A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.
David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good idea. We've supported the purpose and spirit of the ARRA/HITECH incentive programs, and believe ONC's/HHS' re-definition of EHR technology puts it on a trajectory to improve the quality and efficiency of health care in the U.S. But this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.
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8
March
I’m viewing the latest rumblings in the US health care debate from the confines of a clear but cold Britain, where the big news is that the country is joining the PIGS in entering economic meltdown—or at least being a lot more broke than it thought it was. (PIGS are Portugal, Greece, Ireland & Spain, not farm animals). And yet it appears that health reform is making if not a comeback then at least vigorous palpitations. The reason for this seems to be the strength that the Anthem Blue Cross/Wellpoint premium rises have imbued into the Administration.
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20
February
Twenty-seven years ago, President Ronald Reagan and a Congress split between Republican and Democratic control agreed to a radical new payment scheme for Medicare. The resulting legislation trimmed billionsof dollars from the federal budget and caused medical inflation to plummet, yet still maintained quality of care.
Although this stunning achievement led to a permanent change in how both the public and private sector pay for health care, it has gone curiously unmentioned during more than a year of rancorous health reform debate. Nor isit likely to arise at the much-ballyhooed bipartisan summit. The topic simply raises too many squirm-inducing questions. In this instance, conservatives and liberals alike can agree that political discretion is the better part of valor.
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16
February
This April 6–7, the Health 2.0 Europe conference will feature the many ways in whichWeb 2.0 tools are providing innovative solutions to, amongst others, our fundamental need for self-expression, known more recently as “user-generated content”.
Several panels will refer to these issues, but we will focus in this post on the Hospital and Payers’ panel. Payers want to ensure that their patients are being oriented to good care. Hospitals want to know that they are being considered “justly”.The Health 2.0 panel will include demonstrations byGuide Santé (France) and Patient Opinion (UK), both web 2.0 sites created by physicians concerned by patient satisfaction with hospitals and clinics. Payerslike the UK NHSand Big-Direkt from Germany will participate in the conversation and Big-Direkt will also demo their new online tools.
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9
February
Todd Park is definitely one of health care IT’s good guys. Todd was the brains (but not the mouth!) behind athenahealth. Since he left athenahealth, he spent a year back in California doing angel investing (Ventana among others) and being a dad. But despite his desire to stay on the west coast, he was dragged intothe vortex known as Washington DC, and for the last 5 months he’s been the (first) CTO of HHS. (BTW he cashed out his investments, and politely turned down my proposal to “care for” his cash while he was being a public servant!)
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4
February
“I want your Ugly. I want your Disease
I want your Everything, as long as it’s Free.”
—America’s leading contemporary philosopher, Stefani Germanotta (aka Lady Gaga)
Insight comes from unlikely sources. Lady Gaga nailed the health reform dilemma. We have a healthcare delivery system that is an orgy of profligacy and excess that offers the false promise of making ugliness, disease and death all optional. And, we the public love all of it, as long as it’s free, at least to us as individuals. We want high tech, high quality, high expectations met, highly trained professionals delivering high standards, paid by someone else.And the magic fairy that will pay for all of this? Health insurance. Give everyone an insurance card and they can have their everything and it will be free, or close to it.
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1
February
According to the headlines, 10 percent of Americans are unemployed. The truth is that closer to 17 percent of the population cannot find full-time work; this number includes workers who have become discouraged and have given up looking for work as well as those who have settled for part-time jobs because they cannot find the full-time employment that they need.
The situation is not going to change anytime soon. As Princeton economist Paul Krugman recently warned: “We are facing mass unemployment — unemployment that will blight the lives of millions of Americans for years to come.”
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26
January
Does it matter whether health insurance exchanges are state-level or national? I used to think that it wasn’t a major issue, but my opinion has changed.
During the health reform debate early in 2009, I thought that other exchange design issues were more important than whether they are organized at the state or national level. In my view, who is eligible to join (all small business employees or just those who receive subsidies?), whether the exchange is the exclusive market for individuals and small groups, and how the exchange will be protected from an adverse selection “death spiral” are critical design features and will determine whether the exchanges are successful.
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12
January
One day before 2009 passed into history, the much anticipated final definition of “meaningful use†was released by CMS and ONC, 556 pages and 136 pages, respectively. The blogosphere experts rushed to summarize the contents, some accurate and some less so, and just like everything that has to do with health care reform, for every rule making there are a dozen new questions being raised by the already thoroughly confused stakeholders at large.
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9
January
The last time the US Senate held a vote on Christmas eve, it was 1895. In that one, lawmakers said it was OK for former Confederate army soldiers to serve in the military. The vote was hailed as a milestone in the slow national reconciliation following the Civil War.
No one was talking about national reconciliation following last week’s Christmas Eve Senate vote on health care reform. A bill was passed with unanimous support by Democrats, against the wishes of 40 resolute, disdainful Republicans.
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8
January