THCB

Categories

Tag: Uncategorized

POLICY: A National Disgrace By John Irvine

• 11

When the story first came out, it didn’t look like much.
Just a few problems that needed correction: a little mold here, a few repairs
there, the inevitable complaints from disgruntled patients. But two and a half
weeks after the Washington Post ran a little story by reporters Dana Priest and
Anne Hull titled “Soldiers Face Neglect, Frustration At Army’s Top Medical
Facility“ the Walter Reed scandal has become without question the top story in the country. 

Today, Priest and Hull return with another lengthy piece examining
conditions in the military healthcare system in other parts of the country titled
“Walter Reed Not an isolated case.” The two reporters say that after their initial story ran they were contacted by "literally hundreds of soldiers" from around the
country with similar stories to share. The pair writes:

Nearly 4,000
outpatients are currently in the military’s Medical Holding or Medical Holdover
companies, which oversee the wounded. Soldiers and veterans report bureaucratic
disarray similar to Walter Reed’s: indifferent, untrained staff; lost
paperwork; medical appointments that drop from the computers; and long waits
for consultations.

That appears to answer a question that many people had been wondering about. As New York Democrat Charles Schumer put it over the weekend “if it’s
this bad at the outpatient facilities at Walter Reed, how is it in the rest of the country?” On Sunday,
Schumer called for a bipartisan commission – possibly to be headed by former
secretary of state Colin Powell – to examine conditions facing returning
service men and women.

Predictably, conservative critics around the blogosphere are
pointing at the debacle as evidence that any government run healthcare system
would be a disaster. Kevin MD writes: “What’s happening at Walter Reed is small
sample of how government-run health care would turn out. Does the public understand
the implications of a nationally-run health care system?”

"Will the Bush-bashers join with free-market critics to effect real change and
help the troops who need and deserve better care? We’ll see," writes Michelle Malkin.

Continue reading…

BLOGS: Technical note

I’ve just discovered that RSS can only handle one podcast per post. So for those of you who get your podcasts via RSS, I’ve republished the HIMSS interviews that I bundled in one post last week. If you’ve linked to the original then I’m afraid you’ll have to re-set.

POLICY: The Not So Common Good

• 3

Catching up from when I was gone….this article on health reform went up at Spot-on a couple of weeks back. It’s called The Not So Common Good.

We’ve been hearing a lot about the problems of the uninsured. We’ve
been hearing more how the cost of healthcare is making it harder and
harder for individuals to afford insurance, and for employers to
provide benefits to employees. Those are the drivers for why health
care reform has suddenly emerged as a political force – even if the
governor who once led discussion of the topic, Mitt Romney, is
backpedaling away from his "liberal Governor of Massachusetts" pro-gay,
pro-big government stance so that he can appear sufficiently
conservative to win a Republican primary or two.


But the train is out of the station on the reform message. Even though the chances of real reform are slim,
everyone and their dog has a plan. Most of these plans are
self-serving. And even the ones that aren’t are generally built on
continuing the employment-based health care system that got us into
this mess in the first place; Senator Ron Wyden, economist Vic Fuchs
and the single payer crowd being the honorable exceptions. Continue

POLICY/HEALTH PLANS: The individual market is screwed

• 33

Whenever you hear some “free-marketeer” complaining that people with incomes over $50K don’t buy health insurance and so uninsurance is voluntary, think about this woman, featured in the NY Times, who would love to buy health insurance but has cancer and so cannot—unless she comes up with $27,000 a year out of her $60K income.

The individual market is corrupt and evil, and inherently unfair. And the organizations that make their living there (hello HealthMarkets, Assurant, Golden Rule et al) are the kinds that you find on the bottom of your shoe. (I’m awaiting Jon Cohn’s book coming out next month to tell you more…).

It is of course not strictly speaking the insurers’ fault. They live in a world where they’re selected against by both sick people and the competition—so it is a collective race to the bottom. Just to remind you for the one millionth time, individual choices of health benefit plans can only be effective and fair within a universal single pool system that needs its rules and boundaries set very carefully, and has risk adjustment built in the back end. And don’t let the libertarians tell you that if you take away all the rules and regs natural pooling will sort it out, unless they’re prepared to move to N.Carolina, get cancer and see how they get on.

POLICY: Breakfast of Champions By Brian Klepper

• 8

THCB welcomes back frequent contributor Brian Klepper. Brian is the president of the Center for Practical Health Reform in Baton Rouge Louisiana. Brian has something to say about economist Daniel McFadden’s recent OP-ED piece in the Wall Street Journal.  If you like this post, you may enjoy his most recent post: "Can Consumerism Save Healthcare?"   

Several people dropped me notes last Friday, asking for comments on a WSJ piece
by Daniel McFadden, a Nobel Laureate in Economics at the University of
California Berkeley. Dr. McFadden provided an eloquent view of the
crisis and its necessary solutions, and also argued that Medicare D
was, according to his research, working well.

 

This
is an interesting problem. After all, Dr. McFadden IS a Nobelist and,
well, I’m not. And he’s a formally trained and obviously highly
respected economist while, again, I’m not.

