The Health Care Blog

So will the public option hurt hospitals? Not in the Ozarks

By Matthew Holt I've had this sitting in my inbox a while, but I thought that with the Senate bill out it was time to have a bit of weekend fun with it. The topic is the fear that a...
November 20, 2009 in Health Plans, Hospitals, Matthew Holt, Policy/Politics, Public Option | Permalink | Comments (5)

Sell Patients like Baseball Players - Seriously

By JOE FLOWER Here's a health care reform strategy that I have not heard anywhere else. Think about this: Why aren't health plans more aggressive in promoting the long-term health of their members, like getting them to eat better, stop...
November 19, 2009 in Health Plans, Joe Flower, Patients, Reform | Permalink | Comments (43)

Abortion Coverage Is About Math As Well As Politics

By AL LEWIS Let us start by acknowledging that those who think abortion is a sin must be respected, and not forced into a risk pool that covers abortion. Let us also acknowledge that those who are pro-choice need to...
November 12, 2009 in Health Plans, The Public Option | Permalink | Comments (15)

Pay (Only) for Health Care that Works

Charles Silver & David A. Hyman Health care is expensive partly because governmental payers and insurers foot the bill for large quantities of medical services that are ineffective, unnecessary, or unproven. According to a RAND report, studies of clinical efficiency...
November 11, 2009 in Congress, Costs, Health Plans, Policy, Reform | Permalink | Comments (30)

Protest Music at AHIP meeting

By Matthew Holt This is much more fun and better sung than traditional protests! And given that AHIP would benefit from a public option, I suspect Karen Ignagni hired them. It looks like it happened in the closing session of...
October 24, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (9)

Why AHIP needs the public option

By Matthew Holt It’s been a fun week. After years of THCB explaining that neither could AHIP do genuine research nor could its venerable President open her mouth without lying, the rest of the world has caught on. I won’t...
October 16, 2009 in Charlie Baker, Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (37)

I was largely in favor of Swiss-style health care...

By Matthew Holt until I found out that the people who the NY Times says are really in favor of it are Bill O'Reilly and Regina Herzlinger… Actually I’m kidding. I knew Regi says she likes it, and Maggie Mahar...
October 1, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (2)

Swine flu, uninsurance and not-so fondly remembering the teenage years

By Matthew Holt We get sent lots of rants to our tips line, most of which we ignore in an amused jaundiced way. But this one I found very amusing. I'm not sure it's 100% accurate, but it is very...
September 30, 2009 in Health Plans | Permalink | Comments (4)

"Reform" Means Higher Costs, Not Lower

By JOE FLOWER A reader asks: "If the current bill passes are my health insurance costs likely to go up, down, or remain about the same?" If the form that I believe most likely to pass actually passes (insurance reforms,...
September 21, 2009 in Costs, Health Plans, Reform | Permalink | Comments (4)

Taxing Health Insurance Companies to Pay for Health Care

By ROBERT LASZEWSKI The Congress has investigated about every conceivable way to tax people to pay for the health care proposals—a millionaire’s tax, bigger taxes on home mortgages and charitable contributions, and a couple of dozen more ideas. Now Congress...
September 14, 2009 in Congress, Health Plans, Taxes | Permalink | Comments (9)

Happy Trails, Trigger

By ROGER COLLIER Okay, my apologies to Roy Rogers, but I was pleased to see in the New York Times that the idea of a public plan trigger is finally getting serious consideration by the White House and by Senate...
September 8, 2009 in Health Plans, Reform, Roger Collier, Senate Finance Committee | Permalink | Comments (3)

Healthcare Reform: Strangled In Its Bed

By JOE FLOWER Follow the bouncing ball here: Health care was a mess, cost way too much, sick people getting dropped by insurance companies and left to die and bankrupted and all that. The obvious solution: Go to a single-payer...
September 8, 2009 in Congress, Health Plans, Policy/Politics, Public Option, Reform | Permalink | Comments (3)

Winners and Losers - Strategy in a Post-Reform World

By BILL KRAMER Most health policy experts are focusing on the daily ups and downs in the political battles over health reform. Within the health care industry, however, there is a buzz about who will be the winners and losers...
September 4, 2009 in Health Plans, Reform, The Industry | Permalink | Comments (29)

Are Cooperatives a Reasonable Alternative to a Public Plan?

