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POLICY: The financial castrophe of uninsurance will get worse

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Just another reminder about the perversity of our insurance system. Steve Lopez in the LA Times writes a about a 57 year undergoing chemo whose COBRA benefits are running out . Whether or not chemotherapy is always the right option in these cases (and you’ll get plenty of arguments about that here on THCB), there is no excuse for a system where financial catastrophe will be visited on families by the random luck of getting sick.

But of course this problem is growing rapidly. Health Affairs confirms today with an Urban Institute study what’s well known—health insurance coverage has been declining while the economy has been expanding. This is the complete opposite of the 1990s, where the numbers covered by employer-provided health insurance increased as the economy improved.

So of course in the coming (or present?) recession the horror stories like that of the teacher and those Jon Cohn wrote about in Sick are just going to multiply.

HEALTH 2.0 Accelerator

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At the end of Health 2.0 in September 2007, CommerceNet’s Marty
Tenenbaum proposed the creation of an industry initiative to accelerate
the Health 2.0 vision. This initiative would do for Health 2.0 what
CommerceNet did for e-commerce, educating and catalyzing the market
through visionary integration projects that demonstrate the potential
of Health 2.0 to improve people’s lives. This first organizational
meeting will forge a direction for the Health 2.0 Accelerator,
exploring potential projects and organizational structures.

Come prepared to share your ideas about the need for a Health 2.0
Accelerator and what it should focus on: What are the problems that are
preventing your technology or organization getting specific tasks done?
What standards are needed to facilitate data exchange and mash-ups?
What partnerships would make your services or products more valuable?
How could a Health 2.0 Accelerator help?

This session is open to attendees at Health 2.0 San Diego only. Please pre-register for this session by clicking on this link.
You are also encouraged to propose a specific topic for discussion as a
potential project, and should come prepared to speak about it briefly
(PowerPoint ok).

UPDATE: Health 2.0 Connecting Consumers and Providers is officially sold out. You can sign up for the waiting list here. You will be notified by email if additional passes become available due to cancellation or a capacity increase.

EXHIBITORS: Want to get your healthcare service or product in front of the right people?  Health 2.0 is the place to be. Connect with investors and high level executives and opinion leaders at the top health systems, health plans and technology companies around the country.  Email in**@********on.com with "exhibitor info please" in your subject line and we’ll get back to you in two shakes.

PODCAST: American Well’s Roy Schoenberg

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Ever since I saw Roy Schoenberg (of American Well)’s view of the future of patient to physician communication I’ve been waiting to bring it to you on THCB and the Health 2.0 Blog. And finally I was able to get him to tell me about it.

So first whip over to the American Well site and watch the video about how it works, and then come back here and listen to the podcast of the interview I did with Roy last week. (I’m afraid the levels are slightly problematic in a few places in the interview, but luckily Roy is louder than I am!)

In addition Roy will be giving an in-depth look at American Well in a sponsored "deep dive" expedition at the Health 2.0 Conference in March.

PHARMA: The ACP does the right thing

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In 1937 marijuana was banned by Congress. The only question asked was, "what’s the position of the American Medical Association?". It actually was in favor of keeping marijuana legal for medical purposes. But the response given to Congress by whoever was pushing the bill (some diligent drug war historian will tell me who) was that the AMA wanted to ban it. And banned it was. And soon the AMA decided that it didn’t approve of medical marijuana–a position it holds to this day

60 years and billions of wasted dollars later, one major physician’s group has decided to change its mind. The American College of Physicians is now urging and easing of the ban on medical marijuana. We can only hope that the ridiculous ban on medical marijuana use, despite its therapeutic properties that exceed many FDA approved medications, are closer to being lifted with this type of support.

A Blueprint for Healthcare Reform by Maggie Mahar

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On this blog, we have often debated these questions: “Why is U.S. healthcare so expensive? Why is it that states like Massachusetts and California just can’t seem to find a way to provide high quality, affordable medical care for all of their citizens?”

In the past, I have suggested that the answer can be found in the work done by Dr. Jack Wennberg and his colleagues at the Dartmouth Medical School. The story that I have posted below provides the narrative behind that assertion, tracing how, over a period of thirty years, Wennberg and his team uncovered the incredible, incontrovertible waste in our health care system.

Wennberg’s work reveals that roughly one out of three of our health care dollars is squandered on unnecessary tests, ineffective, unproven, sometimes unwanted procedures and over-priced bleeding-edge drugs and devices that are no better than the less expensive products that they have replaced.

Only a Luddite would fail to appreciate the wonders of 21st century medical technology. And Wennberg is no Luddite. He is quick to acknowledge that the most expensive, aggressive care that U.S. doctors and hospitals provide is often the most effective care.

