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THCB Gang, Episode 11

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Episode 11 of “The THCB Gang” was live-streamed on Thursday, May 27th and you can see it again below

Joining me were three regulars, patient safety expert Michael Millenson (MLMillenson), writer Kim Bellard (@kimbbellard), health futurist Ian Morrison (@seccurve), and two new guests: digital health investment banker Steven Wardell (@StevenWardell) and MD turned physician leadership coach Maggi Cary (@MargaretCaryMD)! The conversation was heavy on telemedicine and value based care, and their impact on the stock-market, the economy and the health care system–all in a week when we went over 100,000 deaths from COVID-19.

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Matthew Holt

The End of the Game

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By IAN MORRISON

Back in the early 2000s I was on the board of the California Health Care Foundation and one day the German Minister of Health paid CHCF a visit as part of a learning tour of American healthcare. Mark Smith MD CHCF’s CEO invited me to join the meeting with the minister. She was a delightful person who didn’t speak much English, but because she was accompanied by her handler/translator we managed to communicate just fine. Mark and I tried to explain to the Minister how the American healthcare system worked, and we got to the point in the conversation about the money. The essence of the “game” we described was that commercial insurers (particularly self-insured employers) paid a significant multiple of cost (sometimes in excess of 300% of costs) in order to make the math work for providers. We explained that the game works only if these purchasers paid much higher prices. I don’t speak German, but I think she said: “What The F**k?!”. Exactly.

As we enter the Post COVID world, a key question is: Will healthcare simply restart this game? Or make it even more extreme, in fact, by providers turning to those commercial insurers and self-insured employers to make up the difference for the COVID “Elective Collapse Recession” that has so traumatized provider’s finances including hospitals, specialists, primary care, and dentists leading to job cuts, furloughs, salary reductions and bankruptcies of providers.

A number of recent articles have pointed to how the game works. In particular, the always superb New York Time’s columnist Sarah Kliff’s review of the Mayo Clinic and the other highflying institutions whose excellence is rewarded not by value based reimbursement but by high prices for commercial activity under a relatively benign payor mix (industry code for “don’t see a lot of poor people, uninsured or on Medicaid”).

Continue reading…

THCB Gang: Episode 9

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Episode 9 of “The THCB Gang” was live-streamed on Wednesday (instead of our normal Thursday slot) on May 13th at 1pm PT- 4pm ET! Watch it below! Next week we’ll be back to Thursday

Joining me were health “IT” girl Jessica DaMassa (@jessdamassa), health futurist Ian Morrison (@seccurve), health economist Jane Sarasohn-Kahn (@healthythinker), patient safety expert Michael Millenson (MLMillenson), and MD & hospital system exec Rajesh Aggarwal (@docaggarwal). The conversation looked at the likelihod of big picture change, Medicare Advantage expansion, whether the move to remote care is real and sustainable, and at one point got us to war with China!

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels from Thursday onwards— Matthew Holt

THCB Gang: Episode 7

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Episode 7 of “The THCB Gang” was live-streamed on Thursday, April 30th at 1pm PT- 4pm ET! You can see it below. If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels.

Joining me were regulars futurist Ian Morrison (@seccurve), patient advocate Grace Cordovano (@GraceCordovano), quality expert Michael Millenson (@MLMillenson), with guests Raj Aggarwal (@docaggarwal) head of innovation at Jefferson Health System, and our very own health tech “IT girl” Jessica DaMassa (@jessdamassa) from WTF Health. We had a great conversation about the present and future of care delivery and finance. — Matthew Holt

THCB Gang: Episode 6, LIVE 1PM PT/4PM ET, 4/23

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Episode 6 of “The THCB Gang” was live-streamed on Thursday, April 23 at 1pm PT- 4pm ET! 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the sh*t about health care business, politics, practice, and tech. It’s available below and is preserved as a weekly podcast available on our iTunes & Spotify channels.

Our lineup included: Saurabh Jha (@roguerad), Ian Morrison (@seccurve), Kim Bellard (@kimbbellard), Grace Cordovano (@GraceCordovano),Vince Kuraitis (@VinceKuraitis), Brian Klepper (@bklepper1), and a special guest – Alexandra Drane (@adrane, founder of Eliza, Queen of the Unmentionables, CEO of ArchAngels and sometimes Walmart cashier). Lots of great conversation especially around palliative care, patient experience, the real prevalence of COVID-19 and much more.

And if you want to contact Alex about caregiving, here is her Youtube Channel or please email her. — Matthew Holt

The THCB Gang Episode 4

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Episode 4 of “The THCB Gang” was live-streamed Thursday April 9. You can see it below and it’s also preserved as a weekly podcast available on our iTunes & Spotify channels. Every Thursday at 1pm PT-4pm ET, 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the shit about health care business, politics, practice, and tech. It tries to be fun but serious and informative!

