THCB

Categories

Search results for ‘THCB Gang’

Matthew’s health care tidbits: Hospital shooting reveals so much

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

In this edition’s tidbits, the nation is once again dealing with an epidemic of shootings. Now a hospital joins schools, grocery stores and places of worship on the the recent list. I was struck by how much of the health care story was wrapped up in the tragic shooting where a patient took the life of Dr. Preston Phillips, Dr. Stephanie Husen, receptionist Amanda Glenn, 40; and patient William Love at Saint Francis Health System in Tulsa.

First and most obvious, gun control. The shooter bought an AR-15 less than 3 hours before he committed the murders then killed himself. Like the two teens in Buffalo and Uvalde, if there was a delay or real background checks, then these shootings would likely have not happened.

But there’s more. Hospital safety has not improved in a decade or so. Michael Millenson, THCB Gang regular, has made that plain. And that includes harm from surgery. We know that back surgery often doesn’t work and we know that Dr Phillips operated on the shooter just three weeks before and had seen him for a follow up the day before. Yes, there is safety from physical harm and intruders–even though the police got there within 5 minutes of shots being heard, they were too late. But there is also the issue of harm caused by medical interventions. Since “To Err is Human” the issue has faded from public view.

Then there is pain management. Since the opiate crisis, it’s become harder for patients to get access to pain meds. Was the shooter seeking opiates? Was he denied them? We will never know the details of the shooter’s case, but we know that we have a nationwide problem in excessive back surgery, and that is matched by an ongoing problem in untreated pain.

And then there are the two dead doctors. Dr. Husen, was a sports and internal medicine specialist. Obviously there are more female physicians than there used to be even if sexism is still rampant in medicine. But Dr. Phillips was an outlier. He was black and a Harvard grad. Stat reported last year that fewer than 2% of orthopedists are Black, just 2.2% are Hispanic, and 0.4% are Native American. The field remains 85% white and overwhelmingly male. So the chances of the patient & shooter, who was black and may have sought out a doctor who looked like him, having a black surgeon were very low in the first place. Now for other patients they are even lower.

The shooting thus brings up so many issues. Gun control; workplace safety; unnecessary surgery; pain management; mental health; and race in medicine. We have so much to work on, and this one tragedy reveals all those issues and more.

Spotify, Joe Rogan, and Health Care

By KIM BELLARD

Here’s a sentence I never thought I’d have to write: the most interesting discussion in healthcare in the past week has been about Neil Young versus Spotify.  

For those of you who have not been following the controversy, Neil Young gave Spotify an ultimatum: it could have his music or Joe Rogan, but not both.  “I am doing this because Spotify is spreading fake information about vaccines – potentially causing death to those who believe the disinformation being spread by them.”  Spotify chose Rogan.

Mr. Young was not the first to express alarm at some of the Covid “information” promoted on Mr. Rogan’s podcast, The Joe Rogan Experience (JRE); in December, for example, several hundred scientists from around the world issued an open letter to Spotify specifically about JRE, warning:

By allowing the propagation of false and societally harmful assertions, Spotify is enabling its hosted media to damage public trust in scientific research and sow doubt in the credibility of data-driven guidance offered by medical professionals.

Continue reading…

Matthew’s health care tidbits: Drug prices

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

For my health care tidbits this week, I am going to talk drug pricing. Anyone who gets basically any health policy newsletter has seen some of the cash PhRMA has splashed trying to make it seem as though the American public is terrified of drug price controls. But as Michael Millenson on a recent THCB Gang pointed out, when Kaiser Health News asked the question in a rational way, those PhRMA supported numbers don’t hold. 85% of Americans want the government to intervene to reduce drug prices.

Big pharma whines about innovation and how they need high prices to justify R&D spending but health care insiders know two things. First, for ever Big Pharma has spent about twice as much on sales and marketing as it’s spent on R&D. This was true when I first started in health care thirty years ago and it’s still true today. Second, the “R” done by big pharma is resulting in fewer breakthrough drugs per $$ spent now compared to past decades. Which means that they should be increasing that share spent on R&D and need to improve the “R” process. But that’s not happening.

Finally, pharma is very good at increasing prices of branded products and extending their patent protection. Lots of dirty games go on here. Look into it and you can expect a lot of discussion about insulin pricing or discover how Humira is still raking in $16bn a year in the US, despite the fact its original patent expired in 2018. With 85% of the American public in favor, you’d think then that a Democratic Congress would leap at the change to pass a bill that might save the taxpayer $50bn a year in drug costs. But of course that’s not going to happen. There is about $30bn a year in savings in the House version of Build Back Better that passed last week, but there’s little chance of much of that being in the Senate version given Joe Manchin’s daughter’s role running a drug company, and Krysten Sinema being a recent recipient of PhRMA’s largesse. And that’s assuming any version of #BBB gets through the Senate.

Instead hope something small happens to help desperate patients, and wonder how we ended up in a political system that apparently disregards what 85% of the public wants.

Advertising

Looking to get your brand some presence on this Blog? 

