The Health Care Blog

POLICY: Americans apparently prefer Canadian healthcare

Following my article about reimportation on Friday I've been having some email chats with some "Canada doubters" (for want of a better word). So I was most amused to get the latest Harris Poll on the topic. The poll isn't...

HEALTH PLANS: Profits up to $10 Billion in 2003, doubling 2002's level

As if you didn't know it, 2003 was a very good year for health plans. Weiss Ratings has published a table showing that several, including non-profits Kaiser & Group Health Cooperative of Puget Sound had excellent years. (Although Kaiser's looked...

BLOGS: The Bloviator Is Dead, Long Live The Public Health Press

Ross has sunsetted The Bloviator. But he's not going away, he's slightly changed his focus and has a new blog called The Public Health Press. Adjust your bookmarks and RSS readers appropriately, but expect more great stuff.

HEALTH PLANS: Is Kaiser thriving? Probably!

For the last several weeks Kaiser Permanente has been running a series of TV and print commercials called "Thrive". They ads contain a bunch of pap series of suggestions about living a healthier lifestyle and how Kaiser Permanente wants its...

HEALTH PLANS: KFF report on the public's view on managed care

While the managed care backlash is mostly yesterday's news (although some people think it may be coming back), Kaiser Family Foundation has a recent poll showing that managed care remains unpopular, and people still want to be able to sue...

POLICY: Krugman on why Canadian business likes single payer

Paul Krugman focused on health care in his regular op-ed on Friday in the NY Times. Krugman is what passes for a lefty in this country (i.e. he's a moderate social democrat) but in this op-ed he points out that...

PHARMA: Reimportation radio show, with late afternoon UPDATE

This morning I lost my cool somewhat and called into the local KQED Forum radio show, where they were discussing reimportation. One of the guests, Stephen Chang, a biotech CEO and head of a new group called Californians United for...

PHARMA: Drug reps being kept out of clinics

It's worth having a quick look at this USA Today article about the increasing trend of clinics and health systems keeping drug reps away from their doctors. For example: The University of Wisconsin and their clinics in Madison also have...

PHARMA: Vioxx study hits Merck stock price

Cox-2 inhibitors (Merck's Vioxx and Pfizer's Celebrex being the leading products) were introduced a few years back as being as effcective as older painkillers but without the stomach problems that affect about 30% of aspirin, ibuprofen or NSAID users. The...

POLICY: Uninsurance--It's 45 million now

It's taken a long while but the Census bureau yesterday confirmed that in 2003 45 million Americans lacked health insurance. Of course that's actually a wrong number, it's a snapshot which actually means that 45 million lacked health insurance at...

HEALTH PLANS: The Wellpoint-Anthem merger saga goes on

Politics continues to impact healthcare as California insurance commissioner John Garimendi continues to block Wellpoint's merger with Anthem. The latest round is that Garmimendi has asked the court to throw out Wellpoint's challenge to his decision. While there's been plenty...

PHARMA/POLICY: Oncologists, chemo and the new reality, by Gregory Pawelski

New contributor Gregory D. Pawelski writes for THCB about the changes in oncology and chemotherapy reimbursement. TCHB has posted several articles about those changes, notably from regular contributor Matt Quinn. Gregory writes from a slightly different viewpoint with considerable passion....

POLICY: A long and excellent series on health insurance, and a good review of the Kerry plan, with UPDATE

There is an excellent series on the current crisis in health insurance in the San Diego Union-Tribune written by Leslie Berestein. The really avid TCHB wonk reader may know all this, but it's not often the three rings of the...

TECHNOLOGY: Patient Physician email redux

Here's a quickie round-up of some activity in the patient-physician connectivity space (boy, that word makes me miss 1999!) The BMJ has a pretty typical academic article summarizing the good and the bad of patient physician email. The two part...

HEALTH PLANS: Group Health strike--ahh the irony

Here's the AP report on the fact that the workers at Group Health Cooperative of Puget Sound, the nation's most famous staff model HMO, (and no I have heard of Kaiser but I'm being a smartass here) are on strike...

QUALITY: Medcal safety--not Millenson! Instead an interview with a real doctor!

Healthleaders has an interview with Robert Wachter in which he stresses the need for procedural, technology and cultural changes to end systemic medical errors. Go read. great stuff. And not a mention of Michael Millenson in a post about patient...

