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POLICY: How did this sneak into the WSJ?

The opinion pages of the WSJ are known for being full of neo-cons and conservatives — people who think that they know what’s best for you and aren’t afraid of getting the US Government to use its power to enforce it here and abroad. The only libertarians with a megaphone I know are the love ’em or hate ’em John Tierney in the NYTimes, and the pop-culture joker John Stossel on PrimeTime 20/20 ABC.

But what’s this, on Feb 21 the WSJ had a signed op-ed column from staffer George Melloan called Musings About the War on Drugs. The column suggests what anyone who isn’t blind, deaf, dumb, biased or making a living from prohibition already knows — the war on drugs is a complete failure that is contributing to most of the worse elements of society. It continues only as a full employment act for some very unpleasant agencies of the US government (the heartless DEA prominent among them), even more unpleasant private corporations, and international criminals and terrorists — all of whom apparently have similar personal ethics.

Given that the WSJ is usually a mouthpiece for some of the worst hypocritical pontificators of the fascist social conservative right (Bill Bennet, anyone), is something going on that we should know about?  After all a much more rational media organization of the right, The Economist, has been pushing for an end to drug prohibition for years. I’m hoping that this isn’t just a flash in the pan…

THCB: Friday’s out with the trash

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So a few quickies. I’m getting lots of requests for advertising/sponsorship on the blog and with John’s help we now have a link at the top for advertising information. So if you have a product or service to sell and want to sponsor/advertise THCB and reach a keen, pretty big and growing daily health care audience, email me.  And if you are a reader, there are plenty of ways a click or two around the site such as buying a book or signing up for a magazine, can help THCB and keep paying for the lights to stay on….

Of course, my main gig is as a pundit and a consultant, and so my real hope in doing THCB is that some readers working in the strategy/marketing/policy/research part of health care corporations might be interested in hiring me, either for a strategy/research/marketing project or as a speaker. With my consulting hat on I’m rather more focused and less flippant than my THCB pundit side might show, but I bring the same honest and direct approach. Again, please email me for information, or look here.

Finally, as some of you know I just got engaged to the lovely Amanda. But of course I did that before I knew that there were other options.

BLOGS: Health Wonk Review

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Inspired by the Nick doing Grand Rounds, Joe Paduda at Managed Care Matters has put together the first bi-weekly edition of a compendium of the best of blogging about health care policy, business, technology and anything that isn’t really clinical in nature. We’re hoping that it’s going to be a companion to the main Grand Rounds and that it’ll be a place to find some of the best insight into our evolving health care system. And while Joe kindly calls me a co-founder, and I will be hosting in two weeks, this is all his work and he gets the plaudits.

So go on over to the first Health Wonk Review

Consumers: Patient Power Inc.

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death wears a smile todaySomebody has come up with the really clever idea of building a site specializing in patient empowerment t-shirts. A new company called MedTees has set up an online store where you can find pro-patient stuff  you would never find anywhere else. They specialize in shirts that let patients poke fun of their conditions – a very good thing for people who have gone through serious operations or who suffer from chronic illness. 

The woman in the picture is Helen Smith,  a Tennessee psychologist who nearly died as a result of a misdiagnosed heart problem. She says her shirt helped her recover from the trauma of nearly dying. Helen is better known as in the blogosphere as Dr. Helen. She talks about her story here.

UPDATE: The Chicago Tribune ran a story on Wes and Diane Fisher, the couple who came up with the idea. They plan to take the project non-profit.   

TECH: WebMD, a little curious…

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Milt Freudenhiem gets to chat with Marty Wygod, and what he wants to talk about is how WebMD Health “Wants to Go Beyond Information”. WebMD is the old consumer web businesses of WebMD plus the private-labeled consumer sites they run for health plans and employers. Now while you could have (or maybe did) read all about WebMD Health’s strategy on THCB last year (hey the Times is only 6 months late so we’ll be charitable), the weird thing is why it’s being featured.

After all EmDeon, which is the old WebMD’s businesses that comprises the old Envoy claims transaction system and the older Medical Manager practice management system, and the Porex plastics company that was Wygod’s original holding company, still owns most of WebMD Health. Plus it’s vastly bigger. The web business brought in $4 million profit on $45m in revenue last quarter (or an annual run rate of $200m). Pretty decent growth from a $120m business in FY 2004, but not exactly Google-type margins. Meanwhile the real revenue (some $1.2 bn annual run rate) is in the old transaction services and practice management systems. Although the margins there are of course much lower (under 4% compared to 10% on the web side).

Now they say they want to sell off the transaction business and the practice management part. Which leaves them the WebMD Health web business and the plastics company. This is full circle. WebMD was originally a fake web-company. It couldn’t make its core web services work (either technically or as a business), so it took the logical approach of converting its incredible bubble stock price into the acquisition of MedEAmerica, Envoy, Medical Manager and a few other companies that had actual businesses. Now with Web2.0 emerging, and health plans finally deciding that they do give a rats arse about their customers’ online experience, it’s going back to being a web company.

The key issue though is that it’s doing it as an ASP, and it’ll be putting its client health plans’ members’ data on its own servers. That potentially gives it lots of power, which is whey health plans were afraid of it back in the late 1990s and created a fake competitor to it called….(forgot the name, answers on a post card please) Medunite (thanks!) which they later disbanded. Theoretically WebMD could be moving clients between plans as they own the relationship. So it’s an interesting concept, and they have enough tools that they could get it — the consumer eHealth experience — right eventually.

But all the same, 10 years to build a web business that’s $200m in revenue.  Given the amount of cash Marty Wygod already had, it barely seems that all this chopping and changing to come out with a small web company justitfies the brain damage of the last decade. And furthermore, is it really worthy of a NYT exclusive profile?

PHARMA/POLICY: One estimate of what Part D is wasting, with UPDATE

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Dean Baker working under the auspices of the liberal Campaign for America’s Future has written a study of what is being wasted on Part D. His number is $80 billion a year!. Given that the whole program was originally supposed to cost less than $50 billion a year that’s quite some number! The number he’s calculated is (I think) the difference between what the government will pay now and what it would have paid if it was negotiating for the drugs at the VA rate, plus the amount the CBO says CMS is spending on private administration of the project above what it would have cost to simply add one sole plan to Medicare.

Whether or not this analysis is fair, the Dems are nuts if they don’t get a great sound bite out of this.

UPDATE: Of course one Dem, Henry Waxman, is watching.

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