I must admit when I am wrong. My repeated claims that the Massachusetts Health Plan would
be on life support—with a likely ‘pulling of the plug’—by early 2008 have been
proven wrong.It has happened already.
Above the Fold
POLICY/INTERNATIONAL: More boring pointless mush from the AEI
So the WSJ gives another know-nothing big oil-sponsored hack from AEI another forum to use the same tired defense of the US system in the Elizabeth Edwards case. Oh look! Cancer outcomes are worse here than in Europe therefore their health care systems must be worse. With the unspoken implication that if her husband’s plans get enacted she’d be dead.
Just for a minute ignore all the other issues about costs, the 18,000 people whom the IOM says die each year here earlier than they would in those European countries because they’re uninsured, medical bankruptcies up the wazoo, etc, etc, and feast your eyes instead on this little nugget from a much longer article at the Annals of Internal Medicine.
Contrary to popular belief, the health care here isn’t always the best. Many other industrialized countries provide health care that is just as good and sometimes better. For instance, 30-day acute myocardial infarction case-fatality rates are below 7% in Denmark, Iceland, and Switzerland, compared with almost 15% in the United States. Incidence of major amputations among diabetic patients in Finland, Australia, and Canada is less than 10 per 10,000 compared with 56 per 10,000in the United States. And Australia, Canada, England, and New Zealand all have a better 5-year kidney transplantation survival rate than the United States.
There are so many better things to be arguing about.
But if the AEI and the fake free-marketeers want to play that game, why is the American health care system killing people with heart attacks, or chopping the legs off diabetics at more than double the rate of foreigners? Does the AEI really want to go down that path–particularly as there are way more Americans with heart disease and diabetes than with cancer.
CONSUMERS: Interested in doing a book review?
Citiria Publishing is looking for a reviewer for a patient self-help book, "Heart Bypass – The Road Map".
Please contact clive ‘at’ citiria.com. If it’s good I’ll print the review here.
QUALITY: Plantar warts, duct tape and the real cure
David Williams at Health Business Blog pokes some fun at some investigators looking into a cure for plantar warts who used the wrong type of duct tape in trying to figure out if this cure works. (He calls it File this in the “What were they thinking category?”).
However, having had one of those miserable bastards (a wart that generates it’s own dang blood supply) and failed to get rid of it in the conventional way (acid that kills the rest of the skin on the foot but not the plantar wart) I know the answer. It’s this stuff. http://www.amoils.com/warts.html Works exactly as advertised. This is the only medical product I’ve ever endorsed, and no they’re not paying me and don’t know about this posting! (OK, so it’s an “n” of one, but these guys are still in business 4 years later….)
HEALTH PLANS/CONSUMERS/POLICY: Administrative costs–bad and will get worse with CDHPs
PNC Bank has a new survey out saying that 30% of all health care costs are to do with administration—actually it may be more than that if you believe the study in Health Affairs that said it was 20-22% of all provider costs, when the public provider payer segment is keeping an additional 3–20% of all the dollars too. I think that PNC is trying to promote HSAs et al, and perhaps wants to suggest that this will solve the administration problem. As I’ve been saying for a while, the current set up of CHDPs just means that instead of chasing down health plans for the money, providers will be turned into consumer collection agencies.
And PNCs own survey shows that most providers agree with me:
Nearly three-quarters of hospital executives surveyed (72 percent) expect high deductible health plans, which require consumers to pay more upfront costs for care out of their own pockets, to add another layer of complexity to the claims, billing and payment process.
POLICY/HEALTH PLANS: Clowns to the left of us, jokers to the right…..
Yet another study showing that even if you’re insured, because of the structure of our insurance system even the insured have trouble paying bills. Now I know I should leave this well alone. It’s ground that I’ve trampled to death before, such as this story about the insured parents of the sick kid who’ve declared bankruptcy. But when the magic four letter acronym of certain industry trade group pops up (even without a certain lobbyist’s name mentioned) I just can’t help myself.
Along with deductibles and co-payments, The Access Project found other factors associated with medical debt were annual or lifetime "caps" on benefits; extra charges for "out of network" care, even when admitted to in-network hospitals; and complex billing systems by insurers and hospitals that left patients confused about what they owed.
Mohit Ghose, spokesman for the industry trade group, America’s Health Insurance Plans, says the study unfairly blames insurers for rising costs. He says there are many reasons spending on health is going up, including new treatments and drugs, rising demand as the population ages and "defensive medicine" by providers worried that they will be sued if they don’t run every test or offer every alternative to patients. "For too long, people have found it convenient to put any and all problems with the health sector at the doorstep of health insurance plans," says Ghose.
