The Health Care Blog

PHYSICIANS: Better up your political contributions, AMA

California Healthline points to this Chicago Tribune story about physicians and collective bargaining. It's again based on the report the DOJ put out last week--the same one that was so glowingly endorsed by the PBMs. Andy Ribner pointed out, this...

POLICY: Health care at the Convention, or Jones the Policy Wonk explains how I've got my head up my ass it's been used politically and why.

Here's Jones the Policy Wonk in reply to my post on healthcare at the convention where I had written. . . . (and yes I am applauding!) Maybe if the Democrats repeat their fuzzy message enough times, they'll seize this...

PBMs: Express Scripts stock battered by multi-state probe

Let me tell you my tale of woe over Krispy Kreme, a stock with a big hole in the middle that I was shorting off and on for the past year. I closed out all positions and went on holiday...

POLICY: Wonks only please...Uwe's new theorem

Intersting report from Abby Vigenon on Uwe Rheinhardt's new theory on why we haven't got universal health insurance. You may notice that I show my colors (while keeping my cool I might add!) in the comments section.

BLOGS: The power of Craig's "List"

Yesterday I advertised for a tiny amount of writing/editing help for this blog on one entry on one city in Craigslist. Today my hit counter almost doubled. Such is the power of Craigslist. If you don't know about it, it's...

PBMs: Sorry, got it all wrong, PBMs save money

After years of saying that PBMs need to do something else to maintain their value proposition, and repeating that concept last week, I realize that I've got it all wrong. You see, as this press release from the newly active...

TECHNOLOGY: EMR use up among family docs

A survey of family practice docs conducted by the AAFP estimates that some 20% are now using EMRs. Given that I know something about surveys of this topic, I remain a little dubious about the numbers until it's much clearer...

POLICY/POLITICS: Blogging the convention

I have cable TV for the first time and I am typing away listening to the Democratic convention on CSPAN. In general it's pretty dull and barely anyone is mentioning the rather large Elephant in the room of the Bush...

POLICY/HEALTH PLANS: CDHPs--Employers skeptical, actuaries doubtful.

I've taken my time in responding to guest poster Andy Ribner, MD whose piece published in THCB last week was aggressively in favor of one free market approach to health insurance (Medical Savings Accounts) and highly opposed to another (Managed...

TECHNOLOGY: Quick clinics as part of the Walmartization of health care

For some time various people in health care have been talking about the Walmartization of health care. What they are talking about (and you know who you are Mr. Singerman!) is the development of a low cost generic health care...

HEALTH PLANS: Wellpoint stock plummet insanity shock horror probe!

So I assume John Garimendi went short on Wellpoint stock last week. The market marked Wellpoint down 7% on the opening on Monday following Friday's hiccup in the merger process, but it ended down only 4%. I nearly bought some...

TECHNOLOGY: JSK on the Health care IT Federal 10 year plan

Jane Sarasohn Kahn gave THCB readers a sneak preview of the meeting last week to launch the Federal govenrment's new NHII plan. Here's her much more detailed take in her iHealthBeat column.

HEALTH PLANS/PHARMA: Politics is all there is....

Sometimes you can sleep safe at night thinking that your elected representatives are going to leave some things alone. But in the last couple of days it's become apparent that political motivations are the only motivations left for those in...

W,F&A: Bizarre big fraud in southern California

Totally wacky frauds often pop up in health care, and unnecessary surgery at the recently sold Redding Medical Center was the downfall of Tenet. But I can't remember a case of healthy people voluntarily undergoing surgery for a bribe, as...

TECHNOLOGY: The Ten Year Plan -- American health care IT goes Stalinist

So following in the footsteps of like-minded Lenninists Stalin and Mao, HHS secretary Tommy Thompson announced a 10 year plan for health technology on Wednesday. Speaking as a Lenninist (or at least someone who agrees that it's usually better fewer...

PBMs: Something old and something new

You may not know this (I admit I didn't) but there's a trade association for PBMs called the Pharmaceutical Care Management Association which yesterday was one of the first to come out and laud the Administration's call for improving the...