With 100K monthly readers, nearly 40K Twitter followers and another 80K on Linkedin, and a 15-year editorial history of avant-garde publishing on all things health policy, health tech, patient advocacy, and the business of health innovation, who can blame you!?

We have 750+ article contributors, plus our unique video shows, ‘Health in 2 Point 00’ the ‘THCB Gang’ and ‘WTF Health,’ which include investing news in health tech, commentary and chat on the weeks events, and in depth-interviews.

There are two ways to play: Advertising and Content Partnerships.

Advertising 

Small and large sidebar ads and eye-catching interstitials ensure that your brand slips into the subconscious of every single one of our readers. You can start for as little as $3,000. For current rates, specs, and to buy, please contact Matthew Holt at matthew@matthewholt.net.

Content Partnerships

Need a more creative way to tell your story, position your execs as thought leaders, or align your brand with the passionate rabble-rousers who are going to change health care for the better? 

THCB has partnered up with WTF Health to offer mixed-media sponsorship packages that include video, print, advertising, and social media benefits that create bespoke content around your brand, without compromising our editorial integrity, for that ‘is-it-paid-or-is-it-earned’ look. 

As the packages get bigger, the benefits get better — including event hosting and speaking by Matthew Holt or Jess DaMassa, introductions to their health care networks, extra love on social media and more. 

For full details on packages and pricing, contact Jess DaMassa at jessica@wtf.health. 

Matthew’s health care tidbits: Time to get Cynical

Each time I send out the THCB Reader, our newsletter that summarizes the best of THCB (Sign up here!) I include a brief tidbits section. Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

Plenty of reason to worry about the future of American health care this week. The biggest for-profit hospital chain–HCA–was accused of aggressively pushing patients into hospice care, sometimes in the same room, in order to make their hospitality mortality numbers look better. Most of the leading benefits consulting companies were exposed as taking payments from PBMs–yup, the same organizations their employer clients thought they were negotiating with on their behalf. And one of the biggest names in digital health, Babylon Health, tumbled into destitution, taking billions of dollars with it and leaving uncertain the fate of the medical groups in California it bought less than two years ago. Even the most successful capitalists in health care — United HealthGroup and its fellow insurers — saw their stock fall because apparently outpatient surgery volume is ticking up. 

On the policy front the malaise is spreading too. The end of the public health emergency (remember Covid?) is being used as an excuse by the old  confederate states to kick people off Medicaid. Georgia and Arkansas appear to be bringing back work requirements, even though I thought CMS has banned them and every study has acknowledged that they are cruel and ineffective. About 20 million people got on to Medicaid during the public health emergency and KFF estimates up to 17 million may be kicked off, while over 1.7 million already have.

Finally an article by Bob Kocher and Bob Wachter in Health Affairs Scholar remins us that big academic medical centers are nowhere near ready for value-based care (VBC). Jeff Goldsmith has been vocal on THCBGang and elsewhere about how VBC is becoming a religion more than a reality. And I remind you that Humana’s MA program is still basically a Fee-For-service program in drag (even though that’s now illegal in their home state). 

I grew up in American health care expecting that eventually a combination of universal insurance mixed with value-based purchasing would lead to a series of tech-enabled companies doing the right thing by patients and making money to boot. With the managed care revolution, the ACA and the boom in digital health all firmly in the rear view mirror, the summer of 2023 is a lesson that you can never be too cynical about health care in America.

.

April Fools….Data Driven Analysis

By MATTHEW HOLT

I have always thought that THCB almost always had an April fools post. I mean never on the Epic scale–today they’re merging with the other Epic, the Fornite gang–but most years I’d have said we had one. So in an effort to avoid the work I should be doing I went back to to archives to look and find the truth.

THCB started in August 2003 and in April 2005 the “tradition” started with this very worthy & not very clever April Fool about how George W Bush had signed national health care into law. The nothing more April Foolish until 2009 when then TCHB editor John Irvine wrote a piece about me joining Cato.

I got going on the whole thing in 2010 when just after the ACA was passed I declared that THCB and all its various contributors were finding other stuff to do. (They’re all basically back on #THCBGang these days!). The theory was that health care was now solved and we were going to cover fly fishing and renewable energy. If I had just bought that Tesla stock…

So now we were getting into the swing of it and yet no more fools for 4 years! The next one was a goodie though. At the time I was railing against the term mHealth which was battling my preferred term Health 2.0 as the definitional term for the sector. Neither term realized that “digital health” was winning. I explained that we were renaming Health 2.0 “mHealth & Associates” and that employees were going to be referred to as mHealth Ass. and Indu thought I was the “biggest mHealth Ass”. The wonderful coda to this is about 3 weeks later Indu and I met our then most important client, Holly Potter at Kaiser Permanente. She asked us when the name change was happening!! I still tease her about that when I see her!

Then another 4 year gap. In 2018 I revealed that Trump had appointed me to run the VA. I also predicted war with Russia in 2021. So wasn’t too far off! Then we hit a roll, in 2019 I scooped the world with the news that Facebook was entering the EMR business….not too far from the truth.

