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TECH/PODCAST: RHIOs, physician messaging et al–the word from Axolotl’s Ray Scott

Ray Scott is CEO of Axolotl. Ray is a British egghead (a math whiz) who somehow got himself dragged over to California  in the mid-1990s. Since then, and quietly building on a great success in the oddball Northern California surfing mecca of Santa Cruz, Axolotl has been putting in the infrastructure for messaging between health care system participants (and rather more than just that) in lots of different communities. And they’ve embraced the RHIO concept as part of their marketing–(something I keep telling their marketing whiz Nicole Spencer is a bad idea!)

As you know, I’m not a convert to the RHIO concept, so I was keen to hear Ray explain all about what Axolotl does, why they’ve been growing in recent years and how they’re going to keep being successful. Listen here–a transcript will come soon.

PHARMA: 60 Minutes on the MMA

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60 Minutes on Sunday had an entertaining story about the Medicare drug bill’s passage in late 2003. Not exactly new news, but a fun retelling of how Tom Delay, and PhRMA rammed the bill through literally by holding the vote open for three hours and torturing the crap out of any Republican who was a fiscal conservative and likely to vote no.

What amazes me was that any Republicans at all felt squeamish about that. Hadn’t they seen how Delay operated? Hadn’t they met a PhRMA lobbyist in their time in DC? Hadn’t they noticed the Administration cow-towing to industry in every other sphere of government? Didn’t they know that every possible opposition group was bought off in the bill? Hadn’t they noticed the deficit going through the roof?

And what’s the relevance of telling the story again three and a half years later?

(CODA: Dan Burton, one of the Republicans interviewed, is actually somewhat interesting. For example he’s a long time drug war loon, but in 2002 he actually said some interesting things about the drug war almost hinting at the fact that he realizes what a waste of time and money it is. So maybe there is some hope…)

TECH/CONSUMERS: Health2.0 mashup site of the week

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Who is Sick?

User reported data about who is sick, where and when. The site thinks that it’s likely to help people figure out whether they’re sick or whether they jsut have something that’s going around. I have zero idea whether that’s useful or whether this is the eventual use of the site. But an interesting concept indeed. Go play around.

HEALTH PLANS/POLICY: Lawmakers Should Not Reduce Funds for Medicare Advantage Program, apparently (with quick UPDATE)

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Who says so? Well it’s the BCBSA CEO. Lucky that’s not self -serving or anything. Perhaps he’d like to explain how his members and the other health plans valiantly stayed in the Medicare market last time, took huge losses but stuck it out all the way to 2004 when rates were put back up. But this time they’ll quit instead. (BTW here’s the WSJ original to those of you with access)

After all, if we’re going to have revisionist history….

UPDATE: I was rushing to an interview (which you’ll hear tomorrow) so I didn’t get a chance to add one thing Mr Serota appears to have missed out in mentioning regarding the subject. Just like much of the American health care system Medicare Advantage is a good deal for its members, a great deal for its vendors (including but certainly not limited to the Blues) but not such a good deal (according to the CBO et al) for the poor saps who have to pay for it. And who would they be? Yup, it’s that taxpayer fellow again, and of course—due to the accounting and financing techniques of the con-artists who wrote the 2003 MMA, took us into Iraq et al—it’s also going to be paid for in the years to come by their children and grandchildren. But who cares about them when the Blues and other insurers are richer than they’ve ever been?

TECH: In which Dmitriy challenges Health2.0, but reveals that he’s challenged, and not just by the calendar

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Over at Trusted MD Dmitriy “jumps on Health 2.0 Bandwagon”.  Well actually he’s taking the piss, as we English say. The only problem is that today is April 2, not April 1. And Dmitriy doesn’t understand technology diffusion as opposed to stock market bubbles (which Health2.0 and Web2.0 are quite evidently not, unlike the companies in the DotCom boom which obviously were….)

Never mind. It’s fun to have a contrarian point of view. And don;t worry Dmitriy some people who are if not wiser at least a lot richer than you and me are already using the Health3.0 moniker.

As for Health2.0. You’ll be hearing much more about that on THCB. But don’t worry, it’s just a label, and labels don’t mean a whole hell of a lot. But the technology and the trends embodied in it are too powerful to be ignored—just as they were in the DotCom boom. Or is Dmitriy still buying paper tickets from his travel agent?

