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BLOGS: Why blogging matters, even if it’s only a little

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I wrestle everyday with whether writing this or any blog makes any sense from a business or personal perspective. I cringe when friends and colleagues tell me they’re starting a blog, because I know how hard it is to keep going. I also know how long it takes to build readership. But every so often I go back and read something I wrote and forgot about, and I’m more than a little impressed with myself.

So for my last post of the year I want to rebut the recent article by Joseph Rago of the WSJ in which he basically said blogs are a boring waste of time and that bloggers don’t do original work.

There are three reasons why he’s wrong.

Continue reading…

TECH: Health2.0–this time it’s different?

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Dmitriy is worried that Health 2.0 is turning into a bubble. His piece Health Social Networking & Web 2.0 Bubble is a response to his rather prominent featuring in Laura Landros’ WSJ column. He’s concerned that it’s yet another bubble with no business model behind it. I’ll say more about this later, but there are two reasons to be less pessimistic than Dmitriy.

First, the business model is better because a) the tools are significantly cheaper to build and b) one player (You know who) has figured out how to build an advertising supported business online that really works—and is insanely profitable.

Second, even if there are no great riches to be had by independent Web2.0 and Health2.0 companies, the tools, techniques and technologies of Health2.0 will be adopted by the health care system and the consumers of health care. And that will be the most important feature of the entire “movement”.

TECH: Laura Landro picks up on Health2.0

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Now I know that Laura Landro reads (rather than just reccomends) this blog. Today in her The Informed Patient column in the WSJ she discusses the burgeoning patient to patient discussion movement, which is a big part of Health2.0. On the other hand she could just have been talking to Dmitriy who gets plenty of press in her column for his work at TMBN. Others getting mentions include DailyStrength, Healia, and OrganizedWisdom. There’s also quite a bit of discussion of Second Life, which I have been trying my hardest to avoid—given that I waste most of my life online as it is…

But her description of what’s happening behind Health2.0 is excellent:

The social-networking revolution is coming to health care, at the same time that new Internet technologies and software programs are making it easier than ever for consumers to find timely, personalized health information online. Patients who once connected mainly through email discussion groups and chat rooms are building more sophisticated virtual communities that enable them to share information about treatment and coping and build a personal network of friends. At the same time, traditional Web sites that once offered cumbersome pages of static data are developing blogs, podcasts, and customized search engines to deliver the most relevant and timely information on health topics.

TECH/CONSUMERS: Revolution Health & MedBillManager

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 OK for those of you desperate to take a look at Revolution Health’s "invite only" site, here is an officially blessed invitation to go sign-up  (and of course to look at what $500m buys you!).

Meanwhile, at the other end of the opulence scale, start-up Medbillmanager is attempting to compete with Revolution/Intuit et al in the way consumers deal with their medical and insurance  billing/payment.

Obviously it’s early days. But it’s well worth taking a look at both of these two sites to see how new web technologies are putting information, organizational capability, and just maybe power, into the hands of consumers.

BLOGS: Coming out of the woodwork

Those of you bored with the same old health care blogs might be interested to know that there are some more out there.

Veteran physician commentator Dick Reece’s medinnovationblog is starting with a long series of posts about “innovations” in care delivery. It’s mostly aimed at a physician audience but it’s thoughtful stuff—Dick does though need to realize that “blog” is to “post” as “newspaper” is to “article”.

From the crazed Republic of California come two new political health care blogs. Sacramento Bee columnist Dan Weintraub has a host of guest bloggers on California health care at CrossRoads. Those of us too cynical to think that anything meaningful can ever happen on the state level will note that not all of them share that view.

Anthony Wright, head of California single payer advocacy group Health Access, is a contributor to that blog. His own organization also has its own new blog on which he and Hanh Kim Quach are the main authors.

QUALITY/POLICY: Gerald Ford–the poster child for what’s wrong with health care

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Gerald Ford died last night aged 93. By any standards he had a great life. He was a moderate Republican in the House for many years, and then a stop-gap President after Nixon, famous mostly for pardoning Nixon who hadn’t yet been charged with a crime. And then lived on for nearly another 30 years. The American dream of the College jock becoming President and achieving great wealth and happiness—and people liked him!

But it’s the manner of his death that I think is very important. Just two months ago in a “discussion” I had with David Gratzer of the Manhattan Institute, I raised the point that Ford had not one but two angioplasties at the Mayo Clinic—and that as he was likely to die soon anyway that money would have been better spent on pre-natal care for an uninsured woman who was featured on ABCNews that week.

David Cutler recently estimated that adding an extra year of life for the elderly cost $145,000.

So consider Ford’s last few months of life. He was admitted to hospital last January for pneumonia. Then spent much of July in hospital in Vail; then went to the Mayo Clinic for not one but two angioplasties in August. Then went back into hospital in California in October, and now has died in December. All that time he was obviously going to die within a year or so, and all that time he was at least 92 years old.

My guess is that over the last 12 months of his life well in excess of $100,000 was spent on his health care. And that money probably extended his life by three months at most. Now for all we know they may have been the most wonderful three months ever for him and his family, but I’m inclined to think that if he’d died in the summer, his family would have been equally fine with it, and the nation wouldn’t have felt any differently about him. But the cost of extending life an extra year in this type of case is probably around $400,000.

How can that possibly have been money worth spending? The answer is that it cannot have been. And that is where the money is in our system which could pay for all the pre-natal care for uninsured mums, immunizations for sick kids, and procedures for uninsured 50 year olds that we “can’t afford.”  And frankly it’s probably better and more humane care to provide palliative care at home than to put sick old people through yet more invasive and painful procedures.

So the sooner we start having that conversation the better. And if that conversation comes out of Gerald Ford’s death, then at least that spending on the last months of his life might have done some good.

POLICY: Ezra Klein world takeover on track

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Ezra Klein is famous today–he has (I think) his second fifth or sixth op-ed in the LA Times, and this one is about universal healthcare and whay that debate is coming back. My only problem with the debate coming back now is that I think it’s too soon and things aren’t bad enough for us to get to more than the debate–as in get an actual solution. But then I’m a pessimist.

INTERNATIONAL/POLICY: Canadian health care must be better!

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If I was David Gratzer or John Graham’s alter egos I’d be using these two stories to good effect.

The first one one proves that Canadians are getting healthier and living longer than before they had a universal single payer system. And this one shows that your typical heart transplant patient from Canada ends up so healthy that he climbs huge mountains in Antarctica, and the only reason he didn’t get to the top is that the two doctors escorting him up couldn’t keep up the pace!

So by extrapolation the Canadian system must be perfect! With evidence like that, I should write a few op-eds saying so!

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