Mahar’s mandate monologue

I’ve been following with interest the political slap fight surrounding the Obama v Clinton/Edwards positions on mandated coverage. And just when I was getting ready to wax eloquent yet again, into the mailbox arrives Maggie Mahar’s well-written, comprehensive, thoughtful and adult discussion of the subject.
Dammit, she’s hogging all the good stuff.
And I have nothing to add. At least not now.


WC Bill Review – status update

Networks aren’t the only work comp managed care service experiencing change these days. The bill review business is also looking a bit tumultuous, with the landscape shifting in response to, as well as independent of, Coventry’s moves.
I’ll be examining the industry this week, looking at a few of the major entities at a time.

Continue reading WC Bill Review – status update


Would a mandate work?

Paul Krugman and Ezra Klein say yes, mandated universal coverage would – and it is also a key part of serious health care reform. Richard Eskow says no; we have to fix the cost problem before we can cover everyone, and mandates won’t achieve universal coverage (actually Richard says 100% effectiveness, which I agree with – but 99.5% is fine with me).
The first part of the question is rather basic – can a mandate, that is, required coverage for all residents, actually cover all residents?

Continue reading Would a mandate work?


It’s Utilization, &^%())!!

“Utilization changes are the driving force in drug cost changes for WC.”
That’s the key takeaway from the expanded version of NCCI’s annual WC Prescription Drug Study; this 2007 edition goes well beyond prior editions to include more detailed information on cost drivers, stat-by-state variations, generics, and the growth in drug spend during the life of the claim.
But the key is utilization.
The key takeaway? Utilization, not price, is driving drug spend.

Continue reading It’s Utilization, &^%())!!


Welcome back Health Care Renewal

In the almost-two years we’ve been publishing Health Wonk Review, we’ve been fortunate to entice some of the clearest thinkers in the web-o-sphere to host each bi-weekly edition.
Roy Poses et al at Health Care Renewal keeps that tradition alive, adding posts from a few newer entrants while artfully weaving in contributions to produce a cohesive, highly readable edition.


Suit day

Today’s a “suit day”; one of those increasingly-frequent days where business demands require something a bit more upscale than the usual. Today’s event is the Piper Jaffray Healthcare Investor conference in NYC, where I’m on a panel discussing Consumer-directed health care with Jeff Margolis of TriZetto and John Mills of HIP.
We’re slated to discuss the role of consumerism in healthcare’s future, in front of an audience comprised of investors and analysts.