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The Top Ten Immediate Benefits Americans Will Receive When Health Care Reform Passes

Yesterday, the Democratic Caucus of the House listed the provisions of the health reform bill that will take effect “as soon as health care passes,”

The legislation would:

  1. Prohibit pre-existing condition exclusions for children in all new plans
  2. Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;
  3. Prohibit dropping people from coverage when they get sick in all individual plans
  4. Lower seniors prescription drug prices by beginning to close the donut hole
  5. Offer tax credits to small businesses to purchase coverage
  6. Eliminate lifetime limits and restrictive annual limits on benefits in all plans
  7. Require plans to cover an enrollee’s dependent children until age
  8. Require new plans to cover preventive services and immunization without cost-sharing
  9. Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions
  10. Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs.“By enacting these provisions right away, and others over time” the Caucus declares, “we will be able to lower costs for everyone and give all Americans and small businesses more control over their health care choice.”

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

Price Controls Do Not Work

Paul levy

If there is anything about economics that has been proven over and over, it is that price controls do not work. The unintended consequences are usually worse than the problem that led to the solution in the first place.

Massachusetts legislators, feeling the frustration of higher insurance premiums, are now considering a bill to limit doctor and hospital reimbursement payments to 110% of Medicare rates, or perhaps some other percentage of Medicare rates. The problem with this is that Medicare rates are not fully compensatory to doctors and hospitals and have contributed to the increase in private insurance company rates. This was one of the conclusions reached by the Attorney General in her extensive investigation of these matters.Continue reading…

George Clooney Was Onto Something

In the Oscar-nominated movie “Up in the Air,” Ryan Bingham (aka George Clooney), travels around the country firing employees for company bosses who don’t have the stomach to do it themselves -– the ones who prefer to “outsource the downsizing function.”

He finds his own job threatened by a hotshot business school graduate who convinces the president of their company that it would be more efficient to do the long-distance layoffs via the Internet.

Sitting in a hotel bar, our hero makes a passionate speech to his young colleague about how important it is to fire people face-to-face: that a look in the eye, a few words that personalize the institutional rejection and a handshake allow them to maintain some small shred of dignity at the very moment they lose their identity as a valued employee.

This speech resonates with me as I contemplate the waves of e-mail notices in my inbox announcing new electronic tools and personalized Web-based services and sites that can help me take care of myself.  I can take a picture of my rash with my iPhone and send it to my dermatologist.  I can check online to see when I had my last tetanus shot or schedule my next mammogram.  I like interacting with my doctors by e-mail about minor matters.  And if I lived in the empty plains of Eastern Montana, I would probably often prefer a telemedicine visit with a doctor or nurse over a 10-hour round-trip drive for a 20-minute in-person appointment.Continue reading…

Andy Wiesenthal, Kaiser Permanente

Those of you with really long memories may remember that Kaiser had a little kerfuffle with a guy named Justen Deal. As part of that incident, I did a rather unorthodox interview with Andy Wiesenthal from The Permanente Group in 2006 which is still a hell of a read—mostly about the history of how KP got to the Epic decision and where it was in the middle of the installation process.

Fast forward the better part of 5 years. HealthConnect is done. And the pain and not inconsiderable expense is somewhat forgotten. But now it is done, what happens next? A long and somewhat philosophical interview. But a very interesting discussion.

In ONC I Trust …

It’s my nature to question authority.

Whether it’s religion, politics, or even my local administrative leadership, authority figures must earn my trust.

Earning that trust is not easy. As folks who work closest with me know, I believe that much of Dilbert is based on true case studies.

Over the past year, I’ve worked very closely with many people at ONC – David Blumenthal, John Glaser, Judy Sparrow, Farzad Mostashari, Chuck Friedman, Carol Bean, Doug Fridsma, Chris Brancato, Jonathan Ishee, Arien Malec (on loan to ONC for 8 months), and Jodi Daniel. I’ve worked with HHS CTO Todd Park. I’ve worked with US CTO Aneesh Chopra.Continue reading…

Jonathan Bush, quickly

Jonathan Bush gave me a quick interview at HIMSS ten days ago. We had a chat about what the recent restatement of accounting was all about (stock off about 12%), and last night they released numbers that apparently made Wall Street a little happier (stock up 6% after hours)

More interestingly we also chatted about the uptake of the clinicals product (pretty well), and whether and when athena would open its network to other application vendors (in a while).

