The Health Care Blog

Are We Too Small to Succeed?

By DON LINDSTROM The logic behind the government bailouts in the financial and automobile industries goes like this: some institutions are so large and interconnected that their failure could collapse the entire economy. They are considered to be too big...
November 9, 2009 in AMA, Economics | Permalink | Comments (0)

Op-Ed: Why "free market competition" fails in health care

By JOE FLOWER In trying to think about the future of health care, thoughtful, intelligent people often ask, “Why can’t we just let the free market operate in health care? That would drive down costs and drive up quality.” They...
November 3, 2009 in Economics, Marketplace, Reform | Permalink | Comments (32)

Obama’s Medicare Half-Truth

By AUSTIN FRAKT Obama was called a liar during his recent address to a joint session of Congress. Actually, he was not fully truthful about the implications of cuts to Medicare. Obama repeated that his health reform plan includes payment...
September 20, 2009 in Economics, Medicare, Medicare Advantage, Obama, The Speech | Permalink | Comments (43)

Balancing Consistency and Innovation in Healthcare

By DAVID SHAYWITZ Our healthcare system is now facing a problem that has plagued business leaders for years: how do you balance consistency and innovation? The drive for consistency in healthcare is based upon the fundamental observation that physicians across...
September 20, 2009 in Economics | Permalink | Comments (18)

Health care reform: econo-think, democracy and sustainability

By LAWRENCE W. ARRINGTON Bill Moyers Journal recently interviewed Wendell Potter, who spent much of his career in corporate communications for health insurance giants CIGNA and Humana. Every American concerned about affordable and quality health care and the American political...
September 20, 2009 in Economics, Reform | Permalink | Comments (1)

Is an IOM v. CBO Smackdown Looming on Health-Reform Costs?

By TIM MULLANEY The U.S. can cut health-care spending by $250 billion a year within a decade, a congressionally chartered panel will say this month in a bid to show costs can be contained even if all Americans are insured....
September 15, 2009 in CBO, Economics, IOM, Medicare, Reform | Permalink | Comments (8)

Not Really an Option

By GARY NISSEN To: Executives leading U.S. Hospitals The public option appears to back in the national dialogue and I’m wondering how concerned you all are about that. After all, many of you have been quite successful at minimizing the...
September 13, 2009 in Economics, Hospitals, Public Option, Reform, The Industry | Permalink | Comments (16)

Innovation and Absence of Evidence vs. Evidence of Absence

By Joshua Seidman Jon Gabel from the National Opinion Research Center has an excellent op-ed piece in today’s New York Times. The basic argument is summarized in his conclusion: “The Congressional Budget Office’s integrity is beyond questioning. But the record...
August 28, 2009 in Congress, Economics, Information Therapy, Reform | Permalink | Comments (0)

Speculators Bet Reform Won’t Hurt Industry

By DON JOHNSON Speculators seem to be betting that a watered down health insurance reform bill won't hurt health insurers, hospitals, drug makers or medical device and supply manufacturers. Stocks for almost all of these health sectors and for exchange...
July 27, 2009 in CBO, Congress, Economics, Public Option, Reform | Permalink | Comments (18)

A Wild Pitch: HR3200 Brushes Back Health Reform

By JEFF GOLDSMITH On May 12, the flame throwing Chicago White Sox pitcher Bobby Jenks was fined for throwing behind an opposing player, Texas Rangers second baseman, Ian Kinsler. When Jenks, who can throw a 102 MPH fastball, was asked...
July 20, 2009 in Congress, Economics, Hospitals, Jeff Goldsmith, Medicaid, Medicare, Physicians, Policy/Politics, Reform | Permalink | Comments (24)

Careful What You Wish For

By THE INCIDENTAL ECONOMIST On the left are those who would like health reform to include a strong public plan, one that could negotiate large provider discounts, driving down the cost of medical care. On the right are those who...
July 4, 2009 in AMA, CMS, Congress, Economics, Medicare, Reform | Permalink | Comments (25)

Preventing Extortion

By JACK CHURCHILL The debate about a public health insurance option mirrors the debate about public power in the 1920’s and 30’s. The arguments then were very similar to the arguments we hear today. The principal issue then was whether...
July 2, 2009 in AMA, Economics, History, Supreme Court, The Industry | Permalink | Comments (4)

