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PODCAST: Fine art and healthcare–a conversation with David St Clair, MeDecision

A while back I got a rather unusual email from MEDecision– an interesting tech company I’ve interviewed before on THCB. It was actually quoting their CEO David St Clair who’d just seen Malcom Gladwell and it said this:

Picasso was able to produce his greatest masterpieces by the time he was in his
mid-twenties. After that, it seems the quality of his output leveled off, or may
have even dipped a bit. Cezanne was kind of the opposite. He learned from
trial-and-error and leveraged a half-century of life experience, development and
growth to create his best art after the age of 50. I think Mr. Gladwell is dead-on in his assessment that
proposals to fix our health care system can be categorized as taking either
Picasso or Cezanne approaches. Like Picasso, a lot of folks are focused on
finding that one, major, “big bang” idea that will comprehensively solve every
problem. While this methodology may work in certain circumstances (it certainly
worked for Picasso for awhile), I have to agree with Mr. Gladwell that health
care is far too large and complex a system for us to realistically think that
some monumental “burst of innovation” is going to cure its every ill and set it
back on course. No, my money is on the Cezanne approach. After 20 years in the
health information technology business, I truly feel that there isn’t a single
magical solution – even if Michael Moore seems to think there is. It’s got to be
a lot of little solutions building momentum toward larger, system-wide reform.
And we need to engage as many people as we can in the process and give them the
means and resources they need to keep trying new approaches that might work.
Like Cezanne, we need to build on our experiences and develop and grow our ideas
before we can expect the masterpiece to emerge.

As you might imagine, I’m not a fan of incremental piecemeal change in health care, even though I’m not in complete agreement with Michael Moore–whatever certain of my readers might think. And it’s not often that a health care tech company CEO goes off the tech-only reservation (so to speak)  So yesterday I had a long chat with David. It certainly was spirited, and I hope you’ll be interested in the outcome!

PODCAST/TECHNOLOGY: Shiftwise Founder Jason Lander

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Shiftwise wants to become the Travelocity or the Orbitz of the nurse staffing business by bringing web-based solutions to a field that has been dominated for years by agencies using outdated technology. By allowing HR managers to match available staff and allowing staff to bid for available shifts, the company says its technology allows hospitals — and agencies too — to save big bucks on the process of dealing with temporary staffing.  I had a chat with founder Jason Lander about the company’s model and plans for the future.

HEALTH PLANS: Mega Life and Health — Time to call AHIP, Goldman Sachs, Credit Suisse and BlackStone out

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I spent a little time last year on the issue of Mega Life and Health. There’s only one term for this company, and what’s really frightening is that it’s a major player in AHIP. If AHIP is ever going to get itself out of the self-serving position it’s in and transition to being an organization of responsible private health plans that can have a reasonable conversation about the positive role health plans can play , the plans who could live in a future of community rating need to leave, or jettison the scumbags like Mega.

What’s the activity I’€™m so upset about?

Mega Life and Health sells health insurance door to door to poor to middle and low income working people. They claim that they are selling a product which their customers understand. But the point their customers clearly do not understand is that the insurance€ has severe limits on what it pays, especially what it pays per day in cases of expensive care. So if a policyholder gets sick and needs hospital care, Mega only pays out a fraction of what the hospital charges, leaving the poor sucker patient on the hook for the rest. Last year the California Supreme Court ruled that this con, like all the best cons, is legal. And this type of policy continues to be sold (more or less legally) in most states.

Continue reading…

TECH: PHR of cool

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Here’s first press release I’ve seen claiming a PHR that works on your iPhone (from MedeFile). Having said that, as Apple advertises the iPhone as delivering the Internet (not a scaled down version) then presumably any web-accessible PHR is accessible on an iPhone, no?

POLICY/INTERNATIONAL: John Cohn puts the boot in….nicely

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I told John Cohn a while back that he was just too nice, and that he shouldn’t engage in the pointless argument with the free-marketeers about whether we treat cancer better or worse than the Europeans—especially as we do so much worse on many other measures. But John doesn’t listen to me—instead he takes the cancer argument and uses it to stamp all over the free-marketeers. At some point the referee should step in and stop this fight…

Meanwhile here’s the real problem. Next to John’s article on the CBS site is a video of Bush, and this is the text below it:

CBS News RAW: President Bush announced new proposals for the tax code intended to improve health care. His ideas counter Democratic proposals to nationalize the system.

Please could someone at CBS or anywhere else find me an example of a democrat wanting to “nationalize” the system. “Nationalize” means the government owning the production/service a la the Post Office or UK NHS. Not even Dennis Kucinich seems to be in favor of that. So what the hell are they talking about? I don’t know but neither do they. And, as they’re controlling a major news organization’s output, that is the problem.

HEALTH PLANS/HOSPITALS: Kaiser’s tame blogger at it again

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I think that most of the latest fines for Kaiser, which are only vaguely related to its original problems at the kidney transplant unit and are for poor  performance of peer review and handling complaints at its hospitals are generally much ado about nothing. I got quoted by Barbara Feder in the SJ Mercury News saying as much.

This does not, though, absolve Kaiser for not coming fully clean about what happened with the kidney transplant scandal, and for its reticence in having anyone at TPMG talk about it. That’s still the elephant in its living room that both KP and the Dept of Managed Health Care are ignoring.

POLICY: Are they that stupid, really?

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Apparently the Administration is going to follow up on their threat to go after Michael Moore for his Sicko stunt of taking patients to Cuba.. This should give Sicko, which did OK for a documentary but not exactly Farenheight 911 numbers, a bit of a life at the box office.

But can the Bush Administration really be that stupid? (This is a rhetorical question, BTW)

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