It’s Friday, it’s still the late summer, and people are drifting back to work…few comments on any of the posts. But wait!
On one tiny post here on THCB, debate and comment fever has broken out with over 65 back and forth comments. If you’ve missed it, go look at the debate, largely inspired by Jack Lohman, who’s book on the corrupting influence of money on politics is the basis for quite some ranting—from a Republican who favors single payer no less!
The NY Times tells us that we shouldn’t keep all our data in one stash.
They’re right. I have everything important at least in two places, but it’s still a struggle to manage.
You can buy online back up, but at the moment it’s just not worth it. Apple charges $100 a year for a gig? That’s a hell of a markup. You can buy a gig of storage for less than a dollar if you buy more than 100Gs in an external hard drive–-which is what you’ll need if you have movies or much music or lots of photos. Moving it over the net is too slow for those big quantities for now (although it’s getting faster). Moving a gig up or down takes several hours (as those of us who share soccer torrents know) So that’s the issue for storage.
But what about disaster recovery? I came up with a low tech solution but one with other uses. For less than $200 I bought a fireproof, drop-proof safe that is big enough for all my meager valuables and two external hard-drives. My hard drive lives in the safe if I’m not using it. Yes of course there’s a chance that either I won’t put it in the safe or that the effect of an earthquake would destroy the disk drive, but it’s not a bad option as it’s something I use anyway for my other valuables, such as passports.
But as the price points change, what I’ll probably end up doing is going with one of the services that the NY Times is talking about. Already one company (Fabrik) is down to 50 cents a month for a gig of storage. That’s still way more than my solution—I’m storing around 100 Gigs (5 of which I really need). So I might be persuaded to put 5–10 of it online for $100 a year. Xdrive will soon introduce something similar (5 gigs for $120 a year) But the ideal solution is a someone selling me 100 Gigs of back up for a little more than than I pay for my external hard drive—say $100.
We’ll get there as storage costs fall. And in about 5 years it’ll be another monthly bill we don’t even think about. But for now the price needs to fall a lot before it’s a mass consumer or even small business market.
And then consumers will start putting lots more online…think banking records and medical records. Perhaps a few tech companies are starting to think about that, eh?
A couple of years back there was some bad publicity about a hospital in Illinois that had its debtors hauled off to jail. Perhaps they should instead have tried this solution from Burundi—Don’t let them out if they can’t pay!
Friend of THCB Matt Quinn does, if people can just trust each other—apparently they’ve got some trust going in Ohio. Well worth a read, althought the main purpose of a RHIO needs to be a central ASP providing applications for smaller practices; and that has some of the same problems of the back-up storage issue I’m writing about elsewhere on THCB today.
Anyway to figure out what’s going on in Ohio, read Matt’s letter to Hospitals & Health Networks.
The Minnesota Blues plan is floating a proposal for universal care. It looks at first glance like a Mass type individual mandate. Not so long ago Ken Melani, now CEO of Highmark, the dominant Western Pennsylvania Blues plan, had a similar idea.
So it appears that little by little the non-profit Blues are coming around to the fact that they have to have some plan in place to survive the coming revolution. This assumes that their future is a choice between being state regulated utilities in a multi-payer universal care system, or being replaced by the government in a single payer system. And there’s little doubt which one they’d rather take.
Of course these Blues have been denied the option of going for-profit, as the various state legislatures are now wise to the scam that enabled an earlier generation of Blues executives to make themselves rich beyond recognition while providing damn little back to the states that had allowed them that tax-free status for decades (see the experience in Maryland, for instance).
Those that have gone over to the dark side are of course adopting all of the tactics you’d expect, while of course the non-profit guys claim that they have to do the same to remain competitive. If they could construct a universal care multi-payer model in which everyone has to play by the rules of the big local state regulated utility, they’d do fine.
And apparently there are enough senior people, in at least Minneapolis and Pittsburgh, who are beginning to think that that’s the choice they’ll end up with in a few years. So they’re starting to float the proposals now.
HWR is served with pleasure and inspired gastronomie at InsureBlog
Things we already knew:
Doctors are poor at judging their own abilities. It’s a bit like everyone says they’re a good driver, but that 75% of drivers are terrible.
Merck earnestly believes that it was as pure as the driven snow over Vioxx and never knew that it was dangerous until it took it off the market(who knew about Dodgeball, eh — let alone what Kaiser knew several months earlier).
Little girls don’t really cry tears of stone
Things that I don’t think we did know
Online PHR use is up to 7% by July. Which is about 6% higher than they said it was 2 years ago.
According to the survey, commissioned by UnitedHealth Group and conducted by Harris Interactive ® , only 7 percent of U.S. adults use online personal health records and 35 percent of people surveyed were not even aware this resource technology exists.
Just when you thought you’d heard the last of it, Maggie Mahar, last seen over here abusing the health care system, pops up over at The American Prospect smacking down David Cutler’s study. Again well worth reading.
The black stone that resides in the chest of DEA administrator Karen Tandy in the place where the rest of us have a heart must have some gravel chipping off today. The DEA allegedly has revised its rules on prescribing pain-killers:
Yesterday, DEA Administrator Karen Tandy said the agency had been wrong in limiting the multiple prescriptions and had made the tough decision to reverse course. She said the DEA received more than 600 comments from doctors, patients and others about its policies on narcotic pain killers, many of them strongly opposed to the agency’s position on limiting refills.
But basically this is a tiny move—allowing multiple prescription refills for those in chronic pain, but only by doctors who the DEA considers not to be in violation of their unwritten laws. After all, 2 years ago—right in the middle of William Hurwitz’s trial when his defense was about to introduce them—they introduced some similar guidelines they’d worked on with pain specialists for two years. So what happened then? Well given the choice of allowing rational behavior, even according to guidelines they developed and allegedly agreed with, and putting a doctor treating the chronically ill in jail. Guess which one they took?
The agency briefly posted the guidelines on its Web site in 2004 but then pulled them down and disavowed them.
Siobhan Reynolds from PRN is rightly, rightly suspicious
But Siobhan Reynolds, who created the Pain Relief Network several years ago to help defend pain doctors who she said were being unfairly arrested and prosecuted, disagreed and said the new DEA policy has changed little. "Ms. Tandy states here, as she has on many occasions, that doctors need not fear criminal prosecution as long as they practice medicine in conformity with what these drug cops think is ‘appropriate,’ " Reynolds said. "If that isn’t a threat, it will certainly pass for one within the thoroughly intimidated medical community.”
The story is that chronic pain is massively under-treated in this country, and opiates are the most effective way of dealing with that pain. Yet as I pointed out over at Spot-on the mad Calvinists who run our criminal justice system care not a whit.
Managed Care has a conversation with Molly Coye about the progress in automating and infomating the health care system. You’d think she’d be a pessimist after all these years. But she’s not really! Well worth a read.
THCB's Podcasts
Listen to them on Itunes or Spotify
