Friday, October 30, 2009

Why House calls? Customer Experience of House Calls

How do House calls affect the Physician Patient Relationship?

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Why House Calls? Mayo Clinic Transform Symposium

Our Co Founder Answers the Question.... Why House calls?

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Disruptive Innovation In Heathcare- Transform Symposium Excerpt

Our Co- Founder at Mayo Clinic Transform Symposium Asks the Audience How many doctors out there make house calls??

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Mayo Clinic Transform Symposium- Personal Medicine Platform

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Thursday, October 29, 2009

The News - Personal Medicine Benefits Noted By HR Executive Online

In her first employee-benefits column, Carol Harnett highlights two innovative ways employers can combine imagination with good medical outcomes, decreased costs and increased employee satisfaction. Carol is a highly respected employee benefits consultant, speaker, writer and trendspotter.

By Carol Harnett

I am a Bruce Springsteen fan. Along with my friend, Pete Church, who is an HR executive, I recently ventured to the Apollo Theater to watch the taping of Elvis Costello's interview show, Spectacle, with The Boss.

On the drive home, we found ourselves discussing some of Springsteen's points about how to make linkages with audiences and relating it to our work. Springsteen says music is more than melody and lyrics. If Bruce can't place a fingerprint on our imaginations, can't connect to his listeners, then his songs are simply notes and words.

But how do HR leaders create benefit plans that strike a chord with our employees? For my first column in HREOnline TM , I searched for employers and service providers who combine imagination with good outcomes, decreased costs and increased employee satisfaction.

One innovator is Tom Emerick, who has spent the last 25 years working in benefit design for BP, Burger King and, most recently, Wal-Mart, where he was vice president of global benefit design.

In the 1980s while at BP, Emerick realized that a small percentage of employees drove a large portion of the benefit dollars. He began a multi-phase pilot that incentivized transplant candidates to go to the Mayo or Cleveland Clinics for evaluation and surgery, if deemed appropriate.

And thus was born one of the first employer-sponsored domestic medical-travel programs. Emerick was recently recognized by Healthspottr as one of the top 100 innovators in healthcare for this work.

He has gone on to evolve his approach, saying it's key for employers to first establish a tracking methodology to identify employees at high health risk and then "picking out the right place and getting the employees there."

What makes the places "right?" Emerick believes it's the medical facilities' ability to achieve "desired patient outcomes in the safest and least invasive way." Examples include Intermountain Healthcare, Geisinger Health System, Mayo Clinic, Cleveland Clinic, and Cancer Treatment Centers of America, he says.

Emerick says that if even one high-risk employee participates in a year, the savings can be an immediate 5-percent reduction in benefit costs, so it's probably no surprise that more employers today are actively considering medical travel as part of their health benefit plans.

Another innovator is Dr. Natalie Hodge -- a pediatrician who carries an iPhone and tablet computer in her medical bag.

Four years ago, she made the decision to view her patients and their parents as customers. In addition to their wish for easier communication, including by phone and e-mail, she responded to their desire for house calls instead of office visits.

I don't know about you, but I haven't experienced a house call since Dr. Patrick came to see me when I was around 5 years old. My vague memory before he arrived is of my mom swathing me in blankets despite having a fever. The first thing Dr. Patrick did was strip off the blankets. I don't remember much else, but I loved him ever since.

After taking care of me, my pediatrician went into our kitchen, sorted through the things I could eat and drink, and sent my dad out with a list of items to purchase.

Hodge says that's exactly how it works today. The only difference is that she uses technology to bring her office to the patient. "Babies start with a clean slate of medical records," she says, "so it's easy to create their record electronically and give the parents access to it online."

Hodge now operates an e-commerce business called Personal Medicine International Inc ., to help other physicians follow in her concierge medicine footsteps.

What makes Personal Medicine interesting to employers is that it may be used in conjunction with high-deductible health plans as an option or an add-on. Employers can seed the employee's health-savings account or health-reimbursement account with funds to offset the monthly fee or purchase the service directly for workers. Employees can opt to cover one or several of their children, a dependent older parent or the whole family.

Since physicians see their patients wherever it's convenient, parents can go to work and the doctors will meet them at their offices or the childcare centers. Employees are more productive and satisfied with their benefits. And as the H1N1 flu virus heats up, parents can avoid hospitals and the risk of cross-contamination.