WebMD–Nan Forte explains Health Exchange

WebMD introduced a new series of Health 2.0 style forums last week called Health Exchange. Not everyone was thrilled–in fact John Moore gave it a right padding over at Chilmark mostly because of usability issues. I got Nan Forte, Exec VP at WebMD to explain and she talked at length about how much user testing they’ve done, WebMD’s respect and interest in the rest of Health 2.0, and how tricky it is to deal with those pesky users (my words not hers!). Take a listen to the interview.

Nan Forte, WebMD

A Web 2.0 Interview with Miguel Cabrer, CEO of Medting

Image 2

Miguel Cabrer, the founder of MEDTING, a global site for the exchange of  medical information and images, will be a panelist at Health 2.0 Europe in Paris. Formerly CIO of Hospital Son Llatzer, the first digital hospital in Europe (European Commission eHealth Award in 2004) and eHealth Coordinator for the Balearic Islands Health Department,  Miguel Cabrer is now an independent eHealth Advisor, Member of the HIMSS EMEA Governing Council and Member of the IMIA Web 2.0 taskforce workgroup. Our Health 2.0 Regional Ambassador to Spain, Miguel even found the time to be interviewed by Denise Silber of Basil Strategies, Health 2.0’s partner in Europe!


Denise says: Please tell us the main reason for a physician to use Medting?

Miguel says: Physicians use Medting to share a clinical case with a colleague from anywhere in the world. They also store images and videos, build clinical cases, and access content for research and learning purposes. Content can be restricted to invitees only. A hospital or other organization can create its own extranet with the Medting Enterprise platform.

Denise says: How did you get the idea that there was a need for these different functionalities? Was it something you would have wanted when you were working in a hospital?   Continue reading…

Microsoft at HIMSS

I’m still catching up with my HIMSS interviews. This is Chris Sullivan and Mike Raymer from Microsoft who are talking about the evolution of the Amalga product—the business intelligence engine—and the current state of HealthVault.

Unstable Public Opinion

Joseph White, a professor of politics at Case Western Reserve University, made this interesting observation in his weekend column in The Fiscal Times:

“On most issues, there is no such thing as a stable “public opinion.” People do have general attitudes, beliefs that they can use to evaluate a choice. But often voters hold different attitudes that would lead to different evaluations of the same choice. How they answer a question depends on which considerations have been raised in their minds most recently.”

Therefore the analysts who predict Democratic defeats in November based on negative survey responses about health care reform now are making a fundamental error. The Republicans have shown great ability to raise considerations that push the evaluation in one direction. Yet some of that effort has been encouraged by the concerns conservative Democrats raised during the debate as they tried to make legislation better fit their preferences. They will not be making those arguments as they run for reelection. In the election campaign there would be far more spending on ads to defend the legislation. The press coverage may focus more on the actual provisions of the bill as opposed to the GOP charges. But focusing on the actual specifics will only be possible if there is a law that passed and can be defended. Democrats have to be able to point to something and say: “this is what we did, this is the truth about it, this is how it would help you.”

The Democrats also have to remember that the “losers who can’t deliver” consideration will be far more prominent in November if they pass nothing now. In short, the battle over interpretation of the health care reform effort has only begun. We do not know how it will turn out in November, but there are good reasons to believe the Democrats are better off fighting it with a new law in hand.”

Merrill Goozner has been writing about economics and health care for many years. The former chief economics correspondent for the Chicago Tribune, Merrill has written for a long list of publications including the New York Times, The American Prospect and The Washington Post. His most recent book, “The $800 Million Dollar Pill – The Truth Behind the Cost of New Drugs ” (University of California Press, 2004) has won acclaim from critics for its treatment of the issues facing the health care system and the pharmaceutical industry in particular. You can read more pieces by Merrill at  Gooznews.com.

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