The Health Care Blog

POLICY: Medicare round-up around the blogsphere

My take on the Bill remains the same. The details will see it losing support among seniors, but probably not enough to matter politically. Paul Ginsburg sees it differently and thinks that there might be another 1989 style repeal on...

POLICY: Medicare bill passes

So it's done. The Medicare bill passed the Senate this morning 54-44 with the votes of enough conservative Democrats to ensure an easy passage. My suspicion is that there's a lot less here than meets the eye. However, Tom Daschle...

TECHNOLOGY: eHealth update

I posted a while back on Manhattan Research's new Cybercitizen health findings. In the past week I've received Forrester Research's Healthcare First Look email and also seen a new article from Caroline Broder at iHealthBeat on Manhattan research's eHealth findings....

QUALITY QUICKIE: Ratings getting off ground, but humbled by technology

While it's really baby steps, it looks like the slowly emerging consumer-directed health plan movement is finding some information out there to show its members. Even stock site CBS Marketwatch has noticed in this article called hospital, doctor quality ratings...

POLICY: Medicare drug bill on its way to passage.

Well, the bill is going to make it. The dissidents in the Senate led by Kennedy could only muster 29 votes in favor of a filibuster (they need 40). So the bill will pass tonight. Drug stocks and PBM stocks...

INDUSTRY: Tenet watch

Sometimes the old favorites don't disappoint! Tenet is in the news again with some more subpoenas about possible fraudulent referrals, this time in Louisiana, and a spat with Blue Cross in California which said that half its cardiac procedures at...

POLICY: Medicare bill making it?

As I go to bed late, late Sunday night it looks like the Medicare bill is going to avoid a filibuster and get through the Senate. Go see Don Johnson at The Business Word for the latest news. Meanwhile here's...

PHARMA: Statin drugs may go OTC in UK next year and Crestor update

As you probably know by now, the UK has a national health service (NHS) which pays for prescription drugs. Most Brits pay a small (or if they are over 60 no) co-payment when they get their drugs and the real...

TECHNOLOGY: eHealth update

I posted a while back on Manhattan Research's new Cybercitizen health findings. In the past week I've received Forrester Research's Healthcare First Look email and also seen a new article from Caroline Broder at iHealthBeat on Manhattan research's eHealth findings....

POLICY: Medicare Bill just gets past the house

And in a rare Saturday posting . . . After some real hard core arm-twisting, (plus leaving the voting open for 3 hours), at 6am this morning the House passed the Medicare Bill 220-215. It looked like it was going...

PHARMA: PhRMA members learn to play the game

So I can't quite stay away from the Bill.... In a reminder of how hardball politics is played in the USA these days, there's a report out today (hat tip to California Healthline) that shows that in the first 6...

GENERAL HEALTHCARE: A run-down of interesting stuff

I've been a bit mesmerized by Medicare drug coverage in the last week or two and I've let a lot of stuff build up in my "draft folder" -- so I'm going to do brief comments on many of the...

PBMs: Caremark hiccup or It's better to be lucky than good

Well I told you last week that I'd had a small bet on the PBMs losing value this week as investors realized that the Medicare legislation wasn't guaranteed to pass. It happened for random reasons that I bought put options...

QUALITY QUICKIE: IOM calls for National EMR

The latest IOM report in the series that started with To Err is Human is out. It calls for national computerized information systems and improved data standardization. I'll write more on this later but for now read this article

PHARMA: Update on COX-2 piece

In my recent post about Cox-2 inhibitors, I suggested that pharma companies had been successful in getting them widely adopted, and that conversely PBMs and payers had done a bad job in counter-detailing. One doctor emailed me suggesting that I...

POLICY: The Medicare bill latest, or What does the failure of Medicare+Choice mean?

It's impossible in a brief post to capture the full essence of the current Medicare bill. (Although Jeanne Scott's latest newsletter tries very hard)! In a few days we'll know whether it has the votes to make it in the...

POLICY: Fuchs' proposal re-emerges

I've been engaging in some comments over at DB's Medrants on some articles by the Hoover Institution's Thomas Sowell in which he has been essentially defending the status quo (albeit in what I think is an intellectually weak manner that...

