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Health in an Obama world — what we know so far

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By Jane Sarasohn-KahnObama

We know the name of the 44th President of the United States: Barack Obama. As the next President’s supporter Oprah Winfrey is known to ask, "What do you know for sure?" When it comes to health, there are a few things we know about a President Obama.

First and foremost, addressing challenges in U.S. health care will require a multi-pronged strategy which brings stakeholders together. The key health-aches to address will be:

  • Covering the uninsured
  • Stemming rising health care costs
  • Wiring the health information infrastructure and getting electronic health records into medical practice
  • Funding what works, and de-funding what doesn’t
  • Ensuring an innovative health discovery and commercialization environment.

This is not a one-man job, and Senator Obama knows that. He has surrounded himself with a cadre of experts who understand these Big Hairy Health Issues and are on the forefront of solutions. He has, thus far, made smart choices in his campaign staff and advisers. This is the concept known as "judgement."

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Going Green In Health Care…

By CHARLIE BAKERI’m pretty sure that most public policy types believe they are doing
the right kinds of things to encourage a greener and more resource
sustainable economy.  And in many cases, I’m sure that translates into
a set of initiatives, laws and regulations that put the arm on private
sector organizations to do “better.”  I was thinking about this
yesterday as I was looking at the massive, paper, perfect
bound provider directories Harvard Pilgrim is required by MA state law
to produce.

I then started to think about all the paper we are required to
produce under various state and federal statutes and regulations, and
all the mailings and letters we are required to send out to various
constituents – providers, employers, members – under other state and
federal statutes.  I took a picture a couple of years ago of the amount
of paperwork – it covered a monstrous board room-like table in a very
large conference room – that the state of Massachusetts required us to
file to maintain our license to sell insurance in Massachusetts.  I
remember thinking then, “what a waste.”

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METRICS: Web 2.0 technologies penetrating marketplace

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“Social media is changing the way that consumers gather health
information from the Internet. Patients and caregivers are no longer
limited to static resources but are now sharing advice and treatment
experiences online,” explained Meredith Abreu Ressi, Manhattan Research Vice
President of Research, “And it’s not just younger audiences connecting
online – consumers with conditions such as cancer, fibromyalgia, and
depression are also avid users of these types of resources. Health 2.0
is happening, and it’s changing the way things are done in the
healthcare industry.”

Manhattan Research estimates that 60 million U.S. adults are Health 2.0 consumers, using "blogs, online support groups, prescription rating sites and other health-related social media applications." The company’s Cybercitizen 0.8 report came out this week in the aftermath of the Health 2.0 in San Francisco. Ressi shares her reaction to the conference and talks about trends in online advertising and consumer behavior in the Web 2.0 era in a Manhattan Research podcast.  PODCAST 

The next president’s health agenda

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By Merrill Goozner

Note: This post first appeared at Goozner’s blog, Gooznews.

Picture_4A year ago, health care held a solid lead in the polls as the number
one concern of the American people. But by the time the Iowa caucuses
closed, and Barack Obama surged to his unexpected win, it had been
supplanted by the economy, a changing reality I noted in this New Year’s Day post.

As my daughter and I stood in a crowd of well over 100,000 people
last night in Manassas, Virginia, and heard the Democratic nominee give
his stump speech for the last time, I was struck by how little of it
was devoted to any issue beyond the core economy. His mom’s struggle
with paying her bills as she lay dying of cancer and the need to put
health into our sick care system got a line; but so did the war in Iraq
and going after bin Laden. As in 1992 when the last Democrat got
elected for the first time, it’s the economy, stupid.

But unlike some pundits who say the health care issue will be put on
the backburner for the first half of the next president first term, I
do not believe the nation will have that luxury. Curbing the growth of
health care spending will reassert itself as an issue next year because
it is key to restoring this nation to economic competitiveness.
American businesses are at a competitive disadvantage when they must
pay twice what companies in other countries pay (whether premiums or
taxes) to provide their workers health coverage.

The morning after reality for the next president is that the U.S.
spends more on health care than any other nation on earth — 16 percent
of gross domestic product and rising. Yet nearly 50 million Americans
go without health coverage during the year, and in traditional markers
of national well-being — longevity and infant mortality — the U.S.
ranks below many former Communist bloc nations of Eastern Europe.

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If You Have a Right to Health Care, How Much Care?

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By MAGGIE MAHAR

Hat tip to Kevin M.D. for calling my attention to “The  Covert Rationing Blog,” where Dr. Rich offers a concise summary of the dilemma we  face as we move toward a consensus that health care is not a privilege, but something that every human being should have. (One can call that a “right” or a “moral obligation that a civilized society has to provide health care to everyone.”)