For me, what is interesting about both of these approaches to employer-provided healthcare is that employees received equal -- or better -- care in a way that may be more meaningful to them -- and employers gain cost savings within the first year.

This avenue of connecting employer goals with employee desires reminds me of some thoughts from the man himself, Bruce Springsteen, as quoted in an Oct. 17, 2007 Rolling Stone interview.

"My business ... is trying to connect to you ... . You are involved in an act of the imagination together, imagining the life you want to live, the kind of country you want to live in, the kind of place you want to leave your children. What are the things that bring you ecstasy and bliss, what are the things that bring on the darkness, and what can we do together to combat those things?"

Carol Harnett is a highly respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett.

October 26, 2009

Copyright 2009© LRP Publications

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The News

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Wednesday, October 28, 2009

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October 28, 2009

A Message to America's Physicians: Purchasing EHR Technology A Shaky State of Affairs


David Kibbe

Much of the conversation and debate about physician EHR adoption has centered on the single issue of the (high) cost of purchase.  However, we'd like to suggest that the situation is much more complex and involves several more subtle variables.

Consider, for example, uncertainty about the future.  In a recent speech, Lawrence Summers, Director of the White House's National Economic Council for President Barack Obama, related the following analysis about decision-making under conditions of uncertainty in the marketplace, which he had first heard from Ben Bernanke, current Chairman of the Federal Reserve, in a speech Mr. Bernanke gave over 30 years ago: "If you as a business were considering buying a new boiler, and if you knew the price of energy was going to be high, you would buy one kind of boiler.  If you knew the price of energy was going to be low, you'd buy another kind of boiler.  If you didn't know what the price of energy was going to be, but you thought you would know a year from now, you wouldn't buy any boiler at all.  And in exactly that way, it is illustrated that the reduction of uncertainty, through the resolution of disputes, is, I would suggest, all important, if we are to maintain confidence."

Let us paraphrase both of these eminent economists, while applying the same set of ideas to the purchase of electronic health records: If you as a physician were considering buying a new EHR technology, and if you knew the reimbursement rates for your practice were going to be high, you would buy one kind of EHR.  If you knew the rates of reimbursement were going to be low, you'd buy another kind of EHR.  If you didn't know what the reimbursement rates were going to be, but you thought you would know a year from now, you wouldn't buy any EHR at all.

Continue reading "A Message to America's Physicians: Purchasing EHR Technology A Shaky State of Affairs"

Brian Klepper, David Kibbe, EHR, HITECH | Permalink | Matthew Holt Comments (5)
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Senate Health Care Reform: Two Huge Problems, One Giant Red Herring


Pity poor Senator Harry Reid. Not only is he facing an uphill reelection fight in Nevada, but as Majority Leader, he must reconcile the health care reform bills from the Finance and the Health, Education, Labor and Pensions committees so as to attract sixty Senate votes. He’s guaranteed support from the more partisan Democrats, but to attract Democratic and one or two Republican centrists without losing liberals, he has to find ways to deal with two huge problems with the bills—and one giant red herring.

The giant red herring is the public option, THE big stumbling block for reform, mostly thanks to the efforts of lazy-thinking doctrinaire politicians of both parties—especially in the House. (Yes, Speaker Pelosi and Minority Leader Boehner, I mean you.) The reality is that for a public option to provide an adequate network, its payments to hospitals and physicians must be at least at Medicare levels. As experience with Medicare Advantage shows, this means its costs will be close to those of private coverage or higher, especially if it adopts Medicare’s uncontrolled fee-for-service structure and attracts the least utilization-conscious providers and patients.  All this makes nonsense of liberal claims that the public option is necessary to control costs, and equally, of conservative allegations that it will destroy the insurance industry—and leaves Senator Reid’s “opt-out” solution looking merely perverse.

Continue reading "Senate Health Care Reform: Two Huge Problems, One Giant Red Herring"

Roger Collier, The Public Option | Permalink | Matthew Holt Comments (4)
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Jeff Goldsmith writes:

As you may know if you've read my postings, I'm an outspoken advocate of tightening Medicare fraud and abuse laws. There will be a post on this in a day or two. It's actually the stuff that's legal that is the problem: doctors self-referring patients for radiological scans, surgery, hospitals admissions to facilities they have an ownership interest in. I think there is just as much "fraud" of this type- rampant self dealing- on the private insurance side.