HOSPITALS/PROVIDERS: GPOs under investigation

There's a long article in the NY Times this weekend suggesting that the next target for investigation by HHS and DOJ are the GPOs (Group Purchasing Organizations). The largest of these Novation (the GPO of the VHA a group of...

POLICY: Watching the politics of MMA

The devil is in the details and all politics are local. Cliches, but in the implementation of health care policy and payment in the US, true cliches. Two articles over the weekend bear this out. The AP reports that insurers...

HOSPITALS/PROVIDERS: Hospitalists save money

Over the last 10 years, the hospitalist movement has been growing from a small base in the US. In fact most countries have had hospitalists for decades and use their community-based GPs to refer patients to their hospital-based specialists. In...

QUALITY: Pain, its treatment and hope amongst the insanity

I won't rant on about it, but the DOJ headed by theocratic fascist John Ashcroft has declared war on pain doctors. For much more take a look at the Pain Relief Network's site. And the arrest, imprisonment and career destruction...

TECHNOLOGY: Stent sales go begging for J&J and Boston Scientific, with UPDATE

J&J's Cordis unit has been having production problems with its Cypher stent. Boston Scientific has been having such bad quality problems that it recalled almost all its stents last month. Apparently the surgeons (oops! Alwin points out that I mean)...

POLICY: Apparently health care costs real money (and yes, more on CDHPs)

The NY Times has an article on the shocking fact that increasing health care costs actually cost actual money. Apparently it costs businesses so much in additional health care costs to hire new (especially older) workers that they are hiring...

PHARMA: A great look at how a prescription drug gets marketed

Of all media sources you don't usually expect in depth, balanced features from USA Today. But Tuesday's USA Today has an excellent article by Julie Schmit on how Warner-Lambert (and now Pfizer's) Neurontin went from being a minor epilepsy drug...

PHARMA: Is this the best they've got?

So after Marcia Angell rips the pharma industry a new one in the LA Times last week, the official comeback from Alan Homer, President of PhRMA is nothing short of pathetic. Is this really all that big pharma feels it...

TECHNOLOGY: Forrester 's "Healthcare Unbound" gets some backing from NEHI

Brad Holmes at Forrester Research has a brief out looking at what they are calling Healthcare Unbound. Don't get too worked up about the title--it's the same thing as mobile eHealth (I think!). They think that this could be a...

QUALITY: The VA, Managed Care and care management

Navigate your way over to DB's Medical Rants to read Robert Centor on the VA doing better than managed care plans in a study of care for diabetics. Here's the AP Version and the study abstract. Essentially back in 1998-9...

HEALTH PLANS/POLICY: CDHPs, HSAs, and what's wrong with employer-provided insurance? With contribution from Atlas

The LA Times has an article about CDHPs which is called more choice, at a cost. This article baffles me. A pregnant couple is wondering what services (such as pre-natal ultrasounds) to buy and what not to buy. They need...

TECHNOLOGY: Personal Health Records (or the story of my continuing poverty...)

Harris Interactive has a new study on the use of personal health records. Around 42% keep personal health records with people tending to do it more the older they get. However, the most interesting part of the study was when...

BLOGS: Off-topic, THCB predicts future! Craigslist....

A few weeks back I suggested that eBay or Knight-Ridder may be concerned about the way Craigslist is eating small ads. Last Friday eBay bought 25% of Craigslist. So my "prediction" was in some ways correct. Interesting deal though. Craigslist...

PHARMA: More on the ethics of reimportation and all that, with new contributor Atlas and a cameo from The Veteran

Well the radical communist moderate social democrat nature of this blog has been somewhat shattered by recent contributors, and this post continues that trend. Mark McClellan (the ex-FDA commissioner and now CMS head), Cato and more radical wingnuts libertarian think...

TECHNOLOGY: New Health Care IT booster groups popping up all over the place (and news from Manhattan on eRx)

There's a real mood of boosterism following Stalin's Brailer and HHS' 10 year plan to get health IT up and running. First a group of technology companies including Microsoft, Cisco, Allscripts, NDCHealth, HP and industry alliances Surescripts, RxHUB & NCPDP...

QUALITY QUICKIE: Seniors on the wrong drugs--Medicare & doctors on the wrong incentive plan

Two amazing articles in the NY Times in recent days show that--as John Mattison from Kaiser told me in 1996--although we know what to do we don't know how to do it. First off a study of a PBM's database...

BLOGS: Happy 1st Birthday to THCB and Hi to Genny

One year ago today I started THCB not knowing what to expect. The first post was about What's wrong with Medicare and it still rings true one year, and one massive political fight which resulted in the MMA, later. In...

