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.

Palin: Obama Health Plan “Evil”

Aug 10, 2009• 128

The strange plot of the national debate over health reform this took another twist over the weekend, after (now suddenly ex- Alaska governor) Sarah Palin posted a statement on her Facebook page on Friday denouncing the Obama administration’s plan to reshape the healthcare system as “downright evil.”

In a statement referencing Ronald Reagan and the economist Thomas Sowell, Palin warned of bureaucratic “death panels” that would decide “if my parents (or yours) or my baby with Down Syndrome” are “worthy of healthcare based on their level of productivity in society.”

The full text of the post:

“As more Americans delve into the disturbing details of the nationalized
health care plan that the current administration is rushing through
Congress, our collective jaw is dropping, and we’re saying not just no,
but hell no.

The Democrats promise that a government health care system will reduce
the cost of health care, but as the economist Thomas Sowell has pointed
out, government health care will not reduce the cost; it will simply
refuse to pay the cost. And who will suffer the most when they ration
care? The sick, the elderly, and the disabled, of course. The America I
know and love is not one in which my parents or my baby with Down
Syndrome will have to stand in front of Obama’s “death panel” so his
bureaucrats can decide, based on a subjective judgment of their “level
of productivity in society,” whether they are worthy of health care.
Such a system is downright evil.

The Master and I agree on the goals

Aug 8, 2009• 32

By Matthew Holt

Writing in his blog in the NY Times, Uwe Reinhardt sets out three overarching goals of health reform

1. Financial barriers should not stand between Americans and preventive or acute health care that they sincerely believe will address concerns over a troubling medical condition, in a timely manner, before that condition grows into a critically serious illness.

2. Having received needed health care, no American family should be so financially devastated by medical bills that it cannot meet routine daily living expenses — for example, make utility or mortgage payments on time or finance the education of the family’s children.

3. The future growth in national health spending should be constrained to fall significantly below currently projected spending growth, which has the United States devoting about 40 percent of its G.D.P. to health care by mid-century.

All other goals are subordinate to these three overarching goals, as are the means to reach them.

Last week I posted a very similar “Two rules by which to judge a health reform bill”.

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.

Rule 2 A health care reform bill needs to limit the amount of GDP that is going to health care to its current level, with an overall aim of reducing the share of health care going to GDP.

Uwe is a touch more eloquent in his goals 1 and 2 which split apart my Rule 1, and he’s a touch less aggressive in his goal 3, which is my Rule 2. But other than that these are the same.

Unfortunately in his column of the previous week Uwe created a list of 8 (but it could have been 20) completely contradictory statements about the completely “confused state” of what Americans seem to demand from health reform.

And right now the confusion seems to be winning.

Dumb and Dumber

Aug 7, 2009• 18

By Matthew Holt

I can’t say that I’ve been fantastically impressed by the Democrats’ choice of this year to go after health reform, or their explanation of what it is. And I understand that the only interest of the Republicans is to destroy any political win in the hope that they get a repeat of 1994…although it is just possible that despite their confidence the voters also remember the 2000–2008 period which will also precede the 2010 election.

However, the amount of crap emanating from the right about what’s in the health bills and the evidence of that by what’s showing up in the “tea parties” now invading Democrat congressional members’ town halls is quite extraordinary and does require at least some notice.

Kamen: Healthcare Debate “Backward Looking”

Aug 7, 2009• 27

Segway inventor Dean Kamen thinks the wonkish debate over healthcare reform in Washington is largely missing the point. In an interview with Popular Mechanics editor-in-chief James Meigs and deputy editor Jerry Beilinson, Kamen tells the magazine:

“We now live in a world where technology has triumphed, in many ways, over death. The problem with that is that it’s enormously expensive. And big pharmaceutical giants and big medical products companies have stopped working on stuff that could be extraordinary because they know they won’t be reimbursed, according to the common standards. We’re not only rationing today; we’re rationing our future. ““If you project forward these horrific costs of treating everybody and you want to assume we are not going to respond to that by making the therapies better, simpler and cheaper and in some cases completely wiping out the [diseases], well you know what? We might actually get to that situation—if we stop investing in technology, if we stop believing that the future ought to be better than the past. ““If somebody in this country wants to explain to me that we ought to be spending about twice as much supporting sports as on all of our pharmaceuticals, then stop spending.” “I think this debate shows a fundamental lack of vision, a lack of confidence, a lack of understanding of what’s possible.”

