Health Insurance

Newt Gingrich and I Find Common Ground! Dogs and Cats Living Together! Mass Hysteria!

Jeff O'Connor — Tue, 04 Apr 2006 23:49:00 GMT

Apparently I'm not the only one who thinks the Henry ford Health System's E-Prescribe system is a model for the nation to emulate.

Health cost savings backed
Gingrich calls for national reform
April 4, 2006

BY KATIE MERX
FREE PRESS BUSINESS WRITER

Former U.S. Speaker of the House Newt Gingrich applauded a southeast Michigan effort to save lives and save dollars through collaboration, but said it is just a beginning and called for nationwide reform of the health care system...

"You are as close as any region of the country at beginning to be the health system of the future," Gingrich told about 300 conference attendees. He cited regional advances in electronic prescribing and the collaboration among industry, labor, government and the health industry to improve quality and lower costs in the region's health system...

"I am very impressed with what you have begun to do," Gingrich said. But achieving widespread systemic change at the rate needed to save American businesses from collapsing from the enormous burden of health care costs is "going to be an enormous challenge."

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The current system of employer-funded healthcare puts this country and its businesses at a competitive disadvantage in the global market. While I'm not a big fan of Newt's I'm glad to see that there's at least one registered Republican out there who doesn't think the cure for America's healthcare ills is as simple as throwing more public money at a handful of well-connected public companies.

Bush Supports Healthcare for the Troops and Seniors Until He Doesn't

Jeff O'Connor — Sat, 18 Mar 2006 15:47:00 GMT

This has been a bad news week for people who have been promised medical care by the government, either by virtue of simply being Americans or because they put their life on the line for this country and nearly lost it.

Bush Rejects Push to Extend Drug Benefit Deadline
Steve Holland / Reuters

U.S. President George W. Bush on Wednesday rejected calls to extend a May 15 deadline for the elderly to sign up for a new prescription drugs plan despite complaints that it is too confusing.

At a meeting with residents of a senior citizen community in Silver Spring, just outside Washington, Bush said families of older Americans, particularly adult children, should help them sort out their Medicare options.

One woman, saying she was having trouble helping her 75-year-old mother make a choice, asked whether the deadline should be extended.

"No, and the reason why is there's got to be a fixed time for people to sign up," the president said. "We want people to realize there is — now is the time…. Rolling back deadlines is not going to help your mom make a good decision."

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Ah, yes - the Republican's fondness for adhering to “fixed time.” Like the time they extended debate in violation of parliamentary procedure on a failed bill that gave away public land to oil refineries until it passed. I guess that means some members of the GOP had voted against the bill before they voted for it?

Bush Administration Slashes Veterans Benefits

Over the last year and a half, President Bush has staged more than a third of his major public events before active military personnel or veterans. His rowdy “Hoo-ah”s and policy pronouncements—even when they have nothing to do with military matters—are predictably greeted with rabid applause.

But those easy and unquestioning crowds at military bases and American Legion halls will be increasingly hard to come by as soldiers and veterans start to notice the string of insults and budget cuts inflicted upon them.

With 130,000 soldiers still in the heat of battle in Iraq and more fighting and dying in Afghanistan, the Bush administration sought this year to cut $75 a month from the “imminent danger” pay added to soldiers’ paychecks when in battle zones. The administration sought to cut by $150 a month the family separation allowance offered to those same soldiers and others who serve overseas away from their families. These payments were deemed “wasteful and unnecessary” by the White House.
This year’s White House budget for Veterans Affairs cut $3 billion from VA hospitals—despite 9,000 casualties in Iraq and as aging Vietnam veterans demand more care. VA spending today averages $2,800 less per patient than nine years ago.
This year’s White House budget for Veterans Affairs cut $3 billion from VA hospitals—despite 9,000 casualties in Iraq and as aging Vietnam veterans demand more care. VA spending today averages $2,800 less per patient than nine years ago.
The administration beat back a bipartisan attempt in Congress to add $1.3 billion for VA hospitals to Bush’s request of $87 billion for war and reconstruction in Iraq and Afghanistan.
The White House is seeking to block a federal judge’s award of damages to a group of servicemen who sued the Iraqi government for torture during the 1991 Gulf War. The White House claims the money, to come from Iraqi assets confiscated by the United States, is needed for that country’s reconstruction.

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When it comes to the U.S. healthcare crisis I have seen the enemy, and he is sitting in the White House.

Motown is Abuzz About E-Prescribe - Here's Why You Should Be

Jeff O'Connor — Sat, 25 Feb 2006 14:27:00 GMT

The woes of the Big Three have been national news for a while now, and despite DiamlerChrysler's recent increase in buzz and market share they're not out of the woods either. What's dragging GM, Ford, and DCX down, especially with GM and Ford thriving in overseas markets and all three collectively controlling nearly half of the lucrative North American market?

