To Break the Bank or Not to Break the Bank With Health Care Reform?--The Wrong Question

The new debate in Washington these days seems to be over whether we can or cannot afford to do health care reform given the financial crisis and the huge budget deficits.Some argue that with the rising unemployment rate, certain increases in the number of those uninsured to follow, and the need to inject money into the system, this is the right time.Others say that in the face of daunting

"Consumer-Driven Health Care: Promise and Performance"

I am always struck by the difference between the salesmanship of health plans offering consumer-driven health products and the reality of the data.James Robinson and Paul Ginsburg have an article in the January 27th edition of Health Affairs with an objective review of the consumer-driven movement of recent years.Here is the central point of the article:The performance of consumer-driven health

Five "Shovel-Ready" Health Care Reforms

Five "Shovel-Ready" Health Care ReformsBy Brian Klepper & David C. KibbeMicrosoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We should think expansively about which technologies to invest in, based on the results we want to get.The other message is the

SCHIP Bill Not a Good Sign for Major Health Care Reform

The extension and expansion of the State Children's Health Insurance Program (SCHIP) has now passed the full House and the Senate Finance Committee and is on its way to the full Senate.After minor differences between the House and Senate are reconciled it will become law.However, the way it is being done does not give me a good feeling.In the Senate Finance Committee the Democrats were only able

What It Will Take for President-Elect Obama to Accomplish Health Care Reform

President-elect Obama has listed entitlement reform as a major goal for his incoming administration.Just this week he said, “The big problem is Medicare, which is unsustainable. We can’t solve Medicare in isolation from the broader problems of the health care system.”I doubt anyone would disagree with the President-elect on that score.Fixing the entire U.S. health care system cannot be done in

Cuomo Shows the Health Insurance Indusry Who's Boss!!

New York Attorney General Andrew Cuomo today announced a "victory" in his battle with the insurance industry over how out-of-network physician claims are paid. Cuomo had argued that the industry's use of its out-of-network "customary and reasonable" database "defrauded" consumers and he sued the database's manager, United Health's Ingenix, over the controversy.In a February 2008 post I said, "In

Health Care Reform––Are the Adults Taking Over?

In past posts I have pointed to what I called the “irrational exuberance” over health care reform––that the excitement over the new administration and its ability to accomplish all the big things was getting out of hand.There was even talk that Democrats would use the Senate budget reconciliation process and bypass the 60-vote rule enabling them to use their big new majorities to ram their idea

Sanjay Gupta Could Be a Great Pick for Surgeon General

I have been surprised at some of the political criticism President-elect Obama has taken for considering CNN correspondent Sanjay Gupta for Surgeon General.That some in the Public Health Service would be concerned career officers are being passed over is legitimate. And Gupta does not have managerial experience overseeing thousands of career health officers.But the most successful Surgeon General

Let's Reboot America's HIT Conversation--Part 2: HIT Beyond EHRs

Let's Reboot America's HIT ConversationPart 2: HIT Beyond EHRsby DAVID C. KIBBE AND BRIAN KLEPPERYesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're one of many very important HIT functions, and EHRs and HIT alone won't fix health care. So developing a comprehensive but effective national HIT plan is a

The Five Myths of Health Care Reform––Health Information Technology, Prevention, Outcomes Research, Pay-For-Performance, and Universal Coverage

The arguments that the widespread use of health information technology (HIT), improving health status, expanding outcomes research, implementing pay-for-performance systems, and covering everyone will make it possible for us to afford comprehensive health care reform are commonly cited by people on both sides of the political aisle.It's all a myth.Undoubtedly, these ideas will be at the core of

"Let's Reboot America's HIT Conversation---Part 1: Putting EHRs in Context"

Last Month David Kibbe and Brian Klepper asked me to post an open letter to the Obama Health Team with their thoughts on how to spend the coming federal health IT money. That letter ended up as the centerpiece of a Boston Globe story with the lead line, "some specialists are warning against investing too heavily in existing electronic recordkeeping systems."Encouraged by the response to that