Tag: Uncategorized

Politics 2.0 is a Victory for Health 2.0

Nov 3, 2008• 1

By Michael L. Millenson

I was sitting here getting ready to blog on how Politics 2.0 will affect Web 2.0, when I got an email from the coordinator of a health care-related virtual community established by the Obama presidential campaign. It directed me to a humorous video featuring a group of singing (OK, lip-syncing) Obama staffers bringing a bipartisan message of hope to political junkies facing the looming end of this seemingly endless campaign. Les Misbarack is great fun — although I wouldn’t plan on ditching my Capitol Steps tickets just yet.

This morning, two pillars of the mainstream media (MSM) both examined the role the Internet has played in the presidential campaign. The Wall Street Journal gives us conventional political analysis along the lines of how-the-results-of-this-war-will-affect-the-next-one. The New York Times, by contrast, zeroes in on Campaigns in a Web 2.0 World and begins to discuss the thornier issues of who will generate content, who will control content and how content will be disseminated by online and offline media.

Interestingly, while the Times piece has a photo of Obama Girl, and alludes to her popular “I Got a Crush…on Obama” video in the caption, the article itself makes no mention of user-generated content. You have to go to the online site, Politico.com, to find the “10 most viral videos of the campaign” in order to discover that the Obama Girl video pulled in more than 10 million views.

Finally, a reason to support Obama’s health care plan

Nov 3, 2008• 6

By Matthew Holt

Scott Gottlieb (Wall Street flack, disastrous Bush FDA appointee, and now “Fellow” at the oh-so-independent American Enterprise Institute) is against it.

Pharmacy benefit brainstorm: Ultragenerics

Nov 2, 2008• 3

By DAVID E. WILLIAMS

The financial meltdown, recession, and growth in health care costs
are a triple whammy, even for those with good insurance. As recently
reported, mainstream patients are seeking out
pharmaceutical company Patient Assistance Programs intended for the
poor. Even generic drugs can be pricey if you have a lot of them.

But I think I have a solution: the Ultrageneric formulary. This plan
would feature efficacious products with very favorable side effect
profiles and ultra-low costs. There should be strong acceptance from
physicians because they are already happily prescribing these products.

What’s the secret? My formulary would consist entirely of placebos. As the New York Times reports (Half of Doctors Routinely Prescribe Placebos):

Half of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients…

In response to three questions included as part of the larger
survey, about half reported recommending placebos regularly. Surveys in
Denmark, Israel, Britain, Sweden and New Zealand have found similar
results.

The most common placebos the American doctors reported using were
headache pills and vitamins, but a significant number also reported
prescribing antibiotics and sedatives. Although these drugs, contrary
to the usual definition of placebos, are not inert, doctors reported
using them for their effect on patients’ psyches, not their bodies.

In most cases, doctors who recommended placebos described them to
patients as “a medicine not typically used for your condition but might
benefit you,” the survey found. Only 5 percent described the treatment
to patients as “a placebo.”

I expect this new plan to be a smashing success.

Busy, busy, busy

Nov 1, 2008• 1

By Matthew Holt

So it’s been a wild month at THCB. While the Health 2.0 conference sucked up every available waking and some non-waking moments in Matthew & John’s lives, Sarah Arnquist—our future Pulitzer Prize winner & THCB’s staff writer & editor—has been keeping the fires stoked with a succession of home-grown & judiciously selected articles. And boy has it appeared to attract the public.

THCB numbers

Yup, great content, fun discussions and a combination of Health 2.0 fever and this little event called an election…and that upward trend in visits we’ve been seeing all year has now really popped. 86,000 visits in October to this little blog (all our visit data is open for you to see at the sitemeter button on the bottom right).

So thanks for coming, thanks for allowing me to do a little trumpet blowing, thanks to everyone who’s written for THCB or allowed us to use their writing, and thanks to Sarah for doing such a great job.

And we’ll be making some other changes to the format and the THCB experience in the next couple of months — so please keep coming back!

Health Wonk Review Is Up!

Oct 30, 2008

Over at Health Blawg, David Harlow has a special and particularly entertaining "Samhain" edition of Health Wonk Review. Pull out your costumes and head on over for some treats!

Pitfalls of VIP Syndrome

Oct 30, 2008• 2

By Sarah Arnquist

Slate has an article today by two doctors discussing VIP syndrome in health care and how it can lead to worse care for the rich and powerful, such as Sen. Ted Kennedy, who following a diagnosis of cancer convened his own tumor board.

The authors lay out the pitfalls of VIP syndrome here:

VIP syndrome affects not only treatment but also testing decisions. If
Joe the Plumber requests a CT scan he doesn’t need, doctors simply say,
"No, Mr. Plumber." But Joe Biden can get any CT he wants. Some health
care programs
for corporate executives even involve routine full-body CT scans as
screening tests as part of the "chairman’s physical." The problem is
that these expensive and detailed tests may actually increase the risk
of cancer from radiation exposure
and have never really been shown to improve anyone’s health. And if
there is an incidental finding, as there often is, more tests might be
ordered, which may lead to unnecessary biopsies. And doctors perform
heroic procedures on VIPs not just when there is clear benefit but when there is any question of benefit.

