Happy 11th birthday to the Health Business Blog

The Health Business Blog has turned 11 years old! Continuing a tradition I established with birthdays one, two, three, four, five, six, seven, eight, nine and ten I have picked out a favorite post from each month. Thanks for continuing to read the blog!The controversy over the pricing of Gilead’s Sovaldi for Hepatitis C is a textbook example of price discrimination in action. My quick review of the economic principles involved helped explain the situation.April 2015: E-cigarettes - the California Cooler of the 21st centuryIf like me you came of age in the 1980s you remember the California Cooler, a sweet wine/juice combo that made it easy for kids to start drinking alcohol even if they couldn’t handle the “adult” taste of beer, wine or liquor. They were very popular at the time but I don’t recall anyone ever saying they were a healthy alternative to anything. But when it comes to e-cigarettes, policymakers are confused.May 2015: Of course emergency department visits are increasingHow many times have you read that the rise in ED visits contradicts the predictions of Obamacare supporters who said that providing insurance would send people to primary care?  Although some supporters did make that claim, it's long been evident to many others that those with insurance use the ED and other services more, not less.June 2015: Primary care prognosis. Is it really so grim?The Boston Globe published a gloomy article about primary care containing all the usual cliches. But they neglected some other significant challenges and failed to note factors that may lead to a resurgence of primary care over the next decade.July 2015: How immigrants help health reform succeedMedicare turned 50 in July, which provided an opportunity for all manner of retrospectives and speculation about what the future holds. The Partnership for a New American Economy publicized one of my favorite arguments: that immigrants are a key reason that Medicare is still solvent.August 2015: Ready for the eyeSelfie for diagnosing health problems?A friend lamented that his teenage daughter seemed fixated on taking selfies of her eyeball with his phone.  I thought it was a little odd but suggested that maybe she was looking for just the right shot to send off to an ophthalmology lab for diagnosis. My answer isn't as farfetched as it sounded.September 2015: Why drug price regulation should not be ruled outI’m a proponent of free markets and in general defend drug companies in their price setting, especially when they’re introducing new, innovative products with real clinical and financial benefits.But we have to remember that the reason high prices can persist in the market is that drugs are protected by patents and other restraints on competition such as the orphan drug law. Those rights are monopolies granted explicitly by the government. There’s really nothing free-market about them. Since the government grants these rights it should also be able to regulate the benefits that result from them.October 2015: A wakeup call from the nanny stateA mom decided to make her own decision about what was best for the health of her newborn. The nanny state went nuts and triggered an amber alert that woke up thousands of people in the middle of the night. The only good thing about it is that it’s literally a wake-up call to the whole community about how the system treats vulnerable people.November 2015: United pulls out of ACA exchanges. Should we care?Recently we’ve heard what could be interpreted as bad news about the viability of the exchanges:UnitedHealth is withdrawing from the program. In the highly politicized world of health reform, that information has Obamacare foes sounding the death knell.I see things differently.December 2015: 6 reasons to ignore listicles, even this awesome oneAre you bothered by  articles with headlines like, 21 Euphoric Experiences for People Who Just Love Food, 11 Christmas Cards Only Cubans Would Send or 7 Surprisingly Easy Ways to Get Organized for the Holidays? (These are just a few of the articles on BuzzFeed’s home page as I wrote this.)I don’t like them either, and I don’t read them. (Neither should you.) So I thought I would do something therapeutic by explaining what’s wrong with them.January 2016: How crazy is Ted Cruz's FDA reform proposal?In 2014 I held substantive healthcare policy interviews with all nine candidates for governor of Massachusetts. I thought maybe in 2016 I would do a similar series at the presidential level to help elevate the debate. I guess I was hopelessly naive to think that would be attractive, so instead I've started to analyze some of the more radical ideas put forth by the candidates.In general I don’t think very highly of Senator and Republican Presidential candidate Ted Cruz, but his proposal to loosen the drug approval process is at least worth discussing.February 2016: In Medicare Advantage, providers are becoming payersAccountable Care Organizations enable providers of care to take on some of the functions of health plans and to receive some of the financial rewards as well as the risk. But at least on the Medicare side it can be fairly indirect, with patients “attributed” to providers rather than assigned and little formal ability to keep a patient within a single provider system.So it’s not huge surprise that some integrated provider organizations are going further, and sponsoring Medicare Advantage (MA) plans themselves. That way they are literally both the payer and provider.

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By healthcare business consultant David E. Williams, president of Health Business Group.