Among other things the rising price of healthcare for their current and retired employees, particularly the cost of prescription drugs. The Henry Ford Health System and Health Alliance Plan's E-Prescribe system is interesting enough on its own because, as I alluded to in my previous post, the automation of mundane tasks frees-up resources so that healthcare professionals can engage in more esoteric - and arguably more important - types of work.

As I heard and read more and more in the local media about the importance of E-Prescribe to the automobile industry, it began to dawn on me that there's an even more important synergistic effect that should be considered. It's been said that the American automobile industry is linked in one way or another to one out of every six jobs in the United States. That's roughly 17% of the entire U.S. economy. All things considered that makes the Henry Ford Health System's E-Prescribe program much more than a local success story of healthcare process improvement through automation; it makes it a model for lowering healthcare costs and expanding coverage worthy of national study.

Electronic prescriptions paid big dividends for Detroit hospitals
WWJ Newsradio 950, 2.23.2006 (BROADCAST TRANSCRIPT)

MATT ROUSH reporting:

With the Great Lakes IT report, I'm Matt Roush, technology editor, WWJ Newsradio 950.
A year ago Henry Ford Health System and Health Alliance Plan launched an electronic prescribing initiative at the request of the Big Three automakers. A year later the online e-prescribing system has hit the 500,000 prescription mark and there have been big payoffs. More than 80,000 of the prescriptions were changed or canceled due to drug interaction alerts and messages alerted doctors to more than 6,000 potential allergic reactions.
Also, more than 50,000 prescriptions were changed to increase the use of generic drugs; that will save more than $3 million a year in healthcare costs. The e-prescribing system started with a 60-doctor pilot, it's now in use with 300 primary care doctors at 24 Henry Ford Medical Centers. All doctors at Henry Ford will be using e-prescribing by the end of the year.
With the Great Lakes IT report, I'm Matt Roush, technology editor, WWJ Newsradio 950.

I Have Seen the Future and it is E-Prescribe!

Jeff O'Connor — Thu, 23 Feb 2006 22:32:00 GMT

Here's an excellent example of automating a vital but somewhat mundane aspect of medicine in order to free up resources for more challenging, hands-on tasks...

E-Prescribe lowers drug costs, errors
Henry Ford, HAP tout its benefits

Katie Merx / Detroit Free Press

More than 80,000 prescriptions were changed or canceled due to drug-interaction alerts.
e-Prescribing messages alerted doctors to 6,500 potentially allergic reactions.
More than 50,000 prescriptions were changed or canceled due to formulary alerts, which increased the use of generic drugs.
The use rate of generic drugs by Henry Ford Medical Group improved 7.3%, the equivalent of $3.1 million in pharmacy costs over one year.

Source: Henry Ford Health System

Henry Ford Medical Group filled more than 500,000 prescriptions electronically in the last year through a program launched at the request of American automakers to cut prescription costs and reduce medical errors.

Health Alliance Plan and Henry Ford Medical reported Wednesday that the year-old program, e-Prescribe, already has helped avoid potential drug complications and saved money by reducing adverse drug effects and increasing the use of generic prescriptions.

Here's how it works:

Every time a doctor enters a pricey brand-name drug into the e-Prescribe system, the computer stops him or her and suggests a less-expensive generic version. It also checks for potentially harmful drug interactions and allergies.

The doctor doesn't have to choose the generic, but already, e-Prescribe has resulted in doctors switching 10% -- more than 50,000 -- of all the medicines they prescribed from the proprietary option to a generic alternative. And that means bottom-line savings to the patient, the employer and the health plan.

"Every percentage point increase in the generic use rate saves about $800,000 in drug spending," said Matt Walsh, associate vice president of purchaser initiatives at HAP.

The generic use rate by the Henry Ford Medical Group improved by 7.3% since the program began, Walsh said. That's the equivalent of $3.1 million in pharmacy costs over one year.

The numbers released Wednesday don't say how many times doctors were prompted to try a generic and didn't.

But Henry Ford Medical did report additional benefits to the new program that not only save money, but lives, time and aggravation.

In the first 12 months:

More than 80,000 prescriptions were changed or canceled due to drug-interaction alerts.
e-Prescribe messages alerted doctors to 6,500 potentially allergic reactions.

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Banging the Blogging Drum - Again

Jeff O'Connor — Tue, 07 Feb 2006 22:17:00 GMT

Tomorrow I will put a one-page summary of the pros, cons, and who's who of corporate blogging along with a multi-point plan into the titular basket at the Basket of Ideas breakfast the healthcare organization I work for puts on every quarter.