TECH: Top Health IT innovators 2007

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FierceHealthcare (which I have NOTHING to do with any more!!) is out with a list of Top Health IT innovators for 2007 . Funnily enough several companies I’ve featured here or in my talks are on the list, and #1 is Enhanced Medical Decisions—which I liked so much when I saw it that I started working with it! (So if you’re interested in them, you can email me!) Here’s the full list:

FierceHealthIT Top Health IT Innovators 2007

10.   NaviMedix
9.   PatientsLikeMe
8.   MDVIP
7.   Get Well Networks
6.   MedApps
5.   athenahealth
4.   Devon IT
3.   QlikTech
2.   Practice Fusion
1.   Enhanced Medical Decisions (EMD)

POLICY/POLITICS: Universal Health Insurance and the NY Times–all hail Jon Cohn (with brief UPDATE)

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In recent months, not content with letting Judy Miller transcribe enough Cheney press releases to sink us into a $1 trillion dollar/3,000 lives and counting quagmire in Iraq, whomever runs the New York Times’ health care coverage has essentially handed the keys to the liquor cabinet to a succession of idiots who wouldn’t know anything about health care if they were sober. It’s then printed a series of the most illogical, stupid and plain wrong articles about health care that’s so bad that I’ve run out of ways to describe how if the NY Times were a dog it could not leave its pustilent sore alone.

But Holy Cowdung Batman. Maybe there’s hope, as they’ve this weekend allowed Volvo-driving latte-quaffing liberal Jonathan Cohn—who actually knows something about the topic— to write a long article for the magazine. It’s called What’s the One Thing Big Business and the Left Have in Common? and the answer isn’t too surprising.

But now they’ve taken this timorous first step, what’s next for the NY Times— op-eds from Enthoven or Fuchs? Regular columns from Brian Klepper? Giving Ian Morrison or Robert Laszewski a chance to explain how health care really works? Cutting and pasting from THCB? I’m waiting!

UPDATE: I’ve added a permanent & free link to Jon’s piece so it’s not buried behind the NY Times firewall. He focuses on exactly the correct topic, which is "Do big business CEOs have the cojones to take on the health care industry," in other words to piss off all those drug and insurer CEOs they meet at their Wyoming hunting lodges. And of course can the ones who are losers in the current charade (Safeway, Costco, anyone with a union) persuade enough of their colleagues that they shouldn’t be competing over who can pay the lowest health care benefits–when WalMart seems to be winning that contest too. An excellent piece, so go over there, read it and ponder why the NY Times doesn’t print more like it as compared to the pustilent sore variety for which they seem to have such an appetite.

POLICY: Is Healthcare a right? By Eric Novack

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Food for thought for
the weekend… and beyond. Should the immoral in the rest of the business
world be trumped by the needs of some people?

Would it be ethical for an employer to require overtime and not pay
employees for the work? What if it is just really a busy time and the
public needed access to the store? What would happen if the employer
instituted this policy? Would it be easier or harder for the employer
to find people willing to work there?
The answer, of course, is that employers cannot force employees to
work without pay. And employees would look for other places to find
work and make a living – quickly!
Yet, when we talk about health care, what we know to be morally
repugnant – forcing people to work without pay for fear of sanction –
does not seem to apply.
Some in government – elected officials and bureaucrats – and some
activists believe that health care is a “right.” They see a need for
specialty coverage in emergency rooms that are currently lacking. They
believe that physicians have a moral obligation to be available to
provide care that is needed.  Continue ..

HEALTH PLANS: Bob Laszewski and me–right eventually?

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Bob Laszewski and I have been continuing a dialog over whether Wall Street is smarter than us (obviously it’s richer than us) in ignoring the risk to health plans from the potential cuts in Medicare Advantage proposed by virtually every Democrat who matters. This continued into last week as despite a savaging of Medicare Advantage plans in a Congressional committee, Humana stock went up 5%. Humana is the biggest player in the Medicare private FFS market, which is most in the headlights of the Congressional Democrats since they noticed that it pays more than 12% more per enrollee than the regular FFS program.

But perhaps today the worm on Wall Street turneth. Most health plan stocks are down a few percent as one analyst at least was brave enough to downgrade the biggest of them (although his target price of UNH is still above where it is now!). We shall see.

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