TECHNOLOGY: Are consumer health plan web sites finally taking off? Matt Quinn doubts it!

Interesting blurb on consumer use of health plan web sites from Manhattan Research. Matt Quinn writes: I haven't read the whole study, but I feel that it significantly overstates the case: 21.9 million Americans using health plan web sites for...

TECHNOLOGY: Buyer beware when biotech doesn't live up to its promise

There have been many miracles from biotech but there have also been some rash promises made that haven't panned out. One of these is featured in this Boston Globe story about Biopure. Biopure is a company that has been trying...

BLOGS: Apology to Brian Towell

Last week I published an article from Industry Veteran responding to an article posted by Brian Towell. On re-reading the Veteran's piece in a more grounded manner, he went over the line from being rude about Brian's ideas to being...

POLICY: Free Market Medical Care, by Andy Ribner, M.D.

THCB has a new contributor today; Dr Andrew Ribner, a cosmetic surgeon who wrote to me originally in praise of my opinions about a piece I wrote about Regina Herzlinger a while back. After a bit of back and forth,...

POLICY: In Florida not all the nuts grow on trees

In Florida, the state Supreme Court has decided in its wisdom that its should put competing initiatives on the November ballot about medical errors and malpractice. Both of these are mutual nitpicky tit for tat assaults by the trial lawyers...

TECHNOLOGY: Boston Scientific recalls thousands of heart stents

THCB, in many posts on the subject of drug-eluting stents, has picked up on the occassional quality issues plauging both J&J's Cypher stent and Boston Scientific's Taxus stent in the past few months. But I must admit I didn't expect...

PHARMA: Marcia Angell's frontal assault on big pharma

Hat-tip to Ross at the Bloviator for this one. I know I promised that I'd try to stop writing about pharma, but..... a synopsis of her thesis. Nothing here that you wouldn't know if you'd been observing the industry for...

PHARMA: Free trade and importation redux

So the Australian trade agreement passed the house and it includes the limits on reimporting drugs discussed in THCB earlier this week. Of course they passed it by swearing blind that it won't impact the reimportation issue as apparently Australian...

PHARMA: The Industry Veteran responds to "mountebank" Brian Towell

Oh dear. The Industry Veteran was not pleased about what he read from Brian Towell in THCB two days ago. And he's in a particularly feisty (not to mention rude) mood about it! So send the women and children outdoors...

BLOGS: The Bloviator is back

So go say hello again. We missed you Ross!

PHARMA: When is a kickback not a kickback?

When it's a sample and a legitimate consulting contract, of course. So despite the fact that their employer had settled with the government to the tune of $875m back in 1991 on related charges, eight TAP pharma executives were today...

POLICY: Cuts in Drug Benefits for Retirees

So the hopes that the Administration had of the Medicare Bill being a political plus have looked pretty grim for a while. But they really didn't need their own government agencies putting the metaphorical boot in. The NY Times leads...

QUALITY: More ammo for the malpractice debate

The rhetoric continues to be turned up in the "debate" about malpractice. This LA Times article suggests that a RAND study found that California's $250,000 cap on non-economic damages in pain and suffering awards dramatically cuts the amount that juries...

PHARMA: The Democrats' favorite Republican falls off PhRMA's Christmas card list

John McCain's version of the reimportation bill is worrying the drug industry according to Forbes. I don't think reimportation is the big problem for much the same reasons that an E&Y consultant quoted in the piece doesn't: Critics point out...

PHARMA: More on the future of pharma marketing, by Brian Towell

Last week I published a piece on the future of pharma marketing that included a segment copied from another list-serv by Brian Towell from Doghouseonline that was critical of pharma's reticence. Regular THCB contributor The Industry Veteran was critical of...

PHARMA/INTERNATIONAL: UPDATE ON Free trade pact with the Aussies may mess up reimportation

I promised yesterday to look at the NY Times article about the Australian free trade act which may undercut importation of inexpensive drugs, including those from Canada. I've written about this many times at TCHB but it looks like it's...

