The Health Care Blog – Page 175 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

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Health in 2 Point 00, Episode 112 | COVID-19, HealthDevJam & loads of deals

Mar 13, 2020

Today on Health in 2 Point 00, Jess is joining somebody for their self quarantine in the Oval Office! Shenanigans aside, I give a quick coronavirus update and a shameless plug before diving into our regular coverage of all the deals. As for COVID-19, there’s a ton of activity going on in the digital health world with companies trying to figure out how they can help with this. Catalyst will be presenting some of that, either this weekend or early next week. Next, there’s an FHIR-related HealthDevJam event (free, online) TODAY at 1pm Eastern with lots of great people speaking.

Diving into some non-coronavirus related deals, eConsult company RubiconMD raises $18 million, Lyra Health getes a chunk of change—$75 million—for its mental health platform, Fruit Street Health gets $17 million from an unlikely source, b.well raises $16 million for what’s not a personal health record, and CVS announces that it added 5 digital health companies to its point solution management system. Finally, there’s been some sneaky stuff uncovered about Sanofi. Tune in for all the details on Episode 112. —Matthew Holt

There Is No Time for That

Mar 13, 2020

By ROMAN ZAMISHKA, MPA

Some of the most important engineering lessons were demonstrated on the tank battlefields of World War II when German Tigers faced off against Soviet T-34s.

The Tiger tank was a technical masterpiece of for its time with many features that did not appear in allied tanks until after the war. Despite its much heavier armor it was able to match the speed of lighter enemy tanks and keep up with its own light tank scouts. The armor featured almost artisanally welded interlocking plates. The ammunition featured innovative electric trigger primers and high penetration tungsten shells. The double differential steering system allowed the Tiger to rotate in place. A complex system of interleaving wheels distributed weight evenly, improved off-road mobility and even allowed mobility with damaged tracks.

But while the Tiger was a star on the blueprints, it was a disaster on the Eastern front, not because of its combat performance but because it was a logistical and operational nightmare. The heavy armor made the tank a gas guzzler, which made tanks inoperable when supplies were low. The electric trigger primers would fail in cold weather. When rotating in place the gearbox would often break and German training manuals forbid the maneuver. The highly specialized internal mechanics made production slow and meant the tank often could not be repaired in the field but had to be sent back to Germany, and the great logistic costs meant that Tigers couldn’t drive to the front but had to be brought there by rail.

Pandemic Fears: What the AIDS Battle Should Teach Us About COVID-19

Mar 12, 2020

By ANISH KOKA, MD

As the globe faces a novel, highly transmissible, lethal virus, I am most struck by a medicine cabinet that is embarrassingly empty for doctors in this battle. This means much of the debate centers on mitigation of spread of the virus. Tempers flare over discussions on travel bans, social distancing, and self quarantines, yet the inescapable fact remains that the medical community can do little more than support the varying fractions of patients who progress from mild to severe and life threatening disease. This isn’t meant to minimize the massive efforts brought to bear to keep patients alive by health care workers but those massive efforts to support failing organs in the severely ill are in large part because we lack any effective therapy to combat the virus. It is akin to taking care of patients with bacterial infections in an era before antibiotics, or HIV/AIDS in an era before anti-retroviral therapy.

It should be a familiar feeling for at least one of the leading physicians charged with managing the current crisis – Dr. Anthony Fauci. Dr. Fauci started as an immunologist at the NIH in the 1960s and quickly made breakthroughs in previously fatal diseases marked by an overactive immune response. Strange reports of a new disease that was sweeping through the gay community in the early 1980’s caused him to shift focus to join the great battle against the AIDS epidemic.

A Patient’s View of the Cures Regulations

Mar 11, 2020• 1

By ADRIAN GROPPER, MD

How should we react to 1,718 pages of new regulation? Let’s start by stipulating the White House and HHS perspective:

“Taken together, these reforms will deliver on the promise to put patients at their center of their own health care — you are empowered with control over your own health care choices.”

Next, let’s stipulate the patient perspective via this video lovingly assembled by e-Patient Dave, Morgan Gleason, and the folks at the Society for Participatory Medicine. In less than 3 minutes, there are 15 patient stories, each with a slightly different take on success.

Can the US health care system “pull an Italy?”

Mar 10, 2020• 6

By MATTHEW HOLT

There has been a ton of analysis about COVID-19 and how bad it will get. Some like Joon Yun and Jeremy Faust say the panic is worse than the disease. Others have run the infection rate numbers and predicted that the US will run out of hospital capacity in early May and in Washington state much earlier (end of March).

But there’s no doubt that in the last week or so, sentiment has changed. This week I and 45,000 of my best friends are at home, not at HIMSS in Florida. Many big gatherings like SXSW, Comic-Con and Coachella have been cancelled. Most corporations that can are asking employees to work from home. Just this morning my local school district in California called off school plays and any gatherings with more than 100 people.

