It’s possible that you were distracted by certain events happening yesterday. But it’s time to focus on the job at hand, and in the world of Health 2.0 that means the upcoming Health 2.0 Meets Ix Conference.
Today is the last day to get earlybird pricing at $1,299 for regular and $1,099 for academic/foundation/government—that earlybird pricing expires at midnight tonight.
Here’s the agenda, and here’s where to sign up.
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My father is in his late 80s, so it’s not surprising that he’s had a brush with prostate cancer. That’s why the
Los Angeles Times’ obituary of Donald F. Gleason, the Minnesota pathologist who invented the “Gleason score” for characterizing cancerous growths in the prostate, caught my eye. Gleason died at the age of 88 from a heart attack.The Gleason score is now used almost universally to predict the likely outcome of prostate cancer. But the obituary provided unexpected insight into yet another instance of an agonizingly slow spread of evidence-based medicine for a common and deadly condition and unavoidably raised the question about diffusion of innovation today.Gleason had been an unknown, junior-grade pathologist in 1962 when he was approached by his hospital's chief of urology to develop a standardized rating system for determining the grade of prostate tumors; that is, a measure of how far they had progressed and their likely course. At the time, the obit noted, “each pathologist pretty much used his own system, which made comparing research results among different groups nearly impossible.”
The extension and expansion of the State Children’s Health Insurance Program SCHIP has now passed the full House and the Senate Finance Committee and is on its way to the full Senate. After minor differences between the House and Senate are reconciled it will become law.
However, the way it is being done does not give me a good feeling.
In the Senate Finance Committee the Democrats were only able to get the support of one Republican–Maine’s Olympia Snowe–on the way to a 12-7 approval. They did not have the support of the ranking Republican, Chuck Grassley of Iowa.
Senate Finance Democrats lost the support of the Republicans when they insisted on departing from last year’s bipartisan agreement to leave existing policy on covering the children of legal immigrants
as is. As it now stands, a legal immigrant agrees not to apply for Medicaid and SCHIP
benefits for the first five years they are in the country. Under the
new rules states would have the option of covering legal immigrants.
The new bill also left out provisions from the earlier bipartisan
comprise to limit benefits for higher income families.
Bev MD emailed us in jest in response to "A Shakespearean Approach to Health care reform"
"Whew, from your post's title I thought you were going to say, "First, let's kill all the doctors."
The thread on David Kibbe's post on "The Health IT chasm" continues to be an interesting discussion. Frog design's Stephen Sutton had this to say.
"As a designer active in developing healthcare solutions (hardware and software), I think it is worthwhile to consider the role of the design process used to develop medical IT, as a key contributor to its evident failure. Driven largely by a nightmarish regulatory environment, medical design projects tend to follow a dysfunctional process where much more attention is given to creating a paper trail than actually discovering and meeting the needs of end-users."
Scott had this comment in response to "The Importance of Being Charles Grassley"
"I like Grassley too, but why the worship of bipartisanship? There are only two structural reasons to seek a lot of Republican consensus: to get around/over a potential filibuster and to entrench the legislation so that a future change in government does not lead to its repeal.
David Kibbe had this to say in response to Bob Wachter's post on Medical Tourism's potential in tough economic times.
"I predict we'll also see US Medical Tourism, that is, states where care is much cheaper will attract patients to their facilities. Not so exciting as India, perhaps, but Montana's not a bad place to go for your knee replacement, right?"
Grena Porto wrote in with additional background on Alan Rosenstein MD's post "Disruptive Physician Behavior: Fact versus Frenzy."
As a member of the Joint Commission's Sentinel Event Advisory Group and a champion of its efforts in this area, I would like to add a few comments to Alan Rosenstein's excellent posting: 1) the requirements in the JC's standards as well as the guidance in the alert released in July of 2008 clearly state that this applies to everyone, not just physicians. 2) the work of Alan Rosenstein and ISMP clearly show that the behavior in question is not limited to physicians. 3) although physicians are not the most frequent disrupters, their behavior tends to have the largest impact because of their relative power in the organization.
