The Health Care Blog – Page 868 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Capitol Shortage: Can the Two Democratic Parties Get It Together on Health Reform?

Sep 27, 2009• 1

By JEFF GOLDSMITH

As an exceptionally grumpy American summer grinds to a conclusion, it is apparent that only a bipartisan solution will enable Congress and the Obama Administration to complete health reform. No, we’re not talking about co-operating with the Republicans. Other than a handful of contrarian Republican moderates on the Senate Finance Committee, at least one of whose votes might be needed for eventual passage, the Republicans are irrelevant to the final outcome.

No, the bipartisan solution we’re talking about is co-operation between the two Democratic parties represented in Congress: the “Safe-Seat” Democrats- the Pacific Heights/Beverly Hills/Berkeley Hills/Upper West Side/Harlem Democrats and the “Running Scared” Democrats from the western, southern and border states, who actually require independent and some moderate Republican support to get elected. These parties have very little in common other than the Capital D after their names.

Yet another reason to abolish the Senate

Sep 26, 2009• 12

By Matthew Holt

Ezra Klein, feeling a little soft, interviews Kent Conrad—he of the co-op feed stores for health care idea.

My take on the interview is that I seriously believe Conrad's entire knowledge of health care comes from his time being lectured on the vagaries of Medicare reimbursement by a local rural hospital lobbyist, his one visit to a co-op seed store where he found the farmers chatting happily, and his reading the cliff notes (prepared by his staff) of TR Reid's good but not too sophisticated book focusing on the Beveridge v Bismarck distinction—which is high school civics lesson stuff.

Yet he gets to meet 61 times with the Gang of six that was really going to get it all right before time ran out, and he gets to make policy!

And you wonder why the Senate should be abolished.

What would actually work? Driving down the cost of health care

Sep 25, 2009• 45

By JOE FLOWER

If competition actually drives the cost of health care up rather than down, what would bring lower costs?

What provisions in a “health reform act” would actually drop costs in health care? Let’s leave aside for the moment all the myriad other arguments – some might be seen as too much government intrusion, some would destroy the health plan industry, some would be cripplingly difficult for providers, and so on – and just focus on cost. Given the real structure of health care markets in the United States at this moment, what could be written into federal law and regulation that would actually reduce cost?me of these changes are massive, some would be invisible to those outside the industry, but all could be legislated or regulated, and all would “bend the curve” toward lower costs. Choose any you like, though some are “and” choices, others are “or” choices:

Single payer: Eliminates insurance company overhead, increases medical loss ratio (the percentage of dollars put in returned as medical resources) to perhaps 95%, and gives the government (probably some rate-setting commission) the power to dictate prices and availability, like Medicare on steroids.
“Robust” public option: All providers must take its payments as full payment, rates tied to Medicare rates (perhaps plus a percentage), Medicare rates decided by an independent rate-setting commission.
Limiting medical loss ratios: Many European countries dictate that health plans must return 85% or 90% or 92.5% of the premium paid in as medical services paid out. U.S. health plans, in contrast, compete on (and brag to Wall Street analysts about) how low their medical loss ratio is. Some are as low as 60%.

Interview: John White, Director IT, AHRQ

Sep 25, 2009

By Matthew Holt

Last week I got to spend some quality time in Washington DC including moderating a panel looking at new research behind physician-patient communication at the annual AHRQ conference. AHRQ will play a significant role in comparative effectiveness research, as it basically is channeling the $1 billion or so in the stimulus package for that. But AHRQ is also pretty active in trying to figure out what works and what doesn’t in health care IT, and has an online resource center about that too.

The man running AHRQ’s initiatives in IT is John White, who’s affable, amusing and has an interesting point of view or two. So to let you know a little more about the mysteries of government, here’s my interview with John.

Regina Holliday: Fred’s life & death at 73 cents a page

Sep 24, 2009• 5

By MATTHEW HOLT

If you ever wonder why the efforts to make it easier for patients and families to get information and be treated as equals in their care by the medical care system matter….

If you need convincing that the concept of participatory medicine is important enough for its own society, advocates & journal….

If you wonder whether it’s OK to wait to phase in the possibility of patients actually having rights to their own data….

Read Regina Holliday’s story about Fred’s illness and the way she and he were treated.

Commentology: Obama and End-of-Life Care

Sep 24, 2009• 9

THCB reader Molly Holmes wrote us to say:

As a member of a hospital geriatric emergency team, I’m on the front lines of a major health care issue that need immediate attention. The costs of keeping a person barely alive during their last few weeks of life easily run into the millions. The procedures undertaken at such times are painful and poorly thought out, and do not at all increase the quality of one’s life. The unfortunate senior who falls into the end-of-life emergency medical cycle can expect his or her final days to be miserable and lonely, with family relegated to the sidelines, while medical people rush around administering “care.” Such a person is robbed of dignity, and robbed of the right to die with loved ones nearby.

The reason why medical teams are pressured to perform endless procedures on our most ill seniors is because the legal and ethical issues at stake are in limbo. That’s because the questions raised are not just for individuals to answer, but for society as well. They are questions for a nation.

Protest Music at AHIP meeting

Sep 24, 2009• 8

By MATTHEW HOLT

This is much more fun and better sung than traditional protests! And given that AHIP would benefit from a public option, I suspect Karen Ignagni hired them. It looks like it happened in the closing session of this AHIP conference on Friday although having sat in many of these conferences I do need to tell the protestors that no plotting is done in these Forums. That happens elsewhere…

A Remedy for Healthcare Organizations

Sep 23, 2009

By PAUL LUNDY, VP, Xerox Global Services

The switch to electronic health records can be a daunting task. To make the shift less painful, healthcare organizations should first consider taking control the number of documents flowing through the organization – and the costs associated with printing, sharing and updating them. Developing proactive ways to better manage both hard copy and electronic documents will better equip these organizations for the 2014 EHR deadline.

A recent survey of healthcare professionals found that nearly half (46 percent) of respondents chose document and records management as the most inefficient area within healthcare organizations.1 In fact, the survey revealed that document inefficiencies trump traffic woes – 58 percent said that searching for information at work is worse than being stuck in traffic.

Aneesh Chopra, Federal CTO, talks Health 2.0

Sep 21, 2009

Aneesh Chopra is the new and first CTO of the Federal Government, and he’s also going to be the keynote speaker for the Health 2.0 Conference (Oct 6-7,register here!). I caught up with him for a quick interview yesterday where he discussed his role, Health 2.0 and the new apps.gov site. Off camera we had a great chat and Aneesh both forced me to give a brain dump on exciting companies in Health 2.0 and showed that he knows plenty about the space and has really big ambitions. I can’t say more yet, but let’s say he’s very interested in using new sources of data to improve decisions. I think that it’s great that someone so committed to making technology work for people (and not vice versa) is in such a strong position to influence Federal policy. Here’s the interview

“Reform” Means Higher Costs, Not Lower

Sep 21, 2009• 4

By JOE FLOWER

A reader asks: “If the current bill passes are my health insurance costs likely to go up, down, or remain about the same?”

If the form that I believe most likely to pass actually passes (insurance reforms, individual mandate, weak or no public option or co-ops), I believe that they will continue to go up. There simply is nothing in the bill that would make things more affordable. In health care markets, for a convoluted nest of reasons, more competition causes prices to go up, not down.