Practice Fusion gets investment from Salesforce.com

Aug 5, 2009• 21

By MATTHEW HOLT By default 2

We’ve been keeping tabs on Practice Fusion since the early days and THCB regulars will have noticed several comments and an article from CMO Robert Rowley. CEO Ryan Howard’s been hinting for a while that they were going to be getting into bed with a major software player, that shared their SaaS approach, and today they announced an investment from Salesforce.com, who we also know has been sniffing around health care too. This will include Practice Fusion becoming part of the Force.com (kind of an app store for the Salesforce.com ecosystem, although my guess is that few physicians are going there right now to look for records (not sure they’re going to Wal-mart either, though)

Practice Fusion is claiming that 19,000 users are already on its system which includes basic practice management, as well as a pretty complex EMR workflow. Coming soon will be a greater ability to share information with patients and other physicians over the platform—which allows it to spread via viral marketing. i.e. I’m referring you this patient, click here to get their data and sign up for this free EMR too. It’s not yet CCHIT certified, but Howard is aiming to be eligible for “meaningful use” money when the criteria are finally established.Continue reading…

Senate Healthcare Bill Amendment Allocates Your Tax Dollars To Quacks

Aug 4, 2009• 37

By DR. VAL

With healthcare costs spiraling out of control, and major rationing efforts under consideration – can we really afford to allow purveyors of pseudoscience to use up scarce Medicare/Medicaid resources? It’s hard to imagine that Obama’s administration would approve of extending “health professional” status to people with an online degree and a belief in magic – but a new amendment would allow just that. What happened to our “restoring science to its rightful place” and why are we emphasizing comparative effectiveness research if we will use tax dollars to pay for things that are known to be ineffective?I hope someone reads and removes this amendment pronto (h/t to David Gorski at Science Based Medicine):Here’s the language that Sen. Harkin has slipped into the 615 page Senate version of the health care reform bill:

Online behavioral health on American Well’s platform, and a hint at Cisco/UHG

Aug 3, 2009• 6

By MATTHEW HOLT

As usual I am way behind on tech and Health 2.0 news but here’s one that was “thrown out with the trash” late last week because the service went live on Saturday. American Well has has added TriWest Healthcare Alliance as a client on its online service. Most significantly this is for behavioral health care (psychological counseling et al) for military families covered under Tri-Care—the program for the families of service personnel.

Given what the military has been through in the last decade you can imagine how badly this is needed. And it’s an extension of the current primary and urgent care services already being delivered online.

In fact beyond American Well there are a number of even smaller companies starting to aim at the behavioral health online market—which has a strong tradition of success in telemedicine and is ripe for expansion into the online arena.

However, where I’m really late is that a couple of weeks back Cisco—which does higher-end telemedicine—announced a program with United Healthgroup to provide its HealthPresence technology in mobile trucks for underserved populations. United’s Optum unit also recently announced that it too would be using American Well. So we’re seeing an extension of the use of both higher tech and web-based online care, and that for the first time health insurers are taking this very seriously.

Continue to watch this space as it looks like finally the technology is ready and the payers are finally coming on board. And (ahem) you’ll hear much more about this at the Health 2.0 Conference in San Francisco on October 6–7.

Sunday mumbles

Aug 2, 2009• 19

By Matthew Holt

If you can’t quite remember why we’re doing this health reform stuff, here’s a very amusing defense of the current health care system by Jonathan Adler at Newsweek (hat-tip to Jon Cohn).

Meanwhile by any measure July was the most read month on THCB with sitemeter telling us that there were some 129,000 visits. Thanks to everyone for coming, but to be fair while we could expect health reform month to ramp up the visits a little, this shows the power of Google. If you search “Obama health care”, this excellent article by Bob Laszewski comes up near the top of the front page… Hopefully some of the new readers will see that it’s 18 months old and stick around to catch the new developments. But kudos to Bob L for doing such a great job here and of course on his own blog Health Care Policy & Marketplace Review.

Two rules by which to judge a health reform bill

Jul 31, 2009• 49

By Matthew Holt

Right now we have sausage-making going on in DC and lots of uninformed opinions and outright lies being strewn across the front pages and on cable from newly declared experts. I sat in an airport last night and heard 5 Wall Street pundits spewing rubbish about health reform on one cable show. It even included an aging upper-class British twit declaring that government health care was more expensive than private systems. Clearly he’d managed to miss comparing the 8% of GDP his (and my) original homeland spends on health care versus the 17% we spend here. Later on CNN had 4 random people including Christine Hefner—yes one of those Hefners—talking about it. I suspect that if you know something about health care and your name’s not Michael Cannon you’re just not allowed on cable TV.

But all the hot air aside, even those of us in the punditocracy who know something about the subject matter (i.e. anyone reading THCB) seem to be so deep in the weeds that we have lost the basics about what we should be looking for from a health care bill. So it’s time to make that very clear, and here in my not so humble opinion are the rules by which to judge reform.

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.

Rule 2 A health care reform bill needs to limit the amount of
GDP that is going to health care to its current level, with an overall
aim of reducing the share of health care going to GDP.

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.