Unions May Get a Pass on Health Care Benefits Tax

By ROBERT LAWSZEWSKI There is a major bipartisan effort going on in the Senate Finance Committee to reform the health care system. Reportedly, one of the elements of that effort may be a tax on "gold plated" health insurance benefits...
June 29, 2009 in Economics, Robert Laszewski, Senate Finance Committee, The Industry, Unions | Permalink | Comments (6)

The Road from McAllen to El Paso

By HAROLD S. LUFT Dr. Atul Gawande has provided a chilling description of the problems facing true health reform in his recent New Yorker article. In The Cost Conundrum he describes how medical care is provided in McAllen, Texas, which...
June 15, 2009 in Dartmouth Atlas, Economics | Permalink | Comments (29)

Designing an Effective Insurance Exchange. Or Not.

By ROGER COLLIER If health care reform legislation is passed, it will almost certainly include provisions for Insurance exchanges. Theoretically, these could be key to controlling costs and expanding access to coverage. In practice (and in addition to assumptions about...
June 13, 2009 in Economics, Roger Collier | Permalink | Comments (4)

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

The Great $2 Billion Cost Cut "Promise" Meets Another Obstacle

By ROGER COLLIER It turns out that the hospital, insurance and pharmaceutical organizations who announced with great fanfare a couple of weeks ago their plan to cut/maybe think about cutting* $2 trillion/maybe nothing* from their costs may have been even...
May 28, 2009 in Economics, Roger Collier | Permalink | Comments (16)

What's good for General Motors is good for America

By Matthew Holt In 1953, Charles Erwin Wilson, then GM president, was named by Eisenhower as Secretary of Defense. When he was asked during the hearings before the Senate Armed Services Committee if as secretary of defense he could make...
May 27, 2009 in Economics | Permalink | Comments (22)

The Cost of Health Reform - $1.5 Trillion or ... ?

By ROGER COLLIER Putting the political cart firmly before the horse, the Senate Finance Committee heard testimony last week on how to pay for reform—before they had reliable estimates of how much it is likely to cost. It’s not that...
May 20, 2009 in Economics, Roger Collier, Senate Finance Committee | Permalink | Comments (3)

Health Care Leaders Say Obama Overstated Their Promise to Control Costs

By ROBERT LASZEWSKI That was the headline in Thursday's New York Times regarding Monday's promise by health care stakeholders to reduce spending by $2 trillion. A couple of snipets from the Times article: Hospitals and insurance companies said Thursday that...
May 18, 2009 in Economics, Obama | Permalink | Comments (13)

Healthcare as a Complex Adaptive System

By JOE FLOWER You want healthcare reform. I want healthcare reform. Grandma Jenkins wants healthcare reform. What is “healthcare reform?” What kind of animal are we talking about? How would we recognize it if it came up and bit us?...
May 10, 2009 in Economics, Joe Flower | Permalink | Comments (10)

Op-Ed: Cost-Reduction Strategies Help Hospitals Weather Economic Uncertainty

By DAVID MARKOSKI In today’s current economic climate, many hospitals are reducing staff to cut costs and balance their budgets. An even greater number are trying to reduce administrative costs to save money for the difficult days ahead and retain...
May 6, 2009 in Economics | Permalink | Comments (3)

Is the Healthcare Economy Rightsizing?

By Brian Klepper and David C. Kibbe More than at any time in recent memory, powerful forces are buffeting the health care sector. We are in the midst of profound upheaval, driven by market and policy responses to the industry's...
March 12, 2009 in Brian Klepper, Current Affairs, David Kibbe, Economics, Health Plans, Marketplace, Medical Devices, Policy, Policy/Politics, The Industry | Permalink | Comments (33)

A Broker's Lament: We Brought This On Ourselves

By JOHN SINIBALDI A huge segment of the American population is simply far too strapped to ever afford the premiums and costs associated with health insurance/health care as it is structured today. It isn't the employees of government (local, county,...
March 7, 2009 in Economics, Health Plans, Marketplace, Obama administration, Policy/Politics, Small Business, The Industry | Permalink | Comments (61)

Comparing the effectiveness of comparative effectiveness research

By Sarah Arnquist An increased investment in comparative effectiveness research to gather additional evidence on what medical therapies and technologies work best is often cited as a fix for the nation’s rising health costs. Unfortunately, lessons from its use abroad...
March 3, 2009 in Economics, Obama administration, Policy/Politics | Permalink | Comments (2)

