The Health Care Blog

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, Policy, Policy/Politics | Permalink | Comments (24)

The EHR TimeBar: A New Visual Interface Design

By RICK WEINHAUS, MD The EHR TimeBar functions as a high-level overview of the patient record, as a query device, and as an intuitive navigation tool. Each EHR file (event) for the patient is represented by an icon. The set...
June 26, 2009 in Electronic Medical Records, evidenced-based medicine, Policy, Policy/Politics, Technology, The Industry, Web/Tech | Permalink | Comments (6)

McAllen: A Tale of Three Counties

By DANIEL GILDEN Introduction The challenge of constraining costs while maintaining or enhancing the quality of medical care is vividly brought to life by Atul Gawande in his recent widely-read New Yorker essay. The anecdotal evidence presented in the article...
June 25, 2009 in Chronic conditions, Dartmouth Atlas, medicare, Medicine, Policy, Policy/Politics, prevention | Permalink | Comments (52)

In which I play Obama, answering Michael Cannon

By Matthew Holt Last night I was busy spending two hours of my and my business partner’s time buying health insurance for our massive 4 person company. That means doing a multi-factorial equation between premiums, co-pays, deductibles, out of pocket...
June 25, 2009 in Policy, Policy/Politics | Permalink | Comments (22)

The bleedingly obvious

By Matthew Holt It makes no sense for small businesses to provide health insurance to employees. This testimony from a small business owner to the House Tri-committee yesterday shows it. (Same is true for all employers but none save Ron...
June 23, 2009 in Policy, Policy/Politics | Permalink | Comments (25)

A Dream of Reason

By BRIAN KLEPPER and DAVID KIBBE The dream of reason did not take power into account...Modern medicine is one of those extraordinary works of reason...But medicine is also a world of power. -Paul Starr, The Social Transformation of American Medicine,...
June 22, 2009 in Brian Klepper, Consumers, David Kibbe, e-patients, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (8)

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)

Obama vs Hillary at the AMA

By Michael L. Millenson Sixteen years and two days after then-First Lady and Health Care Czar Hillary Clinton went before the American Medical Association’s House of Delegates to sell her vision of national reform, President Barack Obama is treading the...
June 15, 2009 in Policy, Policy/Politics | Permalink | Comments (15)

David Gratzer is Nice. Dennis Kucinich is not.

By Matthew Holt I had David Gratzer on THCB a while back. He was so nice, that it was really hard for me to get mad with him—even though his book was basically a pack of lies. He seriously suggested...
June 13, 2009 in Policy, Policy/Politics | Permalink | Comments (8)

Op-Ed: How I've Missed the AMA....

By Matthew Holt Over at Dr Val’s Get Better Health site Evan Falchuk from Best Doctors is very grumpy about Steve Pearlstein’s column in the WaPo. Pearlstein rewrites Gawande’s rewrite of Shannon Brownlee’s Overtreated. Not much surprise here—everyone is doing...
June 13, 2009 in Matthew Holt, Physicians, Policy, Policy/Politics | Permalink | Comments (17)

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, reform, The Industry, Transparency | Permalink | Comments (15) | TrackBack

By the numbers, on single payer the Democrats are wussies

By Matthew Holt Now before I explain why I say the Democrats are girlie-men, let me say three quick things. 1. I am not a supporter of Medicare-for-all, or Canadian style, single-payer (or anything primarily based on fee-for-service payment) although...
June 6, 2009 in Policy, Policy/Politics | Permalink | Comments (33)

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)

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)

Thomas Kuhn, Health Care Reform and Vascular Disease

By WILLIAM BESTERMANN The puzzle of improving care and reducing costs in American medicine and in vascular conditions (that is, diseases associated with blood vessel metabolism) in particular - these are responsible for 60 percent of all cost - has...
May 24, 2009 in Chronic conditions, evidenced-based medicine, Medicine, Obesity, Policy, primary care, Quality, Science | Permalink | Comments (8)

Bringing Patients into the Health IT Conversation About "Meaningful Use"

By DAVID C. KIBBE and BRIAN KLEPPER The Obama health team at HHS and ONC are gradually establishing the rules that will determine how approximately $34 billion in ARRA/HITECH funds are spent on health IT over the next several years....
May 21, 2009 in Brian Klepper, Consumers, David Kibbe, Electronic Medical Records, Google, Health 2.0, Jane Sarasohn-Kahn, Marketplace, Policy, Policy/Politics, reform, Web/Tech | Permalink | Comments (35)