Alix Sabin offered this observation in response to Richard Reece's much-discussed "Confessions of a Cultural Anthropologist: The Real Cause of High Health Care Costs."
There is an inherent ticking time bomb in the health care industry’s business model. Health insurance is based on “young and healthies” buying coverage, but not needing care. It reminds me of the business of derivatives and sub-prime mortgages.
In a post earlier this week, Bob Laszewski reported that “the extension and expansion of the State Children’s Health Insurance Program (SCHIP) has now passed the full House and the Senate Finance Committee and is on its way to the full Senate where it will undoubtedly also pass and then be reconciled with the similar House bill.
“However,” he warns, “the way it is being done does not give me a good feeling.
“In the Senate Finance Committee the Democrats were only able to get the support of one Republican–Maine’s Olympia Snowe–on the way to a 12-7 approval.
“They did not have the support of the ranking Republican, Chuck Grassley of Iowa.”
Laszewski is worried: “Senate Finance Democrats lost the support of the Republicans when they insisted on departing from last year’s bipartisan agreement to leave existing policy on covering the children of legal immigrants as is. As it now stands, a legal immigrant agrees not to apply for Medicaid and SCHIP benefits for the first five years they are in the country. Under the new rules states would have the option of covering legal immigrants. The new bill also left out provisions from the earlier bipartisan comprise to limit benefits for higher income families.Continue reading…
Chandler Chicco Companies is seeking a
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A dramatic cease-fire was announced over the weekend. No, not the one
in the Mideast, but rather in the health care market in Massachusetts.
As documented in this Boston Globe story
by Scott Allen and Jeff Krasner, Tufts Medical Center and Blue Cross
Blue Shield of MA reached an agreement on a payment contract. What's
the big deal? Well, Tufts had threatened to pull out of the BCBS
network when it felt that it was not being offered sufficient
compensation for its medical services.
The context was important. The Globe had previously reported
that payments to Tufts and its doctors were substantially below those
received by, in particular, the hospitals and doctors in the Partners
Healthcare System, and often below those received by BIDMC and its
doctors. As I have noted below,
there is really no justification for these differentials, if one
considers the actual quality of care delivered by the major academic
medical centers.
"Here is a treat for regular readers of THCB and, certainly, for everyone who has come to know Matthew. Below, the erudite retired Pathologist, fierce physician advocate, health care chronicler and interviewer, and lover of bad puns, Dick Reece, interviews Matthew, Founder of The Health Care Blog and, with his partner Indu Subaiya, Co-Founder of the Health 2.0 conferences.
As you’ll see below, their exchange is breezy and casual but concise, Dick probing for Matthew’s formative academic influences and Matthew playing it pretty straight, resisting his always present wise-acre gene. It’s actually quite nicely handled on both sides.
Matthew is a person of encyclopedic technical range, with a boundless appetite for information of all types and an irresistible flair for the hilarious. He has a refined sensibility for how things do and might work in the world, and a commitment to avoid the easy path in favor of trying to do things that will positively matter. He is, simply, a shining star. Enjoy."- Brian Klepper
Responding to calls for Washington to take swift action in the face of the bleakest economy in decades, the House of Representatives released a $825 billion package last week designed to stimulate the economy. The early version of the plan targets nearly $150 billion for health care.
The Wall Street Journal has a reasonably thorough overview of the "winners" and "losers," as well as an explanation of the at times arcane budgetary process involved. "The plan’s final shape will depend not only on horse-trading among
lawmakers in the House and Senate, but also on the outcome of the
lobbying frenzy now under way," the Journal says.
Here’s an early breakdown of the health care package:
It’s worth noting that those numbers don’t include the expansion of SCHIP the House approved earlier in the week.
Around the Web: If you want to track exactly where all the money is going – probably not a bad idea when you’re talking about $825 billion plus change- you’ll theoretically be able to follow spending on Recovery. gov. But for the time being you’ll have to wait. The site is not yet online – perhaps not the best sign.
John Irvine contributed to this report from Washington D.C.
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