The Health Care Blog

TECH/PHARMA: Words of wisdom on the infrastructure for prescribing

So (finally!) the piece I co-authored with Jane Sarasohn-Kahn on the prescribing infrastructure has been published by the California Health Care Foundation. Please go take a look. It's called The Prescription Infrastructure: Are We Ready for ePrescribing? I'll be writing...

POLICY/INTERNATIONAL: High co-payments prevent needed care, and not in the US this time

So charging at the point of care, another Zombie of health care policy, isn’t just a problem for the poor here—although it’s going to get a whole lot worse. It’s also a big issue in that place that the US...

POLICY: ACP reccomends UK system

The American College of Physicians is out with its proposals for a better American health care system The paper recommends voluntary certification and recognition of primary care and specialty medical practices that use health information technology, quality measurement and reporting,...

HEALTH PLANS/POLICY: Too much fawning over Len Schaeffer?

No one is arguing that Len Schaeffer isn't a very bright guy, nor that he hasn’t done very well in America’s health care system. He’s also done very well out of America’s health care system. So when McKinsey publishes a...

POLICY: Should Medicaid come after your inheritance to pay for grandpa's LTC? by Eric Novack

THCB’s favorite surgeon is back with an interesting question on Medicaid “lookbacks”, and who should pay for long term care. Eric Novack writes: In today’s Boston Globe, there is an article titled Medicaid proposal could hurt seniors. In it the...

POLICY: One more on Gratzer, Jon Cohn insists...

Volvo-driving, latte-quaffing New Republic editor Jon Cohn has passed over David Gratzer’s latest gaffe. Gratzer is the Manhattan Institute’s resident Canada-basher physician. Believe it or not, the article in the Weekly Standard is called Putting Patients First. Either Gratzer doesn’t...

POLICY: HSAs now will cure uninsurance! And monkeys will fly out of......

Some how or other even though Reggie Herzlinger is apparently having some doubts about how effective HSAs are going to be, the movement is throwing up new intellectual champions. The latest is R. Glenn Hubbard of the AEI who has...

POLICY: Re-print from The Economist on why Bush's health care tax policy is all wet

This is a straight re-print from the Economist magazine. Lots of people have sent me this article, but I found it in an accessible format here. Remember that the Economist supported Bush and even backed the Iraq war, so I...

HEALTH PLANS/POLICY: Health Insurers hold the keys, but wont use them to start the car!

Meanwhile in an attempt to drum up their health plan business and appear smarter than the average consultant bear, Diamond Technology Partners has an interesting press release out. The title basically says it all: Health Insurers Hold Keys to Controlling...

HEALTH PLANS/POLICY: HSAs Triple in 10 Months, or is AHIP just blowing more smoke?

Anyone who reads THCB knows that I’ve never exactly been impressed by the scholarly worthiness of AHIP’s research, or the veracity of its leader Karen Ignani. So I remain just the teeny-ist bit suspicious about their take on the study...

PHARMA/HEALTH PLANS/PBMs/POLICY: Meanwhile Ignangi on drug pricing, best price and fraud

I’m listening to the webcast of the KFF Forum on Medicare, and in the middle Karen Ignagni comes out with this gem. But Karen Ignagni, president and CEO of America's Health Insurance Plans, countered that so far, health insurers are...

PHARMA: McKinell's over-Exubera-nce

Diabetes sufferers will have to wait a longer for Exubera, an inhaled insulin drug that supporters say transform the lives of people with the condition. Pfizer shares soared this morning after CEO Hank McKinnell said the drug has received FDA...

POLICY/POLITICS: Our fearless leader demonstrates his vast understanding of the health care system

Here's the man himself interviewed in the run up to the State of the Union by the the friendly WSJ: The Wall Street Journal: Thanks for taking the time for us. We wanted to think forward to the State of...

POLICY: Wealthy Floridians fear health care costs

Brian Klepper steers THCB to this cracker of a headline from the state of endless sunshine and rampant voting fraud. Poll: Wealthy Floridians fear health care costs. Apparently Florida's wealthiest residents (although the story doesn't define wealthy) fear that the...

POLICY: Over at TPMCafe, Medicare Part D

I have joined in a coversation about Part D with some other old farts and a couple of young punks (but very smart young punks — I was strugling to learn how to pick my nose at their age, and...

POLICY/THCB: Ron speaks

So while I was making my lunch and walking the dog everyone's "favorite" THCB commenter Ron Grenier called me and talked, and talked, and talked. What was he talking about? Your guess is as good as mine, but let's just...