By TIMOTHY S. JOST First, a word about history. We have tried cooperatives before. During the 1930s and 1940s, the heyday of the cooperative movement in the United States, the Farm Security Administration encouraged the development of health cooperatives. At...
August 20, 2009 in Cooperatives, Health Plans, History, Public Option, Reform | Permalink | Comments (9)

Enthoven's ABCDs and why that socialist Gingrich is wrong on standardized benefits

By Matthew Holt Here's Alain Enthoven's four part plan for fixing healthcare. As THCB regulars might guess, it's familiar and very sensible stuff. (Here’s the PDF) A. Create an exchange with standardized plans, make individuals buy through the exchange and...
August 16, 2009 in Health Plans, Policy, Policy/Politics, Reform | Permalink | Comments (4)

Will Hospital Stocks’ Rally Continue?

By DON JOHNSON Since early July, most hospital companies’ stocks have been rallying in anticipation of relief from uncompensated care costs under proposed health insurance reform bills. On Wednesday, however, profit taking hit the stocks in a small way. The...
August 15, 2009 in Health Plans, Hospitals, Medicaid, Medicare | Permalink | Comments (4)

KP lawsuit doesn't sniff quite right

By Matthew Holt It’s about time we had a fun Kaiser Permanente scandal, as it’s been a while, and it appears that they’re having some influence on the side of the angels in DC these days. And tracking vis HISTalk...
August 14, 2009 in Health Plans, Policy/Politics, Privacy | Permalink | Comments (9)

Op-Ed: A Practicing Doctor's Prescription for Health Care Reform

By JORDAN SHLAIN, MD Our national healthcare system needs a 'step-change', not incremental change. We are facing a vast and complex problem. Let's use it as an opportunity; rather than blaming our nation's health problems solely on corporations, providers, insurers,...
August 7, 2009 in Health Plans, Op-Ed, Rationing, Reform | Permalink

Are “Cadillac” health plans the problem?

By BILL KRAMER The debate over proposals to tax health insurance plans is confusing and frustrating. The proposals are usually described as a tax on “gold plated” or “Cadillac” health coverage. According to the media and many spokespeople on the...
August 4, 2009 in Costs, Health Plans, Reform, Taxes | Permalink | Comments (9)

Online behavioral health on American Well's platform, and a hint at Cisco/UHG

By Matthew Holt As usual I am way behind on tech and Health 2.0 news but here's one that was "thrown out with the trash" late last week because the service went live on Saturday. American Well has has added...
August 3, 2009 in Health 2.0, Health Plans, Technology | Permalink | Comments (6)

Commentology

By ANONYMOUS I'm retired now, but as a former lawyer, I simply must speak out in opposition to the various health care proposals that are being bandied about. It used to be said that what was good for GM was...
July 24, 2009 in Commentology, Congress, Health Plans, Lawyers, Malpractice | Permalink | Comments (8)

House Health Care Reform: Ignoring the Elephant?

By ROGER COLLIER After some frantic last minute political gyrations and a lot of pressure from the President, House Democrats have announced details of their draft health care reform bill. Much as expected, the 852-page bill emerging from three House...
July 15, 2009 in Congress, Health Plans, Policy/Politics, Reform, Roger Collier | Permalink | Comments (26)

Eliza gets a nice write up in BusinessWeek

BY MATTHEW HOLT Indeed, it’s so nice that methinks Lucas & Alex were quite seductive! Speaking as a friend and one who’s been indoctrinated into the cult of Alexandra Drane, its interesting to see the mainstream press picking up the...
July 13, 2009 in Health 2.0, Health Plans, Technology | Permalink | Comments (1)

Op-Ed: Forward thinking health plans? Look for the guys with the white hats

By RICHARD NOFFSINGER The public noise about health care reform has painted the parties involved in broad brush strokes that tell consumers which in the fray are the good guys and bad guys. News reports have for so long vilified...
July 13, 2009 in Data Analytics, Electronic Medical Records, Health Plans, Op-Ed | Permalink | Comments (10)

Behind the Curtain: Wendell Potter on the Industry's Management of Care and Reform

By BRIAN KLEPPER Stop what you're doing and take out a half-hour to watch this week's superb Bill Moyers' 3-part show, especially the extended interview with Wendell Potter, former CIGNA VP Corporate Communications, for a frank, insider's discussion of how...
July 10, 2009 in Brian Klepper, Health Plans, Policy/Politics, Reform | Permalink | Comments (9)

Rantology: Cannon on Freedom or Power?