The point Dr. Rich is making is that once you decide everyone deserves health care, the question is “how much care.” As he puts it:

“Exactly how much health care are you entitled to  if you have a right to health care?  Do you have a right to certain  specified health care services, to a certain dollar amount of health care per  year or per lifetime, to  whatever health care it takes to achieve perfect health, or to some other limit or non-limit?

“The question of limits (whether we should have  them or not, and what should  they be) has been a central theme of this blog and of DrRich’s book. To reiterate the fundamental problem: 1) In America we believe that it is wrong to limit health care in any way, that  everyone is entitled to the very best health care, that any bit of health care that offers even a small potential of benefit should be provided, and that death itself is merely a manifestation of insufficient research (or actionable incompetence, or systematic discrimination against the  unwealthy, or corporate greed).  2) But against that closely held belief, we must balance the unremitting law of  economics which tells us that there is simply not enough money in the known  universe to buy all the health care that might potentially offer some small  amount of benefit to every person. Health care spending has to be limited,  or it will become a fiscal black hole.”

Dr. Rich is correct on all counts. Our American love affair with medicine — and in particular, medical technology — is all  tied up with our fear of death, and a feeling  in some quarters, that “American optimism” demands that to strive for immortality. We put such emphasis on the individual, and the individual ego; how can we accept that, someday, it will be extinguished? (I’ll always remember the doctor who told me, in an interview, “Of course, one day, most people will die.” I wonder who he was  excluding from “most people”? )Continue reading…

President Obama: A victory for health care?

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By THCB StaffObama

Now that the results are in and the United States has officially elected Barack Obama as its next president, what does that mean to you and what will that mean for health care in America?

After nearly two years of campaigns, countless pages of material written about Obama’s health care plan and the possibility of reform, the U.S. has elected a Democrat as president and put Democratic majorities in both the House and Senate.

What do you predict the next four years will bring?

This is your space to reflect, comment and debate. Please share your thoughts, and let’s get a vigorous discussion going.

What I want to happen and what I think will happen

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By Matthew Holt

Election day. At last it’s over. A gazillion dollars, mostly wasted making TV stations richer. Two years of
campaigning resulting up in 3–4 months where rushed decision making will create a future that we all have to live with.

It looks pretty clear that Obama will win, with an increase in Congressional control for the Democrats. Although we Dems are used to losing when it never seemed possible…

So what do I want to happen? Certain things need to be done straight away.

1) Guantanamo Bay must be closed & torture renounced.

2) Rampant spying on Americans, national security letters & government abuse of power must be ended.

3) We need a declared route out of Iraq, immediately. (And a truth commission to deal with the lying sacks of **** who got us in there to reward themselves and their now much richer friends wouldn’t be a bad idea).

4) America must rejoin the international community, including
abiding by the principals of Kyoto, the International Criminal Court
& the UN Human declaration of human rights.

5) The drug war should be ended and a rational system of regulation introduced (OK I know I’m dreaming on this one).

6) A Manhattan-type project should be set up to really push the development of alternative energy. (I have some hope this will happen)

7) Complete house cleaning in the Federal departments and agencies
like Justice, EPA, FDA and many more, which have been over-run by
politicization and an attack on science. And a re-adoption of a serious
role for government.

8)  A really broad effort to fix the discriminatory, unfair American health care system

But what do I think will happen?

Less than that I’m afraid. But let’s stick to health care reform
which (other than the drug war) of all the above is the least likely to
happen.

The conventional wisdom is still probably correct.

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Baseball and Health Care: Only One Is a Spectator Sport

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By Joshua SeidmanSiedman

It’s fascinating when two of my passions collide in the opinion pages of the New York Times like they did over the last week. On Friday, October 24, some seriously strange bedfellows came together to write about, “How to Take American Health Care from Worst to First.” Strange enough that Newt Gingrich and John Kerry joined together, but
the lead author was Billy Beane, often thought to be the pioneer in the
trend toward data-driven major league baseball general managers.

I’ve been studying the health care system for nearly two decades,
but I’ve been studying sabermetrics (complex baseball statistics) since
a decade before that. So you’d think that their argument would resonate
with me and, to some extent, it does.

Their thesis is rational in many ways. Much of what is done in
health care has no evidence basis, and we end up spending a lot of
money on things that are unnecessary or even detrimental (or, at the
least, things for which we just don’t know). By developing a better
evidence base and encouraging more use of it, we could improve quality
and lower cost.

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