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TECH/POLICY: McCall gets off the Scrushy way

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Want to be a fraudulent gazillionaire running a public company? Get your CFO (or in Scrushy’s case a plethera of them) to commit fraud, blame it all on them when it gets discovered, and suggest that as CEO it’s got nothing to do with you, and who were you to know anyway—after all you were just the CEO?

OK, so it didn’t work for the Enron guys, but then again everyone in Houston knew someone who lost their job or life savings. Most San Franciscans haven’t got a clue what McKesson does, or that it’s one of the biggest companies in town. So when the Jury Acquits, Hangs in Trial of McKesson’s Former CEO and GC, it shows that McCall gets off the Scrushy way. Well done. Now will some one give me a big public company to run?

POLICY: Morrison, Klepper & Enthoven–radical communists or mercantilist capitalist apologists?

You be the judge!

Ian Morrison is trying to point out  to the upper echelon of America’s body politic (i.e. the rich bit of its health care system) that some compromise may be reasonable in order to avoid single payer.

Brian Klepper and Alain Enthoven are pointing out why that compromise is necessary now — not something that a random walk through the unthinking business columns of the NY Times might suggest.

Of course they’re all optimists. As I’ve told all three (all of whom I know and greatly admire), I think the systems will trundles on till the middle of next decade when at the behest of the China central bank (or whoever controls economic policy then) the President will be forced to put AHIP, the AHA, the AMA, PhRMA and their Congressional lackeys in a room and offer them two choices. And single payer will be the more acceptable one.

POLICY: Healthcare crisis countdown

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The Christian Science Monitor has a pretty interesting article about how the healthcare crisis countdown may lead to a big debate in health care politics either 2008 or later. My guess is much later, but it’s a matter of timing. And the later the system players leave it to sort themselves out, the more likely it’ll be that we get an unthinking single payer solution (as opposed to a thinking one).

Meanwhile John Abramson has joined the hate America crowd. Just because he has data and evidence on his side, he thinks he can get away with that stuff?!

TECH: McKesson Buys Per-Se Technologies

McKesson is buying Per-Se Technologies . Per-Se was the result of a series of roll-ups in practice management and hospital billing companies, which bought the “switch” part of NDC two years ago. McKesson itself has quite some experience buying technology companies that are roll-ups of others! (And not all of that experience was good!).

More later on the impact.

POLICY: Health care astroturf gets me all grumpy

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I wrote a scathing piece about an astroturf lobbying organziation that is pretending to be something it’s clearly not. My Spot-on editor Chris Nolan didn’t want me to be sued for libel, so the resulting slightly less caustic article is up there called Action and Reaction. My version was subtitled "Taking the piss."As ever come back here  to comment.

Back in the day when there was some vague interest from Democrats in fixing our health care system, a kindly millionaire gave a pile of money
to a lobbying pressure group that had quite some influence behind the
ill-fated Clinton Health Plan. Not too much has been heard since from
Families USA and its leader Ron Pollack. Sadly, those of us of a
certain age felt that its day in the sun had come and gone.
But what was interesting about Families USA was that, unlike
other Capitol Hill groups with "friendly" names, it actually lobbied
for things that might make pretty good sense to families, especially
poor ones. Namely national health insurance coverage that couldn’t be
taken away if the breadwinner got sick. Continue

POLICY/INTERNATIONAL: Damn communists with endowments, again

So the Commonwealth Fund is at it again. Notice how “Commonwealth” has the same root as “Communist”? I thought you did.

Why else would they come out with yet another study showing that compared to other parts of the world that spend a whole lot less money, the U.S. Lags in Several Areas of Health Care. But don’t worry. If you get cancer here and have insurance, you might outlive those damn foreigners…or at least that’s what David Gratzer thinks is the main result of those studies.

If you want to see the whole article in Health Affairs, this is the link. But it doesn’t tell you anything we didn’t already know.

PBMs/BLOGS: A blogger at a major PBM

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Libratto is a blog written by a senior exec from a PBM, Bob Neaser at Express Scripts. I haven’t exactly been polite about PBMs or more accurately about their customers’ willingness to explore their business models over the years. I’ll be interested in watching this blog and seeing what Bob thinks. He’s been posting a little the last two months and I want to encourage him to make the arguments. He started with a rants about why employees should demand less waste in their health care benefits and I (and probably Eric Novack) would agree. But of course one man’s waste…

Still I’m looking forward to more from Bob, especially with the CVS/Caremark deal apparently changing the PBM model.

You should also look at Adam Fein’s blog Drug Channels. He has lots of interesting things to say about PBMs, pharmacy chains et al—even if he’s a little less cynical than I am!

INTERNATIONAL: Cuba exporting doctors

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Here’s a long and interesting article on Cuban Medical Diplomacy. Essentially Castro has been exporting doctors all over the place, and now Chavez is using Venezuela’s oil money to pay for it. I was reading along wondering why we hadn’t imported a few Cuban MDs to handle the US inner cities when I discovered that apparently they offered to send 1,000 to Louisiana after Katrina, but were turned down.

The article is pretty favorable, even though it’s clear that the export of doctors and concentration on the medical care system is at least partly a propaganda stunt by the Cuban government. A couple of things worth noting, though.

First, sending doctors overseas to help other poor people may be worthy and all that (and has the positive benefits of upsetting foreign medical associations, as it’s done in Venezuela) but it doesn’t mean that human rights within Cuba are respected any more than there were during the Cold war. And sometimes the lack of human rights compounds the medical problems there. For example a colleague of mine’s daughter went to Cuba  to do a medical mission/training and met and married a Cuban doctor while there. That doctor was not allowed to leave with her to go to the US, and when he formally applied to do so, was fired from his job, and no longer allowed to practice. Thankfully he escaped by sea, after several, several terrifying attempts. But there is no justification for refusing to allow people to leave a country; and in this case it caused his medical training to be wasted.

Second, and this is my cynical side talking—isn’t excessive spending on health care something that only rich country like ours can afford? What has a poor country like Cuba gone without to provide doctors for the rest of the developing world?

assetto corsa mods