The scandal is: what's legal. And I stand by my earlier statement that the big money is in running up the tab on the privately insured, not in Medicare. On private insurers' margins, I've never subscribed to the populist garbage about obscene profits. Uwe Reinhardt had an excellent analysis of the Wellpoint 10K the other day in the New York Times. Health insurance is actually not a very good business. Many of these firms would be a lot more profitable if they were better managed, and eliminated a lot of the paper and clerical overburden, and if they were more aggressive in bargaining with providers. Since the same companies process Medicare claims, I don't see us escaping them. Management in both our private and public systems is mediocre and not improving. (Medicare has been without an Administrator for two years, spanning two administrations).

It's really a waste of my time to participate in a philosophical BS argument about government=bad, private sector= good. That sort of ended after college for me. We have a mixed system. I've worked in both private and public sectors. If we want to cover the 55 plus population, my best case scenario is for Medicare to assume the insurance risk, and contract with well managed HMO type health plans to actually co-ordinate the care. We've both spend decades working in this field, Nate- 34 years in my case; I've spent most of my time in provider space, and have a much clearer idea than you do about where the waste is. Don't get me started- if all you're looking at is claims data, and in essentially one market, believe me, my friend, you don't know what you don't know . . ."

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October 27, 2009

Glen Tullman on EMRs, life, the universe and everything

By Matthew Holt

A couple of weeks back Allscripts' CEO Glen Tullman was on the Cats & Dogs panel at Health 2.0 and he said some pretty controversial things about the state of EMR adoption (yes it was happening), certification of meaningful use (it was being diluted and the tax payer faced being ripped off) and other vendors, or at least one other vendor from small town Wisconsin that wasn't playing fair in the quest for interoperability).

Given that I always enjoy talking to Glen and also that he's as responsible as anyone else for getting Obama interested in the concept of why EMRs and automating health care matters (and therefore why there was so much money in both Obama's campaign pledges and in the stimulus package for EMRs), I thought it would be fun to have Glen back on THCB to expand a little on what he told us at Health 2.0. And yes there was plenty more interesting stuff where that came from. (Be warned, the sound quality is not great, but its completely understandable)

Here's the interview

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Putting Profit before Patients

By Dr. Anthony H. Horan

The Big Scare

During my 30+ years as a board-certified urologist I’ve seen quite a bit of suffering, much of it needless, in my opinion.  In my work both in private practice and with the VA in Fresno, CA. I’ve encountered many men who’ve received treatment for prostate cancer that greatly diminished their quality of life and produced horrible side effects, but did absolutely nothing to prolong their lives.  These patients served as the inspiration for The Big Scare:  The Business of Prostate Cancer, a book I wrote, hoping to spare men from the over-diagnoses and over-treatment for prostate cancer that’s taking place in this country every single day.  I contend that screening for prostate cancer with a blood test and treating the cancer, discovered in the absence of a palpable nodule, offer no measurable good that outweighs the measurable harm. Instead, I advocate interceding before a man is falsely diagnosed with clinically significant prostate cancer. 

Prostate Cancer is relatively common disease, with about 260,000 men over the age of 50 diagnosed each year.  But as daunting as that number may sound, the fact is that prostate cancer is a very slow moving disease with estimates showing that 94% of the cancers detected with the routine PSA blood test would not even cause death before the age of 85.  More men die in accidents than of prostate cancer.  The PSA is a test I have major qualms about and objections to.  The PSA test has triggered an enormous number of expensive and unnecessary prostate biopsies, which have led to treatments, a rash of radiation and radical surgery injuries, and death.  After undergoing radiation, only 55% of men retain erectile function.  So this is an issue that not only impacts the lives of many men, but the lives of their significant others as well.   

Continue reading "Putting Profit before Patients "

Physicians | Permalink | Matthew Holt Comments (10)
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What's got lost in the public option kerfuffle

By Matthew Holt

Not so long ago, July this year in fact, PhRMA boss and former Dem Blue Dog & Republican Billy Tauzin told the Aspen Health Forum that a straw poll of Democrats at dinner with him in DC all said that they didn’t think there’d be a public option in the final bill arriving on Obama’s desk. By the way Tauzin, Dashle, and the rest all said that there would be a health care bill passed in 2009 even though the summer of “death panels’ was just getting under way.

