Category: Health Tech

Live from Aspen: the moderates’ view on Obama health reform

Jul 27, 2009• 14

By Matthew Holt

Paul Krugman’s article today excoriates the Blue Dogs and a former dog Billy Tauzin in particular. He also (as I did a week or so back) wonders where the Dogs were when the Bush tax cuts were bumping the deficit more than the proposed health reform bill will and redistributing wealth from future poorer taxpayers to the very rich in the process.

Funnily enough I’ve been at the Aspen Health Forum where the self-same Billy Tauzin used his not inconsiderable Cajun charm and a dollop of PhRMA’s money to buy me (and a bunch of others) a whisky and a s’more on Saturday night, and took part in a couple of panels I watched on Sunday. We had a couple of brief chats, one about his cancer treatment and another about getting big Pharma to behave better. He claims some progress there (voluntary restrictions on DTC, better posting of clinical trial data, reductions in marketing excess to docs). I suggested that there was more progress required both in pricing policy and PR. He said it was hard, I told him that was why they paid him the big bucks.

Interview with Jonathan Bush, AthenaHealth CEO

Jul 26, 2009• 3

By MATTHEW HOLT

In this interview Jonathan Bush explains the nation’s major problem: a severe shortage of MUMPS programmers. Well not exactly, but as always the AthenaHealth CEO is well worth watching. And of course he’ll be at Health 2.0 on the same panel as Allscripts CEO Glen Tullman. That will really be worth watching, and of course you can sign up to come to Health 2.0 in October here.

Carleen Hawn debuts HealthSpottr and a list

Jul 24, 2009• 29

By Matthew Holt

Carleen Hawn’s new site HealthSpottr is up and she’s starting with a list of the Top 100 random people in health care. Well it’s supposed to be innovators, but it mashes up a bunch of Health 2.0 folks with some biotech people, some health policy types (Berwick & Wennberg are close to the top), some health system types, and some academics. And yes, a certain Harvard Business School prof who’s one step ahead of the SEC is ahead of Uwe Reinhardt, with Enthoven not on the list. Perhaps most amusing is that Microsoft’s Peter Neupert is #1 while no-one from Google is on the list (Although Adam Bosworth is in there).

As you know I think lists and awards are tosh. But they are the US Weekly of the online world—trashy, you can’t admit to reading, but very good fun. Special prize for the THCB regular who can find the wrong photo attached to a name swiped from these very pages (hint, a mix up between two people who write together a lot),

So dive in and enjoy, and I think Carleen will be back with something a little more substantial soon.

Meanwhile, perhaps THCB should do one–I’m thinking “worst people in the healthcare world”. Votes for who I’d put on top please…

Costs v Coverage: Krugman gets it–Brooks is almost quite close

Jul 24, 2009• 11

By Matthew Holt

So Paul Krugman, the NY Times Nobel Prize winning lefty columnist, says this (and echoes what I’ve been saying for a while)

So where in America is there serious consideration of moving away from fee-for-service to a more comprehensive, integrated approach to health care? The answer is: Massachusetts — which introduced a health-care plan three years ago that was, in some respects, a dress rehearsal for national health reform, and is now looking for ways to help control costs.

Why does meaningful action on medical costs go along with compassion? One answer is that compassion means not closing your eyes to the human consequences of rising costs. When health insurance premiums doubled during the Bush years, our health care system “controlled costs” by dropping coverage for many workers — but as far as the Bush administration was concerned, that wasn’t a problem. If you believe in universal coverage, on the other hand, it is a problem, and demands a solution.

So universal coverage systems find that they can’t just let the health care system increase costs because there is no safety valve of the uninsured to dump out of the system. We’re all in it.

Rantology: Sympathy for the blue devils?

Jul 22, 2009• 21

By Matthew Holt

I do have some vague sympathy for the Blue Dogs, the group of mostly red-state Democrats who have to pretend that they care about fiscal responsibility. They, like me, think that we shouldn’t be increasing taxes on the non-health sector to pay for universal coverage. Unlike me they think that we should be reducing any commitment to universal coverage by reducing the level at which subsidies for people mandated to buy health care coverage cut off—which will leave us in a situation with lots of people who forgo coverage because they can’t afford it. I of course think that we should be finding the money to cover the uninsured from within the 16% of GDP we already spend on health care and then ratchet that overall number down, but then again I don’t have to get elected to Congress.

But I do have one modest question. Where were the dogs/devils’ concerns about the deficit when George Bush was borrowing for the future to pay for income and dividend tax rebates for the very wealthy, by invading Iraq and hiding the accounting, and by creating the boondoggle that was the Medicare Modernization Act. Now it’s late at night and I’m not going to go chasing voting records from 2001–3. But I sure have my guess….

