“As it happens, … It turned out that I had a genetic variant that implied a moderately increased risk of meningioma, the second most common type of brain tumor.

The information came a little late to be useful. Last summer, … found me half conscious on the floor. The diagnosis at the local hospital was meningioma, a benign (i.e. non-cancerous) tumor inside my skull but fortunately outside my brain.”

pointer to: Bloomberg Economics Radio – two top healthcare economics experts amicably discuss (.mp3) the current reform efforts – both agree the mendacity and outright lies are deeply poisoning the debate. The first main issue is the so-called “uninsured issue” which most other countries have resolved (simply, everyone deserves to be and is covered) which they see as resolvable through public-private and/or private-exchanges for the 20-25 million folks who cannot afford coverage – at little or no extra cost to the tax payer.  The much larger ($trillions$) question remains how to keep up with good medical care and keep down costs. Both agree that incentives to physicians that promote the use of evidence-based practices – rather than fee-for-procedure would accomplish this.  However, both see this as a VERY long-term debate that will progress incrementally in the decades to come.  Certainly the health 2.0 movement will transform this conversation in the decades to come.

A welcome respite of scholarship and collegial respect amidst the rising demagoguery in the heartland.  Related posts here and here.

pointer to: Information technology investor and member of the pioneering “PGP-10″ personal genome volunteer Esther Dyson has a great article on the Health 2.0 movement in – the mainstream of all mainstream media – the Financial Times.

Was sort of holding my breath with fingers and toes crossed these past few weeks, but now am given up.  Much like team Obama’s efforts to regulate the financial services industry (only slightly less of a clusterf**k than healthcare), its a slow motion trainwreck where the average taxpayer just ends up worseoff after all the political concessions.  Seems like the very folks who are most vocal are the ones who’d rather not change a thing.

This is my take on the doublespeak within the beltway:

BUSINESS: We are being crushed by rising healthcare costs.

INSURANCE: We only make a nickel on every $1 we pay out to doctors, and they are always raising their fees.

DOCTORS: We’re forced to treat the growing ranks of uninsured and must shoulder the burden when they cannot pay.

OK, so lets try to expand medicare and design a wider government managed plan…

BUSINESS: We can’t afford the higher taxes to pay for universal care and our employees don’t want to give up the plans they have.

INSURANCE: We don’t want to compete with the government-run plan since it will undercut ours.

DOCTORS:  We don’t want “evidence-based medicine” and to be told by the government what we can do and how much we can charge – we like our perverse incentives!

And don’t forget about Mr. and Mrs. middle-class USA who want top-o-the-line care but don’t want to pay more than they did in the 1960′s.

What a total bust. I think the Health 2.0 movement is doing something really interesting – outside the system – and also very key – something that can elevate the most needy, uninsured members of society to the forefront.

No more dwelling on the wreckage.  On to strategies that help.  More science & more Health 2.0!

Just discovered FORA.tv media channel – happened on this discussion with Joe Pantoliano on his advocacy for mental illness.

pointer to — Dr. John Grohol, the CEO and founder of Psych Central, has a great post “You have the right to your health data” and introduces the Declaration of Health Data Rights,  a simple statement of fundamental patient rights.  Check it out and endorse!

Just a pointer to an amazing analysis on the politics of moving forward with a more comprehensive government sponsored healthcare option.  Sadly, but not surprisingly, the flow of lobbying funds predicts who will vote to maintain the status quo.

I much enjoyed the recent article, “Do Not Ask or Do Not Answer” in the August 25th Economist. As genetic data begins to trickle into the hands of consumers, the debate on genetic privacy grows more intense. On the one hand, the article notes that the SRY gene has long been used to price insurance (its the gene that determines the male vs. female pathway during embryonic development – sorry males) and that a look at one’s parents and siblings gives a fairly decent sense of one’s genetic liabilities. On the other hand, the article notes a study showing that folks who find they carry a potent Alzheimer’s risk gene are more likely to purchase extra health insurance – thus out-gaming the insurance industry to their discontent. Both hands having acknowledged the disconnect, the article turns to the search for new financial strategies for the future when consumers possess detailed knowledge of their own genomes (speaking of which, take a moment to browse Jim Watson’s genome). Some of the solutions noted were a form of compulsory universal coverage where neither side can outgame the other, HSA’s where out-of-pocket expenses are paid from individual tax free investment account and other new business models such as provided by RedBrick Health where benefits are maximized by optimizing participants behavior. The science is moving fast. Will the health insurance markets keep up?