Now Jonathan Cohn at TNR is reporting (along with others) that Harry Reid is going to include the public option with an opt-out for states that don’t want it (think Red states), rather than the trigger (public option to come later if health care costs go up) or the co-op (moving the rest of the US to Seattle) alternatives.

This is a turn around—no question. It’s apparent that the summer of death panels actually hurt the anti-reform crowd. It’s also clear that the recent barrage from AHIP actually hurt its stated case against the public option—although as I’ve said on THCB I think that AHIP will do better with one in place.

But the problem is that this all disguises the real questions about the minor insurance reform we’re about to pass.

Continue reading "What's got lost in the public option kerfuffle"

Matthew Holt, Policy, Policy/Politics | Permalink | Matthew Holt Comments (8)
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THCB Update

New: Become a fan of THCB on Facebook. Stay in touch with us on our Facebook Page!

Follow us on Twitter:  Track us post by post. 

Via E-mail:  If you haven't had a chance to sign up for THCB UPDATE yet, you really should. You'll get a helpful reminder email from us when important posts go up on the site.

Continue reading "THCB Update"

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October 25, 2009

Is Healthcare IT Ready for its Big Coming Out Party?


In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided me, “slowing down the momentum.” Some called us Luddites.

Although we hated to be skunks at the IT party, we felt that the facts spoke for themselves. While decent computerized provider order entry (CPOE) systems did catch significant numbers of prescribing errors, we found no studies documenting improved hard outcomes (death, morbidity). More concerning, virtually all the research touting the benefits of HIT was conducted on a handful of home-grown systems (most notably, by David Bates’s superb group at Brigham and Women’s Hospital), leaving us concerned about the paucity of evidence that a vendor-developed system airlifted into a hospital would make the world a better place.

Continue reading "Is Healthcare IT Ready for its Big Coming Out Party? "

Bob Wachter | Permalink | Matthew Holt Comments (7)
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October 24, 2009

Health 2.0: Beneath the Hype, There's Cause for Real Hope


Health 2.0 is a trend accompanied by both buzz and buzzwords. That worries some advocates for the poor, underserved and just plain old and sick. Will those groups be left behind in the latest information revolution?

The potential positives of the Web-as-health-care platform for interactive health care services could be seen in two full days of presentations and discussions at a recent meeting in San Francisco, called the Health 2.0 Conference. Still, a certain Silicon Valley sensibility remained: widgets for weight control were much more likely to target the calorie count of cappuccinos than corn dogs.

Yet the real question is not whether Health 2.0 arrives clothed in hype; of course it does. The capitalistic ritual of "new and improved" is similar for software and soapsuds. The important issue is whether the substance of Health 2.0 can help deliver health care services significantly more efficiently and effectively while reducing disparities. Look beneath the hype and you can see it's already starting to do so.

First, full disclosure. I moderated a conference panel that addressed health care costs, quality and, in part, the poor. My expenses were paid, and I've been working with conference organizer Matthew Holt and colleagues on a report that explains Health 2.0 in a way that makes sense to those who work in the trenches.

The most important thing to understand is that Health 2.0 is genuine change happening right now, not just another idea of how health care might be different tomorrow. The Web-as-platform (dubbed "Web 2.0") and its technical architecture of user participation and customization are already ushering in Government 2.0, Journalism 2.0, etc.

Continue reading "Health 2.0: Beneath the Hype, There's Cause for Real Hope"

Health 2.0, Michael Millenson | Permalink | Matthew Holt Comments (2)
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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 this AHIP conference on Friday although having sat in many of these conferences I do need to tell the protestors that no plotting is done in these Forums. That happens elsewhere… 

Health Plans, Policy, Policy/Politics | Permalink | Matthew Holt Comments (9)
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Regina Holliday: Fred's life & death at 73 cents a page

By Matthew Holt

If you ever wonder why the efforts to make it easier for patients and families to get information and be treated as equals in their care by the medical care system matter....

If you need convincing that the concept of participatory medicine is important enough for its own society, advocates & journal….

If you wonder whether it’s OK to wait to phase in the possibility of patients actually having rights to their own data….

