I am up at Spot-on ranting about how an endless beauty parade among candidates who agree with each other doesn’t help us figure out what we get come election time. Please read it and come back to comment if you like.
Four Big Trends – Brian Klepper
Several events and trends emerged over the last year that will reverberate throughout the health care
marketplace in 2008 and going forward. While none of these dominated the trade press like some other issues – electronic and personal health records, RHIOs, the evolving labor shortage, pay-for-performance reimbursement – these manifestations of change are occurring in the marketplace as well as through policy, and are moving health care forward in fundamentally positive and far-reaching ways.
Health 2.0The most significant for the long term in terms of its capacity to change how health care works is the Health 2.0 movement, which Matthew Holt and Indu Sabaiya have played a central role in facilitating and explaining. In some ways, Health 2.0 is simply a continuation of what has come before: companies creating new value through information and connecting with customers over the Web. Health 2.0 takes this approach into every area of health care data, often driven by companies outside of or at the margins of health care, who have no financial stake in perpetuating inappropriateness and waste, and who see an opportunity to make money by rationalizing the system.
POLICY: Do mandates matter? with UPDATE
Former Labor secretary Robert Reich has appealed to Democrats (in other words Paul Krugman and Obama’s
camp) to stop squabbling over healthcare mandates. Basically he says that Clinton would have to let some people who couldn’t afford health care out of the mandate (as is happening in Massachusetts) and that Obama’s plan would get us close enough to universal coverage that the difference isn’t worth arguing about.
Writing in THCB last week Robert Laszewski pointed out that the cost of buying insurance is sufficiently high that a subsidy would have to be so large and go so high up the income scale that it wasn’t politically realistic — and certainly wasn’t working in Massachusetts. So in his view Obama and the Republicans (Robert is actually generous enough to give some of them credit for having thought about this) are right not to push for a mandate.
But then of course, with no mandate you’re not getting everyone into the pool. So what do you end up doing with those who don’t have insurance when they need care? You end up with what happened in Hawaii, where universal pay or play ended up in 90% insurance.
POLITICS: Just Saying No to crass politicization
Yeah, I know it’s not likely that anyone will pay attention given the season, but I do feel that there are enough cases with which to bash insurers which are legitimate that John Edwards didn’t have to start politicizing one in which not only was the insurer’s argument pretty good, but about which a government-sponsored universal system would also have to make the same choices. So I’m up over at Spot-on about Just Saying No.
To separate himself from the Democratic front-runners former Sen. John Edwards has spent the last few days laying into insurance company, Cigna, for its failure to immediately approve a liver transplant for California teenager, Nataline Sarkisyan. That action, says Edwards, in concession speech after concession speech, is emblematic not just of the health care system’s break-down but of a failure of the current American political system.
Edwards like most Democrats wants a single payer health system and his plan is the closest of the three front-runners to providing one. But his advocacy of Natalie Sarkisyan’s case raise a question no one else seems to be asking.
On Practical Reforms – Brian Klepper
Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others.
Over at Health Care Policy and Marketplace Review, Bob Laszewski asks an important, practical but vexing question for universal coverage advocates: Can you really mandate people to buy health insurance?
POLICY: Ian Morrison–to be thrown out by the Paisley Fabianists club
In a great article called The Fallacy of Excellence my old boss and friend Ian Morrison explains what we intuitively know. people don’t understand that more care is not better care. This is going to lead to lots of political problems as we get to righting the Wennberg-illuminated wrongs.
On the other hand, Ian’s lifetime membership in the Paisley Fabian Society will probably be revoked when they find out he’s been watching the Republican candidates debate…..
