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Above the Fold

On the Road Again: Health 2.0 Motorcycle Tour

Sep 17, 2008• 1

By David Kibbe

Kibbemotorcycle

In "Zen and the Art of Motorcycle Maintenance," Robert Pirsig writes about the different reactions to our experiences living with modern technology, which he describes as romantic, classic, and a third and completely separate element and perspective, which he calls Quality.

I’m finding that there is a bit of all three in my Health 2.0 motorcycle tour and the interviews along the way. It’s a curious revelation, and I’m somewhat awestruck by the relevance of his musings about how we lived during the 1970’s to our situation here in the new century with health, wellness, and the Internet.

Exploring and conquering new health care frontiers

Sep 17, 2008

By Scott Shreeve

The September/October issue of Health Affairs is dedicated to reviewing concepts of the medical home. It is most likely the most current, authoritative, and impressive review of this emerging idea. Health Affairs is an excellent resource for health policy wonks to gather, but in recent years has become more accessible to the general health care audience. I would recommend it as required reading for anyone interested in learning about this trend.

Simultaneously, there have been some recently updated “state of the industry” reports coming out of the retail health clinic world. As noted by Jane Sarasohn-Kahn, the fact that more and more retail clinics are being created has increased access, improved quality through an evidence based approach to a limited set of clinical conditions, but has not done nothing to address the cost issue. In fact, increasing the supply of retail clinics, has simultaneously increased the demand for these services. This is a common phenomenon within healthcare, and the supply driven demand has been well described particularly in the hospital setting.

Forcing the candidates to get real on health care change

Sep 16, 2008• 9

By Robert Laszewski

Let’s pretend that either Senator Obama or Senator McCain will be able to implement their respective health care reform plans if elected. This exercise should be easy. We’ve been doing it for months now.

Or, we can get real and expect them to do the same.

For all the arguments both candidates are making that they are change agents, including over their competing health care reform proposals, this dirty little secret remains –– neither Senator’s health care plan has a chance of being implemented.

Adding layers to Health 2.0

Sep 16, 2008• 5

By Susannah Fox

Jen McCabe Gorman drew a picture at HealthCampDC last that I really liked. Luckily, I found this image of her Medicine 2.0 presentation, so nobody has to decipher my sketch.

The one difference is that, on Friday, Jen pointed out that the outer square ("content") is Health 1.0 and Health 2.0 begins with the "community" square. After reading her research paper, I now understand that the next inner square is Health 3.0, or content + community + commerce and the final, innermost square is Health 4.0, which would add coherence to the equation. Health 4.0 in this model is the "evolutionary stage connect[ing] the real world of brick-and-mortar systems with the virtual world of online services."

The paper is well worth a read, whether you agree with this model or not. I’m going to have to think about the following points, for example:

Another weakness of current Health 2.0 initiatives is the tendency of communities to attract similar people. Many focus on connecting "like-minds," relatively homogeneous groups such as patients with the same diagnosis or physicians in the same subspecialty. Similar groups then generate very similar content. Users become settled and ‘comfortable’ and thus less inclined to venture out and advocate for other consumer groups and sytemic change.

When is the same spending more spending?

Sep 16, 2008• 2

By Matthew Holt

When it’s routed through the government because their spending is done with mythically different dollars than private spending. Or at least it is in the bizzaro world of free-marketeer policy analysts. Let me explain…

A couple of weeks back a small consulting firm working for McCain sent me an article written by University of Minnesota economist Roger Feldman about the cost of Obama’s health plan. They were complaining that I hadn’t featured their analysis. So I read the report which suggested that the Obama plan would cause $450 billion in health spending. Bear in mind, Obama suggests that it’ll cost $65 billion, so this is quite some stretch.

I was going to write a long, learned article about this, but instead I’ll just show you the email back & forth.

Around the Web in 60 Seconds (Or Less)

Sep 16, 2008• 1

The majority of ER patients leave confused and with unanswered questions, which can contribute to medication errors and return visits, the New York Times reports. And the study published in the Annals of Emergency Medicine was among English speakers! Imagine the confusion among those with limited or no English.

Illinois is debating its certificate of need laws, following a decision by the US Department of Justice and Federal Trade Commission that it hampers competition and weakens the market’s ability to contain costs, the Chicago Tribune reports. The Illinois Hospital Association president defended the law: "The state has a legitimate interest … in preventing the proliferation
of profit-seeking enterprises that seek to cherry-pick well-paying
patients or those who have good insurance coverage, leaving
full-service community hospitals to provide vitally needed but
money-losing services, such as emergency and trauma care and care for
the uninsured, that are poorly reimbursed or not reimbursed at all."

Pennsylvania politics over medical malpractice insurance subsidies threaten the existence of the state agency that monitors hospital finances, occupancy, procedures and infection rates, the Pittsburgh Tribune-Review reports.

Health Affairs has critiques of McCain and Obama’s health plans, along with a proposed comprimise by Wharton professor Mark Pauly.

Golden Rule Founder dies

Sep 16, 2008

By Matthew Holt

It is not seemly to speak ill of the dead so this is all you’ll hear from me about the passing of Patrick Rooney, founder of Golden Rule. An obituary is here.

Health 2.0–time to make a move

Sep 15, 2008• 3

The Health 2.0 Conference is a scant 5 & 1/2 weeks away, and as of Monday midnight on the west coast the rate for attending goes up $300 to the full rack rate. So please visit www.health2con.com and get your pass today.

The health search future

Sep 15, 2008• 5

By Jane Sarasohn-Kahn

Over the past couple of weeks, the eHealth world learned that RevolutionHealth engaged Morgan Stanley, the investment bank, to help assess the company’s ‘alternatives.’ The early talk was to raise capital, but the tenor seems to have switched to sales or merging. One talked-about suitor for Steve Case’s start-up is Everyday Health.

This news comes on the heels of a new comScore report that reports 21% growth in the "health information" site category, from 57 million visitors in July 2007 to 69 million in July 2008.

The No. 1 in health search portals continues to be WebMD, which grew by 3 percent year on year. WebMD was also top in display ads versus other health sites. WebMD had 290 million display ad views in July 2008.

The problem with astroturf

Sep 15, 2008• 5

By Matthew Holt

….is that sometimes real weeds might sneak in and mess up the nice green carpeting you’re laying down.

To wit, here’s an exchange between an SEIU member and AHIP President Karen Ignagni at the AHIP astroturf meeting in Ohio. When asked why Wellpoint’s CEO is still talking about profitability (and going off message to the political world when going on message to Wall Street), Ignagni starts off about “No Margin, No Mission”.

Err … Karen, that’s the line used by non-profits that (theoretically) have a mission to do some social good. The mission of investor-owned companies like Wellpoint, Healthnet, Aetna, United, et al is to make a profit. Your opponents can show you lots of “insurance companies” that do a pretty good job (or at least as good as your members and usually better) and don’t make a profit. Hint: one’s called Medicare, another is the VA.

And at another astroturf forum a different AHIP spokesman also showed a lack of comprehension of basic economics when he apparently said that it is necessary for the insurance industry to make profits to cover costs. Err no, you have to cover your costs to cover your costs — profit is on top of that!