QUALITY: Rise reported in medication errors

There's a new report from The US Pharmacopeia about medication errors in 2002. It's not clear from the press release but this article in iHealthbeat points out that there's been a 31% increase in hospitals (to over 480) reporting and...

TECHNOLOGY: Physician email and IT use

This is one of those, "I'm glad they wrote it so I didn't have to," posts. iHealthbeat has two articles updating physician use of email and physician IT use. You may have seen smatterings of some of the studies used...

PHARMA: New free-market ideas on counter-detailing

Arnold Relman, former editor of the NEJM and long term opponent of for-profit health care, has an op-ed piece in the NY Times complaining about the impact of pharma companies sponsoring CME. Relman suggests getting pharma companies out of CME....

POLICY: Just in case you thought the AARP endorsement sealed it...

The AARP's endorsement is supposed to have sealed the Medicare Bill--but just take a look at this message board which spews vitriol towards AARP from its own members! Hundreds of messages here are all opposed to the Bill. I picked...

PHARMA/PBMs: Are Cox-2 inhibitors over-used?

Cox-2 Inhibitors have been a major therapeutic class since their introduction in the late 1990s. Led by Pfizer's Celebrex and Merck's Vioxx, the pain-relievers are roughly a $6bn market--not as large as the statin market but nothing to sneeze at....

HEALTH PLANS: Kaiser CEO interview

The Sunday San Francisco Chronicle had a somewhat rambling interview with Kaiser CEO George Halvorson. The main isues he raised were: a) the conversion from an acute to a chronic health system raises costs b) Kaiser is committed to evidence-based...

POLICY: Medicare agreement-is it a charade?

So while the news says that the bill is out of conference on Friday and has enough backing to get through, Ted Kennedy basically said on Sunday that the Medicare bill wasn't going to make it past him in the...

PHARMA: Stock update and Medicare

While the PBM stocks have been going up, the same thing is happening to the big pharma stocks, as you can see in this chart of a pharma stock index , and in the performance of Merck's near 10% surge...

POLICY: More on uninsurance

A while back the Bloviator and I had some discussions parsing out the 2002 uninsurance numbers. There was some controversy (that the two of us settled to our satisfaction, at least) about those numbers from the census bureau to do...

PBMs: No one's listening to me?

Despite my doubts as to whether we're going to get a Medicare drug bill, the market has decided a) that we will and b) that the PBMs are going to benefit the most from it. The last two days have...

TECHNOLOGY/INDUSTRY: More Tenet-related scuttlebutt

Not that it's my natural proclivity, but I am enjoying the rumor-mongering abilities that writing this kind of a blog gives me. You'll recall a while back that I came upon some rumors that Tenet had hired a company for...

PBMs/POLICY: Will tentative Medicare deal stick?

I noticed that the PBM stocks took off like a rocket at the end of the trading day yesterday. The news was that a tentative deal Medicare has been reached by the committee negotiating a compromise Medicare bill. PBMs are...

PHARMA: Lipitor stops build up of plaque

When I first saw this headline: Pfizer's Lipitor Stops The Plaque, I misread it and thought that it said Lipitor stops "plauge"--now that would be a hell of an off-label use!

POLICY: Canada Follow-up

Well I must be sniffing the air correctly. Today's WSJ online has, other than its headline, a very fair piece on Canada and how hospitals direct traffic to high-tech procedures. It may be very unAmerican, but it seems to work...

TECHNOLOGY: Two quickies

While you get your teeth into the long post about Canada that I put up late yesterday, here are two interesting follow-ups to technology issues already tangentially discussed in THCB. 1) Patient-Physician email--Here' s a thoughtful article about the overall...

INDUSTRY: I promised that I wouldn't write about this!

OK, OK I promised last week that I wouldn't write about them or him again....but that doesn't stop you reading about you know who at you know where.

POLICY: Oh Canada

This article is about Canada's health system and its relationship to the US health policy debate. It is not meant to be an endorsement of Canada's system, or an endorsement of single payer for the US. From my personal point...

