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POLICY/HOSPITALS: (Google) Mapping NYC Health Care Disparity: 1985-2007, by Mike Connery, The Opportunity Agenda

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About 9 months ago research director of The Opportunity Agenda, Brian Smedley, guest-blogged on THCB about a New England Journal of Medicine study. his colleague Mike Connery wrote to me to tell me about this:

Yesterday, as part of our Health Equity program, we rolled out a new tool that I think you’ll find very interesting. The tool is a new website designed to visually illustrate the economic and racial disparities that exist in New York City’s health care system, and drive all New Yorker’s of conscience to take action by emailing their elected officials. It’s a Google Map mash-up that takes data on NYC hospital closures between 1985 and 2007, and overlays it on an interactive city-wide map that can display either the racial or economic demographics of the Five Boroughs during three periods: 1985, 1995, and 2005. 

Using this tool, visitors can visually see how hospital closures disproportionately impact poor neighborhoods and communities of color.  Text on the sidebar guides the user through each decade and demographic overlay, explaining the changing conditions of the city and the impact that closures have on underserved communities.But the site is more than just a visual resource, it is also a data-rich resource for researchers that contains a variety of reports and fact sheets (as well as data on the patient demographics, payer source, and quality scores for each hospital), a community forum for health care advocates and New Yorkers, and an activism tool that encourages New Yorkers to write to their elected officials in support of creating a health care system that works equally for all. 

All data on the site is from the census bureau, the New York State Department of Health and the New York State Planning and Research Cooperative System.  The data were analyzed by Darrel Gaskin of the Johns Hopkins School of Public Health. The Opportunity Agenda, in partnership with a coalition of NYC health care advocates, assembled this map in response to the activities of The Berger Commission (aka the hospital closures commission), whose recommendations are now sitting on Gov. Spitzer’s desk. You can find more info on the Berger Commission here.

When we talk about health care policy in America, very rarely do we mention the roles that class and race play in determining our access to and the quality of health care that we receive. Hope you find the tool interesting and useful.

HEALTH PLANS/POLICY: Meter Reading–How Regulation Might Fail

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Today I’m up at Spot-on in a piece about the influence of big health plans on reform efforts called Meter Reading: How Regulation Might Fail.

Maybe, just maybe, we’re getting serious about health care.


This week’s news says yet more unlikely allies are advocating healthcare overhaul.


The alliance between the Business Roundtable, unions and interest groups – an even more unlikely bunch of reformers than Republican Gov. Arnold Schwarzenegger and the insurance association  (both already out with their own plans) –  are all saying, loudly and clearly, that something must be done. It’s all leading to an odd sense of optimism – one I don’t, sadly share.


Forces outside of health care are starting to talk the talk about
forcing change. Former Massachusetts governor and Republican
presidential hopeful Mitt Romney’s health plan, the election of a
Democratic majority in Congress, and ever- increasing costs are all
forcing everyone to get those old reform plans out again. And as
evidenced in this discussion even political columnists from the WaPo think that something is going to happen – although they do tend to misread the light at the end of the proverbial tunnel. Continue

As ever come back herre to comment

POLICY: Kling’s Response to Holt, Havighurst, and Cohn

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Arnold Kling’s response to Holt, Havighurst, and Cohn is up at Cato Unbound. You know that I and Jon Cohn are going to largely find fault with Arnold Kling, while Clark Havighurst is a fellow traveler who actually says very sensible (but probably unrealistic) things about the tax treatment of health benefits.

In his response Kling agrees with my premises but doesn’t agree with my conclusions. Fancy that!  Still go over there and read all the essays, because it’s good stuff!

TECH: More on Revolution Health

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Over at tech blog TechCrunch, there’s a piece on Revolution Health. What’s most interesting is the comment section, where the CEOs from DailyStrength, Organized Wisdom, and others and the Chief Medical Officer of Revolution itself all pitch in.

Frankly, the nit-picking over who does what best reminds me of the line about the fleas arguing about who owns the dog. For this Health2.0 stuff, these are such early days that the only people I really discount are the ones arguing that we shouldn’t rate doctors or allow patients to talk to each other in communities. (Yes, there are a few commenters saying exactly that).

Of course people will still be trying to close that door long after the horse has bolted.

TECH: Free eRx from Allscripts and friends, with UPDATE

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Allscripts, backed by a cast of friends, is going to let any physician in America sign up for its ASP-based eRx system (which links into Surescripts) for free. The coalition is called the National ePrescribing Patient Safety Initiative (NEPSI) and it has its own website and press release and everything!

Also in on the deal are two biggie health plans, Wellpoint and Aetna, several tech companies (Dell, Cisco, Fujitsu, Microsoft, Sprint, & Google), Surescripts (connection to pharmacies) and Wolters Kluwer (drug databases). I assume there is some money flowing around (presumably from the health plans) to cover the costs, but it’s not clear how much or to whom. I’ll endeavor to find out.

The old joke is that for physicians to adopt technology, free isn’t cheap enough. I guess that we’re about to find out.

UPDATE: Well I actually listened to the whole webcast (yes, my life is pretty sad!). The most interesting thing is the Glenn Tullman (Allscripts, CEO) said that the 5 years commitment was $100m. That’s real money, and the only real place that they can expect to get (most of that) is from the health plans—unless Glenn’s got the negatives of Bill Gates or Larry and Sergey with the goats. And it’s probably a similar amount that Wellpoint and the others have already spent on these initiatives, much of that with Allscripts—so there’s probably a migration of those regional projects going on.

The other thing mentioned was that the system would have interfaces with practice management systems—what that means in reality remains to be seen of course.

CONSUMERS/QUALITY: A DIY Approach to the Diabetes Epidemic by Amy Tenderich

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#1 health care blogger, well actually #1 patient blogger, but probably the most important one in the whole medical blogosphere, Amy Tenderich has written a book called called Know Your Numbers, Outlive Your Diabetes about (obviously) how to manage diabetes. We don’t deal much with actual medical care over here at THCB, but for your holiday Monday I thought that an introduction to her book would be a great start. And of course who better to introduce it than Amy herself!

Forget any inkling you may have had that the media is sensationalizing the "diabetes epidemic"€ story. It’€™s real folks. In fact, the American Diabetes Association just launched a campaign called "Every 21 Seconds"€ as in that’€™s how often another American is diagnosed. Diabetes now affects the lives of 20.8 million children and adults in this country, and at the going rate, could rise to 50 million by the year 2025.
With the medications and tools available here in the US, the devastating effects of this disease are largely preventable.

Continue reading…

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