Read Regina Holliday's story about Fred's illness and the way she and he were treated.

e-patients, Electronic Medical Records, Health 2.0, Matthew Holt, Technology | Permalink | Matthew Holt Comments (5)
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October 23, 2009

State of Health Care Quality: Some States Better Than Others

By Margaret E. O'Kane, President National Committee For Quality Assurance


Peggy O'Kane has been running the NCQA for longer than she might care to remember. NCQA is an independent, non-profit organization whose mission is to improve the quality of health care everywhere, but it's best known for creating the HEDIS measures that rate health insurer and provider performance. I've been a fan of Peggy since I met her in the mid-1990s. Today she shows she's still fighting the good fight. This is her first contribution to THCB --Matthew Holt

Suppose you’re one of the 22 million Americans living with diabetes and you have to decide where you  want to live. Your choices: Providence, Rhode Island, or Houston, Texas.  Providence is pretty and you’d have easy access to lobster dinners and weekends at the Cape. But Houston is warmer in the winter and just a hop, skip and a jump from a weekend in Cancun.  A hard decision but you’re leaning toward Houston because, let’s face it, you hate shoveling snow!

But then you take a look at the 13th annual State of Health Care Quality Report by the National Committee for Quality Assurance (plug alert: I run the place) and you find out the quality of care for diabetics is nearly 11 percentage points better in New England than it is in the South Central region of the U.S. and you begin to reconsider. In fact, you look at the newest data released October 22 and you find that the quality of care in the Texas region of the country is consistently the worst while care in New England is almost always the best.  Providence here I come!

Continue reading "State of Health Care Quality: Some States Better Than Others"

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Health 2.0 Tools: The power of Twitter


Matthew Holt

Picture 31

The power of Twitter is real kids, and not for what you think. Used properly Twitter is an information filter. Exhibit A is what happened to the Von Schwebers who run PHARMASurveyor. They were a huge part of the Tools Panel which featured interoperation among 8 members of the Health 2.0 Accelerator at Health 2.0 a couple of weeks back. Then last week they were at an AHRQ conference on Drug Interactions when this happened. Erick von Schweber’s email picks up the story .. 

The Chief Medical Officer of Express Scripts is doing his talk, about halfway through, and then tells this rather academic audience of scientists and researchers that there's something new they need to attend to. It's called Health 2.0, he says, and he puts up a PowerPoint slide with screen captures from WebMD, HealthVault, Healthline, DoubleCheckMD, etc. Then he tells the audience that the prior week he saw tweets about something new in the space, so he checked it out. He says this is the next major leap ahead in drug safety. So up comes a series of four slides, all screen grabs of PharmaSURVEYOR. And he calls us the Accelerator and explains what we do, disclaiming that he had no knowledge that we'd be there at the conference (I had moderated that morning's session on making DDI evidence more relevant to patients and physicians; Hansten and Horn were my speakers, the guys who introduced the term "drug interaction" in the mid-sixties). He tells the audience that they must go to PharmaSURVEYOR as well as begin thinking in terms of consumer generated healthcare.

Now it just so happens that the Chief Scientist of Express Scripts but not the Chief Medical Officer had been to Health 2.0 and (I assume) seen the Tools panel demonstrations. But, and this will amaze no one, busy executives at big corporations don’t always immediately communicate all of their learnings with each other. So how did the Chief Medical Officer find out? He probably saw a re-tweet of the #health2con hash tag. That, ladies’n’genelmen, is how our kids is learning these days.

And do you want to see the incredible tools panel from Health 2.0 which contained both the accelerator integration project (in two parts), the debut of Keas, and Eliza showing the first Health 2.0 marriage? Funny you should ask.

Conferences, e-patients, Electronic Medical Records, evidenced-based medicine, Health 2.0, pharmaceuticals, Technology | Permalink | Matthew Holt Comments (4)
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October 22, 2009

Health 2.0 - The Consumer Aggregators

The Consumer Aggregator Panel at Health 2.0 San Francisco

Featuring: Roni Zeiger MD, Product Manager, Google Health, Wayne Gattinella, CEO WebMD, David Cerino, Microsoft Health Solutions

Moderator: Jane Sarasohn-Kahn, Think-Health

Overview: With consumers turning to online sources in record numbers, competition is heating up between the giants in the field. In this segment recorded at Health 2.0 San Francisco, key players at Google, Microsoft and WebMD talk about important shifts in the industry landscape over the last year, their companies' near term plans and the powerful trends likely to shape the way Americans - not to mention the rest of the planet - use the internet to look after their health and search for reliable health information.

