Tag: Uncategorized

POLICY: How will you get paid? By Paul Levy

Apr 26, 2007• 13

Paul Levy is the President and CEO of Beth Israel Deconess Medical
Center in Boston. Paul recently became the focus of much media
attention when he decided to publish infection rates at his hospital,
despite the fact that under Massachusetts law he is not yet required to
do so. For the last year and a half he has blogged about his
experiences in an online journal, Running a Hospital,
one of the few blogs we know of maintained by a senior hospital
executive. Today he gives his take on pay for performance.

This is the next chapter in my Wednesday is Student Day series. Rocky, a medical student, asks below: "What is your take on pay for performance, and will it be integrated into BIDMC?"

My
economics professors in college set forth a series of theories and
formulas that described the functioning of the free market. We all knew
that this formulation was unrealistic, in that most markets are
imperfect. There is often "friction" between parties in a marketplace
that result in imbalances between supply and demand, that result in
uneven knowledge between and among buyers and sellers, or that
otherwise gets in the way of an economically efficient equilibrium
condition.

INTERNATIONAL: Rationing American style

Apr 26, 2007• 10

I don’t approve of health care by anecdote, but there are plenty of loonies on the Canada bashing right who do. And some of them make movies to prove their point. I also think that taking individual stories out of context, compared to using data to describe the actual patterns of care, isn’t that valuable in an intellectual sense. But it sure seems to work in an emotive one.

But let me warn those aspiring Canada-basher film-makers. While you’re out raising your millions, certain pro-single payer groups here have beaten you to it. Apparently the bashers may not know this but there are both people who have problems south of the border, and others with video cameras who’ve met them. I’m awaiting the assurance that this is all the Canadians fault somehow.

The rest of you in the more rarefied crowd at THCB can go back to your regularly scheduled programming.

THCB: Email problems

Apr 26, 2007

My hosting company’s site was hacked yesterday. While they fix it I can’t get email. If you need to find me try matthewseparate AT gmail.com

PHARMA: Fard on Pharma-Non-Profit Cause Alliances

Apr 26, 2007

Fard Johnmar at Envision Solutions has another report out. This one is about the public’s view of disease specific non-profits, such as the American Diabetes, Heart, Cancer, et al Associations/Societies and their alliances with drug companies. Neither side looks too good. To learn more head over to the Spotlight on Pharma-Non-Profit Cause Alliances.

JOB POST: Policy Analyst/Organizer – Healthcare for All

Apr 25, 2007

Come help lead the fight for health care for all! The Campaign for America’s Future (CAF) and the Institute for America’s Future (IAF) seek a policy analyst/organizer to work on our campaign for universal healthcare. This person should have experience in developing and working with coalitions and should be a creative self-starter who can help drive progressive issues like universal healthcare into the national debate. This position will report to CAF’s co-director and will work closely with our online communications and press teams.

POLICY: Ezra Klein’s The Health of Nations

Apr 25, 2007• 13

Now I’ve met Ezra I can stop calling him the young punk. He has written another excellent review of health care in universal coverage nations, including socialized medicine in the heart of America for our allegedly most treasured citizens.

It’s called The Health of Nations. Go read it.

It’s not entirely without flaws, almost all to do with the lack of good recent data that’s a problem with these comparisons and a need to conserve space. He skips over the UK’s private insurance system which enables the rich to trade up for elective surgery, and the recent increases in spending under Blair which have enable the Brits to buy spare capacity in private countries, (and ramped up GPs pay!). It would be nice to have Ezra do something similar on Japan and Holland (although Japan looks something like Germany plus a Canadian fee schedule, and Holland looks like an Enthoven-wet dream).

What’s also to some extent missing is the changes that have happened recently. Humphrey Taylor remarked to me on Sunday that Americans dont realize how much other systems are changing as ours essentially never does. The Brits have gone to 30% P4P in primary care; the Dutch to individually purchased insurance in a managed competition framework; the Danes and the New Zealanders have added rapid deployment of IT (100% EMR use in ambulatory care); whereas the Australians have added a private top up layer over their traditional socialized medicine system; the Swiss have their individual mandate.

Of course all of these systems have their problems and all are changing; we’re stuck in 1991. And in fact the VA system, although it works very well it about to be hit with a wave of Iraq war vets who have real problems–and is unlikely to get the resources it needs to deal with them.

And although it goes without saying to those in the know, we should keep repeating that this is the only system that visits not only ill health on the unlucky but often financial disaster too.

POLICY: Introducing CalHealthReform.org by Marian Mulkey

Apr 23, 2007

Marian Mulkey is a Senior Program Officer with the California HealthCare Foundation (CHCF). CHCF is an independent, nonpartisan health care philanthropy whose work focuses on improving health care in California by promoting innovation in care and access to information, so that people can get the care they need, when they need it, at a price they can afford.

Gov. Schwarzenegger and legislative leaders from both parties have introduced proposals to expand care and coverage for many of California’s 6.5 million uninsured residents. The process as it unfolds may have important implications for the state and the nation as a whole.

This is an exciting and historic time for those of us committed to
improving access to high quality, affordable health care. Yet a host of
questions remain.

• Who should pay for health care coverage? • What is the definition of affordable coverage? • How can costs be contained? • How do we ensure high quality in our health care system?

BLOGS/POLICY: WorldHealthCareBlog

Apr 22, 2007

I’m in DC at the World Health Care Congress where I’m writing about speakers like George Halvorson from KP talking about health care reform (he’s right but wrong) and Tadataka Yamada from the Gates Foundation talking about health in the developing world. It’s all up on the WorldHealthCareBlog.org

POLICY: Criticizing Jonathan Cohn

Apr 20, 2007• 5

OK, it’s official. All this congratulatory fawing over Jonathan Cohn and his book Sick is getting to me, and I have a real criticism about him. And it’s the topic of my column over at Spot-on today–Jonathan Cohn is Way Too Nice.

By the way, Jon is coming round for breakfast later—I’m going to interview him and see if he’s able to defend himself from that charge. Perhaps he’ll turn out to have a vicious streak that I don’t know about.

BLOGS/PODCASTS: Dr. Julie Gerberding, Director CDC & Peter Neupert, Microsoft

Apr 19, 2007• 2

As you may (or may not) know I’m in a gaggle of bloggers who are posting at the World Health Care Blog—which has been set up surrounding the World Health Care Congress. Yesterday I did two podcasts to whet people’s appetite before the Congress which starts Sunday in Washington DC.

The first was with Dr. Julie Gerberding, Director CDC. We talked about public health, including inevitably this week’s gun violence.

The next was with Peter Neupert who is head of health care at Microsoft. He’ll be on a panel at the Congress with Intel and Google talking about consumer use of health IT, but he also spoke about Microsoft’s general strategy in health care and about Azyxxi (hope I spelt that right!).

And if you’ll be in DC or at the conference please get in touch. I’ll be podcasting from there so I may make you famous!