More on the politics of health care reform:

Health “reform”: Lest we forget…

Jul 21, 2009• 17

By Matthew Holt

There’s been a lot of hand-wringing and b.s. discussed about the comparatively minor health reform that’s snaking its way through Congress. And when I say comparatively minor I mean it. Mostly because there’s lots this legislation doesn’t do.

1) There’s no significant reform of how we pay for health care—even though Orszag, Obama et al want it, and maybe Rockerfeller will inject the “MedPAC as Federal Health Board” into the end result….but I doubt it.

2) There’s no significant change in how we raise money for health care. Employment-based insurance stays as it is. Medicare and Medicaid basically stay as they are. Even if there are NO revenue sources for extending care to the uninsured, it’s still only a roughly a 5% increase in the cost of health care. If you hadn’t noticed we get that increase every year anyway! (By the way CBO actually scores the economics as being significantly better than that).

3) There’s no significant tax increase. Well the apologists say so, but the proposed tax increase on very high earners is trivial compared to how well they’ve done in the last twenty years. The chart below shows the share of overall earnings since the 1980s.

Eliza gets a nice write up in BusinessWeek

Jul 13, 2009• 2

BY MATTHEW HOLT

Indeed, it’s so nice that methinks Lucas & Alex were quite seductive! Speaking as a friend and one who’s been indoctrinated into the cult of Alexandra Drane, its interesting to see the mainstream press picking up the “phone as a tool” theme. The BusinessWeek article shows that a) these calls work to change behavior if targeted correctly and done well and b) that Eliza is humming along very nicely financially. What it doesn’t hint at, but is well worth considering, is the vast potential for these calls to collect data from patients as well, as to relay information to them. As you may guess you’ll see more from Eliza at Health 2.0 this fall, and you can be sure that we’ll be hounding them on that latter point.

The other Michael Jackson mega-mix

Jul 6, 2009• 1

By MATTHEW HOLT

Never ones to be shy with an interesting view into celebrity pharmacology (and truth be told responding to a little tickle from me) the inventive folks at PharmaSurveyor have added Michael Jackson to their celebrity drug cocktail page.

It’s an interesting way to show the dangers of multiple drug regimens, and a great way to show off PharmaSurveyor’s computational capabilities of analyzing multiple drug regimens at once. (PharmaSurveyor calls those assessments surveys). You can find it on www.michaeljacksondrugs.net which has a static picture of Michael Jackson’s survey and links to the interactive one on PharmaSURVEYOR.com. (FD I’m an advisor to PharmaSurveyor with a few stock options)

Sunday reading-Jon Cohn on French & Dutch health care

Jul 5, 2009• 21

By Matthew Holt

Jon Cohn has a long article in the Boston Globe about how the French and Dutch get health care about right at half the American cost with none of that unpleasant Canadian or Britishness that FoxNews loves to complain about. Given that (if we get reform even vaguely right) we’ll look more like Holland or Germany that Canada, it's your essential Sunday reading.

Of course Jon is slightly too nice as ever. One minor point about access to specialty care—it may take longer there than here, slightly. But in the same Commonwealth study Cohn quotes, waiting times for elective surgery were shorter in Germany than they are in the US. And of course no one there gets bankrupted by the cost of medical care.

Biggest and best month ever on THCB

Jul 2, 2009• 6

By Matthew Holt

By the time most of you read this, I’ll be heading to England to tell those Limeys how to do healthcare right the American way….or something like that, and then off to China. I’ll be back in Freedonia in about 10 days

But I’d be remiss if I didn’t mention the stellar month we’ve had at THCB. Apart from last October when the election and Google brought lots of people to THCB (particularly to one excellent article by Bob Laszewski on Obama’s health plan) this has been by far our most heavily trafficked month. We’ll end up somewhere around 85,000 visits and 135,000 page views. And the quality of the writing in posts from Jeff Goldsmith, David Kibbe and Brian Klepper, Roger Collier, Michael Millenson, Susannah Fox and many many more, has been excellent. In addition we’ve had lots of controversy notably in Daniel Gilden’s fascinating piece on McAllen and Grand Junction that’s been read and commented on by lots of very very astute people. Then there’s been the campaigns like HealthDataRights.org, and lots of fun back and forth in many many comments.

So many thanks to THCB editor-in-chief John Irvine & associate editor Ian Kibbe for keeping the wheels turning, to all our contributors, to our sponsors/advertisers who enable us to keep the lights on, and of course to all of you for coming and reading and having your say! — Matthew Holt / THCB Publisher