The Health Care Blog

POLICY: Congress is slowly getting it together

It's not exactly major health reform, not universal health insurance, not even anything on the scale of the 2003 Medicare bill, but Congress is starting to put some legislation together on health reform. The new patient safety bill sets up...

QUALITY: Voluntary error reporting system eventually rolls out of Congress

So Congress has finally passed a bill creating a voluntary medical error reporting system. Baby steps six years after To Err Is Human, but I had to turn to Michael Millenson expecting him to be overly cynical. But do I...

HEALTH PLANS/PBMs: Wall Street loves 'em

It's a wacky day on Wall Street. Since Aetna's quarterly announcement that it made a decent profit hitting expectations, the entire sector has gone a little doolally. And not all at once but over the course of the day. Look...

TECH: VistA, apparently free really means "cheap", sort of

Neil Versel has done a little poking around and found that when the NY Times says that CMS will give VistA away for free, they actually mean for a license fee of $2,700. So free just got quite a lot...

POLICY: War on Pain doctors gets another scalp

So this time it's the University of Arizona Pain Clinic which is planning to close. Why? It's main doctor has left and they can't find anyone to replace him -- I wonder why. So what does that mean? During the...

HOSPITALS: And while we're on the subject of making too much money

If you read the Bruce Bodaken interview referenced in my other post today you'll see that he complains about a certain hospital organization pricing too aggressively and being cut out of part of the CalPERS HMO network that Blue Shield...

POLICY/HEALTH PLANS: Bruce Bodaken--as good as can be expected but...

The SF Chron had an interview with Blue Shield of California CEO Bruce Bodaken . In general when you're looking across the spectrum of the self-interested actors in American health care, the genuine non-profit insurers (e.g. Kaiser and a few...

TECH: Accenture slams hand that fed it well in door, and then stamps on it

This title alone had me really chortling -- Accenture Slams CRM As Ineffective. Beyond the fact that no one in health care has yet made CRM work, didn't anyone at Accenture get the slight irony of this, given they made...

POLICY/PHYSICIANS: Medpundit spreads (perhaps legitimate) FUD on P4P

Sydney (Medpundit) is very smart. Much of what she believes is wrong (i.e. I disagree with her), but she's a great indicator of where the conservative (in both senses of the word) solo doc is, and you can bet your...

POLICY: We need to separate the Medicare discussion

Those of you who get my FierceHealthcare newsletter (and if you don't you should as it's free!) will have read plenty from the NY Times last week about how Medicaid is a web of corruption and fraud and from the...

TECH: Microsoft spreads Vista FUD

Get your conspiracy theories going. One day after the VA and CMS release VistA for small physician offices, Microsoft tells the world that its "new" OS Longhorn (or Windows 2003 or whatever it was originally) will, in a stunning piece...

POLICY: Immigrants use less care

As you'd rationally expect, immigrants end up using less health care than those born here. My assumption is that it's a factor of income and insurance status, and it seems that they do use relatively more ER care because of...

POLICY/POLITCS: Clintoncare -- a quick review

Following my piece on Hlillarycare and why it failed, Martin Goldsmith wrote to me with a slightly more comprehensive review of everything that happened. This is from a article submitted for the forthcoming 11th Presidential Conference -- William Jefferson Clinton...

POLICY: The War On Pain Doctors gets to the big time

NY Times Op-Ed columnist John Tierney (the guy who is the replacement for long-time conservative columnist William Safire) has written two excellent articles; one on the war on patients and one on pain doctors -- basically exposing the DEA for...

TECH: Here comes VistA and eRx update

This week CMS announced that the oft-touted VistA system -- the EMR developed by the VA -- would be made available for free. Given that similar EMR systems are sold for up to $15,000 a seat, this might appear to...

BLOGS/TECH: Brief musings on technology

Just brief musings for Thursday, after I blew way too much time on the HillaryCare piece earlier this week at the neglect of paid employment.... Browsers: I have downloaded Firefox 1.0.6. You may recall that I went back to Internet...

POLICY: Data on abortion

So the next Supreme Court justice has been announced and women's right to choose about their own reproductive health will likely be substantially reduced, according to NARAL which really doesn't like Roberts. Given that an interesting study was released today...

POLICY/POLTICS: Why Hillarycare failed...and what we need to learn from that failure

This is the continuation of an article I've threatened THCB readers with for some time about what in my view really happened the last time we got serious about health care reform. And in it there are lessons for what...

PHARMA/POLICY: Quick Plan B update with UPDATE

For those of you still playing along at home, it now looks like the FDA is going to make a final decision on the status of Plan B by September 1. So that should get us to a confirmation of...

POLICY/QUALITY: A good round up of lefty propaganda, and Berwick gets a gong

The Christian Science Monitor has a quick diatribe on what a mess health care is, and how the HSA/CDHP movement will be a five to ten years distraction before we end up at some type of universal coverage/single payer. The...

PBMs: Just to keep you up to date, with UPDATE

We haven't heard much about the plans that will end up being the Medicare Part D quasi-PBMs. These are known in CMS-speak as the Participating Prescription Drug Plans [PDP], and they're going to be selling plans/enrolling seniors and then administering...

POLICY: New York Medicaid fraud

While I've been ragging on Florida, the NY Times has noted something we've all known for a while -- New York's Medicaid fraud may reach into the billions. Given that New York's Medicaid program spends more in total and way...

