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Bad Medicine: How The AMA Undermined Primary Care in America – Brian Klepper

On Tuesday’s Wall Street Journal website, Dr. Benjamin Brewer describes
physicians’ reactions
to the 10.1% cut in Medicare physician payments
that will take effect January 1. He argues that the onus will fall,
once again, disproportionately on primary care physicians, who are
already losing the struggle to keep their heads above water.

He is right, of course. There is no question that Medicare must rein in
cost.
But the cuts are approximately the same across specialties and
therefore regressive. Insensitive to its distinct role, its lower
revenues and its high operational costs, they hit primary care harder
than they do specialties. Given its already battered status, the cuts’
impact on primary care could translate to real consequences this time.

Continue reading…

Health IT breakthrough possible in Washington by Eric Novack

Capitol2
Unnamed senior officials at CMS confidentially report that serious bipartisan discussions are ongoing to help get the Health IT bill completed.

“Electronic medical records and e-prescribing, if mandated throughout the country, would save thousands of American lives each year”, one CMS official stated.

A senior Democrat house staffer, speaking on condition of anonymity, said that the leadership thinks that the current situation, where dozens of private companies are aggressively competing against one another to get a foothold in the world of health IT, is counterproductive, wasteful, and costing lives.

“Venture capital and the drive for profits is a distraction that this country, with 47 million uninsured, can simply not afford.”

Proposals apparently under consideration include banning advertising of health IT to doctors, licensing requirements for anyone involved in the sale or promotion of health IT products, and a special ‘health IT tax’ on health IT companies which would allow the Office of the National Coordinator of Health Information Technology (ONCHIT) to distribute funds to areas of the country that lack a health IT infrastructure.

Calls to House Speaker Nancy Pelosi (D-CA) for comment have not been returned.

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HEALTH 2.0 UPDATE

Meanwhile, if you’ve been thinking about signing up for a pass to the next Health 2.0 conference you have until midnight today to qualify for our early bird rates. Health 2.0 Connecting Consumers and Providers will be held March 3-4 in San Diego at the Westin San Diego.  We’ve worked out a great deal with the Westin that will get you a room for the low rate of $229 plus tax a night. The Reservations Hotline is 888.627.9033. You’ll need to mention Health 2.0 when you call to be eligible for this rate. 
As a gentle reminder, if you’ve signed up for Health 2.0 San Diego but not completed the registration process you’ll need to finish the process by giving us a credit card in order to qualify for the rate.

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POLICY: Try and reconcile these two basic statements

The National Federation of Independent Business, which says it has 350,000 members with active lobbyists in 50 states, warned politicians and policy makers on Wednesday not to impose new health-benefit obligations on small employers. The group said in a statement of principles that “a health care system built on employer mandates or on pay-or-play taxes is unacceptable.”

***

In its statement of principles the federation called for universal health care, with a government safety net to help the neediest obtain coverage. But it opposed proposals to place health care under an umbrella of Medicare-style “single payer” financing. Government safety nets should not be allowed to “crowd out private insurance and care,” the federation said.

Yup, it’s the math challenged folks at the NFIB staking out their territory–hating the current system, fraudulently demanding universal health care and opposed to any solution.

The incredible thing is that a single pool/social insurance system would be incredibly positive for small business—especially if based on progressive taxation. First, the number one impediment to people starting small businesses is job-lock due to fears over losing health insurance. Second, most small businesses don’t make that much money, so a social insurance scheme would only “hurt” the very few very wealthy small business people. Somehow that group manages to politically dominate the discourse at the NFIB—when they’re not shilling for the richest families in America, that is.

My real analysis of the NFIB was done over at Spot-on last year. It’s well worth a read as it spells out the math on why a universal health care system funded by progressive tax would be a godsend for most small businesses. But sadly they just can’t ideologically get their heads around it.

Health 2.0 Casting Call

Media2_3We are excited to announce a new panel format at our Spring conference, “Connecting Consumers and Providers” in San Diego on March 3-4, 2008. In addition to spotlighting demos and reactions from industry experts, we will be capturing the user-experience of people living with health conditions as they use Health 2.0 technologies in their everyday lives.

Has the web changed your life? Does it help you deal with the isolation of a condition or improve your quality of life in some other way? We are looking for a few good consumers/patients to feature live on stage or in a video segment. Our roving video crew will be traveling the country to document interesting real-life stories showing how Health 2.0 impacts both people and the healthcare system.

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POLICY: Trading Places was right!

Trading

Every so often I read an article that (I hope) confirms what we know is right. Remember “Trading
Places
”? Dan Akroyd is stripped of his upper-class environment and fails. Eddy Murphy is plucked form the gutter and succeeds, and the experiment “proves” that it’s “nurture not nature.”

In this op-ed, All Brains Are the Same Color, psychology professor Richard Nisbett shows that IQ scores are remarkably influenced by the environment in which kids are brought up, and race has basically nothing to do with it. After he demonstrates that fairly conclusively, Nisbett gets to the punchline:

What do we know about the effects of environment?

That environment can markedly influence I.Q. is demonstrated by the so-called Flynn Effect. James Flynn, a philosopher and I.Q. researcher in New Zealand, has established that in the Western world as a whole, I.Q. increased markedly from 1947 to 2002. In the United States alone, it went up by 18 points. Our genes could not have changed enough over such a brief period to account for the shift; it must have been the result of powerful social factors. And if such factors could produce changes over time for the population as a whole, they could also produce big differences between subpopulations at any given time.

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HEALTH 2.0: Industry heavyweights meet in San Diego

Dk130x72This meeting held by the Markle Foundation
near San Diego  over two days  last week may turn out to be
the most
important health information and technology policy meeting of the past
5 years.  So I’ll try to choose my words for this post very carefully.
If this increases the length somewhat, I apologize for that in advance.

Why was this meeting significant?  Simply put, the Health 2.0 community was involved. With Microsoft’s Peter Neupert, Google’s Missy Krasner, Adam Bosworth from Keas.com, Esther Dyson, Jamie Heywood from PatientsLIkeMe.com, Karen and Richard from Sophia’s Garden, and representatives from MinuteClinic, Wal-Mart, IntuitDell, eClinicalWorks, and Intel
present and vocal, this meeting had a different, and to my mind more
open atmosphere than any other policy meeting I’ve attended.  It was
not dominated by entrenched large health care enterprises, such as the
academic hospitals, Kaiser, health plans,  the large IT vendors, and
the AMA.  In fact, those organizations were often on the defensive in
the conversation, because they are perceived by some as not making it
easy for consumers to get to the information they want and need.  In
fairness to these and other incumbent groups who were present, I
witnessed a new and a very welcome openness to discuss ways to get the
data into the hands of the consumer.

– Continue this post on the Health 2.0 Blog

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