Category: Uncategorized

Why Health Care Reform Is So Difficult in the United States

Dec 22, 2009• 37

By HUMPHREY TAYLOR, Chairman, the Harris Poll, Harris interactive

Humphrey_Taylor_HI Why is it so hard to change the American health care system? And so much easier to change other countries’ systems?

I pondered this question recently while attending the Commonwealth Fund’s International Symposium on Health in Washington where our latest survey comparing primary care in eleven countries was discussed. I heard presentations describing changes that have been, or are being, implemented in England, France, Germany, Norway, Sweden, Switzerland, the Netherlands, Canada, Australia and New Zealand. In some cases, these are fundamental reforms in how medical care is delivered and how providers are reimbursed. Many of these countries can demonstrate real improvements in the quality of care and efficiency in their systems.

Coal in Your Christmas Stocking?

Dec 22, 2009• 7

By ROBERT LASZEWSKI

Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?

Republican Mississippi Governor Haley Barbour had this to say about the Senate bill last week, “This health care plan is like mackerel in the moonlight. Longer that it's out there, the more that it stinks.”

And yesterday, MoveOn said this about the Senate Democratic health care bill in an email to its members, "America needs real health care reform—not a massive giveaway to the insurance companies. Senator Bernie Sanders and other progressives should block this bill until it's fixed."

When Haley Barbour and MoveOn are saying about the same things—this bill should be stopped in its current form albeit for very different reasons—that says a lot.

Virtual Medicine: The Lever That Just Might Save Independent Practice

Dec 21, 2009• 11

By RICHARD REECE, MD

Give me a lever long enough, and a prop strong enough, I can single-handedly move the world.

— Archimedes

Independent medical practice in America is in trouble. It is fragmented, with some 900,000 doctors – 300,000 primary care doctors and 600,000 specialists- practicing in disparate settings. These physicians are located in roughly 580, 000 locations. Some are solo, most are in small groups, and many are clustered around 125 academic medical centers, 100 integrated groups, and 5000 community hospitals.

Doctors are not unified – less than 20 percent belong to the AMA. Some 110,000 are members of Sermo – a social networking organization that tends to house dissident physicians. The MGMA is said to represent 300,000 doctors.Continue reading…

Cool Technology of the Week

Dec 19, 2009• 8

By JOHN HALAMKA

John Halamka is the CIO at Beth Israel Deconess Medical Center and the author of the popular “Life as a Healthcare CIO” blog, where he writes about technology, the business of healthcare and the issues he faces as the leader of the IT department of a major hospital system. He is a frequent contributor to THCB.

I recently wrote a Computerworld Column about Email Overload.

I’m a data oriented guy and was curious to learn detailed statistics about my own Blackberry use. I found a great Blackberry application called “I Love Blackberry” from EarlySail.Continue reading…

Kate’s Counterpane

Dec 19, 2009• 1

A wonderful sad and happy story about someone who never thought disease could happen to them. (It’s relatively long and plays in sections or you can go to the original site)

From a system/policy perspective, the role of complementary and allopathic medicine is pretty interesting. But this is a story about a fighter.

Health 2.0 Does Webinars

Dec 18, 2009• 2

By Matthew Holt

I'm excited to announce the latest program coming from Health 2.0 – The Health 2.0 Show with Indu & Matthew! This monthly webinar series will focus on news from the Health 2.0 community, a look at some cool new technologies, and interviews with industry leaders.

January 19, 2010
11 am PT / 2 pm ET
We’ll start the series off with a look at what lies in store for Health 2.0 in 2010 – including updates from the Advisors, the Accelerator and exciting new partnerships.

We’ll also chat with Thomas Goetz of Wired Magazine about his upcoming book,The Decision Tree: Taking Control of Your Health in the New Age of Personalized Medicine and his thoughts on technology, personalized medicine, and how it all relates to Health 2.0.

For more information and to register, check out: http://www.health2con.com/webinars.

Health Reform as Theater: Let Me Down Easy

Dec 16, 2009• 4

By MICHAEL L. MILLENSON

For a Broadway stage, the set is simple and spare – a long, white leather couch, a handful of wooden tables and chairs. No ornamentation is needed; the stories being told on the stage are what command the audience’s attention. Let Me Down Easy is health reform as poignant, funny and gripping theater.