POLICY: State budget crunches are real

Just in case you thought that state budget deficits caused by the ruinous Bush deficit/ending of the Clinton bubble (delete where applicable to suit your political taste) were somewhat academic, read this report on Colorado's decision to remove legal immigrants...

TECHNOLOGY: Patient-Physician email--Is it or is it not a "good thing"?

Two studies from Oregon, one from Kaiser Northwest and the other from Regence (Oregon Blues) contradict each other about patient physician email. You can see more either at iHealthbeat or from the Portland Business Journal (reg reqd for both). In...

TECHNOLOGY: My, does Trizetto have a good PR firm!

Jeff Margolis, the former wunderkind CIO of the HMO world, is now CEO of Trizetto. As this somewhat fawning piece in the business section of the NY Times explains, Trizetto has grown to be a $300m revenue company, providing administrative...

POLICY: Medicare competition as a political football.

The New York Times points out a couple of things about the Medicare bill negotiations in this article, Competition Causes Widest Split Over Medicare. These issues won't be strangers to those reading TheJeanneScottLetter, whether or not you were sent there...

TECHNOLOGY: More on technology, handhelds and synchronization

I'm still under the cosh on some other projects, so while you are waiting on my pearls of wisdom you should check out the interesting articles in this compendium from Modern Physician/PWC's survey on technology use among physicians. Then go...

PHARMA: Is it Nature or Nurture?

Remember the movie Trading Places when two rich old men put Dan Akroyd into the gutter and take Eddie Murphy out of it to figure out whether it's nature or nurture that affects people's outcomes? Well there's an equivalent going...

INDUSTRY: New HealthSouth management blames Scrushy

I know that you're tired of hearing about it and I promise that this will be the last article I ever write about Healthsouth--but I couldn't let go the little fact that, surprise, surprise, the new management that's been in...

PHARMA: A little more info on Crestor

There's a little more info about the adverse events with Crestor, in a report called What's the Matter with Crestor? from Friedman, Billings, Ramsey & Co Research. (I couldn't find a way to get the report without opening a brokerage...

DSM/TECHNOLOGY: Is DSM going the way of the PBM? (mostly) by Matt Quinn

From THCB's disease management office, Matt Quinn passed this little morsel my way. Apparently disease management is now so effective that employers, payers and traditional providers are increasingly unwilling to pay extra for guarantees that DSM works. Traditionally DSM companies...

QUALITY QUICKIE: Are hospitals screwing over MD whistleblowers?

Via DB's Medical Rants, I found this series in the Pittsburgh Post-Gazette on how hospitals are using a wrinkle in an obscure 1986 Act to ruin--literally, professionally and financially-- doctors who blow the whistle on poor quality care. There are...

TECHNOLOGY: Manhattan Research's latest data on Cyberhealth

I was kindly invited to sit in on a webinar by Manhattan Research this morning on their new Cybercitizen Health v3.0 data about ehealth consumers. The webinar used Placeware, a competitor of Webex that I used to use to do...

INDUSTRY/TECHNOLOGY: Healthsouth wackiness hits new high

Given my previous long ramblings about Healthsouth and my interest in mobile PCs for health care workers, I couldn't let yesterday's news pass without at least noticing that: a) Richard Scrushy finally got hit with an indictment on a mere...

POLICY: Oh Canada, implications for the US, part 1

Medpundit has written an article over at Techcentralstation basically saying that Canadian doctors hate the system there and are leaving for the US. I've responded briefly in the comments there, but am working on a much longer piece that will...

INDUSTRY: Aggressive collections by hospitals questioned.

The Wall Street Journal reported last week on very aggressive tactics used by a few hospitals to collect on debts. As you can't see the WSJ articles unless you subscribe (for money!) I didn't link to it, but med blogger...

INDUSTRY: Can anything else go wrong at Tenet? Maybe...

Just when Tenet thought it was safe to poke its head out, a court has taken it back behind the woodshed and ordered it to pay $273m rather than the $9m it thought it owed to John C. Bedrosian, a...