Happy 5th birthday to the Health Business Blog

The Health Business Blog turns five years old today. Continuing a tradition I established with birthdays one, two, three, and four, I have picked out a favorite post from each month. Thanks for continuing to read the blog!March 2009: Podcast interview with Per Lofberg, chairman and CEO of Generation HealthPer Lofberg, former CEO of Pharmaceutical Benefits Manager, Medco, explains why he's started a company to help payers and employers optimize the use of genetic testing. Several months later, CVS Caremark invested in Generation Health and named Lofberg president of its PBM business.April 2009: There goes the brideImmigration of skilled workers is a key driver of US health care and the overall economy. Anti-immigrant sentiment and legislation has made it more difficult for immigrants to live in the US. Meanwhile economic conditions abroad have improved, so there's less motivation for immigrants to jump the hurdles. It used to be an Indian doctor living in the US was considered a good catch by women and their parents in India. But that's not so true anymore.May 2009: Big Pharma and Twitter = Big joke! and Big pharma’s products on Twitter: UnimpressiveI started using Twitter (as @HealthBizBlog) in May and found out that big pharma was hopelessly lost in this medium. Many of the user names for top drug companies and their products were controlled by cybersquatters, weirdos and random people. Not surprisingly big pharma was (and is still) struggling to figure out how to use Twitter, especially with the regulatory constraints they face. Still, couldn't a 20-something working for one of their ad agencies at least grab up Twitter names associated with pharma trademarks?June 2009: Partners Healthcare takes a beating on suburban expansionThe Boston Globe ran a story on how Partners Healthcare is expanding from its urban roots to open facilities and hire physicians in suburban Boston. The implication: here comes the big bad wolf. My own view is more nuanced and the Globe included my comments in their article. In particular, Partners is doing what any successful organization would do while community hospitals have been slow to figure out how to compete, even though they could make a compelling argument that they are less expensive with equivalent medical quality and better customer service levels.July 2009: Charlie Baker for Governor. I can understand the appealFormer Harvard Pilgrim Health Care CEO Charlie Baker is running for Governor of Massachusetts. The Boston Globe said Baker was following in the footsteps of fellow Republican Mitt Romney, trying to position himself as a business turnaround artist. I argued that Baker didn't need to pattern himself on anyone else: after all running a health plan is probably the best preparation available for being Governor of Massachusetts. June/July must have been my time to be in the Globe, since the paper published excerpts of this blog post on its Op-Ed page.August 2009: Broader implications of Aetna’s never event policyWhen a factory makes a faulty widget the manufacturer can't sell the final product and has to absorb the labor, material and capital costs of the wasted efforts. When a hospital or physician makes an error, they can typically bill for the work involved in making that error. Not only that –they can also bill for the work involved in correcting the mistake or mitigating the damage! Aetna's "never event" policy aims to change that, at least for the most egregious mistakes like amputating the wrong limb. Most observers think the impact will be minimal, but I see it as the start of a broader trend not to pay for any errors at all, making health care more like the rest of the economy.September 2009: Are you ready for $30,000 health insurance?We're headed toward $30,000 annual family premiums within 10 years, according to the Kaiser Family Foundation. I'm not generally an optimist, but I think we'll straighten things about before then by "bending the cost curve."October 2009: Radiology continues to lead the commoditization of medicineTeleradiology is making radiology services more of a commodity by increasing standardization and price competition. Radiology is the extreme edge of the wedge but other specialties will be subject to the same forces over time as bandwidth and computer processing power increase and as people get used to dealing with doctors from a distance.November 2009: Why not lower the recommended mammogram age to 30? or 20?The USPSTF's recommendation to start routine mammography screening at age 50 brought out a lot of passion from breast cancer advocates, radiologists and politicians. It's an emotional issue, but the fact is screening can lead to plenty of harm as well as good. I followed up on that piece with Overuse of mammography in elderly women with cognitive impairment, which gets specific in detailing the actual harms to a sub-group of women that should not be getting screening mammography.December 2009: Welcoming immigrants and robots to fill the nursing shortageIn reaction to one of the periodic scare stories about upcoming nursing shortages, I suggested immigration and robots as partial solutions. Although I specified 2025 as the time frame and said there would still be plenty of jobs for nurses, I caught a lot of flack, with one observer calling me "just plain nuts."January 2010: Drew Altman and the message from MassachusettsKaiser Family Foundation president Drew Altman offered his insights into what voters in Massachusetts were trying to say with their support of Scott Brown for Senate.  I agree that Brown ran an excellent campaign but also point out just how badly Democratic candidate Martha Coakley performed in the election.February 2010: Podcast interview with Medco CMO Robert Epstein and DNA Direct CEO Ryan PhelanI ended the blog year about where I started: a podcast interview with another major PBM becoming active in the genetic testing space, this time through acquisition.---Thanks again for your indulgence!