THCB

Categories

Above the Fold

Outrageous by Eric Novack

• 4

Outrageous!!

First and foremost—congratulations to Matthew and Amanda on their
wedding!!! Now to the outrage!!!

In Friday’s Boston Globe , health reporter Alice Dembner reports the plight of a 60 year old woman who has to pay twice the amount for health insurance as a 27 year old. “That’s discrimination!!” she says in the article.

Yet MSNBC reports that, “ a typical couple retiring in 2020 will have paid about $100,000 in lifetime Medicare taxes. ‘For that price, this couple is scheduled to receive about $500,000 in lifetime Medicare benefits over and above the premiums it additionally pays in retirement.’

Also, has anyone checked out how much more it costs to get auto insurance
for a 20 year old versus a 60 year old?

Hmmm…

Essential Reading: Laszewski on Rove and Medicare D – Brian Klepper

• 8

All of us who have worked in policy during our careers know the old joke that there are two things you never want to see made: sausage and laws. Never was this more true than with Medicare D.

Earlier this week, Robert Laszewski at Health Care Policy and Marketplace Review wrote an eloquent and succinct piece called "Good Riddance to Karl Rove: How Part D Left An $8 Trillion Debt And Got Them Nothing," a genuinely damning indictment of the cynical use of power. Read Mr. Laszewski’s posts and you quickly get the fact that he is a keen, unbiased, open-minded, analytical observer of the Washington health care scene. His obvious knowledge about the circumstances and his stature lend terrific weight to his words. I’d urge every person who reads this blog to read Mr. Laszewski’s column, and to pass it around to your colleagues.

Continue reading…

HEALTH2.0: The People’s choice award

• 9

By now you know that the Health2.0–User Generated Healthcare
Conference organized by Matthew Holt (THCB) and Indu Subaiya (Etude
Scientific) is all set to take place on September 20th in San
Francisco.   Among other things, there are four fabulous demo panels on Search, Tools for Consumer health, Providers and Social networks, and Social Media for Patients.

You would not believe how many people want to show their cool tools on these panels. Well it just so happens that we ended up with one spot left on the Social Media for Patients Panel. We already have the wonderful Amy Tenderich (DiabetesMine) to moderate. On the panel are OrganizedWisdom, DailyStrength, MedHelp, PatientslikeMe & SophiasGarden.

So how to choose the remaining panelist from so many great possibilities? Too tough for us to decide, so we’re throwing it over to you. The contenders, listed in no particular order with a line or two of description are below. Please go take a look—don’t worry if these don’t exactly fit your definition of “social media”—we have ways of shoehorning the most interesting sites into our program.

Continue reading…

Can We Talk, Frankly? – Brian Klepper

Over at The Doctor Weighs In, Bill Bestermann literally grabs our attention and forces feeds us a highly informative, and, dare I say, USEFUL physiology lesson in If You Want To Get It Up – You’ve Got To Get It Down. The subject is the one topic that men (and the women who care about men) really care about: erections. That’s right. Ever thought that even you (or your male partner), burly, strapping man among men, could be afflicted with erectile dysfunction? Get the skinny on the why, what it means and what to do about it from Dr. B. In the process, you’ll get a glimpse of the Marlboro Man and learn some fascinating background on how Viagra came about.

A Broker Afterthought: An Acknowledgment, An Apology and A Criticism – Brian Klepper

In the comment section of my post on broker compensation, KWeller properly points out that 1) some states regulate broker commissions more stringently than Florida does and 2) I do a disservice to brokers who practice without financial conflict. He is right, and I apologize to anyone whose practice is at odds with my description.

On the other hand, as several other commenters noted, the practices I described are well-known and widespread, and they occur because the brokerage profession does not self-regulate very effectively. (If it makes anybody feel better – it shouldn’t – neither do many other groups of health care professionals.)

So if you’re not one of the broker’s I was referring to, please excuse me then for pointing to the poor behavior of your colleagues. I wouldn’t have tarred you with the same brush if you had held your fellow brokers to a higher standard of practice.

Consultants to Hospitals: Prepare for Transparency – Brian Klepper

• 4

We must view and treat the community as the "owner" to whom we are fully accountable. Aggregate financial performance data, aggregate productivity performance and aggregate quality and patient satisfaction data belong in the public realm. How else can consumers make a decision to…support us?