This will be my latest tactical maneauver in a two-year battle to get the word “blog” on the radar of my company's CEO. My previous efforts have largely involved me playing the role of Cyrano to the Sales and Marketing management's Christian. Unfortunately Christian, having no idea of what I was talking about, never uttered my words to Roxane.

Can you tell that I wasn't a computer science major?

The southeast Michigan market for healthcare is one of the most competitive and difficult in the nation right now. Plagued by layoffs and generally poor corporate performance among its subscriber base, I believe that my organization needs a more effective communications strategy than it is currently employing. Not that what we have right now is bad; it isn't. The problem is that our message doesn't stand out. I believe a corporate blogging strategy will help change that.

Healthcare is a deeply personal issue as it touches on two of the most intimate and important areas of a person's private life: their health and their wallet. Yet, as the article I referenced in my previous post illustrates, the healthcare industry as a whole is very impersonal in its interactions with the majority of the people who consume its products and utilize its services.

It's true that outside of the providers themselves, there's only so much that can be done in the way of direct, personal contact with your customers. My organization rightly prides itself on the services it provides to patients with chronic health problems and the communication channels it maintains (largely through printed materials) with broad categories of our subscriber base (women, seniors, etc.). The strength of these programs lies in their ability to convey a great deal of information on relatively narrow topics to discreet segments of our customer base; their weakness lies in the converse. Simply put, they are of little or no interest or value to the majority of the people we service. Yet they are also comparatively expensive programs to maintain.

Especially in light of current economic conditions in my state, I am baffled by the failure of my organization and its competitors to utilize such a cheap and effective communications medium. Under the best of circumstances, people like assurances that their money is being well spent. Under difficult circumstances they demand it. What better way for a CEO to communicate his or her vision, demonstrate empathy and understanding of consumers' needs, and present proof that they're getting their money's worth than through a blog?

In the healthcare industry new products and services don't mean a thing unless they're delivered in context. So you're rolling out Consumer Driven Health Plans (CDHPs). So what? What does that mean to me, the consumer? Why is it a good thing? How does it help me better allocate my healthcare dollars? Without going into my own views on the topic, rest assured that there are a lot of opinions on CDHPs to be found on the Web, much of which appear to answer these questions in the negative. Advocates of CDHPs need every advantage at their disposal to counter these negative reviews and clearly articulate their view of the product and its benefits.

Another advantage that early adopters in the corporate blogosphere have is that blogs are a self-promoting medium and they generate their own buzz. You heard it here first: the initial wave of healthcare CEOs who start blogging about their organization and the goods and services it provides are all but guaranteed additional, positive media coverage while the johnny-come-lately bloggers will have to settle for being also-rans. Love them or hate them, believe them or not, the early adopters have an advantage that no amount of money can buy late in the game.

bizjournals.com Hypes Poll Findings

Jeff O'Connor — Sun, 01 Jan 2006 15:14:00 GMT

Poll: Don't require businesses to provide health care
bizjournals.com

Millions of employed Americans go uninsured each year because their companies, for many different reasons, do not offer health care benefits.

But 47 percent of respondents in an informal Los Angeles Business survey said they do not feel the responsibility for health care lies with the employer, and that businesses should not be legally required to offer it.

"Paying for health care isn't any more the responsibility of an employer than buying groceries for the employee," said one respondent. "The employer should pay the employee, and the employee should decide for himself how to use his money."

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Shame on bizjournals.com for this one. Despite the article's title, only 47% of respondents stated they believed the responsibility of providing healthcare to employees doesn't lie with the employer. That's a plurality at best, and a minority opinion at worst.

Healthcare is an extremely important issue that should be examined objectively and impartially; half-baked “informal business polls“ that don't even identify the polling group do a disservice to people who are actually working to address the healthcare crisis in America today.

Personaly, I'm betting the polling group consisted entirey of small business owners. The word "responsibility" appeared twice, but it was directed at employees, not employers. Also, the financial impact of employer-provided healthcare insurance was raised but only in the context of small businesses, despite the prevalence of the topic in the national press as it applies to Fortune 500 companies like General Motors and Wal-Mart.

If you read the rest of the article, other individual responses were quoted that raised some red flags to me about how seriously this poll should be taken by readers. One in particular, equating bird flu with cancer and naming it as a specific health threat that should require employers to provide insurance strikes me as ridiculous - and an obvious straw man argument.