Related video:  

Gov 2.0: Obama administration CTO Aneesh Chopra talks about the administration's call for innovation  in Silicon valley and broader adoption of information technology throughout the healthcare system. A must see in light of the national healthcare reform debate and growing investor interest in health IT.

The future of electronic medical records: Electronic medical records may be the most controversial technology around in an area with little shortage of controversey.  In the popular "Cats and Dogs" panel at Health 2.0, the key players in the debate over the future of this crucial technology take center stage in a culminating debate moderated by Health 2.0 co-founder Matthew Holt.  Dr. David Kibbe of the American Association of Family Physicians (AAFP), is an early proponent of electronic medical records who has since publicly reversed his position. Glen Tullman is the CEO of industry leader Allscripts and a commissioner on the board of trustees of CCHIT, the certification body responsible for overseeing much of the electronic medical records industry. Jonathan Bush is the CEO of athenahealth, a relative newcomer that has enjoyed a good deal of success challenging industry orthodoxies.

Affordability Model | Permalink | Matthew Holt Comments (0)
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October 21, 2009

Hiding In Plain Sight: Using Medicare To Solve The ‘Public Option’ Conundrum



As Senate and House Committee versions of health reform move toward unified legislation and floor votes, the most complex political challenge is how to resolve the “public option” controversy.  While one would have thought weightier issues such as the shape of Medicare reform, the taxation required to support coverage subsidies, or the presence or absence of mandates would have been pivotal in this debate, the seemingly peripheral issue of a Medicare-like “public option” might be the hill on which health reform dies.

The reasons are almost completely political.  The Democratic base wants to end private health insurance.  Single payer advocates view the public option as a down payment on an entirely public health financing system. Public option advocates believe that the plan’s bargaining power will drive private insurers out of business.  (I’ve argued in a previous blog posting that, without fully understanding what they are doing, these single payer advocates are probably right.)

Moderate Democrats, who will need independent and some Republican votes to be re-elected next year, cannot afford to be perceived as advocating a further expansion of government influence.  After deeply unpopular partial nationalizations of our banking and auto industries, public support for further expansion of government power appears to be waning.  Republicans appear ready to capitalize on the growing backlash against deficits and growing government power in the coming Congressional election cycle. 

Continue reading "Hiding In Plain Sight: Using Medicare To Solve The ‘Public Option’ Conundrum"

Jeff Goldsmith, Medicare, Public Option, Reform | Permalink | Matthew Holt Comments (52)
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Who should tell your MD what to do?


In this Wall Street Journal op-ed, Norbert Gleicher suggests that expert panels won't improve health care because the the quality of the research on which they would base their physician practice guidelines is not reliable. Instead, he suggests that our system can self-correct when experts lead us astray. He asserts that we have a "well working free market of ideas in health care, where effective therapies can rise to the surface and win out."

I'm somewhat sympathetic to Dr. Gleicher's point about a government-imposed clinical review process, but he overstates the case about a current free market of ideas. Individual insurance companies and Medicare currently make payment decisions with regard to therapeutic judgments every day. How are they informed, and what are their sets of vested interests? Much of that remains hidden from public view.

Meanwhile, too, doctors and hospital practice what Brent James calls "regional medical mythology," patterns of care divorced from scientific evidence, based as much on the local supply of specialists and what they learned from their predecessors as any other factors.

Perhaps what Dr. Gleicher is trying to avoid is the replacement of this array of unscientific medicine with the establishment of a centralized panel of unscientific medicine. In essence, he is suggesting that it is worse for the federal government to get it wrong for the whole country at once than for the individual participants (payors, MDs, and hospitals) to get it wrong each in their own way.

Seriously, though, one can apply some analytical rigor in support of Dr. Gleicher's thesis. Just as a diversified investment portfolio does better over the long haul in terms of risk mitigation, so too might the country do better over time with a diverse set of views as to appropriate diagnostic tests and therapies.

Paul Levy | Permalink | Matthew Holt Co

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