By Matthew Holt Ah-ha. Michael Cannon has now replied to me and it basically comes down in his mind to me being a crypto-fascist Stalinist wanting to break the will of the American people mediated through its representatives, the health...
June 30, 2009 in Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (25)

A little more on insurers, and reform means more of the same

By Matthew Holt In the comments on my piece on Michael Cannon (which Michael has not commented on sadly, as I was hoping for a nice fight! Michael has replied here and I'll reply back on Monday), everyone’s favorite insurance...
June 27, 2009 in Health Plans, Matthew Holt, Policy/Politics | Permalink | Comments (31)

Op-Ed: A Social Democrat Weighs in on a Government Health Plan

By DAVID HANSEN I was born into a Berkeley family of Social Democrats—my father studied Swedish economic policies—then I trained in social-democratic Economics in Scandinavia, before cutting my career teeth in a Norwegian Labor Party think tank. I thereby personify...
June 24, 2009 in Health Plans, Op-Ed | Permalink | Comments (23)

More bad press for Insurers. Will anyone care?

By Matthew Holt Jon Cohn notes that Wendell Potter, a former PR executive with Cigna and Humana. will be appearing before a Senate Commerce Committee today. Note the word “former”. Trudy Lieberman has an interview with Potter where he repeats...
June 24, 2009 in Health Plans, Policy/Politics | Permalink | Comments (20)

Your AHIP Quiz Question of the Day

By Matthew Holt This is something that's been puzzling me for a few weeks. We all know that insurers are very good at making sure that they insure healthier risks than average. In the individual market they do this openly,...
June 21, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (20)

The Dumbest Thing I Have Ever Seen An Insurance Company Do

By ROBERT LASZEWSKI And, I’ve been in the business for 37 years. First, let me stipulate we really need a system of universal care where everyone gets to have insurance. But we don’t yet so certain rules are unavoidable until...
June 20, 2009 in Health Plans, Robert Laszewski | Permalink | Comments (28)

Beyond the Beltway – How Most of America Sees Health Reform

By BILL KRAMER What are people saying about health reform beyond the beltway and outside the health wonk debates? I’ve been meeting with Rotary Clubs and local Chambers of Commerce during the last several months, and they’re talking about different...
June 17, 2009 in Health Plans, Obama administration, Policy/Politics, Reform | Permalink | Comments (10)

The Health Industry's Achilles Heel

By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished...
June 10, 2009 in Brian Klepper, David Kibbe, Health Plans, Obama administration, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (15) | TrackBack

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 National HIT Organizations - How it All Works

By John Halamka Several blog readers have asked me to take a fresh look at all the organizations related to ARRA and explain how it all works. Here's my understanding: Office of the National Coordinator The Obama administration's ONC is...
June 8, 2009 in Health Plans, The Industry | Permalink | Comments (2)

Michael Porter--seduced, converted, or bludgeoned into accepting reality?

By Matthew Holt What a difference a few years makes. Michael Porter is the Harvard Business School prof who charged into health care a few years back. He (with Elizabeth Teisberg) wrote a book called Redefining Health Care which suggested...
June 4, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (34)

American Well gets busy with guidelines, Optum

By Matthew Holt Our friends over at American Well have two announcements today. First, they’re releasing what they call Online Care Insight, which is essentially the integration of care guidelines into their online care system. We saw a glimpse into...
June 3, 2009 in Health 2.0, Health Plans, Technology | Permalink | Comments (3)

Cal Blue Shield wins recision case, but it's very, very strange

By Matthew Holt So Blue Shield of California wins the first case it’s fighting over the recission issue. But it’s in very strange circumstances. The plaintiffs (a couple trying to get coverage for a doctor they like that wasn't in...
May 29, 2009 in Health Plans | Permalink | Comments (7)

I'm not sure that's how Uwe meant it!