PHARMA/POLICY: Drug coverage in Medicare Catastrophic (1988) and in the Clinton plan (1994), by MedPac

This is taken straight from a hard to navigate PDF document created in 2000 by MedPac (and advisory body on Medicare for the Congress). It’s a good primer on what happened, especially to drug coverage under the by now forgotten...

POLICY: Medicare and HSAs: Ready for Their Close-Ups

My weekly column is up over at Spot-on, and despite trying hard to avoid it, I’ve been forced into the murky waters of Medicare Part D and HSAs. There are no comments there, so feel free to come back here...

HOSPITALS/PHYSICIANS/POLICY: More data on specialty hospitals suggests the obvious

HSC is out with another study on local markets, and this time it’s looking at specialty hospitals. Not a new tune. HSC finds that purchasers in three local markets where there are plenty of specialty hospitals believe that the hospitals...

QUALITY/PHARMA: Statins in the water in the UK, but generic ones

And in more from the UK, statins are now going to be put in the water. Well not quite, but allowed to be given to anyone ever suspected of maybe in the future developing heart disease given to anyone ever...

POLICY/QUALITY: Assisted suicide, as rational as can be

In a remarkable front page story, the London Times has an excellent article on why assisted suicide should be legal in any rational country, as it is in Oregon and apparently Switzerland. The story is called Why a retired GP...

POLICY/POLITICS: Ezra Klein skewers the HSA, Joe Paduda skewers the CDHP, with UPDATE

(This entry bumped up to top because of fun UPDATE) Apologies for my later start this morning, those of you who follow my knee problems will perhaps be as pleased as I am to know that I spent the weekend...

TECH/PHYSICIANS: Medtronic helps out whistleblowers, by The Industry Veteran

The Industry Veteran is back on his preferred way to make a buck in health care Another whistle-blower makes good, this time on the device side of health care manufacturing. It appears that Medtronic pays spinal surgeons upwards of a...

TECH: JSK on Google

Over at iHealthbeat the ever wonderful Jane Sarasohn Kahn writes about Paging Dr. Google.

PHARMA/POLICY/POLITICS/PHYSICIANS: Tierney with some optimism on the DEA's war on doctors

Writing (unfortunately behind the fire-wall) in the NYT, John Tierney attacks the Republicans as being the Party of Pain. With their attempts to stop the Oregon assisted suicide law, and the relentless attack of the DEA on pain doctors, the...

BLOGS/TECH: Bloggers meeting, sadly without me

A group of tech bloggers are meeting at HIMSS at 8.30 pm on Sunday Feb 12th in San Diego at Hennessy’s Gaslamp pub. Sadly I wont be there as I don’t show up till the next a.m -- being too...

POLICY: The future of retirement

In this book review of a couple of finance books in the New York Times, Neil Genzlinger is close enough to being right to remind us why we need to figure out the underlying problems in the health care system....

THCB: Last call for submissions

Last call for submissions for the THCB health care reform competition. Your mandate: solve the health care crisis in 250 words or less. Be sure to, ahem … read the contest rules, before submitting your master plan, as it's clear...

POLICY: Joe Paduda explains what's wrong with Part D's economics

While we’ve been focused on what’s wrong with Part D’s implementation, Joe Paduda reminds us all about one of the other problems with Part D. It’s that by it’s nature a voluntary benefit is going to attract adverse selection. In...

QUALITY/POLICY: Need an Organ? It Helps to Be Rich

ABC News reporter Joy Victory found a really juicy angle on the problems of being uninsured. Her article is called Need an Organ? It Helps to Be Rich. As you might suspect getting on the waiting list for an organ...

POLITICS/POLICY/PHARMA: Compare and contrast GWB and LBJ on Medicare

Jonathan Cohn takes a good look at the Medicare implementation now and then, in What Bush could learn from LBJ on Medicare. Not too surprisingly the current screw-up wasn’t evident in 1965, even though the Johnson Administration had only 11...

PHARMA: The gift that keeps giving, or PhRMA being dumb and dumber

Somehow I’ve ended up on Peter Rost’s mailing list. Now he’s a guy who knows a thing or two about the wacky behavior of big pharma. Peter sent me a press release about that novel that PhRMA funded until the...

POLICY: Busboys On The Street

I’m up at Spot-On talking about pay or play, and the San Francisco Busboys On The Street. Next week we’re taking the politico-nerds remedial education in another direction, but for now this finishes pay or play….

