The Health Care Blog

Sunday reading-Jon Cohn on French & Dutch health care

By Matthew Holt Jon Cohn has a long article in the Boston Globe about how the French and Dutch get health care about right at half the American cost with none of that unpleasant Canadian or Britishness that FoxNews loves...
July 5, 2009 in International, Policy/Politics | 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, Policy, Policy/Politics | Permalink | Comments (24)

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)

And in reply to the ABC Obamamercial...

By Matthew Holt Stephen Colbert’s Republican Health Care Infomercial. Quite wonderful. Can’t get it to embed but here’s the link
June 26, 2009 in Policy/Politics | Permalink | Comments (1)

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)

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)

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)

How Relevant is the American Medical Association?

By RAHUL PARIKH, MD Like most doctors, I was busy seeing a full schedule of patients when President Obama addressed members of the American Medical Association at their annual meeting in Chicago. The speech was billed as a crucial confrontation...
June 20, 2009 in Obama administration, Physicians, Policy/Politics, Reform | Permalink | Comments (18)

The State of Meaningful Use

By MICHAEL PAINTER Is it possible that the State Department is technologically bolder than the HIT Policy Committee? On Tuesday, that committee convened by the Office of the National Coordinator as required by the American Recovery and Reinvestment Act released...
June 19, 2009 in Policy/Politics | Permalink | Comments (2)

Ezra says pusillanimousity has won

By Matthew Holt Now he's no longer a young punk but an insider of the first order Ezra Klein has come up trumps and got an early copy of the latest Senate Finance committee legislation/trial balloon. It’s not going to...
June 18, 2009 in Policy/Politics | Permalink | Comments (16)

Rant: THCB transforms the New York Times, makes offer!

By Matthew Holt Just a few years ago The New York Times was on its last legs, printing Judy Miller’s re-mouthing of Cheney’s lies, holding back the wiretapping story until after the 2004 election, and generally spouting a lot of...
June 17, 2009 in Matthew Holt, Policy/Politics | Permalink | Comments (1)

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)

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)

Quick Sunday roundup or "OMG I agree with Tyler Cowen"

By Matthew Holt I can't say that I often agree with libertarian Tyler Cowen and I think it's pretty appalling that the New York Times gives someone with such, as Republicans used to say, “out of the mainstream” views a...
June 14, 2009 in Policy/Politics | Permalink | Comments (2)

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)

A Special Reform Edition of Health Wonk Review

by BRIAN KLEPPER Over at Managed Care Matters, the always thoughtful and energetic Joe Paduda has, once again, done us all a service. Tasked with hosting this edition of Health Wonk Review, he has assembled a great range of pieces...
June 12, 2009 in Policy/Politics, reform | Permalink | Comments (0)

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

Alex Drane -- Engage with Grace

By Matthew Holt Alex Drane is at AHIP in San Diego and she’s talking not about Eliza, or health plans, but is talking about Engage with Grace. It’s a wonderful interview, although Alex knows that associating end of life care...
June 9, 2009 in Policy/Politics, Quality | Permalink | Comments (0)

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)

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)

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)

The Health IT Stimulus and FQHCs — Don’t Forget About Us!

By JAMES KAHN There is a critical element in the American Recovery and Reinvestment Act (ARRA) that targets funds for Federally-Qualified Community Health Centers (FQHCs). An FQHC is an organization defined by the Medicare and Medicaid statutes that receives funding...
May 7, 2009 in Electronic Medical Records, Obama administration, Policy/Politics | Permalink | Comments (4)

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)

Leave Natasha Richardson out of the health care debate

By Sarah Arnquist Please don’t turn Natasha Richardson’s tragic death into a symbol for why Canadian-style universal health care is bad and the United States is better. In the last six hours, I’ve seen articles from at least a dozen...
March 29, 2009 in Policy/Politics, reform | Permalink | Comments (30)

Patient-based Health Reform or "Fannie Med?"

By Richard Scott Set against the backdrop of the $787 billion stimulus bill and deficit spending that dwarfs the federal outlays of FDR's New Deal and LBJ’s “Great Society,” the idea of spending hundreds of billions - or even trillions...
March 27, 2009 in Policy/Politics | Permalink | Comments (71)

Health Care Reform: Ideology, Self-Interest and Rhetoric

By Humphrey Taylor and Ian Morrison Thirty years ago, one of us asked the retiring CEO of one of the largest drug companies what was the worst mistake he had made as CEO. Without hesitating he said, “Opposing Medicare. We...
March 24, 2009 in Policy/Politics | Permalink | Comments (54)

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)