Yup, they really are cashing in on the Placebo Effect.
Above the Fold
CDC Officials Blocked Public Health Report
The Center for Public Integrity, a public interest investigative journalism organization, has obtained copies of a Centers for Disease Control and Prevention (CDC) study of environmental and health data in eight Great Lakes states that was scheduled for publication in July 2007. The report, which pointed to elevated rates of lung, colon, and breast cancer; low birth weight; and infant mortality in several of the geographical areas of concern has not yet been made public.
A few days before the report was slated to be released, it was pulled. Meanwhile, at precisely the same time, its lead author, Christopher De Rosa, has been removed from the position he held since 1992. The Center for Public Integrity is asking why.
The study, “Public Health Implications of Hazardous Substances in Twenty-Six U.S. Great Lakes Areas of Concern” was developed by the CDC’s Agency for Toxic Substances and Disease Registry (ATSDR) at the request of the International Joint Commission, an independent U.S-Canadian organization that monitors and advises both governments on the use and quality of boundary waters.
The CDC report brings together two sets of data: environmental data on known “areas of concern” — including superfund sites and hazardous waste dumps — and separate health data collected by county or, in some cases, smaller geographical regions.Continue reading…
HEALTH PLANS: Wellpoint can’t leave bad enough alone
You’d think the folks at Blue Cross of California or in their parent corporation in Indianapolis would have heard of Lisa Girion of the LA Times by now. Do they really think that by compounding the PR disaster they had with the recission stories of last year their public image is going to be helped by sending their prospective members’ applications to doctors and asking them to check them?
Health plans already ask doctors for medical records of their patients. And that’s a big enough pain as it is. Now it’s apparent that they’re asking them to check the forms of new enrollees. Their explanation that it’s for the good of the medical groups taking capitation probably doesn’t wash, as it’s probably the patient’s previous medical group which has the relevant information. Here’s the through the looking glass story from Lisa Girion at the LA Times.
My only assumption is that Wellpoint has decided that it can get away with basically anything and is desperate to make hay while the sun shines. After all no corporation can get away which such silly behavior for ever.
Hating employer-based insurance, Chelsea Clinton-style by Michael Millenson
Chelsea Clinton is complaining about her health insurance. As a self-employed consultant, I almost felt sympathetic, until I saw she works for an asset management firm, Avenue Capital Group, that manages just over $20 billion worldwide. They are able to accomplish this with just 350 employees spread out over (take a breath): New York, London, Beijing, Bangkok, Hong Kong, Jakarta, Luxembourg, Manila, Munich, New Delhi, Singapore, and Shanghai.
The company’s Web site says the core team has been together for many years, so I strongly suspect the pay and benefits are actually quite, quite nice. Chelsea told CNBC she is “not happy” with her health insurance, but she didn’t offer enough detail to determine why her health benefits are so markedly inferior to the ones her Mom enjoys as a senator and that she’d like all Americans to be able to access.
Avenue Capital is more colloquially described as a hedge fund specializing in the debt and equity of “distressed companies.” I thought only Republicans did that kind of work, but it turns out her boss is a big Democratic donor. Poor Chelsea — first Stanford, then Oxford, then McKinsey & Co., and now this, stuck with “job lock” in a career that pays an ambitious 27-year-old just a few hundred thousand dollars or so annually on her way to a dreary low-seven-figure compensation. Who knows what hardship her health plan forces her to endure?
Call me cynical, but for that kind of money, you don’t need to buy into your senator’s health plan — you can buy the whole senator!
Editors Note: It’s worth mentioning that although Michael is a general purpose cynic he’s also a declared supporter of Obama for President.
PHYSICIANS: Your data is wrong!
Read this article from the Dallas Morning News called Insurers’ ratings often aren’t accurate, doctors complain. It’s very very important, in that it explains both what’s wrong with using claims data to do analytics without working a little harder than most insurers want to, and also how the AMA is gearing up to beat back P4P, physician segmentation, Consumers checkbook and everything else in one simple phrase.
"Your data is wrong and I’m a good doctor"
TECH: Beating up on Maggie’sFarm Blog
Maggie Mahar’s blog HealthBeat is so good that I’ve been itching to find something wrong over there to criticize! (That’s a British trait of criticizing your heroes; sorry!). And finally I have. Her co-conspirator Niko Karvounis wrote a piece on eVisits that’s so off the mark I had to go off in the comments over there.
The rest of you go there and take a look at what Niko said about The Downsides of Virtual Medicine and at my comment. And of course pay more attention to the fantastic stuff Maggie (and usually but not in this case, Niko) writes there—as well as here….
