healthsignals new york

What a pleasant surprise

One of the fun things about the web is how you can see things coming in the back door that you wouldn't have seen otherwise. Backtracking some of the site traffic I found a new link and a very nice surprise.

Healthsignals New York was nominated for a Medical Weblog Award (in the category of Health Policies/Ethics)  sponsored by Echo Journal, a blog devoted to echocardiography, cardiology and clinical sciences. You'll see many others there as well and if you're new to this game, it's a good list to start with. Guess I need to link to Echo Journal.

Regular readers know that I'm an admirer of Matthew Holt and that I link to his work often (in fact, I have a backlogged posting with such a link still awaiting completion). So it's doubly gratifying to see that it was Matthew who nominated Healthsignals New York. Thanks Matt!

Somehow, this feels like high school ...

State healthcare IT policy

I'm presenting tomorrow on the policy angles relating to healthcare information technology. The sponsor is the University at Albany's Institute for the Advancement of Healthcare Management. Here's the presentation (PDF). Download rodat_on_hc_it_11_04.pdf

Good for them; bad for us

Also via Crains ...

The $388 billion spending bill just approved by Congress includes $300,000 for Montefiore Medical Center for its clinical information system.

Rep. Eliot Engel, D-Bronx, and Sens. Hillary Rodham Clinton and Charles Schumer secured the money for the Bronx hospital's cutting-edge computer system.

Regardless of how wonderful the particular system Montefiore is deploying and how important it is that we all go in this direction, relying on political pork is not a sound business model, either for any specific institution, other provider, or the system as a whole. This kind of garbage is a marker of how fundamentally backward the financing of healthcare is and how degraded healthcare politics have become.

And, by the way, what kind of system can Montefiore deploy for $300 grand anyway? Sounds more like a political gift that just happens to have an IT label attached to it.

Even I'm not this crazy

One of my personal failings is that I often try to rescue organizations and efforts that are truly doomed. But you know, sometimes, we've just got to let failing institutions fail.

Even with his credentials and his money, this doctor could do so much more than to try to bail out another teetering hospital.

Via Crain's New York Business:

With a $25 million price tag, Dr. Robert Aquino's Christmas present to himself sounds like an over-the-moon bauble in a luxury catalogue. The doctor bought his very own hospital, Parkway Hospital in Forest Hills, Queens.

Comes complete with 210 beds and $12 million in debt.

Happy Thanksgiving

This link won't be active long, but it's one of those stories that brings me up short wondering whether I would have the courage. We all hope so, but don't know until the challenge arrives. First we have to recognize the challenge. Then we have to be up to it. In the New York Times, Thanksgiving day, 2004 the story of a reunion:

... They first met in 1942, when Morawiecka, her two sisters and their mother took in the Nowacki family after Nowacki's father was sent to a Nazi death camp. The Catholic family, at risk to their own lives, provided a safe haven for the Jewish mother and son at their Warsaw home ...

On this Thanksgiving day, the best to you and yours.

One of the downsides of single-payer

When all of the eggs you want to buy are in one basket, which has one owner, your leverage is diminished. So even if you're the only buyer, you don't always get eggs for breakfast. Ontario physicians have just (decisively) rejected a new fee structure proposed by the government.

Once you take a system to single-payer, the providers are an interest group, upon which government is dependent as well as the other way around. The status quo then becomes extremely powerful. That may be OK for a while, but eventually the system becomes ossified.

Employment based coverage declines in NYS

Excellus has done an analysis of the latest editions of the Census Bureau's Current Population Survey (CPS) and discovered that:

Employment-based health coverage among adults dipped slightly in upstate New York from 2000-2001 to 2002-2003, but the level of coverage upstate is more than 13 percentage points higher than downstate.

An average 72 percent of upstate adults had health coverage through their employment during 2002-2003, compared to 58.8 percent downstate. In all locations, coverage rates had dipped a point or two from the average of the two previous years, 2000-2001.

Meanwhile, government-based coverage for adults - including Medicaid, Medicare and military-sponsored coverage - rose from 10.9 percent to 11.8 percent upstate, 13.5 percent to 14.7 percent downstate during the same period.

Here's the report (PDF). Here's the release.

Second Berger report out

The Governor's Medicaid advisory group, chaired by Steve Berger put out a report months ago concentrating on long term care. The long awaited second report, focusing mostly on hospitals came out last night.

We should have a copy in a couple of hours and will try to do a quick summary today and a more extensive analysis as soon as possible.

Bruce cashes in and becomes a ... consultant

New York's own Bruce Vladeck, PhD., is joining Ernst & Young LLP. He'll be a Principal in its Health Sciences Advisory Services (HSAS) practice and will act as East Coast Director for E & Y's Academic Medical Center services.

After an academic career, where he made his bones writing the still classic, Unloving Care, the Nursing Home Tragedy, went to the Robert Wood Johnson Foundation and then to New Jersey's Health Department, where he was deeply involved in their first run at hospital rate regulation. Then off he went to run the United Hospital Fund. From 1993 to 97 during the Clinton Administration, he was Administrator of the Health Care Financing Administration (HCFA), running the Medicare and Medicaid programs in the predecessor of today's CMS in DHHS. Then he headed to Mt. Sinai and now to E & Y.

Well Bruce, this will be a different gig for sure.

Here we go again

You heard it first in the ... Oneonta Daily Star. Hey, you know the drill. A few months before a renewal year for the Health Care Reform Act (HCRA), the newspaper column inches devoted to the topic start creeping up. Well, maybe it's not the first. Maybe others did their stories earlier and, having seen them so many times before, I just couldn't bear to read them again.

Let's give credit to the writer, John Milgrim. At least he went straight to the politics. Usually what we see first is a spate of articles about the terrible financial condition of New York's hospitals, setting the stage for putting their hands outs, palms up.