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Pioneering new injection to cure heart failure without need for major surgery

So reads a headline in a good article in The Telegraph, a UK newspaper. Per the article, “The technique, which involves a simple injection, could aid the recovery of hundreds of thousands of heart failure patients – and could even consign heart transplants to history.” Great

‘Cowboy’ Doctors Could Be A Half-A-Trillion-Dollar American Problem

That is the title of a terrific article published in Common Health—Reform and Reality.  The author is Carey Goldberg. “Cowboy” doctors are defined as ones who “…who deviate from professional guidelines, often providing more aggressive care than is recommended — are responsible for a surprisingly big

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged 55 or Younger

Vik Khanna wrote a great piece on his blog with the title above. He writes, “Al Lewis and I are frequently attacked by the wellness ignorati when we claim that many of the diseases their programs purport to prevent are virtually non-existant in working age

They said what?

This is a new blog by the brilliant and always entertaining Al Lewis, with whom I co-wrote the book Cracking Health Costs. He has created “TheySaidWhat?”, which identifies “possible mistakes in high-visibility contexts and offers those who committed the mistakes the opportunity to correct, apologize for or retract

The Battle Against Misdiagnosis

The WSJ just published an op ed with that title. (Subscription required)  The author is Hardeep Singh who is chief of Health Policy, Quality and Informatics at the Michael E. DeBakey VA Medical Center, and an associate professor at Baylor College of Medicine. Singh writes that

Pioneering new injection to cure heart failure without need for major surgery

So reads a headline in a good article in The Telegraph, a UK newspaper.

Per the article, “The technique, which involves a simple injection, could aid the recovery of hundreds of thousands of heart failure patients – and could even consign heart transplants to history.”

Great news, yes?  Not so fast…

But before anyone goes GaGa over this news they need to consider this: if this technique proves out, it will have a small impact in the US. The problem here is that many of the invasive heart procedures in the US now have safer, effective, and less expensive medical alternatives, but “cowboy” doctors in the US disregard such alternatives in a wholesale way.

Why do so many US doctors ignore effective, proven, medical alternatives to surgery? Because they get rich doing so. That’s why.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

‘Cowboy’ Doctors Could Be A Half-A-Trillion-Dollar American Problem

That is the title of a terrific article published in Common Health—Reform and Reality.  The author is Carey Goldberg.

“Cowboy” doctors are defined as ones who “…who deviate from professional guidelines, often providing more aggressive care than is recommended — are responsible for a surprisingly big portion of America’s skyrocketing health costs. The paper concludes that ’36 percent of end-of-life spending, and 17 percent of U.S. health care spending, are associated with physician beliefs unsupported by clinical evidence.’ ”

Oddly, some of the more elementary doctor rating systems tend to be biased in favor of Cowboy doctors in their methods by giving higher ratings to specialists who do comparatively more surgery that their peers, the very ones who may well may be the Cowboys this article describes. My advice about doctor quality ratings: caveat emptor.

EdisonHealth carefully screens to ensure the doctors in it’s Centers of Excellence programs are not, repeat not, Cowboys.

Many of the worst Cowboy doctors are in cardiology and orthopedic surgery, but Cowboys are even doing a load of transplants that are clearly contraindicated for the patients at an average five-year cost of about $1.5 million.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged 55 or Younger

Vik Khanna wrote a great piece on his blog with the title above.

He writes, “Al Lewis and I are frequently attacked by the wellness ignorati when we claim that many of the diseases their programs purport to prevent are virtually non-existant in working age adults.”

Further, (A) new data brief from the CDC proves us right. The prevalence of coronary artery disease or stroke in working adults under age 55 is less than 3.0%.”

Heart attacks and strokes are overwhelmingly a function of aging which, of course, is not preventable. Workplace wellness will be effective in preventing heart attacks and strokes only if it can morph into the Fountain of Youth. Period.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

They said what?

This is a new blog by the brilliant and always entertaining Al Lewis, with whom I co-wrote the book Cracking Health Costs.

He has created “TheySaidWhat?”, which identifies “possible mistakes in high-visibility contexts and offers those who committed the mistakes the opportunity to correct, apologize for or retract their mistakes…or explain how their positions are correct and we have made a mistake by questioning them.”

Al offered “wellness companies $1000 to answer simple questions about their own claims, and all except one refused.” That one had made an error.

Further, TheySaidWhat? has a fun section called “The (Even) Lighter Side”.  Check it out…it’s fun.

Whatever Al does is both entertaining and most insightful.  I hope you enjoy his new blog.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

The Battle Against Misdiagnosis

The WSJ just published an op ed with that title. (Subscription required)  The author is Hardeep Singh who is chief of Health Policy, Quality and Informatics at the Michael E. DeBakey VA Medical Center, and an associate professor at Baylor College of Medicine.

