The Health Care Blog – Page 897 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

What “reform” legislation will achieve

Jun 12, 2009• 3

By Matthew Holt

This from single payer advocate Don McCanne whose quote of the day is a rich source of nuggets. He gave a talk in Orange County (California’s equivalent of Kansas)

Health Care Council of Orange CountyJune 11, 2009Annual MeetingKeynote: “Health Care Reform – What Has to Be Done”By Don McCanne, M.D.Opening questions directed to the audience:How many here believe that it is probable – not certain, but probable – that Congress will pass health care reform and President Obama will sign it this year?(Most individuals raised a hand)How many believe that the legislation will provide insurance coverage to everyone or almost everyone?(Not one hand went up)How many believe that the legislation will be effective in slowing the rate of health care cost increases?(Not one hand went up)

Sounds about right to me.

On a side note, I had a great talk with Hal Luft yesterday which will be on THCB next week. Hal had an interesting perspective on whether we should aim for 100% coverage or slightly less. Basically if we get to 100% of citizens covered, then it’ll be easy to cut the funding to safety-net providers who are looking after the homeless, the mentally ill, the destitute and many undocumented aliens (and lots of documented ones too). If we aim for say 98%, then we could justify keeping the safety net providers in a separate system and the 10 million or so (2–3%) of undocumented aliens in the country would at least have somewhere to go for their care.

Can’t say it’s my preferred solution, but it’s an interesting point.

Health Care Cooperatives–An Old New Idea–So What’s a Blue Cross Plan?

Jun 12, 2009• 4

By ROBERT LASZEWSKI

As opposition to a Medicare-like public health plan option grows, there has been a lot of talk about the compromise idea of creating not-for-profit health insurance cooperatives
that would compete on a level playing field with existing private
insurers. The reasoning goes they would keep the existing insurers
"honest" by introducing a new element of competition.That's a great idea.And it was a great idea 60 years ago when the first Blue Cross plans were established.

Problems with IE? Try Firefox or earlier versions of I.E.

Jun 12, 2009• 4

For those of you using certain versions of Internet Explorer, we’re having some significant problems in the last day or so on THCB getting things like the right hand margins to appear, getting videos to appear and play properly, etc. (Issue seems to be limited to I.E. 8.) For now, these appear to be resisting the easy fix, BUT the good news is that everything is working fine in FireFox. So to those of you having trouble, can we suggest you use FireFox for the moment to view THCB and we hope to have regular service resumed soon.

A Special Reform Edition of Health Wonk Review

Jun 12, 2009

by BRIAN KLEPPER

Over at Managed Care Matters, the always thoughtful and energetic Joe Paduda has, once again, done us all a service. Tasked with hosting this edition of Health Wonk Review, he has assembled a great range of pieces on the current reform process, which make for enlightening, entertaining and sober reading. This one is useful, provocative and very educational. Check it out!

Interview with IPC The Hospitalist Company’s Adam Singer

Jun 12, 2009

By Matthew Holt

I don't delve into the world of hospitals, physicians and health care operations as much as I should. So when I was asked to interview Adam Singer, the CEO of IPC The Hospitalist Company, the biggest company (and a publicly traded one at that) managing a group of hospitalists–the internists who run patient care in more and more big and small facilities, I thought I should!

What I didn't realize is that not only does Adam know lots about the present and future of hospitalists and how that role has emerged in recent years, he also has some pretty strong views on the relationship between hospitals and doctors (keep 'em separate), bundling (no, thanks) and also the supply of physicians (let in more international docs or we're in a big hole). So it's a wide ranging discussion and one I think you'll enjoy. Here it is.

The Health Industry’s Achilles Heel

Jun 10, 2009• 16

By BRIAN KLEPPER and DAVID C. KIBBE

“You never want a serious
crisis to go to waste.”