HEALTH PLANS: Who said this….?
In one of the many newsletters I diligently peruse so that you don’t have to be contaminated directly I read this. Astonishing, even considering the source.
I had a terrific opportunity to speak to 700 health insurance agents and brokers on Tuesday morning, here for the Capitol Conference of the National Association of Health Underwriters, most ably led by CEO Janet Trautwein. These people are entrepreneurs who are on the front lines of saving the private market for health insurance in this country, and they are my heroes.
So who is it who thinks that this country’s health care heroes are the insurance brokers and underwriters who are in fact just waste motion making money off our dysfunctional insurance system? Answers/guesses in the comments please…..
CODA: I was actually speaking at a PRI event last year and met an insurance broker who explained to me that he was giving wonderful service to his clients. I with a hint of cynicism asked him what he meant and he said that he was helping them navigate the health care system, finding them the right doctors and negotiating with hospitals for them. I pointed out that those were the functions of a health advocate not a traditional insurance broker. He agreed. Hmmm…I said so you want to move your business from commission based insurance sales to fee-based consumer advocacy, and he told me that he had even been discussing this with Sheila Kheul (the main proponent of single payer in California) as a potential role for brokers in a single payer world. How many health advocates like you do you think we need in California, I said. About 2-3,00 he said. How many health insurance brokers and underwriters are there in California I asked. About 50,000 he said.
That leads to me thinking that this bunch isn’t going quietly into the night….but then again they’re "heroes"
POLICY: Has the dog’s sore not completely healed?
The NY Times has been getting much better in its reporting on health care policy. After all David Leonhardt had Shannon Brownlee’s book as economics book of the year! And they’ve been getting Jack Wennberg in frequently.
But every now and again something crops up that worries me about it’s desire to go straight adn reminds me of that dog with the licking problem. Today it’s the idea that concerns about health care costs are global, which I guess is true, and that the rest of the world–where employers often don’t pay for health care–is becoming more like the US where employers do. The short piece is called Going Global With Concerns on Health Costs and the casual reader might think that systems are converging around the idea that employers should pay for health care because governments can’t afford to.
Leaving aside the basic point that the route by which money is raised to pay for health care is not very relevant compared to how it’s spent and the system by which people get coverage, the article makes two tiny confusions.
First, as it says, it’s supplemental health care costs that employers are paying for in most countries–and in many countries like the UK they’ve done that for decades. Here employers pay for everything. that’s a massive difference.
Second, the increase in percentage paid by employers is only big enough to grow really fast in 4 countries. Those are India, China, Venezuela and Russia. Not exactly health care systems that compare to the US. Our health care system is bigger than those economies!
Sunday Morning Post, by Brian Klepper
Here’s a classical example of a federal regulatory agency holding fast to two opposing ideas at the same time. I wonder what it means?
Last week the Department of Health and Human Services posted an interesting notice announcing a new program that recognizes 14 (presumably) forward-thinking health care coalitions of providers, employers, insurers and consumers, which it refers to Chartered Value Exchanges, or CVEs. (Who comes up with these names?!) HHS promises that, by summer of 2008, it will provide "access
to information from Medicare that gauges the quality of care
physicians provide to patients." This "physician-group level
performance information…can be combined with similar private-sector
data to produce a comprehensive consumer guide on the quality of care
available" in each community. Cool! Sign me up!
PHARMA: Reprieve for Amgen looking doubtful
In a story titled somewhat cryptically Medicare chief stands by anemia move (do they mean he’s trying to become anemic?) Reuters reports that CMS is not backing down from its decision to radically cut payments for anti-anemia drugs for chemotherapy patients. In English this means that Amgen’s Arenesp (& Epogen, though that’s not officially for cancer patients) and J&J’s Procit (which is Epogen re-marketed by J&J) are not going to recover their lost sales from last year. Those sales began to be lost when studies revealed that the fairly rampant use of those drugs was overuse, and also that they were causing some severe side-effects.
Of course for reasons that we all know (e.g. they have little to do with clinical endpoints and more to do with financial ones), community oncologists have flipped out. I do like the response from Dr. Barry Straube, the chief medical officer at CMS. He said:
Our staff looked at over 800 evidenced-based articles published in the literature," he said. "I doubt seriously whether most clinicians read all 800."
Of course the real impact of this was not on patients per se, but on Amgen’s stock price, which has not had the best of years. The little rally late last year was on hopes that CMS would change its mind. I’m afraid that that gravy train looks like it’s over.