Disgusting, and another reason why marriage needs to be re-defined

By Matthew Holt Tara Parker-Pope reveals two cases where discrimination kept a partner, and in one case the dying woman’s children, away from their loved one while they were dying in hospital. One hospital involved is Jackson Memorial in Miami,...
May 18, 2009 in Hospitals, Policy, Policy/Politics | Permalink | Comments (9)

Connecting finance to coverage

By Matthew Holt Repeating his message that Health Costs Are the Real Deficit Threat OMB Director Peter Orszag goes into the not exactly friendly territory of the WSJ Opinion pages and explains that practice variation is unnecessary and wasteful, comparative...
May 15, 2009 in Policy, Policy/Politics | Permalink | Comments (16)

An Open Letter to the New National Coordinator for Health IT: Part 3 -- Certification As The Elephant in Health IT's Living Room

By DAVID C. KIBBE and BRIAN KLEPPER In the first and second parts of this series we talked about how and why there is no universal definition for the term "EHR." Instead there is a legitimate, growing debate about the...
May 8, 2009 in Brian Klepper, David Kibbe, e-patients, Electronic Medical Records, Health 2.0, Obama administration, Online Communities, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (19)

Of Healthcare and Toilets

By TOBIAS GILK “Any system produces exactly the results it was designed to produce,” or so goes the saying. If we don’t like the results we get, we need to re-examine the system and not simply individual inputs. In the...
May 4, 2009 in Policy | Permalink | Comments (7)

Where's THCB's share of the money? Or does Stuart Browning feel left out?

By Matthew Holt My lefty friends at Moveon.org emailed me (and a few million others) appalled that Rick Scott’s group is going to be spending $1 million running ads attacking the as yet officially non-existent Baucus/Daschle/deParle/Obama health plan. Now that’s...
April 27, 2009 in Policy, Policy/Politics | Permalink | Comments (6)

An Open Letter to the New National Coordinator for Health IT - Untying HITECH's Gordian Knot: Part 1

By DAVID C. KIBBE & BRIAN KLEPPER Congratulations to David Blumenthal on being named National Coordinator for Health Information Technology (ONCHIT). Dr. Blumenthal will be the person most responsible for the rules and distribution of the American Recovery and Reinvestment...
April 26, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (19)

An Open Letter to the New National Coordinator for Health IT: Part 2 - Opening the Aperture of Innovation

By DAVID C. KIBBE & BRIAN KLEPPER One of the important decisions before Dr. Blumenthal and his colleagues at ONC and HHS is whether the national health information network will be one of closed appliances that bundle together proprietary hardware,...
April 22, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (21)

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

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)

Cats and dogs on film--Tullman, Leavitt, Bush

By Matthew Holt Anyone who’s been following along on THCB will realize that there’s a huge divide about whether the HITECH act should pay for and dictate a specified, certified type of EMR product use OR pay for data and...
April 13, 2009 in Electronic Medical Records, Matthew Holt, Policy, Policy/Politics, Technology | Permalink | Comments (2)

A liberal is a conservative exposed to the NHS

By Matthew Holt The old adage is that a conservative is a liberal who’s been mugged. So I was much amused by this letter from a Republican to the local paper (Salt Lake Tribune) in the most conservative state in...
April 12, 2009 in Matthew Holt, Policy, Policy/Politics | Permalink | Comments (28)

A Self-Fulfilling Prophecy: The Continuity of Care Record Gains Ground As A Standard

By BRIAN KLEPPER We live in a time of such great progress in so many arenas that, too often and without a second thought, we take significant advances for granted. But, now and then, we should catalog the steps forward,...
April 10, 2009 in Brian Klepper, Consumers, David Kibbe, Electronic Medical Records, Google, Health 2.0, Personalized Medicine, Policy, Policy/Politics, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (20)

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 (4)

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 (38)

Drug war lunacy--Connecting the Dots

By Matthew Holt Next month the Supreme Court will be given the chance to redress one minor the lunacy of the last thirty years of the so-called “war on drugs”. It will get to decide whether in the name of...
March 24, 2009 in Policy, Policy/Politics | Permalink | Comments (8)

Bluementhal is new health IT czar

By Matthew Holt David Blumenthal, known slightly more for being a policy wonk than a geek (or perhaps known best for being a wonk about geek issues!), has been appointed the new Director of the Office of the National Coordinator...
March 20, 2009 in Policy, Policy/Politics, Technology | Permalink | Comments (10)

Don't think anything is certain on the reform front

By Matthew Holt And in more from the "is it really bad enough out there to guarantee health reform?" front... Pew Research is out with a poll showing that the numbers in favor of a major health care system reform...
March 20, 2009 in Election 08, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (5)

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)

Jonathan Cohn on the internal politics of Obama's health care plan

By Matthew Holt Jonathan Cohn has started blogging almost daily on the politics of health care at The Treatment. And it's a treat to read. Jon is a member of the recently exposed vast left wing conspiracy (so am I,...
March 18, 2009 in Matthew Holt, Policy, Policy/Politics | Permalink | Comments (7)

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)

My forecast: a sad conclusion to the health care bubble...

