By Evan Falchuk
Gary Schwitzer links to a Business Week article that says health insurance is a very uncompetitive market. Schwitzer notes this hasn’t gotten much attention, and wonders if it is a reason why health insurance premiums keep going up.
It is – and it isn’t. As with most things in health care, there’s more to it than it seems.
By Evan Falchuk
For the next in my continuing series of real people making real change to health care I interviewed Joanne Jones, Senior Director of Benefits & Global Mobility for Genzyme Corporation. Genzyme is one of the world’s leading pharmaceutical companies, with more than 11,000 employees. It’s also one of the world’s most innovative companies when it comes to health care and health care benefits.
Joanne recently shared her thoughts on how Genzyme helps its employees live healthier lives, and how Genzyme helps their employees and their families improve the quality — and cost — of care.
By Evan Falchuk
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Following my earlier webinar, I said I would be doing a series of Q&A’s with benefit executives from some of the country’s most innovative companies. The first one features the insights of Delia Vetter, Senior Director of Benefits of EMC Corporation. She shared her views on employee benefits, health care IT, and how an important company like EMC thinks about the hottest topics of the day.
I think you’ll find her thoughts very interesting.
By Evan Falchuk
The American health care system is so bad, even people who have health insurance go bankrupt.
The New York Times, searching for a poster child for this problem, uncovered other, more interesting questions.
By Evan Falchuk
The Boston Globe reports on a battle brewing in New Hampshire over the state’s health care plan for its employees. The story focuses on the possibility the plan might end up being taxed under the new reform legislation being debated in Washington.
But it begs the question: how much of our country’s health care expense burden is created by plans like the one employees of the state of New Hampshire enjoy?
By Evan Falchuk
A poll released last week was billed as showing that “Employer-Based Health Care ‘Not Sustainable’.”
But is it really true?
To answer, you have to realize that there isn’t a solitary system of “employer-based” health care. In fact there are at least three very different kinds. And while at least one is deeply troubled, the others are actually engines of innovation in health care cost and quality.
By Evan Falchuk
Ezra Klein is back with another post showing what happens when you form strong opinions without knowing very much about your subject matter.
Today, he’s here to tell us the “truth” about the insurance industry. He succeeds – but only in making himself look very silly.
By Evan Falchuk
One of the things that is able to inform my views as a blogger is the actual business that I am President of, Best Doctors. In that role, I see every day the ways in which patients and doctors, employers and hospitals, insurers and the government deal with our health care system.
Since the fall, all of the major players in health care have been hit by not only an economic crisis, but also by the most significant health care reform effort in nearly 20 years. As a business, we want to know what these things mean to employers. What are they doing about their health insurance and benefits? How are they changing their strategies for dealing with employee health?
From time to time, we commission surveys and then host (free!) events to share the insights we gain from them. I want to invite you to our next event, a webinar happening Wednesday June 24th, 2009 (2:00pm EST/ 1pm CST/ 11am PST).
By Evan Falchuk
Yesterday’s USA Today reports on a list of doctors the newspaper is making available for free to its readers. It’s a good lesson in how complicated and conflicted health care is – and how hard it can be for consumers to figure out what’s really happening.
Of course, I support the idea of getting as much useful health care information to consumers as possible, including lists of doctors. But a look at how the USA Today list was put together reveals much more than just the names of doctors.
The company USA Today hired to provide its list is one of many similar companies that do sales and marketing research for the pharmaceutical and managed care industries. Their job is to profile doctors by crunching through reams of claims data.
It’s part of the complicated dance of health care spending. Pharmaceutical companies want to profile doctors as a way of efficiently using their sales force. Knowing which doctors are the best targets for your sales and marketing efforts is very valuable. This way, you don’t waste time selling Lipitor to a doctor that already prescribes it 80% of the time. Meanwhile, managed care companies want to profile doctors for the opposite reason. They want to know which doctors have high rates of prescribing brand-name drugs to they can encourage them to switch to generics.
I’m sure these systems work, since pharmaceutical companies and managed care companies spend tens of millions of dollars on them. But it’s not at all clear how a list created for this purpose can have much to do with what is actually important to consumers when they are sick. Or why any of these companies would want to reposition themselves in this way.
One possibility can be found in the halls of the Supreme Court. Over the last few years, some states have passed laws banning the commerical use of doctors’ prescribing information. This is the lifeblood of these profiling companies, and so the leaders in that industry have filed lawsuits to have these laws overturned. If they lose, the business of these companies will disappear, or will have to drastically change.
Maybe they’re trying to find a new business.
UPDATE: More here.
By Evan Falchuk
It’s a secret, hiding in plain sight.
A recently-released GAO study of the health insurance market (.pdf) found:
Health insurers look like — and some might say, act like — your cable company. They’re pretty much regulated that way.
But it’s not just insurers. In the last two decades, there has been an equivalent consolidation of hospitals.
It shouldn’t be a surprise, then, to find hospitals and insurers cutting highly questionable deals that make each other lots of money at the expense of everyone else.
We know what to do about this. In America, we try to introduce competition to fix problems like these. Maybe this is one of the motivations behind the idea of a government-sponsored health insurer. But wouldn’t it be much simpler to open up these markets to real competition?
