real re-alignment around some kind of bundling). All these changes need reactions from the incumbents to reorganize around the new revenue streams.
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As I’ve always suspected, Health Care = Communism + Frappuccinos

Nothing new today from me, but if you’re stopping by THCB looking for some post-Xmas inspiration, I thought you might like this essay I’m rather proud from back in THCB’s past (back in the dark days of 2005). It concerns the eternal battle between government/private funding in the provision of health care, and it’s one of the more fun ones I’ve written.

It’s called As I’ve always suspected, Health Care = Communism + Frappuccinos

Senate passes bill, more to come

It’s Christmas Eve and the Senate just passed a major health reform bill. Personally I think the reforms in it are relatively minor, but the passage of the bill itself is a screaming big deal. When I say minor, what I mean is that we’re leaving in place the inefficient employment-based health benefits system, and we’re expanding insurance mostly by putting more people into the separate but equal Medicaid program.

But this bill is a statement, and an important one.

For the first time we’re acknowledging that everyone ought to have health insurance and that those unable to afford it should be subsidized by the government. We’re also saying that insurance companies should take all comers at a consistent price without respect to health condition (and hopefully we’re implying that their job is to manage care not risk-select). Finally we’re saying that the majority of the cost can be paid for by redirecting inefficient spending within the health care system, and by taxing benefits that are only tax-free because of historical accident.

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Enthoven beats up Gawande

I finally got around to reading Atul Gawande’s New Yorker piece on why the current reform bill mirrors early 20th century agriculture. I learned lots about the role of the Department of Agriculture in teaching farmers what to do. In post-war Britain the radio soap opera The Archers did much the same thing.

I was actually encouraged to remember that in almost every industrialization process, intelligence, leadership, and usually money, from the government was a key factor.

But I felt very uncomfortable with the analogy. First, the incentive for the farmers was to be more productive—even if in the long run productivity meant a relative fall in the price of food and eventually the rise of agri-business decades later. If they did things right there was an immediate market reward. Whereas we know that (from the Virginia Mason and Intermountain examples) increasing quality and productivity in health care leads to negative financial consequences.

Secondly, Gawande seems to be fine with saying that “we don’t know how to be more efficient, productive and effective, so let’s do pilots for years and figure it out.” This is just crap. We’ve both done pilots for decades, and have examples of organizational forms (you know who I mean!) that get it right. It’s just made no sense for most of the health care system to adopt those techniques and organizational forms because they make more money by doing what they’re doing—and government and employers keep paying them.

I was going to write a long piece detailing my complaints blow by blow, but luckily Alain Enthoven has done it for me!

This doesn’t mean I’m against the current bill as I suspect Enthoven is. There is some hope that ACOs and other modern terminology for the types of organization he’s espoused over the years, will arise more quickly from the “pilots” in the bill than Enthoven suspects. But more importantly, I support the bill because the saving money part is the second of my “two rules to judge a bill.” The first and most important rule is

Rule 1 A health care reform bill needs to guarantee that no one should find themselves unable to get care simply because they cannot afford it. Neither should anyone find themselves financially compromised (or worse) because they have received care.

And the current bill just about does that….although Maggie Mahar is pretty doubtful, especially for near-seniors in the first few years.

Interview with Alan Greene MD, author of “Raising Baby Green”

One of the most remarkable talks I heard this year wasn’t about health care. It was about food. Of course, food is very, very closely related to health and health is at least tangentially related to health care.

So I invited Alan Greene of drgreene.com (who is a friend and has spoken at a couple of Health 2.0 Conferences) to tell me about the new book, Raising Baby Green. It really is a potential way to change how Americans (and everyone else) eat, and to use the most important years (the ones we can’t remember!) to do it.

Most importantly Alan is starting a viral campaign to get this information into the hands of expectant mothers. For anyone who knows an expectant mum or someone who might be one someday, this book is very important. And the message needs to get out and get mainstream quickly.

Here’s the interview in which Alan explains how to feed kids right, and we do a little plotting in how to get this into mainstream child-raising.

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