This week, joining me were Jane Sarasohn Kahn (@healthythinker), Anish Koka (@anish_koka), Saurabh Jha (@roguerad), Elizabeth Clayborne (@DrElizPC), and Ian Morrison (@seccurve). A fun and very informative discussion about where the COVID-19 crisis is right now and what it’s going to mean both now and in the near future — Matthew Holt

Médecins sans Hôpitaux (Doctors without Hospitals)

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BY IAN MORRISON

There is lots of talk of disruption in healthcare particularly involving new entrants and weird combinations such as the CVS-Aetna merger, CIGNA and Express Scripts, Amazon Berkshire Hathaway and J.P. Morgan, and now Wal-Mart and Humana all claiming to transform healthcare. At the same time, we are seeing continued consolidation in the traditional healthcare industry with hospital systems merging at the local, regional and national level.

The rise of consumerism is affecting healthcare particularly the retail/primary care area where consumers are spending with their own money in a world of high-deductible healthcare.

The growth of digital health offers the opportunity to disrupt traditional care interactions in both the management of chronic conditions and in routine primary care. And there is a whole new set of patient decision-makers such as millennials who bringing with them different sensibilities in terms of access to services.Continue reading…

Ian Morrison Interview at Health 2.0

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By JESSICA DAMASSA

Hi, today on THCB I’m glad to introduce Jessica DaMassa a new face who’ll be doing many more interviews in the future, focusing on thought leaders in health and health technology.–Matthew Holt

Ian Morrison is probably the best known health care futurist in America, despite being a Scottish-Canadian-Californian. He gave the keynote at last Fall’s Health 2.0 Conference, and gave his thoughts about the role of technology in the future of care delivery.

A chat with Ian Morrison

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My old friend and former boss Ian Morrison will be giving the keynote at Health 2.0’s 10th Annual Fall Conference on the afternoon of Tuesday, September 27th. Ian was President of Institute for the Future in the 1990s, founded the Strategic Health Perspectives service, and is in more health care board rooms and conference halls than almost anyone. At Health 2.0, Ian will share his latest insights into the future of health care. Did we tell you he’s the pre-eminent jokester on the health care speaking circuit? Well he is! You can still Register and come hear what else Ian has to say! But here’s a taster — Matthew Holt

The Trump Healthcare Interview: Part 2

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By IAN MORRISON

Screen Shot 2016-03-12 at 9.55.09 AMDonald Trump is leading the Republican delegate count and has the best chance of becoming the Republican nominee and, just maybe, even President. In February, we at THCB asked Scottish-Canadian-Californian healthcare futurist Ian Morrison to conduct an interview with Trump, figuring that Morrison would have an in with Trump given Trump’s praise for Scottish and Canadian healthcare. Fittingly, that interview was published on THCB on President’s Day, February 16th. Since then Donald Trump has racked up impressive victories and more importantly has released some specifics of his healthcare proposal. THCB thought it was time for Morrison to reach out to Mr. Trump again–Matthew Holt

MORRISON: Thanks for making time Mr. Trump, it is a pleasure to have a chance to follow up with you.

TRUMP: You were a little rough on me last time, but I enjoyed it, I thought I did very well in the interview.

MORRISON: Indeed you did, it was incredible. Mr. Trump before we get to your healthcare plan, let’s just catch up on the race. Since we last talked you have had some impressive victories in a wide variety of states from Hawaii to Mississippi. Why do you think you have done so well?

TRUMP. I’m winning everywhere, everywhere, and with all the groups: vets, high income, low income (we love the low-income). I won Hispanics in Nevada? Hispanics, Trump? They like me because I am a winner, and I’m winning everywhere. I am winning by a lot.

MORRISON: You did particularly well in the South, the so called SEC primaries, where Ted Cruz was expected to do well, particularly with evangelicals. You won by more than 20 points in Alabama for example.

TRUMP: Well they loved me in South Carolina, I won big there and then I did the dog whistle to the Klan and that probably helped, in the South.

MORRISON: You mean being slow to disavow David Duke and the Klan before those southern primaries?

TRUMP: It worked well, we had hats ready: “Make America White Again” but Corey (Editor’s note–He’s referring to Corey Lewandowski Trump’s Campaign Manager who himself made news recently by manhandling a female reporter) told me it probably wouldn’t work in the General, but we trademarked them anyway, I couldn’t believe it was available, so we may use the “Make America White Again” hats later, we’ll see. But now I disavow, I disavow, how many times do I have to say it.

MORRISON: Mr. Trump are you a racist?

TRUMP: Look I told the New York Times Editorial Board the whole story on deep background. Republican primaries are about getting angry, white people to turn up. Those people are tired and angry at the Mexicans, the Muslims, and Obama (we still don’t know if he was born in Kenya). So when we win, we can be nicer in the general election, because I get along with everyone.Continue reading…

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