POLICY/POLITICS/TECH: Jon Cohn plays Gotcha on Part D

John Cohn finds the December GAO report that says that CMS wasn’t ready for Part D’s launch, and also McClelland's response that the GAO was underestimating CMS. Make that “mis-underestimating”, I think. Here’s what the GAO Report says would be...

BLOGS: Shahid Shah's fame knows no end

Shahid Shah, the James Brown of health care blogging, is featured in another interview, this on on Blogging Your Way Up the Career Ladder. Now don't tell me you don't get the James Brown reference.

BLOGS: Why are you not sheep?

So it sit here every day slaving away just to give you a little information and entertainment, and I ask you for one eeny-teeny thing….to go and vote for brave patient and young punkette Kate Steadman’s Healthy Policy blog in...

POLICY/POLITICS/QUALITY: Supreme Court upholds Oregon physicians and patients rights

Some slightly good news in the DEA and DOJ’s continued campaign to get into the practice of medicine in the guise of preventing “drug trafficking”, or more accurately imposing the extreme morals of the religious right on the rest of...

PHARMA: Whistleblowing and more ways to make a buck in big Pharma, by The Industry Veteran

The Industry Veteran some time ago decided that the only decent career path left in pharma was that of whistleblower. He has more evidence to back his case. Here’s the Veteran’s restrained take on the matter. Here’s another piece of...

BLOGS: MLK day

It's a holiday, or it ought to be. I met someone in community relations for Chevron last night. She had to go to work today, but apparently Chevron doesn't mind if African-American employees take the day off. So stop reading...

(Slightly) OFF-TOPIC: Not in front of the children

I’ve always heard rumors about this stuff but I thought they were inventions of the San Fernando valley’s favorite industry, but apparently in South Africa a group of nurses were busted in a sex orgy in hospital. While it sounds...

QUALITY/POLICY/HEALTH PLANS: Good article on pay for performance

Nothing radically new in this but a very good general journalistic article on the arrival of Pay for Performance in middle America. Keeping score on physicians is well worth a read if you haven't seen it. You can use this...

POLICY: Of course, you know, this means war!

The Maryland legislature enacts a Wal-Mart specific pay-or-play bill. It says that any company with more than 10,000 employees which doesn’t spend 8% of payroll on health care benefits needs to pay into a state fund. What’s not to like...

OFF-TOPIC: How much more ridiculous could US Skiing get?

The winter Olympic is coming up, and you may not know it but the US has a seriously talented, and seriously wacky, skiing star. His name is Bode Miller, and he is a free-spirit, lives in a motor home, skis...

QUALITY/POLICY: Chronic care DM fails in a FFS world

This is no news to THCB readers, but let me remind you. Chronic care is hard work. Disease management programs are only partially effective because — even if you get it right — it goes against the incentives of doctors...

PHARMA: What will it really take for big Pharma to go Hollywood? by The Industry Veteran

The Industry Veteran, who’s opening the year on quite the tear, has been pondering the latest “trend” in the pharma marketing chatter — the idea that Pharma needs to follow the Hollywood model. Here are his thoughts: Here’s an interesting...

POLICY: And at Spot-on, why local pay or play is doomed, doomed!

I have a piece up over at Spot-On explaining why local attempts to fix the health insurance mess won't get too far. More remedial education, but worth a look!

TECH: Outlook "update" is a backtrack

One of the regular system updates Windows automatically downloaded to me the other day was an "enhancement" to the junk mail filter on Outlook. Until this "enhancement" my junk mail was doing farily well, with only a few false positives...

OFF-TOPIC: Study--7 Percent of Workers Drink on Job

Apparently according to this study “just over 7 percent of American workers drink during the workday — mostly at lunch — and even more, 9 percent, have nursed a hangover in the workplace, according to a study.” This tells me...

POLICY/PHARMA/PBMs: Health spending collapses--all the PBMs doing! (No, not really).

So the numbers on national health expenditure are out, and health spending plummeted by 50% in 2004!! Oops, what I meant to say was that health spending only went up by 7.9% — barely enough to trouble the scorers (as...

POLICY/PHARMA/PHYSICIANS/POLITICS: Some more publicity about the awful state of pain medication

Finally there is some word getting out about the reign of terror the DEA has been running against pain doctors and its awful impact. This article, called Let's Get Serious About Relieving Chronic Pain picks up from the NEJM article...