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The Five Myths of Healthcare Reform

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By ROBERT LASZEWSKI

The arguments that the widespread use of health information technology (HIT), improving health status, expanding outcomes research, implementing pay-for-performance systems, and covering everyone will make it possible for us to afford comprehensive health care reform are commonly cited by people on both sides of the political aisle. It’s all a myth.

Undoubtedly, these ideas will be at the core of any number of health care reform proposals as we begin the 2009 health care reform effort.There is nothing wrong with any of these things and all can make a positive contribution toward improving both the cost of and especially the quality in our health care system. All should be part of a reform proposal.The problem is that none of them would make more than a modest dent in what a reformed system would cost us and not come anywhere near close to
accomplishing the objective of stabilizing our health care costs much less reducing them.

Continue reading…

Cool Technology of the Week

By JOHN HALAMKA

Community_map_2As part of the Harvard Clinical and Translational Science Awards, we’ve built a number of social
networking tools while also leveraging components built by others such as NetAge. These tools typically work by analyzing collaborators on publications, co-PIs on grant funding, and subject matter interests.

A possibly more precise way to identify networks and communities is by analyzing email traffic patterns – senders, receivers and subjects. A novel social networking tool from Metasight called Morphix, does this.

MetaSight Communities of Interest and Communities of Relationships are web applications which can be implemented as standalone applications or integrated with a corporate portal or intranet.

The tools work by automatically analysing e-mail subject titles and recipients. Personal, private and confidential e-mails are excluded.

Per the Metasight website, social networking applications of this analysis include:

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Whata Gupta Fuss

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By Matthew Holt

Mostly because he went off erroneously at Michael Moore in what I remember as two amateur policy analysts being unable to either get their facts straight or explain what was important, Sanjay Gupta’s floated appointment as surgeon general has got the left in a tizzy. And I agree that a neurosurgeon is not exactly who I’d go to for information about public health. But part of the amusement/confusion is that via a now contrite Merril Goozner, CNN’s Sanjay Gupta was confused with another Sanjay Gupta who was a big time recipient of drug company funding.

But does any of this this matter? I know that the rumor is that he’ll have input into health reform, but then again so does anyone who went to a Daschle house party. And if this position is so important, answer me this: who is the current Surgeon General and what notable thing has he or she done?

I knew you couldn’t do it sans Google….

If you really care, Val Jones has recently interviewed the last but one surgeon-general Richard Carmona. In your piece of trivia for today Carmona knows about Health 2.0, or at least is on the board of Healthline.

Anyway we may not have enough general surgeons according to their trade group, but why should the head of public health for the nation be a surgeon. Shouldn’t they be an epidemiologist? And why are they a general? Don’t we waste enough money on the military as it is?

The demise of Medicare Health Support

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By Matthew Holt

I guess we knew it, but here’s the confirmation in the analysis of the first 18 months from CMS.

The summary: DM companies in Medicare Health Support enrolled healthier than average populations; they had limited to no impact on improving their patients’ care, satisfaction or outcomes; and didn’t save any money.

I wonder how Disease Management is going to fare in the future. It’s clear that this "occasional remote intervention" model needs to change.

Viciously Vladeck

The new Health Affairs is out and with it a lovely piece of vintage Vladeck.

In a review of a new book on Medicare  by old Brookings warhorse Henry Aaron and fast rising UT Longhorn star Jeanne Lambrew, Bruce Vladeck soon turns off the main topic (their book) and onto his favorite–the inevitability of the outcome when Medicare tries to do something about health care costs, and the inability of the political system to do much about it.

Policy analysts make fun of politicians who claim they can balance the budget by eliminating "waste, fraud, and abuse," but with a straight face they then propose to control health care costs by making the system more efficient. Efficiency has hardly anything to do with it. What health care costs are all about is market power and the distribution of monopoly rents. Every other industrialized nation understands that and does something about it. U.S. providers and insurers understand it, too, which is why the more sophisticated providers resist any efforts to aggregate power on the buyers’ side. But the mainstream of U.S. policy analysis just doesn’t seem capable of even framing the question, let alone solving it.

