Healthy Sunday Brunch

How healthy was your Sunday brunch today?

This morning, while working out, in lieu of biking, I finally finished reading In Defense of Food by Michael Pollan. It is a great book and was previewed in his NY Times article which I wrote about almost two years ago. The subtitle is An Eater's Manifesto, and the manifesto is, repeating my precis:

Eat food: what your great-grandmother would recognise as food (and nothing with a health claim or more than about five ingredients on the box)

Not too much: most of the US national eating disorder is about eating too much - don't

Mostly plants: plants come to us as whole food, with a balance of goodness we evolved around - most of the other stuff is either bad for us in and of itself, or is bad for us the way we process and eat it

By the way, eating mostly plants should be aimed at leaves rather than seeds.

Having started on the subject of healthy eating, I have a few items for today's brunch about the US health care system ... a favorite, if tragic, topic.

  • Charlie Baker, CEO of Harvard Pilgrim Healthcare (a very well respected HMO here in the Boston area), has a great post on The Five Myths of Healthcare. His post is actually commentary on a Washington Post op-ed of the same name. I particularly like reminding people of myth number one: that America has the best healthcare system in the world. It doesn't.
  • Last month, John Halamka (CIO of Harvard Medical School and of Beth Israel Deaconess medical center) forecast his list of winners and losers in IT (health IT in particular) in 2009. John subsequently reported on a milestone for Personal Health Records (PHRs). The Federal Government's Center for Medicare and Medicaid Services (CMS), opened their systems up for Utah and Arizona Medicare members to use a select number of consumer PHR systems to access their own records.
  • Earlier in the year, Xconomy, a new digital news source for the high-tech world, reported on Boston's status as a hub for a cluster of Health 2.0 companies. This is probably only been strengthened in the intervening times.

Finally, a little dessert ... a 50%-off coupon for first time customers at ScanCafe. ScanCafe scans your photos, slides or negatives at high res and sends you images back. You can send your entire shoebox, and then once scanned you get to look at the low-res scans on-line and choose which images you want to pay for the hi-res version (at least half). When ordering on the company website look for "Add discount" on the order form and enter 50DEC2008.

Each photo gets 2 – 4 minutes of a real human working in photoshop to do touch-up. They did a great job on mine. Apparently the automated touch-up found on many scanners and photo-editors still cannot compete with the human eye in deciding the best moves for many photos. Hence customers like the touch-ups from ScanCafe better... They have more in-depth restoration capabilities as well including for existing digital photos.

Full disclosure: Sigma Partners is an investor in ScanCafe.


Anonymous said...

Who would risk sending their priceless photos to a company like ScanCafe who ships them off to India. You would have to be crazy to trust that system. No thanks!

Richard Dale said...

People with opinions are always welcome on my site. However, the courtesy of a name would be welcome!

As investors in ScanCafe we know that we have processed many millions of photos without problem. In fact these are shipped to India in large crates (they are collected in CA from the consumers, and crated together). Because of this it is even less likely they will get lost - it is tough to lose a large crate. The facility in India is right on the airport (no reliance on road transport there).
I think this is not an area to be worried about.

Jason said...

I have to take issue with the blog that you linked to. Specifically "myth 3". I do not think this is a myth, and Charlie Baker did absolutely nothing to show that this is a myth. While third party insurance has administrative overhead of 17%, Medicare has 5%. ( You are welcome to research it more, but Baker is so clearly an interested party that his unsubstantiated opinion is worthless. Quite honestly, I am disgusted by his post.


Richard Dale said...

I would so like to agree with you about Medicare for all. I am absolutely a supporter of a single payor system. However, in Charlie's earlier post (see he notes that the government keeps costs down by unilateral cuts to providers (docs/hospitals) who make it up by charging the private insurers more. If there were no private insurance, the doctors and hospitals would be very poorly treated contractors of the government (much worse than being an employee). I can see Charlie's point on this ... even though I belive the right prescription is different from his - I think the myth may indeed be a myth.

