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May 2009
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July 2009

Health Care Reform: Avoiding the Billy Tauzin Effect

Health Care reform is a pretty straight forward proposition:  Improve patient health, for the lowest cost, covering the maximum number of people.  But the people in Congress many times have other agendas, namely how can they raise money to get re-elected or get a cushy job in the future.   Not paying any attention to those who elected them.

The last big overhaul was Medicare Part D which gave prescription coverage to seniors.   Unlike the VA system, Billy Tauzin lead the effort prohibiting Medicare from negotiating drug prices.  The result?  The VA gets their drugs for 58% less.  And Tauzin?  He leaves Congress and takes a $2M job with PhRMA the lobbying group.  Sticking the taxpayers with the bill.

Can't happen today?  Think again.   Comparative Effectiveness Research finds out the most effective way for treatment.   But Sens. Jon Kyl (R-AZ), Mitch McConnell (R-KY), and Pat Roberts (R-KS) introduced a bill to prohibit Medicare from using it to deny coverage for less effective treatment.   They want us taxpayers to pay the pharmaceutical companies for treatments that don't work as well as competitive ones.

I'm hoping the American public holds Congress accountable for their actions and keeps them on task.


Keeping up with everything: Bloglines & Evernote

I know you're not supposed to blog over the weekend, but since when did I ever do "status quo"?   I've watched Microsoft's "bing" commercials, even tried it, but I prefer other ways to keep up with the world and find things.  The first product I like is Bloglines.   Sites / people who usually say and do interesting things I subcribe (just 2 clicks).  Today I purged the list back to 25 feeds.   After not caring about some for over a month, hit the delete key.

Back in the dark ages when people actually read trade magazines, I had a file drawer full of interesting items.   I would just tear a page out of the magazine and stuff it into a folder.  Purged it about once a year or so.   Today I have Evernote do the job for me.  I have only a couple of folders, but it sure is handy for remembering, and it beats bookmarking everything.


Why US Healthcare is so Expensive: Measuring the Wrong Thing

"Whatever you measure, will improve".   In the case of Healthcare, reimbursements by Aa procedure and office visits are measured, so they have increased 10x since 1960.    However the patients are not getting better.

As the Washington Post points out:

Of 37 industrialized nations, the United States ranks 29th in infant mortality and among the world's worst on measures such as obesity, heart disease and preventable deaths.

Bright young physicians trained at prestigious and expensive universities enter a profession built on perverse financial rewards. They, like assembly-line workers of the past, are paid on a piecemeal basis, earning more money not by doing better but simply by doing more.

Yet more care rarely translates into better health.


So pay more attention to measuring the outcome you want and don't fall into the trap of emphasizing false indicators just because they are easy.     


Chase Burns Quicken Customers

Turns out that after Chase got into financial trouble last year, they started charging their customers almost $120 / year just to download transactions into Quicken.  A friend called online banking twice to ask about the charges and both times they said "We don't charge anything, Quicken does".

Aa After talking to Quicken, turns out that simply isn't true.   It took a bank manager's phone call to get Chase to fess up that indeed it is their charge.

Great marketing strategy by Chase.  Lie to your customers.

However there is a simple workaround.  Turns out you can download your transactions to a file and then import it into Quicken.   Takes a little extra effort, but you can think of better ways to spend $120.

Or maybe we all need to move to someone who doesn't charge.