Not actually a direct lie this time, you’ll note. But excuse me again, but if it’s not to sort out that stuff—the over use, the defensive medicine, assess the correct use of technology—then what do AHIPs members do for their customers other than slap on 20% and send them the bill? Not much is the answer.
But I guess AHIP is doing its job. They’ve been getting idiot libertarians from no-name universities to write ridiculous op-eds about the value private insurers bring to the system and than has succeeded in getting them placed in that bastion of Marxism The New York freaking Times!! I’ll spare you the whole thing (although this post at Economist’s View explains largely what a pile of crock Cowen writes. But this choice piece of outright idiocy has to make an appearance at THCB:
It is precisely because competing insurance companies spend money evaluating the appropriateness of claims that they are willing to pay for so many heart bypasses, extra tests, private hospital rooms and CT scans.
Given what Ghose says in the line above about how insurers aren’t able to do that stuff because it’s just too hard for them, someone at AHIP has clearly not been communicating well with their pet blogger, or at least Cowen has no idea what a health insurer does. Perhaps he should try to get a job at HBS? He’d fit in well there
And given that Cowen is an out-there libertarian nut with no basic chops in health care, and for whom this is his second recent appearance in the Times, it’s worth asking how many op-eds has the Times featured from Alain Enthoven, Vic Fuchs, or anyone else with half a brain on the topic this year? You know my guess as to the answer.
PHARMA: WSJ’s new blog, NCAA and The Industry Veteran‘s handicapping
The WSJ has a new health blog. Should be good to keep tabs on—focusing mostly on the business of health care. No posts from Barbara Martinez as yet (pity!). One of their earliest posts is a comparison of March Madness basketball with Pharmabrackets. The Industry Veteran is amused but not too impressed:
The March Madness tournament in NCAA basketball has made millions of office workers with too much time on their hands look at the world through elimination brackets. I don’t know if this is an improvement over their tendency over the past 20 years to conceive all existence in terms of spreadsheets. What it has done is taken their parlor trick pastime into some unusual substantive areas. The other day the Wall Street Journal published elimination brackets showing how they believe Big Pharma will devolve into a Final Four. It’s amusing, but as with spreadsheets, regression analysis and other idiot-savant endeavors, it shows a thorough detachment from commonsensical reality.
Any consummation of their elimination pairings runs afoul of some major impediments.1. GSK + AZ. No way, Jose. GSK’s biggest product is Advair and AZ is hoping Symbicort will be its second biggest. A combination would have to axe one of the two.2. Sanofi-Aventis + Novartis. Not in this century. S-A is France’s stake in the ground for a presence in Pharma while Daniel Vasella and his director allies at Novartis are devout Swiss nationalists. More likely the US of A and France would merge to form one country.3. Merck + S-P. Makes sense in that Fred Hassan admits S-P needs pipeline and while S-P can bring marketing acumen to Merck, try getting the latter to admit they need that.4. Pfizer + Amgen. Amgen’s stock is down now because of their shenanigans on Aranesp, but as of 12/31 their market cap was just under $80 billion. Pfizer didn’t do so well with its last megabuy when they acquired Pharmacia for around $60B. I think Pfizer’s CEO Kindler and CFO Shedlarz would be out on their asses if they tried this. Besides, Amgen chairman-CEO Kevin Sharer is the new president of Big Pharma’s lobbying group, PhRMA, and he wouldn’t sell his own company while he’s serving as the industry’s figurehead spokesman.
PHYSICIANS/TECH/QUALITY: Tuesday’s ACC report will hurt the stent market
The NY Times has an article about how stents are likely to be found to be less useful than would be indicated by the amount of use they get from cardiologists. More bad news for JNJ and BSX, but something that THCB has been sniffing around for quite some time now.
POLICY/POLITICS: Democrats debate health care
I can’t say that I’m very interested in what they’re saying now…I’ll check in more in a year and a bit. But the Democratic candidates Saturday had a debate about health care. More here at the Campaign for America’s Future.
HOSPITALS: Wow, a big new one in San Francisco
Looks like Sutter is opening its extensive coffers to create a big-ish new hospital mid-way between its flagship CPMC and their Fennian rivals at St Francis in the heart of San Francisco. Given that we’re not exactly underbedded here, I wonder if they’re eventually going to shutter one of their other campuses (presumably the Pacific campus which was the old Pacific-Presbyterian in the halcyon days of yore—e.g. 10 years ago)