Brian Klepper and David Kibbe have written a terrific piece on how and why health care is in a handbasket and wondering where it’s going. But as we ex-futurists know, there’s lots of luck required to make a good forecast....
March 12, 2009 in Health Plans, Matthew Holt, Pharma, Policy, Policy/Politics | Permalink | Comments (12)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

Frances Dare explains HITECH, really well

By Matthew Holt Frances Dare from Cisco is a buddy of mine who has more and more been their student of what's going on in Washington. Given that we just saw the biggest piece of health care IT legislation ever...
March 4, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Podcasts, Policy, Policy/Politics, Technology | Permalink | Comments (0)

Reform? Marginal, I fear...

By Matthew Holt Today’s news is that there is now a double header running health care with the addition of the (notably all-female) team of Sebelius & DeParle joining Orzsag, Zeke Emmanuel and a host of others with influence on...
March 3, 2009 in Matthew Holt, Policy, Policy/Politics | Permalink | Comments (33)

Health 2.0 more interesting than porn!

By Matthew Holt Last Thursday I gave a talk to a very high powered group, the National Committee on Vital and Health Statistics. My old colleague Matt Quinn is now working for the soon to be very rich Agency for...
March 1, 2009 in Health 2.0, Policy, Policy/Politics, reform, RHIOs, Technology, User Generated Content | Permalink | Comments (5)

Getting "the CCHIT question" wrong

By Matthew Holt There’s been a lot of blather from one commenter (who may or may not be a front for a group of malcontents) on the WSJ Health Blog and lots of other blogs about CCHIT and whether it...
February 24, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Policy, Policy/Politics, Technology | Permalink | Comments (8)

Divided we might get somewhere, but not yet

By MATTHEW HOLT The NY Times describes the Republican-less lobbyist meetings with Democrats that are allegedly getting towards a consensus on an individual mandate as the way to universal health care. Funnily enough some of those same groups (e.g. The...
February 20, 2009 in Election 08, Health Plans, Mandates, Matthew Holt, Obama administration, Policy, Policy/Politics | Permalink | Comments (7)

Connecting the dots--Uninsured people are poor!

By MATTHEW HOLT A bunch of random articles all hit at once on Wednesday morning. And they win the John Madden award for stating the bleedingly obvious. This is kind of a companion piece to my rant about Friday's NY...
February 20, 2009 in Health Plans, Matthew Holt, Obama administration, Policy, Policy/Politics | Permalink | Comments (10)

Someone sit Michael Cannon down before telling him this!

By Matthew Holt Apparently there some kind of experimental clinical innovation going on in the UK. If this isn’t a typo from the Torygraph, how is the mental model of the free-marketeers going to survive? I suspect that Gratzer, Giuliani,...
February 11, 2009 in Policy | Permalink | Comments (4)

Grand Rounds

By Matthew Holt Welcome to Grand Rounds. It's been quite some time since THCB hosted the medical blogosphere's major compendium. So sit back and enjoy a stroll through the gardens of medical and health care obsession. It's still a fresh...
February 10, 2009 in Matthew Holt, Policy, Policy/Politics | Permalink | Comments (7)

Jon Cohn: Obsessed with baseball and a hopeless optimist

By Matthew Holt Jon thinks that Baseball Teaches Us (something) About Health Care Reform. Replace the star player with a bunch of utility infielders, and we’ll still win the pennant. Don’t worry Jon, Daschle isn’t the only one who came...
February 9, 2009 in Election 08, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (7)

The AMA Wins a Round Against Accountability and Patient Information

By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson...
February 6, 2009 in Brian Klepper, Consumers, Current Affairs, Health Plans, Policy, Policy/Politics, Quality, reform, Technology, The Industry, Transparency | Permalink | Comments (12)

Op-Ed: Why the Senate should be abolished, Parts 34-36

By Matthew Holt Irrelevant small states with no people in them that exist by an accident of history are chronically over-represented in this country — both in the electoral college and most obviously in the Senate. And those states are...
February 5, 2009 in evidenced-based medicine, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (22)

A whole lot more Medicaid, but there's a catch

By MATTHEW HOLT It looks like the stimulus package is going to spend a whole lot more on Medicaid AND subsidize the purchase of COBRA for laid off workers. Unlike the “let them eat cake” brigade who’ll decry this as...
January 28, 2009 in Marketplace, Policy, Policy/Politics | Permalink | Comments (22)