Turn Your Head and Cough - the Healthcare Industry's Prescription for Big Profits Through 2020

Jeff O'Connor — Tue, 20 Dec 2005 12:19:00 GMT

In a recent study, PricewaterhouseCoopers found that 90% of all healthcare leaders don't believe a taxpayer funded healthcare system is the solution to America's healthcare crisis. This is despite the fact that the federal and state governments are funding nearly 50% of current healthcare costs in the United States today, and that healthcare costs are expected to rise to the point where they consume 21% of US GDP by the year 2020.

Without going into my personal feelings about “socialized medicine“ vs. the current U.S. healthcare model, I find it telling that in the PricewaterhouseCoopers study:

When asked what are important or very important to the future sustainability of the nation's healthcare system, more than eight in 10 (82 percent) said equal access to care; two-thirds (66 percent) said market-driven competition, and nearly 4 in 10 (39 percent) that said medical technology would need to be rationed (emphasis mine).

Yet the same study concluded that:

Technology will play an important role in strengthening the U.S. health system. Approximately three-quarters of respondents viewed information technology as important or very important for integrating care (74 percent).

This makes absolutely no sense to me. If the cure to America's healthcare ills lies - at least partially - with the free market, why impose artificial limitations on the availability of medical technology? Especially when it is seen as one of the pillars of the U.S. healthcare system?

In their 1996 paper entitled Information Technology and Productivity: A Review of the Literature, Erik Brynjolfsson and Shinkyu Yang found that “the price of computing has dropped by half every 2-3 years.” This was a reference to the hardware and software costs of computing before the advent of open source software and commodity hardware. To be fair, Brynjolfsson and Yang did not address the issue of to what extent medical technology affected the productivity of healthcare workers because data pertaining to the medical industry was not - and is not - easy to quantify.

However, the impact of medical technology on the productivity of healthcare workers is not the issue here; the desire of the industry's leaders to ration - and thereby charge a premium for - the technology itself is. Moreover, studies conducted to measure the impact of technology on productivity within the healthcare and insurance industries since 1996 show a strong correlation between the proliferation of technology and increases in the quantity and quality of healthcare services within the United States. Unless there has been a fundamental change in the nature of the laws of supply and demand, rationing medical technology should drive healthcare costs up, not down, and therefore threaten the sustainability of the U.S. healthcare system rather than help it.

I stand by my previous assessment of the industries' motives in light of these studies. The healthcare industry loves to feed at the public trough; what it fears are the economies of scale that would be created if the federal government were to get serious when throwing its collective weight around. Medicare Part D is a huge give-away to the health insurance industry, for example, and the last thing health insurers want is to see the government imposing standards that would shrink the size of the taxpayer pie. Unfortunatley, the healthcare industry also apparently fears the power of a truly free maket. Between these two extremes are gross inefficiences, huge profits, and you, me, and everyone else in this country who needs access to competent, affordable care.

Saving Money at What Cost?

Jeff O'Connor — Mon, 12 Dec 2005 11:00:00 GMT

The Commonwealth Fund has concluded a study that finds a good deal of dissatisfaction with consumer-driven health plans (CDHPs).

This, of course, comes as a surprise to no one.

The organization I work for launched a high-deductible CDHP a little over a year ago. The enthusiasm for the product within the company was directly proportional to the lack of enthusiasm in the marketplace for it.

The idea behind a CDHP is simple: make consumers responsible for allocating their healthcare dollars. Under the influence of the market's "invisible hand," healthcare consumers with CDHPs should maximize their healthcare dollars by spending on procedures and drugs they actually need, as opposed to those they want (or, less cynically, think they need).

The two big assumptions being made about these healthcare consumers are: 1) they're capable of making informed decisions about their healthcare needs, and 2) they'll behave rationally. However, the Commonwealth Fund study suggests that neither of these things are occuring , despite finding that CDHP subscribers are significantly better informed about treatment options and the cost of care than healthcare consumers with more traditional healthcare coverage:

More cost-conscious consumers. Among people in the plans who did receive care, there is evidence that they are more cost-conscious than those in comprehensive health plans. People in the CDHPs and HDHPs were significantly more likely to say that the terms of their health plans made them consider costs when deciding to see a doctor when sick or fill a prescription, to report that they had checked whether their health plan would cover their costs as well as the price of a service prior to receiving care, and to discuss treatment options and the cost of care with their doctors. Nevertheless, they were also more likely to go without care (emphasis mine).

Sadly, the study also found that whatever information CDHP subscribers weigh when making their healthcare decisions, little if any of it comes from their plan providers:

Lack of information. Few health plans of any type provide cost and quality information about providers to help people make informed decisions about their health care. The study also found very low levels of trust in information provided by health plans (emphasis mine).

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