Of course despite me convening panels with Valdeck on them a couple of times, he probably doesn’t think THCB is mainstream policy analysis 🙂

But just last week I said:

As I’ve been saying for a long time, to rationally rationalize the
health care system, we need to make cardiologists in Miami behave like
cardiologists in Minnesota with a consequent impact on the incomes of
doctors, hospitals and stent & speedboat salesman in high cost
areas (Yes, Jeff, I do mean Louisiana, New York, Los Angeles and Boston
too). If the Federal Health Board has teeth, that’s what it’ll do, and
the AMA, AHA, AdvaMed, PhRMA et al know it. Which is why the PhRMA front organizations have been railing against cost-effectiveness for so long.

We know the question. Sadly we also probably know the answer. Vladceck’s short piece is great fun, nonetheless.

Let’s Reboot America’s HIT Conversation Part 1: Putting EHRs in Context

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By DAVID C. KIBBE & BRIAN KLEPPER

Kibbe & Klepper are back with an update to their pre-Christmas piece on EHRs and the forthcoming Obama Administration’s investment policy towards them. Lest you think that this is just a small group here on THCB and fellow traveler blogs shouting to each other, I’d point you towards the Boston Globe article about their previous "Open Letter," which shows that this discussion (and a similar piece on THCB from Rick Peters) appears to be being taken very seriously. As it should–Matthew Holt

On Dec. 19, we published an Open Letter to the Obama Health Team,
cautioning the incoming Administration against limiting its Health
Information Technology (IT) investments to Electronic Health Records
(EHRs). Instead, we recommended that their health IT plan be rethought
to favor a large array of innovative applications that can be easily
adopted to result in more effective, less expensive care.

The
response to that post was vigorous. We received many comments and
inquiries from the health care vendor, professional and policy
communities – urging us to provide more clarity. One prominent
commentator called to ask whether we, in fact, supported the use of
EHRs. We both have been active EMR and health IT supporters for many
years. Dr. Kibbe was a developer of the Continuity of Care Record
(CCR), a de facto standard format for Electronic Medical Records
(EMRs), and has assisted hundreds of medical practices to adopt EHRs.
Dr. Klepper has been involved in EMR projects for the last 15 years,
and the onsite clinic firm he works with provides every clinician with
a range of health IT tools, including EMRs.

Continue reading…

Reprise….Critical of Critical

By Matthew Holt

For those of you who had better things to do than spend last week reading wonkish blogs, I point you towards my article about Tom Daschle’s book. In particular I encourage you to look deep in the comments, for a particularly fun spat between me and a reader called Nate–the type of spat that used to be very common on TCHB but sadly has become a little rarer now we’re all grown up!. The original piece is here and the comments get juicy around Jan 3.

Outlook for health stocks clouded by uncertainty about Obama’s health strategy

By DON JOHNSON

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Although I wrote months ago that health executives weren’t very concerned about the elections, I think they have to be now.

Many health stocks are depressed and they will be until the
uncertainty about Obama’s proposed nationalizing of the health
insurance markets is resolved. We don’t know exactly what he’ll try to
get through Congress. And we don’t know whether the GOP will be able to
kill or modify Obama’s plans. Clinton had basically the same majorities
in the House and Senate that Obama will have, and he couldn’t get
Hillary care enacted.

The public mood, of course, is much different today. Insurers shoot
themselves in the foot every day, and consumers and politicians are
sick of them. They are much harder to defend today than they were in
‘93 and ‘94. So I think enough GOP senators will support Obama to get
something done.

But the markets aren’t sure, yet. Uncertainty is a market killer.

In addition, with higher co-pays and deductibles, the health
insurance and health care markets are acting much more like normal
markets despite all of the governmental distortions.

This is hurting demand for insurance, medical devices and medical
services. This is shown in the depressed prices of hospital company
stocks.

So, if you’re going to play the health ETFs, play the technicals as
much as the fundamentals, which are very cloudy at this point, imo.

assetto corsa mods