PHYSICIANS: Apparently Florida remains exceptional

Why is there a nursing shortage in south Florida? Apparently it's because the doctors are very badly behaved, sometimes. The South Florida Hospital and Healthcare Association, seeking to recruit more nurses from other areas, organized focus groups of nurses who...

BLOGS: Medical Connectivity Consulting

There's another interesting healthcare IT blog out there called Medical Connectivity Consulting. For those of you who are deep in the weeds about this sort of thing it had a nice article about wireless communications in hospitals last week.

PHARMA/POLICY: Medicare Part D

This is a complete cop-out as I'm still hacking away on my Hillarycare piece, and haven't even read this, but the article in Health Affairs called Riding The Rollercoaster: The Ups And Downs In Out-Of-Pocket Spending Under The Standard Medicare...

POLICY/POLITICS: The evolution of Hillary Clinton and the failure of reform in 1993 (TO BE CONTINUED)

I have been meaning for some time to write about what really happened in 1993-4. But I'm finally going to get off my duff (or more accurately) sit on my diff and do it because of the close to ridiculous...

BLOGS/TECH:Sacred Cow Dung and physicians and technology

Chris Mayaud is one of the more amusing entrepreneurial doctors it's been my pleasure to go drinking with and have on the odd panel (Also the only one ever to use an almost appropriate 4 letter word and get away...

TECH: PHRs for health plan members...maybe, maybe

And in the bitter, twisted segment of THCB this week, apparently Empire Blues will be offering personal health records to their patients. And the records will be prepopulated for the members with information gleaned from claims data. including outpatient lab...

POLICY: Yup, it costs more here

Two studies out. Not exactly new news. I did a study looking at laproscopic cholecystectomy between Japan and the US for my master's thesis in 1992. The result then was that it cost twice as much here, when in those...

POLICY: Joe Paduda on consumer spending restraint

Joe Paduda has an article about Steve Case's determination to piss away $500m changing health care. In it he correctly notes the problem with Colin Powell's argument that buying health care services and buying TVs are about as simple as...

POLICY: Individual insurance, sigh, with UPDATE

The NY Times had a pretty decent article on what a pain in the ass the individual insurance "market" is and it also reminded me of one reason why the eHealthinsurance study last week was so flawed. That study compared...

TECH: The Switch is the trouble with CPOE and EMR

Last week I had two separate, but close to identical, conversations with software companies that claim to have found the solution to the problem of getting physicians to use the EMR. But in neither case did they perceive the problem...

TECH/POLICY: Why health care costs so much, part 37

Bend OR, pop 100,000, now has 8 MRI machines. That compares to the fact that all 97 million Canadians have to share one MRI in downtown Saskatoon that's only available on Tuesday mornings when they take the cow that shares...

BLOGS: Hospital impact

Hospital Impact is an interesting new blog that has several issue areas mostly, but not exclusively, of interest to hospital admin folks. Worth checking out. I can't quite figure out who's behind it, but it seems to have some connection...

HEALTH PLANS: Mckinsey on CDHPs

McKinsey, a very smart firm that should be trusted about as far as it can be thrown in terms of putting its clients' interests above its own, is out with what looks a pretty well researched report on CDHPs. My...

HEALTH PLANS/POLICY: Individual health insurance -- going cheap!

Two people have mentioned this report from eHealthinsurance.com, so I thought I'd better address it. The first is from "friend of THCB" Brian Klepper at the Center for Practical Health Reform. He writes: Here’s a report, issued a couple days...

HEALTH PLANS: United not big enough, needs to buy Pacificare

Some thing tells me that United thinks that the government trough for health plans will continue to overflow a while longer. Apparently it's planning to buy Pacificare for a mere $7-8 billion. Pacificare shares jumped 10% and then were halted...

PHARMA: What Peter Rost did over his holiday weekend

While you were enjoying your burgers, beer and bangs, Peter Rost was writing a book review of his boss' new book. And he decided to put in a very obvious place called Amazon.com. Here it is: Pfizer's CEO, Dr. Hank...

POLICY: What is it that we wonks argue about?

Tom Hillard -- a new contributor over at the transmuted SignalHealth (which is in someway an offshoot of John Rodat's Health Signals New York) -- has this beautiful line about the managed competition versus single payer argument. For aficionados of...

PHARMA/POLICY: Steeves responds to McGarvey

Ayelish McGarvey is back with a follow up to her piece in The Nation on Plan B, which was the subject of a previous piece here in THCB. The new piece called Plan B for Plan B explains the weird...

INDUSTRY: HealthcareRenewal skewers Health Affairs

John Iglehart's rather soft questioning of Guidant's CEO in Health Affairs comes under most excellent and accurate fire from Roy Poses over at Health Care Renewal. A prominent editor of a prominent health policy journal devoted considerable effort to and...

POLICY: Thank God there's no rationing here!

Back with more a little later (Typepad's been a bit problematic today) but to start, just a quick note to those who say that there's rationing in Canada and the UK and that we're so lucky it doesn't happen here....

POLICY: This weekend we celebrate Freedom!

This weekend we celebrate our nation's birthday and its proud heritage of freedom and justice. It seems that the most important freedom left in America is the freedom to push the limits of laws, especially those designed to protect the...