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POLICY: Doing my bit to piss off the unthinking right

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Cool. I make an off hand remark about conservative think tanks and get them all riled up. Amy Ridenour, who has an interesting place in the panoply of right wing think tanks and influence peddling, prints an email I wrote her and tries to answer my questions. I’m sure Mr Scaife thinks his money is well spent.

Of course what my piece was doing was directly stealing the conservative right’s tactics of changing the debate. Except in my case I’m doing it logically.

For instance, the right called inheritance taxes “death taxes” suggesting that they fall on everyone who dies—even when only a tiny minority pay them. So the law is changed and a mythical family farm is saved, and so funnily enough is the family fortune of the Waltons and their billionaire friends.

Similarly the right has been attacking foreign countries for alleged sub-standard care, and using that to justify our appalling health care financing system. All I’m doing is asking them to defend the care here that’s found to be of a worse standard. And of course Amy can’t. Perhaps her man Hoggy can. I’m looking forward to his response!

TECH/PODCAST: Generic Medical Devices, really? The interview with Richard Kuntz, CEO

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At a great meeting in Nashville last week Brian Klepper was explaining to us all how medical supplies were 40% of a hospital’s budget and how the margins on those devices were in the stratosphere. You’d assume that someone would do something about that.

And then lo and behold I get contacted by a company that may be that “someone”. There is not a generic medical device market comparable to the generic drug market. But that will all change if Richard Kuntz, CEO of Generic Medical Devices has his way. Listen to this interview to find out more

TECH/CONSUMERS/THCB: Health2.0 Agenda Announcement!

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I am delighted to announce the line-up and agenda for Health2.0–User Generated Healthcare, which will be held on September 20th in San Francisco.

After an introduction and summary of the Health2.0 report (from little ol’ me and my colleague Indu Subaiya) we move into a panel looking at the view from the big consumer aggregators in online health care. Who are of course with one exception the big general aggregators—Google, Yahoo, Microsoft & WebMD.

Then we move into the 4 categories of Health2.0. Search, Social Media for Patients, Tools for Patients/Consumers, and Social Networking for and about Providers. You’ll see really focused demos of communities and tools that are already existing. All delivered in a focused manner that will really hit the high points

We also have a stellar group of industry luminaries to react to what they’ve seen including leaders from Kaiser Permanente, Cisco, Regence BCBS, RelayHealth/McKesson, the view from financial/Internet veterans like Marty Tenenbaum from Commerce.net & Esther Dyson, and other industry players from providers, pharma and plans.

This is also going to be a highly interactive day, with an “unconference” topic tables at lunch, exhibits and demos in the breaks, networking on speed, and interaction with the audience in every panel.

We know that you’ll have seen nothing in health care like Health2.0–User Generated Healthcare and we’d love to see you there. For more information and to register go to www.health2con.com

UPDATE: Download a PDF copy of the agenda and announcement here.

PHARMA: Rost–Pfizer’s Indian problem

Peter Rost is running a story about potential murky dealings in Pfizer’s subsidiary in India, which smack of (perhaps typical) corrupt practices in emerging economies. Essentially the story seems to be that local management ripped off shareholders, lone accountant raised stink with Corporate in NYC, and got fired for his trouble. Here’s part one and two. Of course Peter is trying hard (perhaps too hard?) to link this to the current Chairman and CEO, but it’s all good fun reading. I do think that sometime around now Pfizer probably wishes that it had just given Rost the job he wanted when they bought Pharmacia, and reacted with less paranoia. But you make your bed, and….

TECH: Exercise while working

The WSJ’s Health Blog actually features something about health (normally it’s just about drugs). It’s about a doctor at Mayo who’s working with Steelcase to create a treadmill that you walk on while standing at a desk. While we’re talking about wellness programs at work this might be one. But of course treadmills are bad for some people with bad knees (such as me)—ellipticals would be much better.

Of course he’s not the first. Here’s the set up that VC Brad Feld has in his office.
Now Feld is nuts (in a good way) in that he runs marathons, is a
fitness freak, and does conference calls from his “treadputer” using
bluetooth et al while running. But if it works for him….

Treadputer_small

 

As for me? I do most of my phone calls while walking the dog….

POLICY/HEALTH PLANS: Marsha Gold, spoilsport communist!

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At Health Affairs Mathmatica’s Marsha Gold takes a look at the expansion of Medicare PFFS plans. Those are the ones that our friends at AHIP are so keen on, because of all the benefits they bring to poor elderly seniors (stop that sniggering at the back!). My word, is she “fair and balanced”!

Perspectives on current MA trends are largely in the eye–and orientation–of the beholder. If one believes that all choice is good and competition brings prices down, MMA has clearly been successful in expanding choice and competition. Because higher payments are driving the market, beneficiaries who enroll also benefit because benefits, even in the more limited plans, probably compare favorably against those of Medicare alone for not that much more premium. It could be that once attracted to MA, enrollees can be moved to more managed products, as some firms have indicated that they want to do.If one tends to believe less in the market, some aspects of current trends are a concern. Most narrowly, the current expansion is fueled by MA payment rates that exceed what traditional Medicare now pays. At least in the short run, this means that Medicare pays more for each beneficiary that is attracted to MA. The added fiscal burden on Medicare is especially high for PFFS plans, because firms are benefiting from "floor" payments. Although individual enrollees may gain, beneficiaries as a whole may be harmed if higher payments add to the fiscal stress on Medicare, making the program less viable in the long run. Choice also makes demands on beneficiaries’ time, is challenging for many not familiar with the issues or those with cognitive limits, and adds the risk that coverage will be unstable if the forces that facilitate firms’ development of PFFS plans also make it easy for them to exit MA.Do the benefits exceed the risk? Although people will differ in their calculations, I suggest that the answer could well be negative.

The joke is that her piece is called Medicare Advantage In 2006-2007: What Congress Intended?

Err, yes Marsha, it pretty clearly was what Congress (or at least the staffers who wrote the law at AHIP’s behest) intended. We, the taxpayer, meanwhile just need to drop trou and bend over.

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