Long time THCB readers will remember how several times I’ve called out AHIP president Karen Ignagni for being economical with the truth. Today in a letter to the NY Times she actually tells it how it is. Medicare Advantage plans provide more and better benefits than the FFS program. Ignagni also says that FFS program is outdated and that Medicare Advantage plans also emphasize prevention, wellness, care coordination and management of chronic conditions, do better than the FFS program in reducing hospitalizations and even are fostering the innovations needed to reduce health care cost growth. So given that there is so much waste and poor care in the FFS program (over 35% by most estimates) why do the so superbly managed Medicare Advantage plans require and spend more money per capita than the FFS program? Imagine my surprise when I was unsuccessful in my search to find the explanation for this in Ms Ignagni’s letter.

By Matthew Holt

There’s a new world emerging of customizable materials and it’s being led in health care by designers like my old friend Scott Summit. Scott designed products like an early prototype of the Palm V (yes, there was a life before the iPhone!) and servers for Apple and Silicon Graphics, but in the last five or so years he’s got very interested in the human body—particularly artificial limbs.

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There ‘s an excellent article by physician Ken Murray at Zocalo Public Square suggesting that few (or no) doctors would put themselves through routinely practiced end of life care. Let’s face it. The system is on automatic for reasons that are lost in professional medical culture and propagated by the Jerome Groopman meme that we must keep practicing new stuff to find out what works, and if lots of people suffer on the way….well that’s the cost of progress. The result is a medical system that does massively excessive care of everyone–especially the nearly dead. As the old joke goes, they really do put nails in coffins to keep the oncologists out. Yes there are cases when intensive treatment does work, but I suggest everyone looks at the engagewithgrace.org site in order to start the conversation with their own families and providers. At least take the system off automatic for you and your loved ones.

Every VC loves and hates the hockey stick–that growth curve that potters along and then suddenly shoots up. But if you check out the new numbers from CDC the use of a basic EMR is on that hockey stick curve. Adoption of a “basic system” has gone from under 17% in 2008 to 33% this year, with another 40% of doctors saying they’re going for the Meaningful Use gold–which means essentially a more than “basic” system. So maybe this is a hockey stick curve that we can all love. (Well all other than the curmudgeons over at Health Care Renewal!). On a somewhat related personal note, I too was awaiting the hockey stick of EMR adoption. I abandoned my attempt to catch the start of the hockey curve in 2000 when I quit my EMR survey job at Harris Interactive. All I had to do was hang on for another eight years and I’d have been proved right!

By Alan Greene

I’ve been helping Alan Greene and his all volunteer team on the Whiteout campaign. And today Alan has exciting news about the progress so far! Talking about starting solids you can see how my daughter Coco did in this video that we made with Alan!-Matthew Holt

Last Thanksgiving I announced a bold campaign, spearheaded by an amazing band of volunteers, to upgrade babies’ first foods to real foods – and babies’ first grains to whole grains – and to do this in 2011.

It’s November, and we still have a ways to go, but we also have an exciting reason to celebrate!

Over 10,000 physicians, mostly pediatricians, took part in a July/August 2011 survey by Medscape.com that demonstrated an historic shift in their feeding recommendations this year. The first question in the survey was “What do you recommend for baby’s first food (check all that apply)?” The options were white rice cereal, whole grain cereal, a vegetable, a fruit, egg yolk, meat, or other. Of those who answered as of August 31, the number one choice was white rice cereal – garnering nearly twice as many votes as the next most common.

But after reading an article about WhiteOut Now, our public service campaign the survey results were strikingly different. Responding to,” What will you recommend for baby’s first food (check all that apply)” only 3% even included white rice cereal among their recommended choices. Physicians were also asked, “Do you think white rice cereal is the best choice for baby’s first food?” About 3% of those who responded had “No opinion” and an overwhelming 93% responded, “No.”

As of now over 12,000 physicians have taken part in the survey, and the change continues to spread. To me this major reversal suggests that the old white rice cereal recommendations were based on well-meaning habit rather than on science or even on careful consideration. When asked to reconsider, an overwhelming majority of physicians were quickly able to see advantages of abandoning the old recommendation.

Evidence is mounting that changing early feeding habits is critical to reversing the childhood obesity epidemic. This stunning survey suggests that first feedings are poised to change. A reason to be thankful indeed!

Here’s my comment on a recent Health Affairs blog post from Heritage’s Nina Owcharenko whining about the ACA as a g’vermint takeover.I wrote “I’m really pissing myself about this one. Only in the bizzarro world of American politics can the nutjobs on the right, and not just any nutjobs but on the right but Nina’s actual colleagues at Heritage design the basics of a health care policy and then declare it something that’s antithetical to their very being. Furthermore, it’s only in bizzarro world of American politics that a massive expansion of PRIVATE health insurance legislated in the ACA is called a government takeover, or in Nina’s words puts the “trend toward government-based coverage on the fast track”. If Nina had bothered to check she’d realize that the vast majority of Medicaid enrollees — 66% according to KFF– are in private plans and the rest are being moved there. Yet this is another expansion of government!” Of course if you look at the Health Affairs version where they moderate comments, you’ll note that some of the words I wrote and the words they publish are slightly different

What does a know-nothing Republican who doesn’t believe in science and is front-runner for his party’s nomination for President say about health care? Pretty much the same that the rest of them now do–unlike McCain, Huckabee et al in 2008. What’s the new Republican ideology? Apparently. there’s not much wrong with health care and what there is wrong, caps on malpractice payouts will fix. Perry cites the increase in the number of doctors in Texas since tort reform caps were put in as proof that it works. Wendell Potter at PR Watch shows that, when corrected with facts, everything Perry says is rubbish. But then again, were you surprised?

It’s hard to think of a more opaque market than that for individual health insurance. But perhaps there’s enough data that can be reworked so that ordinary people can get a better understanding of it. Todd Park, HHS’ CTO, for sure thinks so, and just last week arranged (as in he said in this blog post) to allow developers to download files with data from all the markets in all 50 states & DC.  My hope is that this will inspire people like eHealthInsurance.com to put the most important part of any plan comparison (out of pocket maximums) front and center on their plan comparison tools. Otherwise, I may just have to build my own….