A supermodel compares the high-powered physicians a cosmetics company gets her after she signs a lucrative contract to the doctors she had access to during her working-class childhood. A middle-aged woman emotionally refuses dialysis because of the terrible injuries her daughter sustained while undergoing dialysis when a hospital’s mistake left her covered in blood. And a cancer patient hospitalized with a post-chemotherapy fever describes being told not to take it personally that her chart has been lost: “that happens here quite a bit.”

Every word is true, every story describes a personal struggle with illness, dying and the medical care that sometimes happens in between. Twenty people speak, each in a separately titled vignette, but only one person appears on stage. That’s Anna Deavere Smith, who carefully selects verbatim excerpts from interviews she conducted and then meticulously mimics those interviewees’ body language and speech patterns in a manner so convincing that, in the miracle that is theater, she disappears into her characters. Some are well-known – Lance Armstrong, former Texas Gov. Ann Richards – others are not – a musicologist, a Buddhist monk, a rodeo bullrider.

Improving the Harvest: Farming and Health Care

Dec 16, 2009• 14

By BILL KRAMER

I love Atul Gawande’s writings on health care.

He has a rare talent for describing technical details of health care, insurance and finances in terms that most people can understand. His recent article in the New Yorker discussed the current health reform bills’ approach to curbing costs, using the agricultural industry as a potential model.

One of his basic points is similar to one I have made before. He describes two kinds of problems: “those which are amenable to a technical solution and those which are not. Universal health care coverage belongs to the first category . . . Problems of the second kind [referring to rising health care costs], by contrast, are never solved, exactly; they are managed.”

I would frame it somewhat differently. The two basic kinds of problems are those, which are amenable to a government solution, and those which are best addressed using decentralized market forces.

MedEncentive’s Five Year Report

Dec 15, 2009• 11

By Matthew Holt

As many involved in the worlds of Health 2.0 and Information Therapy know, some of the most interesting experiments in the world of patient-physician engagement have been happening in the somewhat unlikely environs of small town Oklahoma. There the City of Duncan has put its employees (and their providers) into a system that incents (but doesn’t mandate) physicians to practice according to accepted guidelines, and incents (but doesn’t mandate) patients to read information prescribed by their physicians about their treatments (and tests them about it). The system then asks each party to rate the other.

It sounds simple and frankly, compared to much in health care, it is. The system is supplied by MedEncentive, an Oklahoma City firm led by the charming and engaging Jeff Greene. While I remain fascinated by MedEncentive’s program (and FD MedEncentive has sponsored the Health 2.0 Conference in the past), it’s perhaps grown a little more slowly than Jeff and other fans might have liked—given the scope of the problem.

But the results have been impressive in reducing costs (mostly by reducing hospitalizations) and increasing patient involvement. Yesterday MedEncentive released a five year retrospective. The key finding?:

City of Duncan costs for the most recent year was 8.6% less than five years ago prior to implementing the Program, which is 34.9% less than the projected costs. The resultant four year savings equates to an 8:1 return on investment. (emphasis added)

Jeff abandoned a lucrative business in physician practice management to have a go at this intractable problem. Five years on he deserves plaudits for what he and his team have achieved, and hopefully we’ll see much more innovation like this mushrooming in the future.

Given the relatively lightweight nature of the intervention, I’m amazed that many much larger payers/employers haven’t given it a try. After all, whatever else they’re doing doesn’t seem to be exactly working too well!

There Be Dragons: The Fiscal Risk Of Premium Subsidies In Health Reform

Dec 14, 2009• 14

By JEFF GOLDSMITH

Last week, the Congressional Budget Office weighed in on the biggest economic imponderable in the health care debate: how private health insurance premiums will behave under health reform. Building on its December 2008 CBO health insurance market analysis, CBO forecast largely benign effects from health reform’s private market reforms and subsidies on the vast majority of the presently insured (e.g. voting public).

According to CBO, only 17% of Americans in the so-called non-group market–largely individuals–would see premium increases in 2016 (the CBO reference year), because they would be required to purchase fatter benefits with less economic risk. CBO believes that the other 83% of the presently insured will see little or no change.

Analysis of how the health insurance market will behave under health reform has become ferociously politicized. After the infamous PriceWaterhouseCoopers study sponsored by health insurers suggested possible large premium increases, the CBO report might provide cover for members of Congress who are contemplating irreversibly tying the federal budget to a volatile “private” insurance market. I think the fiscal risks of a partially federalized private health benefit are significantly greater than CBO has suggested.