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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.

PODCASTS/HEALTH PLANS/TECH: Interview with Stan Nowak, CEO of Silverlink

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Here’s the transcript of my interview with Stan Nowak of Silverlink. The original audio is here.

Matthew Holt:  Hi, it’s Mathew Holt of THCB and I’m back with another podcast. And this time I am talking with Stan Nowak, who is the CEO and President of Silverlink. You may not be familiar with Silverlink; they are a company that relatively new and relatively small. But they have a big client base doing, primarily outbound automated phone calls. We spend a lot of time on THCB talking about the Internet, the web, Health 2.0, and all these kind of new ways that people are using computer technology to communicate with each other. But what we obviously we don’t realize, well we do realize but don’t think much about it, is that in healthcare; a lot of the activity is in phone calls. And there is a big market in trying to do the phone call better and to gain more information from that.So, I chatted with Stan a couple of week back and I thought it would be interesting have him on a podcast because Silverlink has introduced some new initiatives. But they also have been doing a lot of stuff that probably is not familiar with people. It has sort of been under the radar, both in terms of working for PBMs if you have Medicare Part D and working with many health plans. So, first off, Stan, good afternoon. How are you doing?

Continue reading…

POLICY/HEALTH PLANS: Has George changed his tune?

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Found this Interview with KP CEO George Halvorson put out in January. Here he is talking about single payer

PwC: Are there other practices you see overseas that you think are importable?George Halvorson: One of the nice things about almost every other country, particularly the ones with single-payer systems, is that they focus very heavily on primary care. Most health-care costs come from a very small number of people: 1% of the population represent 40% of the costs; 10% of the people represent 80% of the costs, etc. So the largest potential you have for changing the total cost of health care is to focus on that small group of people and take care of them appropriately. And the only really effective way to focus on those people is with primary care. You need to intervene medically with those people before diseases progress to the point where they’re extremely expensive. And that requires a primary-care model.Countries with single-payer systems all have put in place extensive primary care, and employ much less expensive specialty, secondary and tertiary care. That’s actually not a bad model, because what you end up with is fewer people needing a heart transplant. If you need a heart transplant, you may be less likely to get it in those other countries. But if you have really good primary care, you’re much less likely to actually need the heart treatment.PwC: Does that mean there are trade-offs regarding care?George Halvorson: Only if you have to decide where you’re going to invest. If you decide to invest in the primary care part of the equation, then you eliminate the need for some of those very expensive treatments. On the other hand, if you don’t invest in the prevention part of the agenda, then you have to invest much more heavily on the tertiary side of the equation. It’s a cost trade-off for the system. For the patient, think of the quality-of-life perspective: Would you rather have a massive heart attack, or would you rather be treated by a primary care doctor? It makes more sense to focus on early prevention and not on the tertiary care rescue model.

It’s a sensible and pretty accurate description. But that’s not exactly the terms he was using about single payer more recently at the Commonwealth Club when his description of single payer used the terms “rationing”, “Canadians coming to the US” and he alluded to single payer being like the prison health care system. I wonder what changed his tune? Was his body invaded a la Harry Potter movies by Sally Pipes?

BOGS: Worldhealthcareblog

The WHCC Europe edition has it’s own blog at  Worldhealthcareblog.org. Very detailed recounting of what’s going on at the conference. I did it for them at Washington Dc last year and will be doing so again next month.  No one told me that I could have gone to Barcelona too!

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