– Rahm Emanuel, White House Chief of Staff

Timing matters. The health industry has demonstrated steadfast
resistance to reforms, but its recently diminished fortunes offer the Obama
Administration an unprecedented opportunity to achieve meaningful change. The
stakes are high, though. The Administration’s health team must not miscalculate
the industry’s goals, or waver from goals that are in the nation’s interest.
The two are very different.

Aligning the forces of reform will be the first challenge. The White House and Congressional Democrats appear to be
collaborating to develop a unified reform design. Even so,
the effort is hardly pure. Lawmakers have been receptive to industry influence.
The non-partisan Center for Responsive Politics
reports that, in 2009, health care interests have already spent $128 million on
Congressional lobbying contributions, more than any other sector.
The tide now turned, most of that largess has gone to Democrats.

Canadians? Not as good as us!

Jun 10, 2009• 5

By MATTHEW HOLT

Several of my friends in the blogosphere are getting very excited because eHealth Ontario has pissed away a few million dollars and the now fired CEO got more bonus than was seemly. So she gave Accenture and Price Waterhouse Coopers low 7 figure no-bid contracts and it’s now transpired that consultants billed food and random travel for expenses. MrH at HISTalk gives it two separate mentions in his section of the news and Inga piles in as well.

But I must remind you that as in all things Canadians pale in comparison to how we do it here.Continue reading…

Matthew went to Redmond, 2–Bert van Hoof, HealthVault & devices

Jun 10, 2009

By MATTHEW HOLT

Continuing my tour around Microsoft’s HealthVault team I met with Bert van Hoof. Bert is the devices guy who showed me lots of ways to get data into HealthVault. If you’re interested in how a power user links devices and data (and if you excuse my amateurish video work), you’ll like this one!

If you’re having trouble with this video in IE, you may need to download the latest FlashPlayer version. (Sorry, our video service Vimeo is having some problems that appear to need the latest version of FlashPlayer. You can do that here. Alternatively Firefox seems to work fin (but don’t let the folks at Microsoft know that I told you that!)

Matthew went to Redmond, part 1– Bill Reid, Healthvault

Jun 10, 2009

By MATTHEW HOLT

Last week I went to a search summit in Seattle where Microsoft told us all about Bing, their latest attempt to do something about Google’s Windows-like market share in search. After a quick chat with Health search guru Alain Rappaport, I ducked out early to go meet with the healthcare team in Redmond—focusing mostly on HealthVault.

Here’s the first of four interviews that THCB will be showing over the next four days. This is Bill Reid, who’s the Director of Product Management for HealthVault. (Excuse the shaky handheld!). Bill gives the latest view from Healthvault about how the roll out is going and what we can expect.

Gawande Nails It on Healthcare Costs

Jun 9, 2009• 33

By BOB WACHTER, MD

I just finished reading Atul Gawande’s June 1st New Yorker piece – it’s the Talk of the Health Policy Town – on healthcare’s “Cost Conundrum.” Like most of Atul’s work, the article is lyrical, powerful, insightful, and correct.

As you’ve probably heard, Gawande profiles the town of McAllen, Texas, whose healthcare costs are nearly double the national average. He swats away the usual explanations (our patients are sicker, more obese, more addicted, more Mexican; our lawyers are nastier; our quality is better…) to unblinkingly zoom in on the real culprit: a culture in which providers’ greed trumps the patients’ interests. He contrasts McAllen’s healthcare culture with that of El Paso, just 800 miles up the border, a town with similar demographics but whose healthcare costs are exactly half as high. He also describes the Mayo Clinic, which manages to deliver the best healthcare in the country, perhaps the world, at a fraction of McAllen’s costs.

His main point is that policymakers need to focus less on who pays (i.e., should there be a “public plan”?) and more on creating physician-led accountable entities that manage the dollars and possess the wherewithal and incentives to make rational choices about how to organize care – the ratio of primary care docs to specialists, the number of MRI scanners, the algorithm for the workup of chest pain or gallstones. Atul understands that we can’t snap our fingers and change culture, but that culture will change when structure and incentives are lined up correctly.Continue reading…