— Rich Umbdenstock, President and CEOAmerican Hospital AssociationInterview in Hospitals and Health Networks, 10/18/04

Most health care professionals sincerely believe in performance transparency, especially if it applies to someone else. Three years after the encouragement of Mr. Umbdenstock and similar pronouncements by colleagues throughout the industry, many physicians, health plan executives and hospitals executives remain extremely resistant to public reporting of pricing and performance.

Norton Healthcare in Louisville KY has developed one of the most progressive and forthright quality reporting efforts in the country. On their site, they provide their performance figures on a range of indices, indicating where they fall above or below national benchmarks. (You can just imagine how thrilled their staffs were with this decision to "bare all." ) The home page for their quality section lists six principals that drive their reporting.

   1. We do not decide what to make public based on how it makes us look.

   2. We give equal prominence to good and bad results.

   3. We do not choose which indicators to display.

   4. We are not the indicator owner.

   5. We display results even when we disagree with the indicator definition.

   6. We believe unused data never become valid. 

Norton sets a fine example for hospitals. But now, as demands for transparency become more compelling, the mega-consulting firms, always quick to lead the way and claim credit once a trend has been firmly established, are throwing their hats into the ring as well, hoping to provide guidance for tidy if exorbitant sums.

And so it is not surprising that the consulting firm Grant Thornton, in its spring newsletter Health Care Rx, has a thoughtful, pragmatic article urging hospitals to review and potentially change their pricing, document justifications when necessary, and generally take steps to ensure that they’re prepared as transparency efforts become irresistible. Its a good piece and, for hospital execs, well worth a few minutes time.

The Presidential Candidates On Health Care

Over at the Huffington Post, Dr. Susan Blumenthal and her team at the DC-based Center for the Study of the Presidency, have released their third in a series of articles comparing the Presidential candidates positions on various aspects of health care. This piece focuses on their views on the scientific and medical research that underlie progress in public health.

This has undoubtedly been yeoman’s work for this group of researchers, and as the election draws closer we’re indebted to them for making these positions so clear.

My guess is also that this article’s topic is particularly dear to Dr. Blumenthal, who is a former Assistant Surgeon General and recent recipient of the
US Public Health Service’s Distinguished Service Medal.

Managed Care Redux – by Brian Klepper

• 7

Like democracy, managed care is a great idea. It’s just that its rarely been tried.

Even so, my guess is that its about to re-emerge in a new, improved form, and possibly with some other name. If the signs around us now have any meaning, it will be different than our experience of a couple decades ago, and much truer to the original principles and possibilities that first caught our attention.

Last week the New York Times’ David Leonhardt ran another pop health economics piece, exploring several presidential candidates’ notion that the savings captured by providing better care could fund the uninsured. He explains better care as really being prevention – making sure that patients get services that stave off illness – and better management of the care process once they do get sick. And then, quoting a variety of health care experts, he takes issue with the notion that these approaches actually produce returns-on-investment. The problem, you see, is that while you may save money on the diabetic who avoids hospitalization to get his foot removed, you’re spending money taking care of all those diabetics who wouldn’t ever have had a costly problem.

Continue reading…

Pharma PR: Either ‘Roid Rage or Comatose by The Industry Veteran

• 2

    Two examples emerged in the last few days to indicate that Big Pharma’s CEOs are unable or unwilling to control the functional departments of their companies.  The first involves GlaxoSmithKline (GSK) where CEO J.P. Garnier actually instigated the problem instead of managing it.

    In response to major controversy and an FDA advisory committee hearing over the safety of GSK’s diabetes drug, Avandia, Garnier launched a George Bush/Karl Rove style of PR blitz.  The campaign started by blithely ignoring the empirical reality of three separate studies (by Steven Nissen in The New England Journal, GSK itself and the FDA staff) that found Avandia raised the risk of myocardial infarction by 30%-40%.  Instead GSK cried that it was a political victim.  In a self-righteous and self-pitying display, the company’s US Pharmaceuticals president, Chris Viehbacher claimed on June 15, "In the end science will win."  Then on July 9 the company’s media relations people arranged for Garnier to give the Wall Street Journal the benefit of his successful experience at managing
through crisis.  There we learned his battle tested lessons such as “fight data with data,” communicate with employees daily, and other drivel to the effect that a dog has four legs. 

    

Continue reading…