Disruption breaking out over at Scott Shreeve's place

Clayton Christensen's publisher is pressing me to read The Innovators Prescription and then interview him. Sadly I haven’t had the time to pay the book the attention it deserves. Messrs Kuraitis & Kibbe already did a review on THCB and...
February 21, 2009 in Economics, HHS, Marketplace, Matthew Holt, Medicare, Scott Shreeve | Permalink | Comments (2)

The Perils of Play or Not Pay

By ROGER COLLIER Remember those heady days with a newly-elected Democratic President and solid Democratic majorities in both houses of Congress, when it seemed that national health care reform was just around the corner? Remember how, after the face-off between...
February 5, 2009 in Economics | Permalink | Comments (12)

The New Science of Vascular Disease

By William H. Bestermann M.D. Vascular disease and the conditions that produce arterial problems consume roughly one- third to one-half of the $2 trillion annual spend in American health care. The science and systems exist today to dramatically improve the...
January 28, 2009 in Economics, Policy/Politics, primary care, Quality, Science | Permalink | Comments (9)

Please, do not ban reference-based pricing

By Rick Peters, MD & Karl Luber, MD We were stunned (yes, we're naïve and idealistic) to read in The Kaiser Family Foundation newsletter and The Wall Street Journal article last week that CMS (surprise) and the now former the...
January 25, 2009 in Economics, Medicare Advantage, Obama administration, Policy/Politics | Permalink | Comments (3)

Health care wins in initial stimulus package

By Sarah Arnquist Responding to calls for Washington to take swift action in the face of the bleakest economy in decades, the House of Representatives released a $825 billion package last week designed to stimulate the economy. The early version...
January 19, 2009 in Economics, The Industry | Permalink | Comments (7)

A Shakespearean Approach to Health Care Reform

By Roger Collier With the opening of the new Congressional session, the latest health care reform effort is off and running, with HHS Secretary-designate Tom Daschle telling senators at his confirmation hearings of his desire to work collaboratively and listen...
January 15, 2009 in Economics | Permalink | Comments (5)

Free Trade and Free Antibiotics

By MICHAEL MILLENSON The next time you visit your doctor with a case of the sniffles, he may want to inquire about your position on the North American Free Trade Agreement before deciding whether to reach for his prescription pad....
January 12, 2009 in Economics | Permalink | Comments (3)

"The Innovator's Prescription": Christensen's Book Offers Insightful Dx, Unrealistic Rx

By Vince Kuraitis and David C. Kibbe Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare . The book is co-authored...
January 8, 2009 in Economics, Electronic Medical Records, Health Plans, Policy, Policy/Politics, Technology, The Industry | Permalink | Comments (8)

Shocker--Karen Ignagni almost tells the truth

The NY Times' Robert Pear has an article on the politics of the Obama Administration introducing a public plan as part of FEHBP. As you might expect a boat load of Republicans who were told in grade school that private...
January 8, 2009 in Economics, Health Plans, Hospitals, Medicare Advantage, Obama administration, Policy, Policy/Politics | Permalink | Comments (21)

Not exactly health care, but follow the money...

By Matthew Holt Michael Lewis has returned from writing about Jim Clark, technology, baseball and football to his first topic; finance. (Liars Poker is still the best book about Wall Street ever) His two part piece with hedge fund manager...
January 5, 2009 in Economics, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (3)

Outlook for health stocks clouded by uncertainty about Obama’s health strategy

By DON JOHNSON Although I wrote months ago that health executives weren’t very concerned about the elections, I think they have to be now. Many health stocks are depressed and they will be until the uncertainty about Obama’s proposed nationalizing...
January 4, 2009 in Economics | Permalink | Comments (0)

The Downfall of AIG

By ROBERT LASZEWSKI Those of you outside of Washington, DC likely missed the Washington Post's three-part investigation of the events leading to the downfall of AIG. It makes for good holiday reading. I highly recommend the series to you. Knowing...
January 2, 2009 in Economics, Robert Laszewski | Permalink | Comments (0)

Health and health care in 2009 - a year of managing risks and wild cards

By Jane Sarasohn Kahn As we inevitably do this time of year, we prognosticate about the new year. This time around, it's a toughie: there are too many uncertainties that preclude us from doing a straight-line forecast for 2009, especially...
December 30, 2008 in Economics, Jane Sarasohn-Kahn, The Industry | Permalink | Comments (0)

