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The BerkeleyMBA Business of Healthcare Conference

The BerkeleyMBA Business of Healthcare Conference is tomorrow. It has a good line up and those of you desperate to see me in the flesh can find me on the IT panel in the morning. Also on that panel will be people from Intuit, RelayHealth, iMetrikus, and Healthline. Other interesting speakers include MaryAnn Thode, the soon to be ex-head of Kaiser Hospitals, N. Cal; Kevin Young from Gilead sciences, and J. Carl Craft, from Medicines for Malaria venture. There are several other breakout panels, including one with Arnie Milstein from Mercer on it. I believe admission is only $80.

Of course if it was the Stanford Business School Conference it would be much better, I’m sure! But when I was at Stanford our football team was better than Cal’s—times appear to have changed.

PHARMA/BLOGS: Jim Edwards torpedoes own career!

Some of the best reporting on the pharma business in the last few years has come not from the mainstream press but from Jim Edwards, a reporter buried in the marketing industry trade press at Brandweek. Given the fact that certain Manhattan-based major press publications could use to improve their pharma and health care journalism (and I’m not talking about the WSJ, think more of dogs and sores!), I was hoping and expecting to get an email one day from Jim telling me of his new gig.

But instead, he’s decided to not only stay at BrandWeek but also to commit journalistic suicide and become one of us. His new blog is called BrandweekNRX. Pity. But I look forward to reading it!

PHYSICIANS/INTERNATIONAL: GPs making hay in the UK

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My dad told me never to become a doctor. As I failed physics "O" Level and wandered off into social sciences that was probably sound counsel for me, but in general his advice may not have been correct. With the bonus payments and a bunch of other incentives, it looks like British GPs are really making out these days. Apparently average income is now north of 100K GBP, which is far in excess of income for primary care docs over here (if you take it at the $2 to 1GBP exchange rate).

And they are pretty happy about it, or as we Chelsea fans say "top of the league and having a laugh"

TECH: Health plan uses novel security solution

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A smaller Pennsylvania Blues seems to think that it’s going to be providing access to their data to its members everywhere. It’s using some interesting security tools to do it.

Diversinet Corp. (OTCBB: DVNTF), a leading provider of mobile authentication security and access solutions, today introduced MobiSecure™ Wallet and Vault, new solutions that give users secure and immediate access to a host of personal, financial, and insurance identity information, as well as other critical, privileged data. Offering both convenience and security, the new MobiSecure products give banks and other financial institutions, insurance companies, and health care providers a unique and easy-to-use solution they can use to provide individuals with fast, convenient and secure access to new applications and services via mobile phone, PDA or PC browser. Diversinet also announced today it has signed a licensing agreement with Blue Cross of Northeastern Pennsylvania (BCNEPA) for the MobiSecure Wallet and Vault.

TECH: PHR talk

Those of you who couldn’t get into the live version of the PHR webinar I was on the other day can now go to the Center for Information Therapy events web page and listen and watch for yourself. (Or I suppose if you did see it but thought it was so good you wanted to see it again, you can do that too!) It’s the first in the list of “past events.”

I had some problems getting audio in my version, so let me know if that happens to you. But it’s a fairly nifty audio and slide integration.

And yes it’s very bizarre giving a speech into a telephone when you can’t hear anything on the other end at all!

POLICY: Why Healthcare reform won’t work

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I’m up at Spot-on with a few thoughts about the current state of the healthcare reform movement. You’ll get the gist of my argument from the title. The piece is called  "Why Healthcare reform won’t work."  As usual, return to THCB to leave your comments. If you want more, go look at my last column "The Bush Health plan."

It’s taken quite a bit of the time. But the efforts by Republicans George Bush, Arnold Schwarzenegger, and Mitt Romney have finally convinced the national press that the rash of cancellations in the individual insurance market is a story worth writing. Perhaps it’s because we’re now discovering that this is a national phenomenon.

It’s somewhat older news here in California where it looks as though the state may decide that any retroactive cancellation of policies needs to be reviewed by an independent official. One Californian insurance company, Kaiser Permanente, caught with its hand in the cancellation cookie jar has already proposed something similar but it’s less likely that competitors WellPoint (Blue Cross of California’s parent), HealthNet and Blue Shield of California will be quite so thrilled.

Blue Cross of California, one of several plans being sued in California, says that it rescinds an average of 1,000 policies each year out of about 260,000 new individual enrollments — less than one-half of 1%, says spokeswoman Shannon Troughton.

WellPoint is strictly speaking right to say that less than 1% of its applications get canceled. But it’s evident from the various testimony already leaked from depositions of Blue Cross of California’s employees that the applications of any individual policyholders submitting high claims were routinely subjected to a review looking for the slightest excuse to cancel the policy. But that’s not the heart of the matter.