But not always. This is what is less obvious. It would seem that by spending so much more than other countries, we would be buying the best care on earth. But the evidence shows that, often, we are not. And therein lies the conflict at the heart of our money-driven health-care system: while more health care equals more profits, it does not necessarily lead to better health.

Continue reading…

Where will all the employees go? By Eric Novack

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A quick question:  With calls for a substantial increase in government involvement in health care by so many—and, among the major justifications is the claim of high administrative overhead in the private sector relative to government—what do the proposals plan to do with the hard working people currently working in the health insurance industry?The insurance workforce is estimated at close to 2.5 million.  It would be not unreasonable to say that 25% of that is health care related.  And that does not even include the people working on health insurance related issues on the provider/ hospital end—a number that absolutely exceeds 600,000.So, put another way: what do the reformers plan to do (a) for, (b) with, the potential displacement of over 1 million workers?Just asking, but could it be that the claimed efficiencies will not materialize and they will stay employed?  Could it be that the costs of ‘retraining’ and financial support for these families will exceed the ‘savings’ claimed?  Which group really will be displaced—will the size of the in-office, and in-hospital administrative workforce even be counted when looking at ‘streamlined’ administrative costs?  Will many of the displaced workers simply end up working as government employees in a similar capacity?I would hope that supporters of the Obama plan, the Clinton plan, and the single-payer plan would weigh in here with real specifics—and not ad hominem attacks…Eric Novack

Web Video Statistics: I Smell a Rat by Craig Stoltz

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Craig Stoltz is a web consultant working in the health 2.0 space. He has previously served as health editor for the Washington Post and editorial director of Revolution Health. He blogs at Web 2.0 … Oh really? 

The web metrics firm comScore has published a tally of of how many online videos were viewed during the month of December. That number is 10 billion. That’s “b,” as in “freakin’ billion.”

Like Mike Huckabee, I didn’t major in math. But as a journalist I do have an Associate’s Degree in Rat Sniffing. And I smell a big one.

By my primitive calculations, if comScore’s stats are correct, during the month of December 2007 2,237 person-years were spent watching online video. (That’s assuming each of those 10 billion videos was watched for :30.)

Continue reading…

Peeling The Healthcare Onion, By George Van Antwerp

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George Van Antwerp is a Vice President at Silverlink Communications where he focuses on developing healthcare communication solutions across the industry with a focus on the pharmacy space. He and I have been conversing back and forth by email for a couple of years (since before he joined Silverlink who are—FD—sponsors of THCB & Health 2.0). He blogs regularly on both topics at Patient Centric Healthcare and today is his first post on THCB

I think an onion is the right analogy for healthcare for three reasons: (1) it can make you cry; (2) every time you pull off a layer you learn more; and (3) what you see from the outside is a lot different than what you see from the inside.

Continue reading…

POLICY: Two awful stories

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Just before you get too lost in the wonkiness of health policy, just remember the financial implications of being sick in the wrong circumstancesin this country. Here’s a woman with a sick kid who is going to have her husband take a pay cut so that she can qualify for S-CHIP.

And here’s a benefit tonight in Richmond Virginia, for Kellie Brown, a student who needed an emergency appendectomy and has dropped out of college to pay of the $10,000 she owes. I kicked in a few bucks; if you’re feeling nice you might too.

Think of the economic insanity of these two things–someone dropping out of college, and someone moving to a lower pay grade because of health care costs!And no, this shit does not happen anywhere else in the civilized world.

HEALTH PLANS: I beat Lisa Girion!

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This might be my proudest moment in blogging. Anyone can be ahead of the WSJ by 5 years. But on THCB I connected the dots between LA Times coverage of the dumb public relations of Wellpoint in California, and New York AG Andrew Cuomo’s assault on UnitedHealth Group yesterday afternoon.

That’s at least 6 hours (maybe 7) before Lisa Girion did it in the LA Times. I emailed Lisa to crow about it this morning…..of course she’s probably too busy being the de facto head of health insurance reform in California — and now the US — to email back, admit defeat and come work on THCB instead!

Being serious for one second, Lisa’s work in exposing the behavior of health insurers may be the most important series of work in health care journalism in the last few years—even more so than the series which exposed the problems at King-Drew and Walter Reed. There’s no question in my mind that it will lead to significant legislation which will go some way to cleaning up the health insurance industry.

And it’s not as if Lisa was mailing this in. She found the recission (retroactive insurance cancellation) stories herself, she did the digging in the courts, and she got what at first blush sounds like a very unsexy type of story to be a major issue in California’s most important paper day after day.

To my mind she’s become a national treasure and I hope that the powers-that-be at the NY Times or perhaps Pro Publica are paying attention!

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