Here are two very interesting and frightening charts that my good friend Warren Brennan, the CEO of SMA Informatics in Richmond, passed along this AM, with this question, aimed at the CFOs of hospitals and other health care organizations:
What do these mean for bad debt and for the health care sector’s future financial performance?
This is a repost of an original that addresses Hillary Clinton’s claim, repeated in last week’s Texas debate, that only her health plan accomplishes universal coverage because it has a individual mandate and Barak Obama’s does not. Senator Clinton goes so far as to say she would garnish wages to enforce her mandate that everyone buy health insurance. Hillary Clinton has gone on the attack in recent days criticizing Barack Obama’s health care plan. She charges that his plan would not cover everyone and hers would.
Is she right?
Senator Clinton has an individual mandate in her plan. That means
that everyone would be required to purchase coverage or suffer a
penalty she hasn’t defined. Senator Obama does not have an individual
mandate in his plan although he would require all children to be
covered. Both candidates would require employers to cover their
employees.
This is nothing like the Clinton Health Plan from 1993.
Senator Clinton has so far been running a smart campaign for President — at least on the policy side — and her health care reform strategy is no exception. She waited until after all of the leading Democratic, and most Republican, candidates had announced their plans and then stuck her plan right in the ideological middle of where her Democratic opponents put theirs. It also looks a great deal like a bipartisan plan enacted in Massachusetts and a bipartisan compromise in the works in California. So on the day it was released, it was correctly identified as being relatively centrist.
I was on my way to see Deborah Peel’s talk yesterday when I was waylaid by a previous engagement that I’d mischeduled in my calendar. Given I had 4 people waiting for me I couldn’t break it but I was very disappointed to not be there.
Fred Trotter was there and had some of his questions answered. Unfortunately he didn’t ask the ones that I am getting so worked up about.
Now I’m off to see Newt Gingrich. Perhaps I’ll get a chance to ask him about his views on it. (And for the record the Google party was fabulous!)
ICW is a German-based consumer facing record company, that is dominant in Germany and several Eastern European countires. Over here they decided that their skills lie in integrating data from disparate systems, very much a Health 2.0 trend (which is why they’re a Health 2.0 Conference sponsor).
They also announced a major open source initiative with Agfa and Sun this morning–which will hopefully give a boost to open source in health care (which thus far has been a somewhat small and lonely community)
My first interview at HIMSS is with Orlando Portale, CIO and Michael Covert, CEO of Palomar Pomerado Health in the San Diego area. They’re planning a new hospital and are working with Cisco and have put together a fun video about their new Virtual Palomar West in Second Life. They both had some really interesting things to say about how to build a large new hospital and how to plan for its use for a long, long time ahead. Here’s the interview.
(FD, Orlando and I are both on the advisory board for HIMSS Community for Connected Health, sponsored by Cisco, and I have done consulting work for Cisco in the past).
Dan Kogan is a veteran IT developer who built some matching systems now prevalent in financial institutions. He’s now turned his attention to healthcare and has started Health World Web. I (Matthew that is) have been advising him as he gets going, and have therefore (as I allways want good material) bullied him into writing about his view of why health care is ripe for this technology and a little about what his company plans to do. (Don’t forget that the same offer is open to anyone who wants to write on the Health 2.0 Blog)
When exactly did the power of healthcare move out of the hands of the people and into the hands of the doctors? Historically, patients do not take the upper hand when it comes to choosing the proper healthcare. Choosing the right doctor becomes a nerve wrecking game of cross referencing the insurance listings with yellow pages, the general listings of a Google search inquiry with proprietary knowledge or word of mouth. Finding a good doctor often reminds a patient of a game of dice. The chances of rolling two 6’s are equal to 1/36 or about 3%. What comes into the equation is the patient’s insurance, the insurance a doctor will accept, the potential path to the specialist through the gatekeeper (if one is required), locale and then, just pure randomness in getting to one of the more than 700K licensed MDs.
For a start, as I said in my last post and many times, and at least one of these commenters has written at length, the benefits of sharing health data in clinical situations massively outweigh the risk. So that should be the focus of the discussion.
I am NOT saying that there shouldn’t be privacy protections and there is no reason in my mind why, for all HIPAA’s flaws, it cannot be extended to PHR providers as covered entities.
However, as far as I can tell nothing that is happening here violates HIPAA. Showing you keyword based advertising may not to everyone’s taste, but it does not mean your private health data is being transferred to anyone. And presumably your data will only end up in these services if you give them permission to accept it, which will include consent to provide whatever services and advertising you’ll see.
And that’s assuming that either company does advertising based on records rather than search terms (which is Google make that 98% of their money).
But exactly where are Microsoft and Google suggesting that they’re going to be selling private identified data? Nowhere. Microsoft has bent over backwards to demonstrate that they have no intention of allowing themselves or anyone else to access your health records without permission. And Google will likely do the same when it announces its plans officially.
Today it’s HIMSS. Yesterday I spoke to the CHIME CIOs and had a good time. Today I’m talking to the Cisco Community for Connected Health and the rest of the time I’ll be accosting people with a microphone. Come back over the days to come to see.
So Modern Healthcare‘s Joseph Conn has a whole page to write about the Cleveland Clinic and he writes just about HIPAA and the fact that this pilot is not going to be covered by it. Writing in the San Francisco Chronicle Victoria Colliver talks about not a lot more, but at least she has someone stating the bleedingly bloody obvious—
"If it’s made convenient
enough and easy enough, people will be no more concerned about privacy
with these systems than they are with their financial information," he
said. "Far more people die because health information is not released
or difficult to get … than anybody’s ever been harmed because the
information has been inadvertently released."
OK so it was me she quoted, but someone needs to give Deborah Peel
and whoever the hell the World Privacy Forum is a big shake. I say this
as a card-carrying member of the ACLU and Amnesty International who is
deeply concerned about anyone’s private information and what use is
made of it.
And the shake is, if a government overhears your private information
illegally (or quasi-legally) it can use that information to take away
your freedom and worse. So the standard for their ability to access
that information should be an awful lot higher than it is in virtually
every country—including this one.
If a private corporation unwittingly lets slip your private health
data, or even uses some aspect of it knowingly to target you for
marketing, the chances of you suffering much from it are very, very low.
These are vastly different things, and conflating the two does not help in the least.
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