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POLICY: We need health cost containment before fixing the payment method , by Jack Lohman

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Das Kapital

Jack Lohman is a retired business owner from Wisconsin and founder of Throw the Rascals Out. He’s become a frequent commenter on THCB, oddly enough as a Republican voter who is in favor of single payer, and I thought that his opinions on health care were interesting enough to merit an opinion piece no the main page. Jack can be reached at jl*****@****pc.com.

MikeGUEST POST

Let’s take a time out.

As the nation struggles with how to pay for health care costs that are spiraling at an annual rate of 17%, five times the rate of inflation, we are virtually ignoring the reasons behind the escalating costs in the first place. We are engrossed in payment methods rather than cost containment, all while the industry seeks innovative ways of taking home a bigger piece of the national pie. Some see the “free-market” as our savior, when in fact, the slow conversion to a free market system that began a decade ago is the reason we are in trouble today. And it will get worse.

Years ago it was considered fraudulent for hospitals to hire their own physicians, for physicians to own an interest in a hospital to which they referred patients, and for physicians to refer patients to an outside laboratory in which they had a financial interest. We also had a certificate of need program that prohibited hospitals from leap-frogging the hospital down the street, thus churning expensive high-tech imaging systems. 

Continue reading…

PHARMA (well sort of): Jim Edwards having a little too much fun

800x600Jim Edwards of Brandweek has been writing about “Bob” the (fictional) recipient of the Enzyte male enhancement pill (John Mack likes Bob too!). As you might have guessed, the pills a crock and the company behind it is a bunch of fraudsters. One hopes this isn’t true of prescription ED drugs. It may not exactly be as insightful as his normally extremely aggressive investigative reporting, but on the other hand Jim may have produced one of the corniest headlines of the year:

Enzyte Executives Stay Firm Despite Growing Troubles

PHARMA/POLICY: Price negotiations coming?

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Joe Paduda is puzzled that drug company prices and profits are going up, yet the NY Times thinks that we can’t get a better deal on drug prices for Medicare. But in some ways that’s a little irrelevant, as the introduction of price negotiations are a political not an economic question. And despite the fact that in 2003 negotiations were politically unacceptable to Tom Delay et al, it appears that (as quoted in Krugman’s column today), the politics of negotiation are all one way.

This is clear from the latest Newsweek poll, which shows overwhelming public support for the agenda Nancy Pelosi has laid out for her first 100 hours if she becomes House speaker. The strongest support is for her plan to have Medicare negotiate with drug companies for lower prices, which is supported by 74 percent of Americans — and by 70 percent of Republicans!

Even assuming that the Dems don’t fumble their current advantage away (or more accurately that the Republicans don’t keep shooting themselves in the foot and the knees) and they take the House and Senate, we’re not getting negotiations tomorrow. First, it might not get past the Senate filibuster, although those poll numbers are pretty scary for Republicans and will take a boatload of PhRMA cash to overcome. Second, Bush will likely veto it, as the current MMA is basically what passes for his domestic legacy (unless he wants “I cut taxes for the richest people in the world and made the children of the middle class pay for it” on his tombstone).

But in any event Pharma needs to prepare for a world in which Medicare drug price “negotiations” are much more likely than they’ve expected heretofore.

QUALITY/POLICY: The Scourge of Skid Row

This is very, very unpleasant. A staph infection outbreak in Los Angeles that’s got its own name— the Scourge of Skid Row. And it’s one reason why public health, including the real basics like housing, clean water and access to medical care affects everyone—not just those without it.

 

POLICY: Six Dirty Little Health Care Secrets

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I’m up at Spot-on talking about Six Dirty Little Health Care Secrets. Comments back here if you like….


With no lurid sex scandal this week and apparently little public interest or Congressional caring about what’s going on overseas, ABC News and USA Today have turned to the health care system to fill some air time and column inches. As you may have heard, ABC’s even been wise enough to ask a couple of bloggers – yes, I’m one of them – to chime in on the debate.


They were asking for solutions to the health care crisis. But asking
for that’s pretty much a waste of time. Americans may hate their health
care system, but they apparently like their health care providers and
even think that their costs are OK. Or at least that’s what one survey
said. But suveys don’t tell the whole story – they serve as a kind of
cover for the real reasons it’s so hard to change the system we live
under. Continue …

PBMs: Cynics patrol

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Late last month Jack Bruner joined PBM Caremark Rx as VP of Marketing. What was he doing before? He was head of Hewitt’s Global Health Care Practice. Who’s Hewitt? It’s one of the biggest benefit consultants in the world. What did it do last year? It tried to put together a coalition of  coalition of employers (HR Policy Association) to go around the PBMs. It basically appears to be failing.

How hard did it try, and on whose side is it (and the other benefits consultants) really on? I’ll let you Wall Street Journal readers decide if you’re suspicious of a revolving door between the consultants and the PBMs.

POLICY/POLITICS: New York Times, dogs, pustilent sores, licking of.

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After the previous three times, I don’t think I can bear it.  This time David Leonhart has written a NYT article saying that the reason we spend more here is because of American culture. This may be the most moronic sentence of the whole series of articles:

We Americans tend to treat any rejection of a health claim as some conspiracy by insurance companies, the government, doctors and the pharmaceutical industry. In other countries, people have arrived at a better understanding that health care necessarily involves economic triage — that $10,000 spent on quixotic care is $10,000 that can’t be spent more usefully.

“We Americans” are somehow are magically controlling the spending, apparently over the objections of  “insurance companies, the government, doctors and the pharmaceutical industry”

He’s supposed to be the economist. Does he have no idea who controls health policy and health care spending in this country?  For chrissake, the government here more or less represents the “insurance companies, the government, doctors and the pharmaceutical industry” and their interest is in spending more, not less. “We Americans” did not get a seat at that table, unless you count patient groups that also have an interest in higher spending and are co-opted by industry. Any high school senior doing a basic political science class  who read the cliff notes on Stigler’s theory of capture can tell you how that works. But apparently you get to miss that class, or Econ 101 if you want to write on health care for the NY Times.

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