Alex Savic from Alensa AGA presented a demonstration on the main stage of the at the Health 2.0 Europe Conference, April 6-7, 2010, in Paris, France. He introduced a new product called NextWidgets which is a tool which health publishers can use to create a store inside a widget.
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During the Great Health Reform Debate of 2009-10, much of the public discussion and media analysis focused on the political battles, the legislative process and specific elements of the health reform bill. We talked a lot about daily public opinion polls, the futile search for bipartisanship, the political implications of the Massachusetts special election and the impact on the upcoming mid-term elections. We also learned more than we probably wanted to about filibuster rules, reconciliation bills and CBO scores. And we were inundated by detailed descriptions and analyses of the public option, abortion, payment reductions to Medicare Advantage plans, excise taxes on “Cadillac” health plans, and many other specific policy issues.
Future historians, however, will want to look more deeply for the policy frameworks and political forces that shaped the health reform bill. From a high level vantage point, there are Five Big Ideas that established the fundamental framework for the bill. With some exceptions, these ideas were not the subject of much public discussion or formal debate in Congress, but each of them shaped the reform bill in fundamental ways. As Ezra Klein and others have observed, much of the form of the health reform bill was established long ago.
1. Managed competition
Why didn’t we go down the path of a single-payer health system?
For many years, a single-payer system was the holy grail of the liberals, and it was the driving force behind the campaigns of many of the current reform advocates. To the disappointment and frustration of those advocates, however, the battle had already been fought and lost long before the 2009-10 debate. In 1978, Alain Enthoven published a two-part article in the New England Journal of Medicine entitled “Consumer Choice Health Plan: A National Health Insurance Proposal Based on Regulated Competition in the Private Sector.” The title said it all. It was a proposal for national health insurance (i.e., providing coverage to everyone) through a structured marketplace of private insurers and providers. As Enthoven described it in a 1993 Health Affairs article, “The History and Principles of Managed Competition,” his concept built on earlier work by Paul Ellwood, Walter McClure and Scott Fleming, as well as the experience of the Federal Employees Health Benefits Plan (FEHBP). In the 1992 Presidential campaign, both of the candidates endorsed this approach to health reform, and it was one of the foundation elements of Bill Clinton’s reform proposal in 1993. In the work of many policy experts since then, it became the de facto consensus approach.
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The Pew Internet Project's Susannah Fox discusses the research group's latest healthcare findings at Health 2.0. Europe. The Pew Internet project is a non-profit research organization based in Washington DC that studies the social impact of the internet.
By JOHN MOORE
Google Health has seemingly been stuck in neutral almost from the start. Despite the fanfare of Google’s Eric Schmidt speaking at the big industry confab, HIMSS a couple of years back, an initial beta release
with healthcare partner Cleveland Clinic and a host of partners
announced once the service was opened to the public in May 2008, Google
Health just has not seemed to live up to its promise.
Chilmark has looked on with dismay as follow-on announcements and
updates from Google Health were modest at best and not nearly as
compelling as Google’s chief competitor in this market, Microsoft and
its corresponding HealthVault. Most recently we began to hear rumors
that Google had all but given up on Google Health,
something that did not come as a surprise, but was not a welcomed rumor
here at Chilmark for markets need competitors to drive innovation. If
Google pulled out, what was to become of HealthVault or any other such
service?
Thus, when Google contacted Chilmark last week to schedule a briefing
in advance of a major announcement, we were somewhat surprised and
welcomed the opportunity. Yesterday, we had that thorough briefing and
Chilmark is delighted to report that Google Health is still in the game
having made a number of significant changes to its platform.
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Pfizer’s Vincent Varlet talks about the pharma giant’s e-initiatives for mobiles for both patients and doctors and the different services that Pfizer provides.
ROB LAMBERTS, MD
I found the discussion around my recent post about treating colds very interesting. Sick people come to the office to find out how sick they are. Most people don’t want to be sick, and when they are sick they want doctors to make them better.
Most people.
Some people want to be sick, and some doctors want to make people sick. I am not talking about hypochondriacs – people who worry that they may have disease and become fixated on being sick. I am not talking about malingerers – people who pretend to be sick so they can get medications. I am talking about the slippery slope of defining disease.
“I lost my job and have felt depressed ever since.”
“My son won’t obey me.”
“I’m just tired and have no motivation.”
“My daughter’s having trouble in school.”
The definition of disease versus normal has become a big issue recently. A recent study found that over 50% of Americans are taking regular medications. In the eye of the hurricane of this controversy is the DSM-5, the new manual for the definition of mental illness. John Gever, of MedPage Today explained in a recent article on KevinMD that the criteria seem, in the eyes of many, to shrink the definition of a “normal” person. The motivation to put a label on normal people, he explains, has various motivating forces:
It’s true that drug companies often do little to discourage off-label use of psychiatric drugs and sometimes encourage it. It’s also true that many doctors throw medications at patients who might do better with other treatments or no treatments. (That’s true for many somatic conditions too, let’s not forget.)Continue reading…
Pieter Vos, from the Council for Public Health and Health Care, gave a keynote address on stage at the Health 2.0 Europe Conference, April 6-7, 2010, in Paris, France. The Council for Public Health and Health Care is the independent body which advises the government on public health and care.
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As the first snowflakes of change fall on the eve of health reform, HR professionals may soon wake up to an entirely transformed healthcare delivery landscape. The Patient Protection and Affordable Care Act (PPACA) clearly will impact every stakeholder that currently delivers or supplies healthcare in the United States.
While the structural, financial, behavioral and market-based consequences of this sweeping storm of legislation will occur unevenly and are not fully predictable, this first round of healthcare legislation is designed to aggressively regulate and rein in insurance market practices that have been depicted as a major factor in our “crisis of affordability” and to expand coverage to an estimated 30 million uninsured. However, fewer than 30 percent of employers polled in a recent National Business Group on Health survey believe reform will reduce administrative or claims costs.
Yet, it is unlikely that reform will be repealed. For all its imperfections, PPACA is the first in a series of storm systems that will move across the vast steppe of healthcare over the next decade resulting in a radically different system. Whether reform concludes with a single payer system or emerges as a more efficient public-private partnership characterized by clinical quality and accountability remains obscured by the low clouds and shifting winds of political will. One thing is certain during these first phases – inaction and lack of planning will cost employers dearly.Continue reading…
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Who can forget last year’s celebration of Global Handwashing Day, when it turned out that Brits wash their hands after using a gas station bathroom about as often as your doctor washes his hands before examining you? And that’s not a good thing.
OK, British researchers didn’t exactly come to that conclusion: I did, in this blog, after comparing what they found about motorists to what the academic literature says about doctors.
Now comes a survey of public bathroom hygiene in the US of A, and the good news is that even America’s worst washers are far more likely to have washed their hands than British drivers. The bad news is that the guy who just used the toilet at Grand Central Station is also way more likely to have clean hands than the guy walking up to your bed at the local hospital.
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