We want death panels!

Can you hook me up?

Can you hook me up?

From Kaiser Health News:

The public overwhelmingly supports Medicare’s plan to pay for end-of-life discussions between doctors and patients, despite GOP objections that such chats would lead to rationed care for the elderly and ill, a poll released Wednesday finds.

Of course it makes sense to pay physicians to discuss these difficult issues. The fear-mongering prompted by Sarah Palin’s characterizing these discussions as “death panels” has been harmful to patients and families.

It’s heartening to learn that most people have been able to cut through the nonsense on this one.

Image courtesy of foto76 at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Why drug price regulation should not be ruled out


I’m a proponent of free markets and in general defend drug companies in their price setting, especially when they’re introducing new, innovative products with real clinical and financial benefits. See, for example, Hooray for high-priced hepatitis treatment Sovaldi.

But we have to remember that the reason high prices can persist in the market is that drugs are protected by patents and other restraints on competition such as the orphan drug law. Those rights are monopolies granted explicitly by the government. There’s really nothing free-market about them. Since the government grants these rights it should also be able to regulate the benefits that result from them.

In many cases the government wisely stands back and lets the market do its work. The generic market for small molecule pharmaceuticals is a case in point. When it works well –which is most of the time– prices fall by 90 percent or more once a patent expires.

But there are exceptions, where the government should consider stepping in. One example (highlighted on this blog in 2007: Abusing the orphan drug law to rip off customers) is when an old, generic drug gains new intellectual property protections for a use that is already common.

Another example that’s becoming more common is when large molecule drugs go off patent. The government is making a big mistake with its ‘biosimilar’ approach, which wrongly tries to apply the generic drug precedent to products that can’t be copied exactly. Instead, as I’ve been advocating since 2006 (A better idea than biogenerics) would be better to leave the original manufacturer with a monopoly, post-patent expiration but to regulate the price. This would be fairer and safer for patients.

We’re hearing a lot of noise about drug prices from politicians, doctors, drug companies, and patients. I won’t repeat what they say here, since you can easily find it elsewhere. This is a substantive issue, with no black and white answers. I’m glad to see it being brought forward into the public sphere.

By healthcare business consultant David E. Williams, president of Health Business Group.

Mercy Virtual’s Randy Moore: ROI isn’t good enough (Podcast)

Randall Moore, MD. President of Mercy Virtual

Randall Moore, MD. President of Mercy Virtual

Mercy Health has been doing big things in digital health. Last year I interviewed EVP Shannon Sock after he spoke in Boston. And recently I met Mercy Virtual’s president, Randall Moore, MD at Qualcomm Life’s Connect2015 conference to ask him some follow-up questions after his talk.

  1. (0:10) You came out on stage and said ROI isn’t a high enough bar to cross. You really have to consider cash flow. Say more about that.
  2. (1:16) You showed a compelling video of a patient’s experience. How much of that is vision and how much is real? For example, do you really have ‘warm handoffs’ to the ER when someone arrives after calling ahead?
  3. (3:34) Many people at the conference have been sanguine about the new ‘value based’ models. But you said hospital-based ACOs are likely to fail. Why?
  4. (6:07) You discussed radically reducing length of stay and increasing market share to stay viable. Does your business model rely on putting your competitors out of business?

By healthcare business consultant David E. Williams, president of Health Business Group.

Health Wonk Review is up at Colorado Health Insurance Insider

Check out the Fall Colors edition of the Health Wonk Review at Colorado Health Insurance Insider.

You will learn the best and worst days to be admitted to the hospital. Plus view posts on physician ethics, ACA replacements, 2016 premiums, work comp spending, census data, IT, and medical records.

Emotion tracking tools –only for trivial purposes?

Who am i?

Who am i?

I was surprised that the Boston Globe’s (Waltham firm helps computers learn empathy by mapping the human face) highlighted such unimportant opportunities for the technology. Here’s what MIT Media Lab spinoff Affectiva is doing, according to the Globe:

  • Helping companies measure emotional responses to advertising
  • Spitting out pieces of chocolate for Hershey’s when someone smiles at the machine

Maybe that’s not so bad for initial applications, but what’s down the road sounds pretty unimportant as well

“If a student got stuck on a tough math problem, an empathetic school computer would recognize the confused look on his face, and instantly offer additional help. An office laptop might see that a worker is bored, and suggest that he take a coffee break or play a simple computer game. A TV that notices that nobody laughed at last night’s Adam Sandler movie might suggest Woody Allen next time.”

Give me a break. A much more profound application for these tools will be to give people better insights into others’ emotions in live one-on-one and group interactions. It will be especially helpful for people with autism and Asperger’s, but it will also be useful for the average person to better understand how others react to them. The technology could (and I assume will) be built in to a next generation of Google Glass or similar.

I know some people who could use such a tool.

I’m not suggesting anything that hasn’t already been thought of, but the Globe should have done a better job reporting on this.

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

See you at the BBJ Future of Healthcare ‘Power Breakfast’

I’m excited to moderate tomorrow’s Boston Business Journal ‘Power Breakfast’ on The Future of Healthcare at the Mandarin Oriental in Boston. We have a great panel lined up:

  • Steward Health CEO, Ralph de la Torre
  • Blue Cross CEO, Andrew Dreyfus
  • State Street EVP, Todd Gershkowitz

We’ll be discussing about healthcare costs, quality, and innovation.

By healthcare business consultant David E. Williams, president of Health Business Group.