Singh writes that according to studies, “…more than 12 million adults are misdiagnosed every year, and our study may understate the magnitude.” Those misdiagnoses often have quite tragic consequences and always harm the patient waste health dollars.

Readers of CHC know that errors in diagnosis are a huge problem in United States. When editorials on this topic are making the pages of the Wall Street Journal, perhaps corporate benefit managers will be motivated to take this on in an aggressive way. Centers of Excellence, like the ones with which large companies are directly contracting, do an outstanding job of getting diagnoses right the first time, and correcting misdiagnoses.

EdisonHealth offers a Centers of Excellence program which just about any company large enough to be self-insured can easily access. I helped found EdisonHealth, which does not charge a PEPM of PMPM fee, just for that reason, i.e. to make sure small and medium size companies can access  and elite Centers of Excellence program too just like the giant companies like Boeing, Lowes, etc.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

In Treatment, There Can Be Too Much of a Good Thing

That is the title of a good article in the WSJ (subscription required) by Laura Landro.

Yes, too much treatment harms your health. Laura writes, “…a new study suggests some patients may be getting too much treatment (for diabetes and high blood pressure), increasing their health risks.”

Adding fertilizer to your garden can be a good thing, but too much an kill your roses. That’s intuitive, I know. The same applies to medical treatment. In the US we excel in over-treatment of variety of diseases…not just high blood pressure and diabetes, but over-treatment in cancer can be lethal too.

People ask me sometimes why I write negative articles about corporate wellness programs. One off the big reasons is many such programs promote over-treatment and over-diagnosis.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

The $1,000 pill

The WSJ posted a good article on specialty drugs written by Karen Ignagni. (Subscription required.)

One quote stuck out:  “A recent study by CVS Caremark…predicted that the price of new hepatitis C treatments like Sovaldi could increase premiums for everyone with private insurance by as much as $300 annually. And that’s to treat one disease. Many more similarly expensive treatments are coming.” (Emphasis mine.)

With this kind of pricing for new drugs we are left with four choices:

  1. Ration the use of such drugs,
  2. Implement price controls on specialty drugs,
  3. Face a long-term recession induced by health care prices, and/or
  4. Increase the number of uninsured by pricing people out of the market for health insurance.

Alas.  I hope someone can show me I’m wrong.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Lying and cheating in Academia can harm your health

The Washington Post published an article reporting on more and more academic fraud. The author was Fred Barbash.

There have always been a load of conflicting studies related to healthcare…what is best to eat, what is best treatment for certain conditions, etc. One source of conflicting study outcomes is outright fraud on the part of researchers. (Another more common flaw in research is bias, but that is a story for another day.)

Writes Barbash, “The Journal of Surgical Research retracted a paper on prostate surgery due to ‘academic misconduct and data falsification on the part of one of the authors.’ “

Further, “An HIV vaccine researcher formerly employed by Iowa State University and accused of spiking rabbit blood samples to make lab results look better is arrested and charged with fraud, pleading not guilty.”

The idea is to win at all costs no matter if you cheat…the Lance Armstrong story over and over except in the “hallowed” halls of universities. This comes as no surprise to me as many university-based medical schools are centers of unethical surgery and over treatment.

The article goes on and on.

It pays to be skeptical of published report of research breakthroughs in healthcare.  After all, a basic tenet of science in healthy skepticism.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Hackers targeting Cracking Health Costs

Dear Readers,

The Cracking Health Costs website has been hit hard by hackers who keeping bringing down the homepage.

The tech people with whom I work are repeatedly fixing the problem but it keeps recurring.

Perhaps CHC has been specifically targeted for some reason.  Or, it may just be random hacking. In either case the hacking seems to be fairly sophisticated.

We are working hard to restore fully CHC.

Thanks for your patience.

Sincerely,

Tom Emerick

Costly Vertex Drug Is Denied, and Medicaid Patients Sue

That is the headline in a WSJ story (subscription required) about how Medicaid in one state is trying to control the exploding costs of an ultra expensive drug. The drug at hand, named Kalydeco, is for cystic fibrosis and costs $300,000 per year.

According to an article in the New England Journal of Medicine, “Patients taking Kalydeco had an average lung function improvement of 10.1% after about 11 months, compared with a decline of 0.4% in patients taking placebo….”

In short, this drug seems to have an advantage over existed therapies, but a rather modest advantage. This is a dilemma facing a benefit plan sponsors today. How much can you afford to pay for specialty which have a very modest comparative benefit? Of course if it’s your child who has cystic fibrosis you want the very best.

This dilemma is summed up by Matt Salo, executive director of the National Association of Medicaid Directors, a professional association, “We have this public health mentality that all people have to be cured no matter what the cost, and also let the innovators charge whatever they want…Those are fine theories independently, but when you combine them together in a finite budget environment, it’s not sustainable.”

Whether you agree of disagree with Salo’s statement, we do need some good conversation on the topic of specialty drugs.

I’d like to see CHC readers weigh in on this.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.