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Interest groups clash over doctor-owned specialty hospitals

Doctor-owned specialty hospitals deliver better quality of care, are more convenient for physicians and patients and take business away from not-for-profit and investor-owned general acute care hospitals, which have been trying to put them out of business for years.

The NY Times reports on the latest effort by liberal Democrats to take down the for-profit specialty hospitals. The Democrats behind this drive don’t believe in for-profit health care providers even though not-for-profit providers are as profit driven as the investor-owned providers. Most Republicans oppose the effort to restrict the growth of doctor-owned hospitals because they understand that many local hospital markets are dominated by a few institutions and that patients and insurance buyers need more competition among providers to keep costs under control.

This is a battle between the powerful American Medial Association, which supports doctor-owned hospitals, and the American Hospital Association, which represents mostly not-for-profit hospitals and wants to end competition from the doctor-owned specialty hospitals.

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Trusera, out of beta & different enough to be interesting

Keith Schorsch is a busy boy. Not only did he write a much commented piece about
Google Health and PHRs on this very station last week, but he also popped by last week to tell me about the new look for Trusera. Several of you saw Trusera launch at the Health 2.0 Conference last March. As of today they’ve removed the Beta tag, and have introduced a new look and new features.

The way Trusera is going about things is by collecting stories and journal entries, and then essentially parsing the keywords and text in those stories to connect people with others with similar situations. The distinction between this and most other social networking sites is that Trusera doesn’t have “forums
” or “channels” per se, but uses its search technology (somewhat inspired by Amazon where several of the founding team came from) to match lurkers and contributers with content and people relevant to them. There’s also some neat tools to help people build their stories with helpful suggestions appearing to the side as they’re being written — think of the Microsoft paper clip but done well! (At this stage it doesn’t take detailed self-reported patient clinical information a la PatientsLikeMe or PHRs).

So far there’s sizable activity on Trusera in autism, breast cancer and infertility, among other conditions. And of course Keith’s aim is to develop hundreds of thousands of members and millions of stories.

Trusera’s approach is different enough to be interesting as another option for community online. The technology is arguably better than others in the space, but as we know from other markets “better” technology doesn’t always mean most successful — as I tell many of my Mac using colleagues. But as was also pointed out to me this weekend, the vast majority of patients are not yet online in these communities. So it’ll be interesting as these numbers grow to see who will remain standing. Trusera clearly has a shot.

JOB POST: PRODUCT MANAGER / Mayo Clinic

Mayo

Mayo Clinic in Rochester, MN, has immediate openings for seasoned Product
Managers to support product development for Web and digital products aimed at consumers and employees.The product manager plays a key role in ensuring the strategic direction, design and on-time delivery of Mayo Clinic Health Solution’s online products including, MayoClinic.com, Mayo Clinic Health Assessment, Symptom Checker, Expert Blogs and other social/new media, and mobile applications.

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State regulators challenge the rights to your DNA

It is something of a surprise that it popped up this way, but the establishment
challenge to Health 2.0 was going to start somewhere. And it appears to have started with two big states, New York & California ordering 13 companies to stop Gene Testing.

Karen Nickel, from the California Department of Public Health, argues that these companies are operating without a clinical laboratory license in California. The genetic tests have not been validated for clinical utility and accuracy.”

But as those companies are outsourcing the testing anyway, that argument barely holds water. Here’s what Navigenics CEO Mari Baker said Navigenics uses a doctor to transit orders and review results, and it relies on a state-certified lab testing company to do the gene tests.”

So what this really is about, of course, is who has the right to order a test? Is it you or do you have to go through a doctor? Or put another way, is it your DNA or is it the state’s?

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Stats Can’t Explain Everything; The Anecdote Remains Relevant

Lately, I’ve been thinking about the difference between stories and stats — those hard and fast numbers that give us “objective” information about everything from the body politic to the human body.

Social scientists like data, perhaps because it makes social science seem more “scientific.” They like to square things off and measure them. They like to count:  How many? How much? What do the polls say?  Percentages are impressive.

Try to tell a story, however, and a purist will remind you that “the plural of data is not anecdote.”

But what some social scientists (and some physicians) forget is that statistics measure only what can be counted. Many of the things that are most important, in medicine as in life, are immeasurable. Stories are valuable because they can capture some of the messiness of reality, including the ambiguities and contradictions that make both human experience and the human mind/body just beyond comprehension. (Since we have only the mind with which to understand the mind, ultimately investigation must end in a stand-off.)

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What do Johnny Cash and employer-based health care have in common?

OK, maybe it’s a stretch but bear with me.

I heard a senior exec from a big health plan say the other day that it’s hard to believe we will ever see the end of health insurance distributed primarily through the workplace in favor of an individual-based health insurance system. In fact, much of the health insurance industry is lining up behind staying with the system we know best and the one who has been our customer all these years–the employer.

That is understandable. As someone who came up through the ranks looking at the employer as the customer and individual health insurance as a minor product subset I have the same reaction.

But I will tell you that this idea of moving away from third-party employer pay and to a system of individual responsibility — or moving from defined benefit health insurance to defined contribution health insurance — has been coming on us for some time now.

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Health costs are small businesses’ No. 1 problem

The cost of health insurance is the No. 1 problem cited by small business owners. Health costs beat gas prices — the No. 2 most severe problem cited by small business, in a March 2008 survey.Smallbusiness

This week, small business leaders convened at the annual National Small Business Summit conference of the National Federation of Independent Business (NFIB).

The report notes the downturn in the economy during the second half of 2007 when the NFIB Small Business Optimism Index dropped to 94.6 in December, the lowest since 2001.

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Obama’s Rx for Change

Clinton has quit, Obama has three times McCain’s resources, and the country is fed up with the Republicans’ war, corruption and toadying to corporations. Democrats have won three "safe" Republican house seats
in recent months. It’s their election to lose, and assuming that the
fences between rivals really are mended, it might be a landslide.

I’ve written previously that I don’t think Obama is serious about pursuing health care reform. But this week he changed his tune and said categorically that by the end of his first term, there would be universal healthcare.

In an Obama administration, we’ll lower premiums
by up to $2,500 for a typical family per year. And we’ll do it by
….covering every single American and making sure that they can take
their health care with them if they lose their job…..We’ll do it by
the end of my first term as President of the United States……

Read the rest at Spot-On and return here to comment.

And the Voters Demand. . . Electronic Medical Records?

Over half of Americans think the next U.S. President should support. . .access to electronic medical records.

Compared to gas prices, the economy and the war in Iraq, this is, needless to say, a fairly minor issue. Even within the issue of healthcare reform, access to EMRs, as digital medical records are known, it’s small potatoes.

Yet a survey released by Kaiser-Permanente at the Information Therapy Conference in Washington shows that a majority of Americans agreed that providing people with online access to their own medical records should be a "top priority" for the next US President.

It’s tough to say what this data point really might mean. But my guess is it suggests people are frustrated by the mess of papers and records that make patienthood so difficult these days. Whether federal support for a nationwide program is the only or wisest solution to this problem is another question, of course. 

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