 

On
the other hand, he’s not really a health care professional. So it may
not be unreasonable to point out that some of his assumptions are naïve
and – how do I say this – exactly wrong.

Continue reading…

INDUSTRY: THCB Job Board

After a good deal of pestering email from readers, I’ve finally decided to offer a healthcare job board on THCB. If you have a health care related job you’d like to advertise to a readership of 35,000 plus industry people, you can send it to us.  For a reasonable fee, your posting will be available to job seekers from around the country and up until you ask us to take it down. You can mail John for details.

Meanwhile, if you haven’t had a chance to sign up for THCB UPDATE
yet, you really should. You’ll get a helpful reminder email from us a
few times a week when important posts go up on the site. In the two
and a half months since the service launched more than 700 950 people have
signed up, thoroughly surprising me. I’ve pledged not to divulge any details about the people who
sign up, but I can tell you that list reads a bit like a health care
who’s who. Go on: It’s free. It’s useful. And people seem to like it.
Go visit the sign up page.

THCB: Sponsorships

THCB’s live blogging coverage of HIMSS 2007 New Orleans would not be possible without the generous assistance of the kind souls at CDW Healthcare. Take a moment to go check out their specials for physicians and other health care providers and you’ll help us continue to provide independent coverage and cutting edge discussion of the issues facing healthcare. We get credit for every person who clicks over, so please take twenty seconds and go visit their site. If you decide to place order, tell them the Health Care Blog sent you — Matthew

 

If you haven’t had a chance to sign up for THCB UPDATE
yet, you really should. You’ll get a helpful reminder email from us a
few times a week when important posts go up on the site. In the two
and a half months since the service launched more than 700 950 people have
signed up, thoroughly surprising me. I’ve pledged not to divulge any details about the people who
sign up, but I can tell you that list reads a bit like a health care
who’s who. Go on: It’s free. It’s useful. And people seem to like it.
Go visit the sign up page.

PBMs: Bob Garris on their trail again?

In Brief non HIMSS news (as I’m still having a little insomnia from jet-lag, and I took it much easier last night on Bourbon street)….

Most THCB readers know that I’m just a wee bit cynical about the “value” provided by PBMs. Much of the data for that view comes from a Creighton University professor called Robert Garis. Well, he’s back:

“We found that brand-name drugs were slightly less expensive when purchased by mail, but generic drugs were more expensive by mail. When we combine the prices for brand-name and generic prescriptions, any differences virtually disappear,’ said Robert I. Garis, M.B.A., Ph.D., associate professor at the Creighton University School of Pharmacy and Health Professions.

And don’t forget that since 2002 (when the data for this report is from) PBMs have moved towards more generics as the rebates have become less important parts of their business and they’re making way more profits on generics. Medco for example increased total profits in 2005 after having its profits from rebates fall dramatically as it passed them back to customers. Margins on generics more than made up the difference. Now Garis is clearly on the side of the retail pharmacies, but given what we know about the PBM business, especially the stories from University of Michigan, I’m inclined to believe him when he says this:

Given a continued increase in generic-drug use by both mail and retail pharmacies and the practice of high markups on generics by PBM-owned mail outlets, he added, retail pharmacies ultimately may offer the better value. He noted that recent reports show generic drugs account for more than 55 percent of all prescriptions dispensed through both mail and retail channels.“Employers need to ask PBMs more questions about their markups on generics, just as they would when purchasing ink, paper or other supplies,” Garis said. “The truth is that PBMs are racking up record profits through an increased use of generic drugs and an increased use of PBM-owned, mail-order facilities.”

BLOGS: What’s a Blog?

• 2

The Boston Globe reports that other executives in town are
less than thrilled with Beth Israel Deconess CEO Paul Levy’s new blog, Running
a Hospital. Levy has been blogging on industry issues for the past few months,
offering a rare glimpse at the decision-making process inside a major teaching hospital, posting on topics ranging from the size of his own salary ("Do I get paid too much?") to negotiations with labor organizers.

Recently, he took the unusual step of posting data Beth Israel’s monthly hospital acquired infection rates on his site and publicly
challenged his competitors at Mass General to do the same. Under Massachusetts law, hospitals are not yet required to make the information public – and most have hesitated to do so, fearing negative publicity. 

Picking up from the Globe’s report:

"There are some things that Boston hospital executives generally believe are
best kept quiet. Gripes about competitors are one. The rates of
hospital-acquired infections among patients are another, at least at this
point. Then came Paul Levy’s blog. In his blog, Levy also has needled Partners HealthCare, the parent
organization of Mass. General and Brigham and Women’s, about their formidable
market share of patients, saying they get paid more from insurers because of
their size." 

Partner’s CEO Dr. Peter Slavin responds in an interview on White Coat Notes, the Globe’s new health care blog, with the CEO’s PR department-blessed version of "Oh yeah, buddy? You and your ‘blog’ want to step outside?"

"There are at least two ways to compete in health care, provide great
care, do great research and excel at teaching — that’s the way we
choose to do it," Slavin said. "The other way is to criticize one’s
competitors. That’s not the method we choose to employ."

Indeed!! 

assetto corsa mods