The Health Care Blog

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 Economics | Permalink | Comments (23)

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, The Industry | 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, reform, 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 (2)

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, reform, Small Business, The Industry | Permalink | Comments (60)

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 (7)

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 (2)

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, reform, 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 (20)

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 (41)

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, reform | 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, reform, 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 (8)

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, reform, 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, reform | Permalink | Comments (1)

Open Wide: Here comes the change you thought would never happen

By Jeff Goldsmith The morning after the election, I posted a speculative blog in Health Affairs on three possible scenarios for President-elect Obama’s implementing health reform: folding it into a bold, ambitious emergency legislative package (Complete the New Deal), carving...
November 25, 2008 in Economics, Election 08, Jeff Goldsmith, Marketplace, Obama, Obama administration, Policy, Policy/Politics, reform, The Industry | Permalink | Comments (22)

Small Business Coverage: A Report from the Trenches

By Brian Klepper John Sinibaldi, a well-respected health insurance agent in St. Petersburg, Fla., has become prominent in Florida's broker community because he counsels and services a large book of small business clients and studiously tracks the macro trends that...
November 25, 2008 in Brian Klepper, Economics, Health Plans, The Industry | Permalink | Comments (4)

Hospitals hit by economic downturn

By Jane Sarasohn-Kahn Forty percent of American hospitals have seen drops in inpatient admissions, according to the American Hospital Association. In the AHA's survey, Report on the Economic Crisis: Initial Impact on Hospitals, it's clear that hospitals are already experiencing...
November 24, 2008 in Economics, Hospitals, Jane Sarasohn-Kahn | Permalink | Comments (2)

America's CEOs set priorities for Obama Administration

By Brian Klepper This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the...
November 21, 2008 in Brian Klepper, Conferences, Economics, Quality, The Industry, Transparency | Permalink | Comments (10)

Big pharma has big problems

By David Williams Big pharma has big problems. The root cause is a lack of research and development productivity, which means a dearth of new products to make up for looming patent expirations. Something near half of big pharma’s revenues...
November 19, 2008 in Economics, Pharma | Permalink | Comments (3)

Moody's predicts winners & losers in Obama health reform

By Jane Sarasohn-Kahn Moody's, the credit rating agency, offers their post-election impressions in their special comment, "U.S. Healthcare Industry: Credit Implications of the U.S. Election." Barack Obama's campaign roughed out principles for health reform across three issue areas: Access and...
November 18, 2008 in Economics, Jane Sarasohn-Kahn, reform | Permalink | Comments (0)

Will layoffs take us closer to single-payer?

By David E. Williams Only a few months ago, Goldman Sachs was touted as an incredible bastion of strength in the face of the credit crunch. Sure some other institutions might have been suffering, but Goldman was savvy enough to...
November 12, 2008 in Economics, Policy/Politics | Permalink | Comments (12)

Getting value from medical devices

By Jane Sarasohn-Kahn The buyers of medical devices aren't very good shoppers. They lack the kind of information about technologies that would help them make value-based purchasing decisions, according to James Robinson in the most recent issue of Health Affairs....
November 12, 2008 in Economics, Technology | Permalink | Comments (1)

If you have a right to health care, how much care?

By Maggie Mahar Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, she is fellow at the Century Foundation and the author of the increasingly influential HealthBeat blog, one of our favorite health care reads,...
November 6, 2008 in Economics, Maggie Mahar, Policy | Permalink | Comments (8)

Is Joe the Plumber responsible for our health care mess?

By Sarah Arnquist The financial collapse in the United States and the long, deep recession the nation will likely endure may be the calamitous event needed to finally tip the country toward adopting a universal health insurance, according to Uwe...
November 2, 2008 in Economics, Policy/Politics, reform, Sarah Arnquist | Permalink | Comments (9)

Can Health Plans Explain Why They Aren't Re-Empowering Primary Care?

By Brian Klepper & David Kibbe Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan....
October 30, 2008 in Brian Klepper, Economics, Physicians, prevention, primary care, The Industry | Permalink | Comments (29)