The Medicare Ponzi Scheme

By Eric Novack Just today, our next President spoke out against the largest investment swindle in US history. The alleged behavior of Bernard Madoff may have cost investors up to $50 billion. “In the last few days, the alleged scandal...
December 19, 2008 in Economics, Medicare, Policy/Politics | Permalink | Comments (19)

Washington, Please Don't Bail Out the Health Care Industry

By RICK PETERS A health care Marshall Plan -- $50 Billion stimulus to get electronic health records (EHRs) in every doctor’s hands or $50,000 to each physician -– what an incredible marketing job. Detroit, are you listening? Stop whining to...
December 19, 2008 in Economics, Electronic Medical Records, Obama administration, Physicians, Policy, Quality, Technology | Permalink | Comments (45)

On Health Care Reform Stimulating the Economy: The Massachusetts Example

By Maggie Mahar Recently, a somewhat starry-eyed op-ed in the New York Times suggested that a $100 billion annual investment in universal health care is just the medicine that our economy needs. The goal, declared Jonathan Gruber, a professor of...
December 14, 2008 in Economics, Maggie Mahar, Obama administration, Policy/Politics | Permalink | Comments (11)

Slicing the health reform pie

By Robert Laszewski I doubt anyone would disagree with the statement that America’s health care costs are too high, continue to grow at an unsustainable rate, and reform is critical to control costs, get everyone covered, and improve quality. In...
December 12, 2008 in Economics, Medicare Advantage, Obama administration, Policy/Politics, Robert Laszewski | Permalink | Comments (15)

Shifting costs from public to private payers

By Charlie Baker The other day, the American Hospital Association, the Blue Cross / Blue Shield Association, Premera Blue Cross and America’s Health Insurance Plans (FYI - HPHC is a member and I’m on the Board of AHIP) released a...
December 12, 2008 in Charlie Baker, Economics, Policy, The Industry | Permalink | Comments (22)

Healthcare and the Job Market

By MERRILL GOOZNER Looking for a bright spot in Friday’s dismal job report? Think how bad it would have been had the health care sector not added 52,100 jobs last month. That’s right. While the rest of the economy was...
December 12, 2008 in Economics | Permalink | Comments (25)

Bad economy leads to poor health behaviors

By Jane Sarasohn-Kahn Half of people over 45 said in a recent AARP survey they've taken a generic drug or over-the-counter (OTC) medication instead of a prescription drug due to the current economic situation. The AARP's report, "Impact of the...
December 10, 2008 in Economics, Jane Sarasohn-Kahn | Permalink | Comments (4)

Sleepless in Seattle

By Matthew Holt In a 36 hour span I left the mountains of Copa Ruinas in Western Honduras, had dinner in South Beach, Miami and after stopping off to see that Health 2.0 central in SF hadn’t collapsed, ended up...
December 4, 2008 in Conferences, Economics, Health Plans, Matthew Holt, Medicare Advantage | Permalink | Comments (9)

Nudging the value glacier

By Sarah Arnquist In just two years, seniors will spend a quarter of their monthly Social Security checks on Medicare out-of-pocket expenses, including premiums, co-payments and deductibles. Meanwhile, Medicare bookkeepers predict total health spending in the U.S. to increase from...
December 4, 2008 in Conferences, Economics, evidenced-based medicine, Medical Devices, Policy/Politics, Quality, Sarah Arnquist | Permalink | Comments (2)

There's waste in the medical system--Duh!

By Robert Laszewski As we begin the health care reform discussion in earnest, many are pointing out all of the waste in the system and the need to research what works best, provide the incentives to do it, manage the...
December 3, 2008 in Economics, Policy/Politics, Quality, Robert Laszewski | Permalink | Comments (6)

Addressing an epidemic of overtreatment

By John Halamka & Rich Parker Health care costs in the U.S. are approaching 17 percent of the GDP and may be as high as 20 percent in the next few years. What is causing the US to have the...
December 3, 2008 in Economics, evidenced-based medicine, Policy, Quality | Permalink | Comments (6)

After 12 months of recession, whither health reform?

By Jane Sarasohn-Kahn We're in a recession; actually, we've been in one for the past year, but no official agency decided to tell us. Perhaps "they" wanted to wait until after the November '08 Presidential election? The declaration of recession...
December 3, 2008 in Economics, Election 08, Jane Sarasohn-Kahn, Policy/Politics | Permalink | Comments (1)