Part of this is the inevitable response to the ridiculous posing of Trump. He showed up at the CDC wearing a campaign hat and declared that he was a great doctor to be because his uncle was at MIT. The Director of the CDC and later the Surgeon-General made toadying remarks about how amazing he was. And neither Pence, Azar, Carson or anyone else allegedly in charge can give a straight answer to anything.

The nation has realized that there is no help or even basic honesty coming from the Federal government. This is after the CDC screwed up the creation of basic testing kits which put the US in a situation where it just can not know the extent of the outbreak. China denied the outbreak, then had to put Wuhan and much of their economy on lockdown. Iran may be in worse shape.

Meanwhile South Korea, Singapore and Taiwan have managed their outbreaks with very rapid testing, quarantining of those infected, and extremely rapid response. The US is still blundering around. Now the private sector is trying to step in as the Feds misstep again and again.

But a likely scenario is that many regions in the US will become like Northern Italy.

Health in 2 Point 00, Episode 111 | #HIMSSpocalypse2020

Mar 10, 2020

Live from the tradeshow floor of HIMSS, it’s Health in 2 Point 00! And no, I’m not fading away from coronavirus on this episode—but how many people could I have singlehandedly infected had the conference gone forward? On Episode 111, Jess and I have some fun with virtual backgrounds and talk about all of the things we’re missing at HIMSS right now. From what Trump would’ve said had he gotten the opportunity to speak, to what conversation would’ve gone on about the new ONC rules, to the big funding announcement we missed, here’s everything that succumbed to #HIMSSpocalypse2020. —Matthew Holt

A Full-Scale Assault on Medical Debt, Part 3

Mar 10, 2020

By BOB HERTZ

The only way to fully eliminate medical debt would be a comprehensive single payer plan, which allowed no fees at the point of service.

However, such a plan would require setting all prices for all doctors, hospitals, labs, and drug companies. All providers would have to be satisfied – in advance — with what the government is going to pay them on each procedure.

Countries like Germany accomplish this through collective bargaining. Japan, France, Taiwan, Israel and Scandinavia also have national fee schedules. However, I do not think you could get all the providers in Toledo to agree on one schedule, much less every provider group in America.

Single payer would also require new income and payroll taxes of at least ten per cent more than we pay now, if we want first-dollar coverage.

A Full-Scale Assault on Medical Debt, Part 2

Mar 9, 2020• 3

By BOB HERTZ

The first section of this article stated that many forms of medical debt can be reduced or cancelled by stronger enforcement of consumer protection laws. These debts are not inevitable and are not due to poverty. It would not require trillions of federal dollars to cancel them, either – just the willingness to go against lobbyists.

Therefore I advocate the following attacks on medical debt:

Phase One

We must cancel balance bills and surprise bills if there was no prior disclosure.

In most cases, providers will not have the right to collect anything more than what the insurers pay them.

Phase Two

We must cancel the older, inactive “zombie debts” that are being purchased by collection agencies.

This line of business must terminate. Providers throughout the country are selling uncollected medical debt for pennies on the dollar to collection agencies, who aggressively attempt to force patients to pay the full amount due. These debt collectors harass patients at work and at home, deploying unscrupulous tactics even after the statute of limitations on the debt has expired.

A Full-Scale Assault on Medical Debt, Part 1

Mar 6, 2020• 3

By BOB HERTZ

The recent proposal by Sen. Bernie Sanders to cancel $81 billion of medical debt is a very good start—but it is only a start.

The RIP Medical Debt group—which buys old medical debts, and then forgives them—is absolutely in the right spirit. Its founders Craig Antico and Jerry Ashton deserve great credit for keeping the issue of forgiveness alive.

Unfortunately, over $88 billion in new medical debt is created each year; most of it still held by providers, or sold to collectors, or embedded in credit card balances.

Tragically, none of this has to happen! In France, a visit to the doctor typically costs the equivalent of $1.12. A night in a German hospital costs a patient roughly $11. German co-pays for the year in total cannot exceed 2% of income. Even in Switzerland, the average deductible is $300.

U.S. patients face cost-sharing that would never be tolerated in Germany, says Dr. Markus Frick, a senior official. “If any German politician proposed high deductibles, he or she would be run out of town.”

As Physicians Today, We Must Both Represent the “System” and Disregard it

Mar 5, 2020

By HANS DUVEFELT, MD

Healthcare today, in the broadest sense, is not a benevolent giant that wraps its powerful arms around the sick and vulnerable. It is a world of opposing forces such as Government public health ambitions and more or less unfettered market ambitions by hospitals and downright profiteering by some of the middlemen who stand between doctors and patients, such as insurers, Pharmacy Benefits Managers, EMR vendors and other technology companies.

Within healthcare there is also a growing, more or less money-focused sector of paramedicine, promoting “alternative” belief systems, some of which may be right on and showing the future direction for us all and some of which are pure quackery.

I stand by my conviction that physicians must embrace the role of guide for their patients. If we see ourselves only as instruments or tools in the service of the Government, the insurance companies or our healthcare organizations, patients are likely to mistrust our motives when we make diagnoses or recommend treatments.