Next Things First


Reform: Finally, Some Discussion of the Real Issues by Rob Coppedge

In light of all the distraction recently generated by discussions of health care IT (and even, cue the smoke machines, Health 2.0), I was very pleased to find Senator Tom Coburn, MD, and Regina Herzlinger’s piece in the Huffington Post.

In a week that for many of us has been dominated by reading the “wouldn’t-it-be-cool-ifs” of messenger bag-carrying technology evangelists, it was refreshing to see a call for a much needed national debate around the *real issues* facing the health care system.

With little fanfare, Congressional leaders may be near to agreeing on the most sweeping expansion of government in a generation – the de-facto takeover of the health insurance market by the government. Congressional Democrats are already icing the champagne. When the President’s “Medicare for all” plan is coupled with the budget, which contains a “down payment” of $634 billion over the next decade for health care, government-run health care may be inevitable.

All sides in this debate acknowledge that the U.S. has long needed easier access to health insurance. This need has gained urgency for the many Americans who are fearful of losing their employer-sponsored insurance in the midst of a recession. Unfortunately, the President’s plan will not only endanger the U.S. economy, but millions of patients as well.

They make clear that the issue here is cost containment. Or, perhaps better, that solving the “access” issue without controlling costs may be politically expedient but is a recipe for disaster.

The fundamental problem is that the President and congressional leaders lack realistic plans to control the health care costs that are already crippling U.S. global competitiveness. As a percentage of GDP, our businesses spend roughly 70 percent more on health care than competitors in other developed nations, yet we hardly receive 70 percent more in real value.

We talk a lot about cost containment – and in the world of health care venture capital, some of the most exciting investment opportunities address just this set of issues. But translating these decidedly market-focused ideas into terms that are politically palatable is difficult. Denying reimbursement for treatments, no matter their relative value or efficacy, has interest groups rushing to mount the barricades. However, as Coburn and Herzlinger point out, there is a risk of even greater hazard if we don’t engage the cost containment challenge now:

In the end, the Democrats’ health care reform will require drastic rationing… Consider Canadian patients, who may wait a year or longer to get radiation therapy. Or ask one of the nearly 1.8 million Britons who are waiting to get into a hospital or have an outpatient procedure. Or talk to the German breast cancer patients who are 52 percent more likely to die from the disease than Americans.

Concerns about rationing and patient outcomes are not demagoguery. How else can a government control costs in the real world? Many experts, including the Congressional Budget Office, dismiss as wishful thinking the Democrats’ claims of achieving efficiencies through bureaucrats’ dazzling implementation of information technology and other technocratic tools.

And this is where the real world collides with the health care technology bandwagon. It goes without saying that health care lags behind in the implementation of back office and administrative information technology. And certainly this is due in some part to all the factors that are debated regularly in the blogosphere. However, it is also due to the basic fact that there has been little ROI for physicians implementing these technologies.

I worry that we are just further confusing the issue. As my colleague Alan Buffington points out:

Isn’t it interesting that no matter how many times they are corrected, politicians and media folk refuse to distinguish between health care and health insurance.  Failing to make this distinction is what causes the problems discussed in the article.

If you watch the blogs, Twitter or CNN, you will have proof that the problem Alan points out is deep and widespread. The problem with health care is that it is “hard” – complex, path dependent, interlocking, huge, with substantial ethical and moral considerations. For most people (especially politicians),  this is way too much.

Posted by RobC

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Gupta Out; Doesn’t Want to Stop Performing Brain Surgery by charlottegee
March 6, 2009, 9:23 am
Filed under: politics | Tags:

ac_guptaCNN’s Sanjay Gupta is officially out of the running for the Surgeon General position, as of last night. From the Washington Post:

Speaking on “Larry King Live” hours after news of his decision broke, Gupta said he did not want to stop performing brain surgery, leave his television career or spend extended time away from his family….

He said the surgeon general “has to have a little bit of a higher profile. Whoever takes this job has to be out there really advocating the issues of public health. At no time is it probably more important than right now, as we’re dealing with health-care reform. These issues really go hand in hand.” …

An administration official said last night that Gupta “was under serious consideration for the job of surgeon general. He has removed himself from consideration to focus more on his medical career and his family.”

Gupta, who was once named one of the “sexiest men alive” by People magazine, was never officially named to the post and continued to report for CNN. Sources said the medical journalist told CNN executives that he wanted to devote more time to his medical practice and to his duties at the network.

Posted by CharlotteGee



Venture Capitalist to Run the SBA by Rob Coppedge
December 19, 2008, 12:51 pm
Filed under: politics, start-ups | Tags: , ,

For those who aren’t following the Obama Administration Cabinet Appointment Ticker, the story is out that a venture capitalist will be appointed SBA Administrator.  In the context of all our recent posts on the challenges facing small businesses, this could be a good sign that the new Administration is going to try to stimulate the early stage market.  The Sun is out again and we are trying to find good news to report.

Mills is a venture capitalist and a founding partner of the New York-based equity firm Solera Capital. She has been an adviser to Maine Gov. John Baldacci on economic matters. She’s also president of the MMP Group in Brunswick.

Posted by RobC



The Politics of Health Care by charlottegee
November 19, 2008, 11:11 am
Filed under: politics | Tags:

Yesterday the Los Angeles Times had a nice piece on the state of health care and its role in the political landscape (or is it the other way around?). The article provided a good overview of where we are now and what may or may not happen, depending on some part on the usual political activities (like the latest PhRMA ad campaign). Here are some of the more interesting snippets:

  • Hospitals and physicians are increasingly worried about the escalating burden of newly unemployed workers being thrown onto the rolls of the uninsured.
  • Liberal advocacy groups see the Treasury Department’s $700-billion commitment to banks and other financial institutions bolstering the case for a similar investment to help sick Americans get medical care.
  • Still unresolved are important details about the cost of a new system, provisions for increasing quality and a mechanism for compelling businesses and people to participate.
  • “We have a huge financial problem in this country,” said Joe Antos, a healthcare scholar at the conservative American Enterprise Institute, who called the idea that bold action would save money on healthcare “completely ludicrous.”
  • “If you don’t fix healthcare, healthcare expenses are going to make this banking bailout deal look like a rounding error,” [Sen. Ron] Wyden told physicians, business leaders and healthcare industry leaders gathered for a meeting today in Los Angeles.

Read the entire article: Political temperature may be just right for healthcare overhaul

And … what do you think of this?: DASCHLE TO HEAD HHS

Posted by CharlotteGee

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