POLITICS: More on the Presidential plan comparison
Long time THCB friend Steve Beller tells me this:
We’ve created a Comparative Analysis of Presidential Health Care Plans, which analyzes much of the details of Susan Blumenthal’s and Kaisers’ work in order to identify top candidates based on voters’ wants and needs. We’ve taken a unique approach in which the complex details are distilled into categories of strategies that simplify comparisons between the candidates, and we’ve included comments on the key factors (with several quotes from Maggie Mahar’s blog and input from Barry Carol). It then groups the candidates on whether they propose universal healthcare, and it ranks them by the amount of attention they give to quality improvement and cost control. Then it matches the candidates to 18 types of consumers, which take into account their current insurance and health situation, their income level, and their support of good care for all.
Here’s the link.
Take a look and feel free of course to give your comments to Steve over on his blog or here.
Meanwhile as major bloggers are dropping like flies from the stress, (get soon well Om!), I feel good about the fact that I took the weekend off to go snow-boarding in some of the best powder the Sierras has seen in a while. And that’ll be all from me today!
Health Care’s Cold Truth: An Iowa Perspective – Michael Millenson
I am writing this blog from Cedar Rapids, Iowa, grateful that the
temperature has warmed from brutally
cold to pleasantly sub-freezing.
Fortunately, the warm feelings left by the extraordinary victory of
Sen. Barack Obama, the candidate for whom I was knocking on doors and
making phone calls these last few days, has trumped the temperatures.
Talking to real voters in the suburbs and rural areas surrounding this
small city provides a nice change from the insular health care policy
world. For one thing, it reminds you that most people don’t care about
“policy,” per se, of any kind. Successful candidates connect first with
the heart and then the head. We instinctively believe that if we trust
a candidate’s values and broad beliefs, we will trust that candidate’s
detailed policy decisions.
Yet the sad reality is that a vast number of citizens won’t even make
that small emotional investment, and they don’t hesitate to proclaim
their apathy when you knock on the door or call. As much as you may
have heard about voters disenfranchised from the Iowa caucuses,
many more simply didn’t care enough to participate. That, alas, makes
Iowa quite representative of the nation as a whole. While Democratic
turnout at this year’s caucuses was double that of four years ago, that
merely turned a “tiny” slice of registered voters into a “small” one.
Susan Blumenthal’s Presidential Health Care Plans Update
Susan Blumenthal, M.D. has updated her exhaustive (and exhausting) list of the Presidential candidates’ health care proposals You’ll find the Side-by-Side Comparisons on the The Huffington Post
POLITICS: The Crystal Ball – Healthcare reform in California
I’m up over at Spot-on discussing why the opinion of 32 corn farmers in Iowa may not matter quite as much for health insurance as what’s going on in my fair state. The piece is called: A Californian Crystal Ball.
As ever come back here to comment.
Pretty much anyone interested in U.S. politics is focused today on
what 32 corn farmers in the middle of the country have to say about the
20-some people currently hoping to run the world by becoming President
of the United States.And while health care concerns have figured in many of the
conversations the U.S. political press has had – or overheard – with
Iowa Caucus voters, it’s been a wild holiday season for California’s
health care system. The impact on what type of health care reform
legislation will eventually come to national attention is probably just
as great.On Christmas Eve a California appeals court unanimously decided that
the way insurers have been practicing in the state for many years is illegal.
The case involving retroactive cancellation of policies was one that
the nice well-behaved non-profit California Blue Shield had fought in
the courts while its aggressive for-profit competitor, Wellpoint’s Blue
Cross unit, had settled.Blue Shield maintained it had the right to retroactively cancel
those insurance policies for which it says that policy-holders had lied
on their applications. At first the series of stories, which started coming out last year and ended up making an appearance in Michael Moore’s Sicko,
seemed cut and dried. People who’d received expensive care were having
their insurance canceled for pre-existing conditions that they’d either
clearly disclosed on their applications, or couldn’t possibly have been
expected to remember. Meanwhile the behavior of the health plans was
shown to be particularly cynical, with one, HealthNet, actually paying out bonuses to staff doing "recissions" based on how many expensive policy holders they kicked off their rolls.Continue reading this post o ver at Spot On.com