By Matthew Holt The AP has a puff piece on the greatness of Karen Ignagni. Well greatness if greatness is defined as doing anything it takes to screw the nation on behalf of her organization’s members, all the while telling...
May 25, 2009 in Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (6)

Octomum gives Kaiser a bellyache

By Matthew Holt First KP somehow gets landed with the Octomum, whom they most surely didn't provided with the IVF in the first place. My assumption is that the multiple birth cost them into the middling 6 figures. Now because...
May 16, 2009 in Health Plans, Hospitals | Permalink | Comments (3)

Vaccine refusal, or Jenny McCarthy, better with fewer clothes on

By Matthew Holt Kaiser Permanente has released a study from its EMR database looking at use of vaccines in its Colorado region. KP in Colorado has data on about 480,000 members dating back to the mid-1990s from when they started...
May 13, 2009 in Electronic Medical Records, Health 2.0, Health Plans | Permalink | Comments (4)

The Public Plan--Mutual Assured Destruction?

By ROBERT LASZEWSKI I typically don’t talk about my travels on this blog but something happened this week that bears reporting. Whether the federal government should or should not offer a public health plan alternative to compete with private insurers...
April 20, 2009 in Health Plans, Obama administration, Policy, Policy/Politics, Robert Laszewski | Permalink | Comments (7) | TrackBack

The Biggest Health Care Controversy on the Hill

By ROBERT LASZEWSKI Since when was a two-tiered health insurance system a Democratic policy goal? Among Democrats in the Congress and at the White House there is a great deal of interest in creating a government-run health plan in the...
April 16, 2009 in Health Plans, Robert Laszewski | Permalink | Comments (29)

Herzlinger--Enthoven was right all along

By Matthew Holt In a blog piece called Why Republicans Should Back Universal Health Care Regina Herzlinger says something that I more or less agree with. Switzerland's system isn't a bad option. Neither for that matter is Holland's. Now of...
April 13, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (3)

Kaiser Permanente CEO George Halvorson on reform and life after IT

By Matthew Holt George Halvorson is the CEO of Kaiser Permanente, and the driving force behind both the HealthConnect EMR implementation and a national player in the health reform debate. I got to talk to him at HIMSS where he’d...
April 8, 2009 in Electronic Medical Records, Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (14)

So what's the real usual, customary and reasonable price of care?

By Matthew Holt The Ingenix mess apparently won’t go away. Sen. Jay Rockefeller is now going after the health plans for using Ingenix’ database. Ingenix and some of its customer health plans have already settled with several states, but apparently...
March 31, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (40)

Will CIGNA Remake The Health Plan Marketplace?

By BRIAN KLEPPER America’s health plans are floundering. If their job has been to provide the nation’s mainstream families with access to affordable care (let’s leave quality out of it for the moment), they have failed miserably, though they were...
March 30, 2009 in Brian Klepper, Health 2.0, Health Plans, Marketplace, primary care, The Industry | Permalink | Comments (15)

Karen Ignagni lie of the day, part 68

By Matthew Holt The big insurers now seem to be doing anything they can to prevent a Medicare-equivalent public plan being launched to beat them up. Yes AHIP has apparently decided to throw the schlockmeisters off the boat, and more...
March 25, 2009 in Health Plans, Matthew Holt, THCB | Permalink | Comments (47)

Tom Epstein, Blue Shield of California, on the hot seat

By Matthew Holt A couple of weeks ago the PR company for Blue Shield of California contacted me asking if I wanted their take on health reform. I somehow suspect that the PR flack concerned wasn't as familiar with the...
March 19, 2009 in Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (5)

A Sticky Solution to a Sticky Problem

By ALISTAIR ROCK “Don’t pull the knot tight,” the philosopher Ludwig Wittgenstein once warned, “before being sure you have got hold of the right end.” Those who hope to sort out the tangle of health care spending would do well...
March 16, 2009 in Health 2.0, Health Plans, Marketplace, Technology, The Industry, Web/Tech | Permalink | Comments (23)