The World’s Best Candy Bars? English, of Course. But I think they miss one vital difference. British milk is not homogenized-just pasteurized, and I’m sure that’s part of the difference.
POLICY: Finally, the review– It’s A Sicko World
I know you’ve all been dying for this. It’s my review of Sicko, up over at Spot-On.
There’s so much wrong with Michael Moore’s Sicko that it’s embarrassing, especially for a health care pundit, to reveal the emotional punch it gives you. You know that your head is being bowled over by your heart, and you also know that it’s very, very cleverly done. But that doesn’t make the message any less powerful. MORE
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POLICY/POLITICS: Susan Blumenthal review of the Presidential Candidates’ health care policy
Susan Blumenthal, M.D. has created a side-By-side Comparison of all the Presidential candidates’ health care proposals. What does it tell you? None of the Republicans have a real proposal–Rudy Guliani has made some big statements about turning the system over to consumers but no one else — including Romney — has dared say much. While Edwards has a convoluted plan (courtesy of Jonathan Gruber) and Obama has been standing far too close to David Cutler, Hillary Clinton has only announced half of hers.
Of course none of it matters too much. The journey between here and real health care reform is a long, long one. But good job by Susan and her team to put it all together.
POLICY: Carmona rips White House
Richard H. Carmona, Surgeon General (and new Healthline Board Member BTW) rips the Bush Administration which made him Surgeon General. He says it’s happened for a while, but apparently according to Koop, Satcher and other Surgeon Generals, it’s worse under this Administration.
"The reality is that the ‘nation’s doctor’ has been marginalized and relegated to a position with no independent budget and with supervisors who are political appointees with partisan agendas. Anything that doesn’t fit into the political appointees’ ideological, theological or political agenda is ignored, marginalized or simply buried.”
C’mon. Given this White House’s record, is anyone surprised? Should Carmona have been? And of course, when it happened, why didn’t he speak out and quit? Still, it’s good to hear about it now at least.
HOSPITALS/QUALITY: Virginia Mason–living in the future before it gets here.
More proof that the Michael Porter-type solution is living in the future before it gets here. Another study, this one from HSC shows that Virginia Mason has improved its processes, is saving money for its customers, and is paying the financial penalty.
Michael Millenson showed the same issues were going on in Demanding Medical Excellence 10 years ago, and effectively not much has changed. Doing the right thing will send providers into bankruptcy and most intermediaries and most end customers just don’t care. Here’s the full story in Health Affairs
It’s the incentives, stupid.
UPDATE: Jamie Robinson interviews Gary Kaplan, Virginia Mason’s CEO. No video, though, Brian!
INTERNATIONAL: Ian Morrison vacationing at the taxpayer’s expense
My old boss Ian Morrison has been in Australia studying the health care system. I’m sure this was a work visit for him with neither a bar nor a golf course in sight. He did though come back with a pretty interesting view of their changing system, called Aussie, Aussie, Aussie which is basically a British style NHS with a robust private insurance sector layered on top of it.
The only thing I’m not so sure of is why the government—any government for that matter—would want to give people a tax break to buy private health insurance. (They do it in the UK too, BTW). Unless of course the politicians concerned planned to amakudari into private health plans later. Anyone looking at the US experience knows that exempting health insurance spending (and mortgage spending) from taxation means that we spend too much money on health care (and houses). The only place I’ve ever seen that tax break successfully taken away was in the UK, where the tax break for mortgage payments was phased out in the late 1980s. Of course it didn’t stop house prices from going up there too, but there’s no need to encourage it.
Still in general, like the French, the Aussies have got to a mix that most Americans outside of the Cato Institute could probably live with. Pity we can’t have it here.
INTERNATIONAL/QUALITY: Reggie will be having a fit
I’ve always been amused that the most cited example of the “focused factory” that Reggie Herzlinger perceives to be the answer to medical cost and quality problems is the Shouldice Institute in Canada. That’s right the country where it takes ten months to get a doctors appointment if you’re pregnant, and where the state controls all health care—concepts Reggie’s not so keen on.
And of course the nearest thing to focused factories in the US are the specialty hospitals which—given our incentives—make most of their money increasing the amount of care given to a set populations (probably unnecessarily) and taking the most profitable cases away from the local community hospitals and away from their mission of care, or their fat endowments (Delete half the previous phrase based on your stance on the matter).
On the other hand if focused factories were established within a cost-constrained environment, presumably we’d get a clue as to whether they are more efficient and save money over all. Well maybe we’re going to find out.
Apparently London is going to be transformed into a city of 200 large multi-specialty group practices with what sounds like specialty hospitals to handle the acute care. This is going to be very interesting.
Meanwhile, in Southern California a doctor buys hospitals, kicks out managed care, jacks up prices and makes bank. Tthat’s real value add to the system
HEALTH2.0: Brief update and lots going on
So the Health2.0 Conference is really heating up. We will be announcing a raft of new sponsors and some interesting media tie-ins next week. There are already well over 100 attendees including lots of people from across the worlds of technology, providers, plans, pharma and finance. If you’re planning on attending and haven’t signed up yet, you may want to act quickly to reserve your spot. The number of guests is limited by space considerations so a sell out is possible, and in fact, looking quite likely. A number of you — at least 25 – have also signed up but have
not yet completed your registrations. Places will only be reserved
those who have completed the registration process, so its probably a good idea to take care of things if you’ve been holding off.
Next week we will be having a contest to fill a slot on the Social Media for Patients panel—I’m hoping that THCB readers will help. Meanwhile, search is a screaming big deal, so in some snippets of related Health2.0 search engine news that I’m just catching up on:
Curbside.MD has new version of its medical search engine out, it matches tagging with natural languages recognition.
iMedix.com has launched in stealth alpha. Wanna be invited to look? I have a few invites to give out.
Revolution Health and Kosmix have signed a partnership deal in which Kosmix’s technology will categorize Revolution’s site. For more on that see my interview with Venky Harinarayan from Kosmix (transcript to come shortly)
Healthline Networks has had Richard Carmona, former Surgeon General, join its board of directors.
Finally, Molly, a black Labrador of indeterminate age has been traded from the Washington DC dog parks to the city with more dogs than children, San Francisco. In related news Molly’s human pet John Lane has been traded from Revolution to Healthline to strengthen the Marketing bench— one of the first free-agent moves in the new Health2.0 season. Probably not the last!
And in the unintended consequences department, our Dutch correspondent tells THCB that Web2,0 is now being used by schoolkids in the UK looking to organize a mass brawl!
POLICY/QUALITY: Klepper on cabbages and Kings (or Congress)
Brian Klepper, who’s traitorously now pimping himself out on other blogs, extends the post I wrote the other day on the CBO at Pat Salber’s blog The Doctor Weighs In. It’s called Mr. Orszag’s Surprise and it’s a very good summary of the CBO document.
Also by Brian is his description of his heart surgery five years ago this week. Moral of the story—choose your parents better.
Finally, I have no idea what to believe about the Peak Oil movement, but Dan Berdnarz’s piece on the impact of the end of cheap energy on the world and global health is pretty terrifying.