PHARMA: A riposte to my crack about pharma, software and auto R&D, by Terry Nugent

Terry Nugent, who's a frequent contributor to the Pharma-Marketing list serv was not too impressed by my recent post about Cato and how pharma companies might have to live in a world where their margins were much smaller but they...

HEALTH PLANS: HIAA, while not existing anymore, beats drum for CDHPs--while its successor AHIP misrepresents KFF study about individual insurance

Last year the Health Insurance Association of America (HIAA), the trade group of small health plans that created the "Harry and Louise" commercials which helped torpedo the Clinton health plan, merged with the Association of American Health Plans (AAHP). At...

POLICY: Seniors continue to oppose new Medicare law. With UPDATE

Harvard's Bob Blendon (a colleague of mine from my IFTF and Harris days), has new polling research out sponsored by the Kaiser Family Foundation showing that two thirds of seniors view the Medicare Modernization Act unfavorably. Here's the end implication:...

PHARMA: The Industry Veteran on Polypharmacy in Psychiatry

Yesterday's WSJ had an article on the increasing use of polypharmacy in psychiatric treatment of bi-polar disorder, depression and schizophrenia. It's controversial because there have been no clinical trials to prove its value, and due to the nature of those...

PHARMA: Marcia Angell makes more waves

Marcia Angell has been on a tear lately promoting her new book. She has a brutal interview in the LA Times which essentially summarizes all the complaints about drug companies made in the last decade. Here's a sample: Conflicts of...

EMPLOYERS: Halliburton sues retirees on health coverage

Last week every liberal's favorite company, oil services supplier, all-round US Army replacement and DOD no-bid contract winner Halliburton, managed to squeak out (more or less) of an SEC investigation into accounting shenanigans that kept its stock price high while...

PHARMA: A bizzaro world view on reimportation

Roger Pilon from Cato, the thinking man's libertarian think-tank (as opposed to AEI or Heritage) last week, decided that the US should give up on the reimportation ban. The basic reasoning is that it won't be a big deal as...

QUALITY: Millenson demands a shock to the system

Writing an Op-Ed in USA Today, Michael Millenson says that making a national error reporting system voluntary won't work. The Senate voted 98-0 to create such a system last week and USA Today had an editorial saying that it was...

PBMs: Spitzer puts the boot into Express Scripts

NY A-G Eliot Spitzer continues his swath through the boardrooms of America. He's piling in on the recent investigations and he comes right out and accuses Express Scripts of fraud. The suit alleges the company inflated the cost of generic...

PHARMA: A tawdry little tale of big money and double dipping

No time to comment much on this one, but this NY Times story is worth reading for insight into negotiations between pharma, health insurers (and PBMs) and Medicaid -- How Schering Manipulated Drug Prices and Medicaid.

TECHNOLOGY: More potential problems for Boston Scientific's Stent

Apparently a new and different type of problem has emerged for Boston Scientific's Taxus stent. In one instance it had problems with its balloon deflation. This follows the big recall story last month, and the particular stent in question was...

POLICY: HSC confirms that employer-based insurance fell during recession

Given the disarray in the individual insurance market, the latest survey from the Center for Health System Change (here's the News Release and here's the longer issue brief) proves that economics is alive and well. There is such a thing...

POLICY/POLITICS: Kerry's post-convention bounce

Jones the Policy Wonk sends me these post-Convention polling numbers. Internals from ABC poll post-convention--Kerry went from 3% ahead on healthcare to 19% ahead. (Sorry I can't figure out an easy way to present this!) The numbers in order are...

HEALTH PLANS/POLICY: More information on the individual insurance market, and yes it still sucks!

The Kaiser Family Foundation does a great job in putting health issues out there in an objective matter. Unfortunately their latest effort on the individual insurance market is, in their own terms, an attempt to get out information without implications....

POLICY: The Industry Veteran on negative advertising, the ethics of clinicians, and is THCB more boring than the Democratic Convention?

The Industry Veteran is back and on fine form, picking up the ball on a piece of crossed out editorial about my least favorite American politician, and running it into the realms of whether the Democrats are right (as Jones...

BLOGS/INTERVIEW: Interview with yours truly at Managed Care magazine

So in the every wierder world where bloggers looking at media are looked at by media too, I'm now joining in. There's an interview with me in the latest issue of Managed Care magazine. You can read it, titled Matthew...