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Above the Fold

Presidential candidates’ health plans

May 12, 2008• 6

By THCB Staff

As a service to our readers, we’ve compiled all the presidential candidates’ health plans in one place for you to easily access. Soon, we’ll have a section of the TCHB devoted to the presidential race and health reform.

Click on the candidate to see his or her full plan for health reform.

As the race carries on, we’ll bring you updated analysis from the candidate’s health advisers, left – and right-leaning wonks and THCB contributors.

Also here is the Kaiser Network’s side-by-side comparison of the current candidates’ plans for quick reference.

Robert Laszewski’s nonpartisan analysis of each candidate’s plan previously posted on THCB are here:

If you’re interested in seeing health reform plans of the candidates who dropped out of the race, here’s the Kaiser Network’s side-by-side comparison.

Stealth marketing: doctors and public radio

May 11, 2008• 3

By Sarah Arnquist

Over at Slate, veteran health care journalists Shannon Brownlee and Jeanne Lenzer raise tough questions about the lack of disclosure regarging four doctors’ ties to the makers of antidepressants, while they told audiences of public radio stations nationwide that the connections between suicide and antidepressants were largely overblown.

The radio program, Infinite Mind, produced the show in April titled Prozac Nation: Revisited.

Here is writers’ nutgraph:

"The radio show, which was broadcast nationwide and paid for in part by
the John D. and Catherine T. MacArthur Foundation, had the air of
quiet, authoritative credibility. Host Dr. Fred Goodwin, a former
director of the National Institute of Mental Health, interviewed three
prominent guests, and any radio producer would be hard-pressed to find
a more seemingly credible quartet. Credible, that is, except for a
crucial detail that was never revealed to listeners: All four of the
experts on the show, including Goodwin, have financial ties to the
makers of antidepressants. Also unmentioned were the "unrestricted
grants" that The Infinite Mind has received from drug makers, including Eli Lilly, the manufacturer of the antidepressant Prozac."

Wal-Mart drops drug prices, shakes up market — again

May 9, 2008• 11

By Jane Sarasohn-Kahn

Wal-Mart continued its first-mover tactics in health by dropping the price of prescriptions again. This time, the target is maintenance meds, which Wal-Mart will price at $10 for a 90-days supply.

This move puts Wal-Mart squarely in the pharmacy benefits management (PBM) segment vis-à-vis ExpressScripts, Medco, and the big PBM players. The three-month mail order med business is the lucrative turf of PBMs. Wal-Mart’s first move into this space was in 2006 when the company priced many 30-day prescriptions at $4, shaking up the industry. I wrote about that market disruption here in January 2008.

Wal-Mart will also offer over 1,000 over-the-counter (OTC) meds for $4 and under. These will all be Wal-Mart’s private labels for popular OTC brands.

As the company with the red bulls-eye did the last time Wal-Mart dropped the price of meds, Target responded as a fast follower by saying they, too, will match the Wal-Mart prices for a 90-day supply of drugs. Target’s program will expand the assortment of $4 Rx drugs and the 90-day supply of these medications for $10 and private-label OTC medications for $4 or less.

Healthy Americans Act could be the place of compromise for health reform in 2008

May 8, 2008• 8

By Robert Laszewski

Health care reform will be hard to do after the November election. I’ve even called it a long-shot.

Wyden_smile Polls clearly show the voters split evenly between the Democratic and Republican approach to health care reform. I can’t tell you who will win the presidency, but I am willing to make the bold statement that it will be a close election and neither very different approach to health care reform will enjoy any kind of mandate.

So finding common ground between these very different approaches will be more than tricky.

But we may already have an outline.

Sen. Ron Wyden (D-OR) and Sen. Robert Bennett (R-UT) have crafted a health care reform plan that gives both sides the most important things each are looking for.

Indian docs endorse O.J. and oatmeal

May 8, 2008• 3

By Sarah Arnquist

PepsiCo maneuvered marketing genius this week by convincing the Indian Medical Association to endorse the health benefits of Tropicana fruit juice and Quaker Oats for three years.

Pepsi
Now, when Indians reach for these products, they’ll see a stamp of approval from the IMA. In turn, Pepsi will sponsor IMA events and forums. This so-called noncommercial deal is the first of its kind globally.

The Indian Medical Association, an organization with 175,000 members, is India’s equivalent to the American Medical Association. It has received harsh criticism for the deal. The Times of India ran opposing viewpoints Thursday on the endorsement.

"The IMA cannot be seen to be favouring any one corporation over its rivals when it comes to benefits that flow from a healthy diet," the opposing editorial states.