Finally in 2020 Michael Millenson told us that Trump was urging Covid sufferers to only get care at for-profit facilities. As it turned out, given how well so many hospital systems have done in the pandemic, he may not have been joking.

So in 19 years we have run 7 April Fools. Which by my calculation suggests that THCB is about 35% foolish. Which I guess is lower than I thought.

Matthew Holt is the publisher and main fool at THCB

You Need a Cyber Team

By KIM BELLARD

Maybe you, like me, are an Olympics fan (in my case: Summer Games, track & field).  Most Americans look forward eagerly to the Super Bowl, while the rest of the world (and, increasingly, many in the U.S.) are waiting for the World Cup.  But too few of us are aware that next summer will be the inaugural International Cyber Security Challenge, an esports event that pits teams from multiple countries against each other in cybersecurity skills.  The U.S. is sending a 25 person team.  

So what, you might say?  Well, if you work in healthcare (or any industry, for that matter), or use any kind of digital device, you should care.  Ransomware attacks on healthcare organizations continue to proliferate. The Colonial Pipeline cyberattack this past spring illustrated the weakness of other parts of our critical infrastructure, and we’ve all almost certainly had some of our personal data exposed in data breaches.    

We’re in a war, but it’s not clear that we have the right army, with the right weapons, ready to fight it. Thus the U.S. Cyber Games.

Continue reading…

Go Ahead, AI—Surprise Us

By KIM BELLARD

Last week I was on a fun podcast with a bunch of people who were, as usual, smarter than me, and, in particular, more knowledgeable about one of my favorite topics – artificial intelligence (A.I.), particularly for healthcare.  With the WHO releasing its “first global report” on A.I. — Ethics & Governance of Artificial Intelligence for Health – and with no shortage of other experts weighing in recently, it seemed like a good time to revisit the topic. 

My prediction: it’s not going to work out quite like we expect, and it probably shouldn’t. 

“Like all new technology, artificial intelligence holds enormous potential for improving the health of millions of people around the world, but like all technology it can also be misused and cause harm,” Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said in a statement.  He’s right on both counts.

WHO’s proposed six principles are:

  • Protecting human autonomy
  • Promoting human well-being and safety and the public interest
  • Ensuring transparency, explainability and intelligibility 
  • Fostering responsibility and accountability
  • Ensuring inclusiveness and equity 
  • Promoting AI that is responsive and sustainable

All valid points, but, as we’re already learning, easier to propose than to ensure.  Just ask Timnit Gebru.  When it comes to using new technologies, we’re not so good about thinking through their implications, much less ensuring that everyone benefits.  We’re more of a “let the genie out of the bottle and see what happens” kind of species, and I hope our future AI overlords don’t laugh too much about that. 

As Stacey Higginbotham asks in IEEE Spectrum, “how do we know if a new technology is serving a greater good or policy goal, or merely boosting a company’s profit margins?…we have no idea how to make it work for society’s goals, rather than a company’s, or an individual’s.”   She further notes that “we haven’t even established what those benefits should be.”

Continue reading…

Matthew’s health care tidbits, week ending Jun 5

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet!–Matthew Holt

In this week’s health care tidbits, I can’t quite leave the $3.5bn Babylon Health SPAC investor document alone. Yes, it’s crazy but not as crazy as you might think. Essentially it’s saying that it’s going to be a better tech enabled version of Oak Street or Agilon. Babylon has put less effort into the medical group management side of the puzzle than Oak Street or Agilon but it hasn’t done nothing. It’s been running GP clinics in the UK for years and now has two Medicare Advantage networks in California w 52k lives. It only did $79m in rev in 2020 but that was presumably mostly in software. They’re aiming for $320m in rev in 2021 (presumably mostly from the medical groups) & $710m in 2022.

In comparison Oak Street’s forecast is $1.3bn in 2021 and $2bn in 2022. So Babylon is shooting to be 25% of its size. Today’s Oak Street market cap is ~$14,5bn, so 25% of that is close to the $3.5bn Babylon is trying to get investors to pay.

Then there’s the story, which is that the bot tech can reduce all types of patient health spend which will increase the margin. Of course their actual mileage may vary. I do love the chart from their investor prez, which not only assumes that they can reduce medical spend abut also that they get to keep those savings long term. I’m not sure the “Partner” in the chart below will be as convinced.

This was the cause of much hilarity on this week’s #THCBGang.

As I said crazy but not completely crazy. And you never know, maybe better care?

Health Tech Deals, on Clubhouse tomorrow (Thursday 8th) at 1 PT/4 ET

Tomorrow we are taking a break from #THCBGang. Don’t worry it’ll be back with a vengeance next week. Instead, Jess DaMassa & I will host a new show “Health Tech Deals” on Clubhouse

So please join Jess and me in The Health Care Blog’s room for “Gossip, analysis & Sh!talking about digital health funding”.

Tomorrow, Apr 8 at 1:00 PM PDT – 4pm ET on @joinClubhouse. Join us! (And if you need an invite to Clubhouse, let me know)

And it’ll be on our podcast channel (Apple/Spotify) from Friday — Matthew Holt