The issue is that we have an individual insurance market which is designed to stay away from the care of sick people. And that’s why healthcare reforms, as they are currently proposed won’t really work. Continuez …

TECH: Cisco’s briefing

A little about my day job today. I’m sitting in a video briefing hosted by Cisco for its provider clients being broadcast to 10 sites. I’m in the one in San Jose, where there are lots and lots of interested parties from a minor, local HMO which has its own small IT projects underway!

I’m telling you this because after the session is done it’ll be posted online, and then there’ll be an online discussion about the issues of installing IT in hospitals, and the possibilities of new technology.

More details later…

POLICY: California Policy Update By John Irvine

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With support apparently growing for the Schwarzenegger plan in California, opponents are already laying the groundwork for a legal challenge. The Financial Times (UK) quotes business sources as saying lawsuits are  "all but inevitable" if the plan passes in Sacramento. That could tie the effort up in court "for years" — perhaps even until after the 2008 elections. According to the newspaper, challengers are likely to use a strategy based on the one used to overturn Maryland’s "Wal-Mart law" last month. 

"Jack Bovender, chairman and chief executive of HCA, the big hospital group, underlines the legal problems faced by such state efforts. "we’re pleased that some states have recognized the gravity of the issue of the uninsured. However, a patchwork of state plans is problematic because of potential problems with ERISA (The Federal benefits law.) That 1974 statute, the Employee Retirement Income Security Act, in effect nationalized employer health plans to spare companies the cost of complying with conflicting state benefits.

"Legal challengers are (also) likely to claim that the plan imposes a disguised tax and so should require a two thirds vote of the  legislature, since California law mandates a super-majority for tax increases. Alternatively, opponents will try to use the Erisa law."

TECH/PHYSICIANS/INDUSTRY: Now the Communists have infiltrated the officer ranks!

Back_surgery
(Speaker adopts very pompous tone) You may remember a little while back that some left wing seditious journalist criticized the sanctity of our free and opaque market system. He claimed that a leading back surgeon at the Cleveland Clinic — the Cleveland Clinic, I say, yes, the very epitome of all that is good and great about American capitalist medicine — was somehow putting his own interests above that of his patients as he used a surgical device that he and the clinic both promoted.

Well this rabble rousing has got completely out of hand. Now a presumably Frenchy cheese-eating surrender monkey type who claims to be a surgeon also specializing in back surgery is also on the hunt. The "surgeon" in question, one Aaron Filler, makes outrageous claims about surgeons — including those who’ve been to medical school and therefore have unimpeachable ethics. He even suggests that those involved in developing and marketing devices claim that they get better results using them that are not replicable by other surgeons.

Nonetheless, concern about an ethical crisis affecting patients was
reinforced by discussions at various professional meetings during 2006.
Formal scientific publications on a new type of spinal device had
revealed extraordinarily high success rates and explicitly reported
“zero” device-related complications (Schnake et al Spine Journal 3:159S
2003). However, a separate study involving only surgeons with no
financial interest revealed an unusually high rate of “device related”
complications and failures (Grob et al, Spine 30:234, 2005). <SNIP>Differences in reported scientific results seemed to reflect the
difference between conflicted versus non-conflicted investigators.

He also casts aspersions on the completely above-board and reputable relations between professional societies of surgeons and their respectable colleagues in the medical device industry.

Many surgeons receive manufacturer funds to attend training meetings in
places like Vail, Cancun and Las Vegas, advertised as academic medical
education events. I recently organized a session at one such meeting
that brought in several nationally respected neurosurgeons to teach new
diagnostic techniques and treatments to reduce the use of implants. Meeting sponsors from the device industry objected and the session was canceled.

Hang on a moment. He said "surgeonS". That means there’s an epidemic of Frenchies breaking out in the ranks.

But I’ve figured out this so-called surgeon’s motives! He’s too lazy to do any surgery! Instead he’s written a book called "Do You Really Need back Surgery". Well it’s not too hard to see his game! Instead of getting up early and cutting away in the great tradition of American capitalist physicians, he wants to sit on his rear and collect royalties. Well, that’s not the spirit of grit and true enterprise that this country’s medical care establishment was built on.

I suggest that the North American Spine Society quickly sets up a Committee on UnAmerican Spine Surgical Activities and drags this Filler, and his fellow travelers like Association of Ethical Spine Surgeons‘ President Dr. Charles Rosen, into hearings where their true Frenchy leanings can be exposed to the world. Then the real American back surgeons can thankfully go back, undisturbed, to operating on anyone who’ll lie down.

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