In the IMA’s defense, a columnist wrote, "Brand promotions of healthy products of a corporation like PepsiCO — that’s more of a cola company — will help it diversify its operations in holistic areas that enhance, rather than compromise, public health."

Did Pepsi ghostwrite that?

Ten years ago, the American Medical Association had to backtrack on an agreement to endorse Sunbeam medical supplies after its members responded with fury. The AMA’s violation of an unwritten 40-year-old rule against product endorsements caused four top officials to resign.

Interview with CEO of Limeade, Henry Albrecht

May 8, 2008• 1

By Jen McCabe Gorman Imageprovider

Henry Albrecht, CEO of Limeade online employee wellness firm, was nice enough to talk with me on his cell phone in the evening (after 5 p.m. West Coast, 2 a.m. Amsterdam time).

Both of us were banging pots and pans, cooking dinner (him), making coffee (me).There’s something comforting about speaking with a high-tech health care executive in such an old-fashioned, "conversational" way.

Thanks again Henry – pleasure to meet you and Limeade.

Interview with Joseph Kvedar, Partners Center for Connected Health

May 7, 2008• 2

By Matthew Holt

Joseph Kvedar is the director of Center for Connected Health, which is part of the Partners HealthCare System’s empire in Boston (that’s Mass General and the Brigham for you old-schoolers). Joe emceed the conference I spoke at yesterday, and I stopped in for a quick chat with him this morning to get an update on the Center’s progress.

If you need an introduction to the Center, its web site is here, a piece Joe wrote for THCB last year is here and the transcript of a longer interview I did with Joe is here.

Today we had time for a quick catch-up, in which he touches on the state of the EMR initiative at Partners, the wider role of Connected Health within Partners, and the state of their current pilots. Here’s the interview (The first minute is a little quiet. My apologies.)

You can also see the details about the Center’s symposium (27-28 October). There, you can find out more about Connected Health than you can imagine, and you’ll probably see a little flavor of Health 2.0 there, too. We hope to bring a little flavor of the community aspect of Connected Health to the Health 2.0 Conference (October 22-23). Yes, we know they’re close together … but speaking as someone who’s been to both, I recommend both highly!

Health Plan Illiteracy: study finds many do not understand their benefits

May 7, 2008• 7

By Jane Sarasohn-Kahn

Health plan illiteracy is alive and well, according to J.D. Power and Associates. The consumer market research firm’s 2008 National Health Insurance Plan Study finds that one in two plan members don’t understand their plan.

In this second year of the survey, J.D. Power notes that, as consumers understand the benefits of their Benefit, their satisfaction with the plan increases. Thus, there is a virtuous cycle that happens between a plan and an enrollee when communication is clear and understood.

J.D. Power looked at member satisfaction in 107 health plans throughout the U.S. in terms of seven key metrics: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service. The survey was conducted in November and December 2007.

Last year, Abt Associates found that most insured workers don’t understand simple health plan language. I abstracted some of Abt’s findings in this chart that I use in many of my presentations. Health plan illiteracy goes beyond general health illiteracy — this is people blessed with benefits who don’t ‘get’ them.

The virtues of virtual visits

May 7, 2008• 2

By Jane Sarasohn-Kahn

Rush-Presbyterian Medical Center’s Virtual Integrated Practice (VIP) is more evidence that remote health care can improve health outcomes.

At Rush, a team has been refining the VIP model for the past four years. The VIP’s objective is to improve chronic disease management for older people by deploying aninterdisciplinary team using communications technology.

The main challenges in primary care for VIP’s target patient population are:

Multiple chronic problems
Polypharmacy
Physical disability
Functional impairment
Economic stressors

The Holy Grail here is that when these patients are optimally-managed, VIP can identify missed opportunities for primary prevention and avoid eventual disability.

Searching for the price of one appendectomy

May 6, 2008• 18

By Sarah Arnquist

This month’s Philadelphia Magazine ranks the city’s top physicians — a fad nearly all major city magazines have adopted because it attracts great advertising dollars.

Tom

But tucked amid the pages of smiling surgeons and OB-GYNs is a gem of a story by the magazine’s executive editor, Tom McGrath, in which he takes readers through the maze he encountered while trying to decipher the hospital and insurance bills following his daughter’s appendectomy.

After his five-year-old daughter had her appendix out at Children’s Hospital of Philadelphia (CHOP), McGrath set out to learn why it was so impossible for him to understand how much his daughter’s surgery and hospital stay cost, how much the insurance company was paying, and how much he owed.

"I discovered two things: first, that much of the cost of our health care is determined behind smoked glass, where patients are never invited to look," McGrath wrote. "And second, that in trying to make sense of a single simple case where everything went right, you can learn a lot about what’s wrong with health care in America."