Bob Wachter wrote a few months ago about VIP Syndrome, noting there is a sizable medical literature documenting this shift in practice for the rich and powerful.

Wachter writes, "Every hospital I know keeps some sort of a VIP list, a tripwire to
alert the organization of the arrival of a dignitary or billionaire.
Even when there isn’t a formal list, you can be sure that a single call
to the CEO’s office is more than enough to lift the velvet rope. That’s
a simple fact of life, and to me, not worthy of a big fuss. Unless,
of course, they’re getting better care than Joe and Jane Average. But
are they? Believe it or not, I really doubt it."

Something interesting that both articles point out is that the top researcher or surgeon often directs the care or operates on the VIPs. Often, these top doctors haven’t been in the OR for a long time.

e-Patient Dave tells his story

Oct 28, 2008• 7

By Matthew Holt

In the Connected Health conference at Partners I sat in on a great session in which e-Patient Dave (Dave deBronkart) and his physician, Danny Sands described his use of listservs, the Internet, email and BIMDC’s PatientSite and other tools in his (successful!) battle with renal cancer—after being told median survival was 24 weeks. I won’t tell the whole story as they’re trying to get it published in an authoritative journal—so that physicians will pay attention and promote this use of technology by patients.

Danny Sands says most patients with his condition feel incredibly alone. but "Dave told me he didn’t think he was isolated. He felt
connected.”

Dave said, “Reading and connecting online makes me a better patient. But it doesn’t make me an oncologist.” But doing all these things via ACOR and the use of CaringBridge and PatientSite did, he believe, increase his hope & outlook, and helped make his treatment successful.

A remarkable story and one that we’ll tell more about later.

(Note: I made a minor edit as my original note got garbled between my ears and my fingers!)

The latest on technology-enabled DM

Oct 28, 2008

By Matthew Holt

I sat in on another session at Connected Health about A Progress Report on Medicare’s CMHCB (Care Management for High Cost Beneficiaries) Pilot. This is the medical group alternative to Medicare Health Support operated via providers not health plans. Some quick notes…

Suneel Rataan from Health Hero: We know that we can make DM work using the Health Buddy and supporting nurses in the VA. But could they make it work in a community setting under Medicare Fee for Service. We know how badly Medicare Health Support has gone, what about this one (CMHCB)? “We can’t talk about the results but our program has not been terminated!” (Actually they have applied for an extension & expansion of the project).

Couple of others, one from Montefiore in the Bronx another from Partners—the Partners one has a variety of practices and the problem is that they need to have the consistent program across those.

Be careful what you wish for

Oct 28, 2008• 16

By Charlie Baker

Charlie Baker is the president and CEO of Harvard Pilgrim Health
Care. This post first appeared on his blog, Lets Talk Health Care.

The show is
pretty much the same – every time. Public sector entity gets in budget
trouble, cuts have to be made, and providers who do business with the
public sector get hammered – hard. It’s happened with Medicare at
the federal level for years, and it happens with Medicaid at the state
level with some frequency as well.

Well, the show is back in town, as state governments face declining
revenues. In Massachusetts, the state is not only cutting Medicaid
payments prospectively – it’s cutting Medicaid payments for some
providers retrospectively – simply choosing not to make payments to
them they had planned on and expected.

I must say, each time this happens, I can’t help but wonder if the
hospital operators and physician leaders who think a single-payer like
Medicare For All is a good idea ever stop to think about how these
agencies deal with their financial problems. When they have a problem,
they unilaterally whack their provider community hard – in ways private
sector payers would never consider.

And then those same providers who think Medicare For All is a great
idea turn to the private health plans they do business with and say,
“Hey – you need to help solve my Medicare/Medicaid deficit – which just
got worse.”

Sheesh. All I can say is, “be careful what you wish for.”

Will a $5,000-tax credit be the silver bullet to solve health care?

Oct 28, 2008• 9

By Shuka Kalantari John_mccain

If Senator John McCain becomes U.S. president he plans to give each American family $5,000 to pay for health insurance premium costs in the individual market. Individuals would get $2,500 for the same use.

How does McCain propose to pay for this? In part, by revoking the tax deductibility of workers’ health benefits and by making cuts to Medicare and Medicaid. Even with these provisions, however, The Tax Policy Center estimates McCain’s plan will run an estimated $1.3 trillion short in funding over the next ten years.

In McCain’s “Health Care Action” television ad, he says, “The problem with health care in America is not the quality of health care, it’s the availability and the affordability. And that has to do with the dramatic increase in the cost of health care.”