Steven Hacker, MD said...

Congratulations on posting what has come to be the hottest sector in healthcare IT. The "center of the universe" of healthcare's goal of converting paper to digital and inefficiency to portability. As as physician, and founder & CEO of PassportMD, we are working with Medicare as I write this post to bring personal health records, concierge consumer healthcare services and consumer directed tools to Medicare beneficiaries. It is no longer just me saying and believing that companies like PassportMD , ie innovative and nimble, represent the opportunity for the US to actually see a significant adoption of electronic health records the government's published goal by 2014. It is clear that the government in the last few years has given up , appropriately, on the idea that physician adoption would be the driver through electronic medical record systems. Everyone knows that physician adoption has been abysmally low. This is due to cost and work flow interruption. So, after coming to terms with this reality, the government and insurance providers, realized that the driver and the piece that fits between the disparate EMR systems is the consumer. With this in mind, standards were finally agreed upon and the CCR and CDA became the CCD. THe standards were shortly thereafter adopted by the AMA, AAFP , etc. All of this happening at lightening speed, ie in the last 12 months. After the standards were adopted , the CCHIT mandated that certification of the back end EMR systems was dependent upon provisioning for these standards. 6 months ago Medicare begins piloting PHR's and most recently selects companies such as PassportMD and Google in a competitive search to begin rolling this out in 2009. PassportMD as a result of this selection and part of this pilot will receive 2 years of Medicare Beneficiary data to help create a beneficiaries PHR utilizing the CCD format. Talk about timing. The time is right now....The PHR will be the standard by which all systems communicate and health records go online, President Elect Obama's goal as well. Last week, further substantiating this development is an independent study in Boston, your town, by Partners Healthcare validating that health insurers will save 21 billion annually after setting up PHR's for their insureds...
The implications of this are clear and the motivation for the PHR from sleepy mom and pop's to forefront with Medicare and PassportMD and others is clearly the direction the next few years will take.
Steven Hacker, MD
Founder & CEO PassportMD,Inc

Jason said...

I think you misunderstood my post and the supporting documentation. Whether or not medicare holds down costs underpaying hospitals and forcing them to overcharge insurance, has nothing to do with the overhead of private insurance vs. medicare. Those overheads 17% and 5% respectively are the overhead of administering the plans (and for private insurance advertising and paying profits), not the overhead associated with the health care providers.

I do though agree with your point that having the government as the single payer would result in health care providers being poorly paid contractors.

Richard Dale said...

Jason ... I so want to agree with you - I have been beating the same drum ... but see more from Charlie Baker (see: from June 2007)
[remainder of this comment is quote from Baker]
But aside from that, the two things I always hear about why it’s a good idea are — Medicare has lower Administrative costs than private health plans and they’re a ”better” payer than the private plans. Hmmm…Let’s take the first one. What I’ve heard before is that Medicare only spends 4% of its money on a per beneficiary basis on administration, while the plans spend 14% per member on administration — a big difference. This is interesting, but misleading. Medicare beneficiaries are over the age of 65. They spend almost three times as much money on health care as a typical private plan member — most of whom are under the age of 65. If the Medicare member typically spends $800 per month on health care, and 4% of that is spent on administration, that’s $32 a month on administration. If the private health plan member typically spends $300 per month on health care, and 14% of that is spent on administration, that’s $42 a month — a much smaller difference. But we’re not done yet. Medicare is part of the federal government, so its capital costs (buildings, IT, etc.) and benefit costs (health insurance for its employees and retirees (!), pension benefits, etc.) are funded somewhere else in the federal budget, not in the Medicare administrative budget. Private plans have to pay for these items themselves. That’s worth about $5-6 per member per month, and needs to come out of the health plan number for a fair comparison. Now we’re almost even. And finally, Medicare doesn’t actually process and pay claims for all of its beneficiaries. It contracts with health plans around the country to do much of this for them. That’s not in their administrative number, either — and it is, needless to say, in the private health plan number.