Potter: Health Plan Profits Matter More Than Patient Health

Testifying before the U.S. Senate Committee on Commerce, Science and Transportation, former CIGNA executive Wendell Potter "...testified that large health insurers routinely and intentionally drop high-risk members. They also make coverage exclusions difficult for policy holders to understand and dramatically boost premium rates for small employers that have high claim costs, he asserted."

Responding to Potter's accusations, CIGNA mentioned the company's long support (emphasis mine) for a health care system that mandates insurance coverage for everyone at the same rates “regardless of whether or not the person has a pre-existing illness.”

Who are they kidding? And since when does acknowledging some new post-election realities constitute "long support?"

Find a pdf of Potter's full testimony here.

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Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor...

gapingvoid cartoon #378

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"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information ...

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