QUALITY: Do we need national standards for pay-for-performance?

A couple of weeks back there was an interesting signal that something that's been debated by policy wonks for some time may be impinging beyond the fringes of the real world of health care. Jack Bovender, CEO of HCA the...

POLICY: A little more about physician supply

Last week I wrote about the nursing shortage, and I took the mainstream view that it really was a big problem, while suggesting that technology may help solve that problem; (in an update to that post, the Industry Veteran somewhat...

QUALITY/POLICY: Who's telling the truth in the malpractice debate?

The answer, is of course, no-one. And this interesting web site Factcheck.org, a non-partisan organization like the Center for Public Integrity hated equally by everyone, has an article about Bush's use of Mark McLellan's research which said that some 8-10%...

PHARMA: More on the state of pharma marketing, by The Industry Veteran

Yesterday I had a long post which touched on the malevolence of some pharma marketing, the alleged incompetence (or at least unoriginality) of other pharma marketing, and the possibility that efficiency in sales will be improved by better user of...

POLICY: Toto, we're back in Kansas and it's 1991 again.

Back in 1991 in a very, very brief moment of (reflected) non-stardom, which I rediscovered on an old photocopy when I was unpacking some boxes during my recent move, my name (and those of my co-authors on a piece about...

PHARMA: Even the The New York Times has noticed that pharma has PR problems

In an article picking up on the Harris data TCHB shared with its stellar, avid readers (that's you BTW) last week, the NY Times this morning places Pfizer's decision to give cheap drugs to the uninsured next to the polling...

QUALITY: The nursing shortage, with UPDATE from The Industry Veteran

Yesterday I ended a piece on medical safety with a reference to a well known British agony auntie advice columnist who will not go into hospital unless she's at the point of death, primarily because of the lack of training...

PHARMA: More on big pharma's marketing and sales strategies

And in continuing rumblings from the pharma marketing corruption story THCB reported on a week or so back -- Schering was mailing physicians checks to get them to prescribe their drug -- a couple more missives have crossed my desk....

POLICY: Scully guilty, but not legally, with BRIEF UPDATE

In a splitting of hairs in a report from the HHS inspector general, Tom Scully the administrator of CMS when the Medicare bill was passed, was found guilty essentially of lying to Congess. In fact while Scully pressured the main...

QUALITY: Hospitals remain dangerous, but talking about the issue makes them safer

I saw Michael Millenson doing Grand Rounds at UCSF last week. Michael, who has been mentioned in THCB a number of times, is a former journalist who has become something of a "bete noir" to organized medicine--or at least would...

TECHNOLOGY: Boston Scientific recalls stents

A while back THCB reported that there were some murmurs about problems with Boston Scientific's Taxus stent. That followed earlier manufacturing problems with J&J's Cypher stent. Now Boston Scientific has recalled about 200 stents with manufacturing defects. This is probably...

TECHNOLOGY: Fuel Cells That Keep Going And Going...

A quickie for July 6th. I have been moving house (and office), had limited access to DSL and THCB has suffered a bit. Sorry, but the move is almost done (You must all come and visit!). My backlog is huge...

HEALTH PLANS: Wellpoint merger wandering through California

While the shareholders have approved the Anthem-Wellpoint merger, it looks like state insurance commissioner John Garamendi is likely to oppose it, causing a little embarrassment for a certain Governator. Meanwhile, the public hearing has been set for later next week....

INDUSTRY: Is nothing sacred? Cardinal admits sinning

OK, not really, but serious bad news at what has been one on the health care industry strongest performers and best run companies. Cardinal Health anounced that it would miss profit forecasts, and was being investigated by the SEC. The...

POLICY: One in five households struggle with medical debt

I'm moving today and tommorrow so dont expect much real thoughtful action here until next week. However, I'll list a few bits and pieces you should keep up with. As you'll recall in my comparisons of Canadian and US healthcare...