OwenBloggers: Isha - MBA '08

Day 4 - Biometrics in the back yard

For the longest time I thought that infrastructure was just roads and buildings and such. Then I started realizing that communication was a crucial part of it. That led to information sharing, etc. Now I see it as a very complicated body influenced by countless factors where one had does not know what the other one is doing. It seems that in HC we have the basics down, the roads and buildings down, but the talking to each other part is still in the realm on the unknown.

We talked to General Harry Raduege who talked about infrastructure issues on the grand scale – state and federal and how everyone has a different system, how the systems are improved just to find out that they don’t work, and how data storage is an issue. Key word of this presentation was standardization. Actually, this seems to be a reoccurring theme in the course: standardization. Standardization of care, protocols, equipment.

We discussed using various forms of communication to bring doctors to soldiers out in the field where medical care in not readily available. Maybe then the Iraq Memorial will have fewer names then the Vietnam Memorial and we won’t  be standing there contemplating why we had to waste so many lives needlessly.

This morning’s USA Today has an article on the increase in mental care cases among veterans. Problem is that after talking various people this week it’s clear that every branch of the military has a different way of dealing with medical cases in that branch – there is no standard of care among them – heck, General Raguege said that different VA hospitals don’t talk to each other and it’s widely practiced for medical service seekers to visit several hospitals to compare what each one offers for the same condition. We are hoping for a nation wide revolution, but we can’t even manage something that we have direct control over. Why? Too many egos in the way, and no one want’s to step on someone else’s toe.

The second speaker of the day was Harry Greenspun from Northrop Grumman talking about the ethical issues involved in implementation of technology, namely electronic health records: how much exactly do you want your doctor to know? Is that weird rash you had after a trip to Vegas relevant to the sore throat you have now? Are you sure?

Quite a bit of his presentation was about usage of technology and possibilities that it brings. We talked of airport security using biometrics and retina scans to skip security lines. There is one issue we did not mention – how much do you want your government to know about you…

The last two speakers were members of the Deloitte’s Center for Health Solutions, Asif Dhar, MD, and Howard Underwood, MD, MBA, MAAA… Both of them added to food for thought. Doctor Underwood talked about the exact science of underwriting insurance. Doctor Dhar discussed the possible usages of electronic health record data. Among them were drug efficacy, efficiency and safety, and even considering using patient data as post market FDA monitoring.

Technorati tags: Owenbloggers.com, Owen Graduate School of Management, Business School, Vanderbilt, Electronic Health Records, Biometrics, Vietnam Memorial, FDA

Day 3 - Presidential candidate

Maybe it’s not the nicest thing to say, but, in a way, every candidate that pulls out of the election is a looser. However, sometimes those that lose have a tremendous influence on those that stay in the race. In this case Tommy Thompson left his mark by opening the Pandora’s Box of healthcare reform. Other Republican candidates are now gently testing the waters while the Democrats seem to have just jumped in head first. It’s interesting to see how different fractions approach elections and issues that they think will play a crucial role in getting elected.

His speech and ideas on healthcare were very interesting as he described the “perfect storm” that is coming and what we ought to expect over the next few years. However his spiel on foreign policy was time wasted for my group. We are not here to alleviate the ills of the world and figure out how America can improve its image in the eyes of the world. We are here to learn how HC policy is set, how HC government agencies don’t talk to each other and how much influence lobbyists really have.

The perfect storm is really simple really. There are four forces converging and quite a bit of it is our doing.

1) There is a shortage of people coming into the field. Anything from nurses and internists to professors that would teach them. We are not allowing foreign doctors to practice because their education is not good enough for us, yet I am pretty sure that they could save a life as easily as an American trained physician. Oh yes, and as the population is getting older, those lovable baby boomers, we will need more of HC services to accommodate them.

2) HC costs will soon double (prediction is 2015) and we will reach $5 trillion mark. That’s 21% of projected GDP. Talk about big spenders… BTW, European countries are hovering between 9% and 12%.

3) The decline in employer sponsored insure will continue and some predict that businesses won’t be able to compete – look at Ford and GM and their pension/HC obligations. Then again American government is yet to acknowledge pension liabilities that it has. It’s nice to use cash accounting isn’t it? And why exactly does GAPP say that companies must use accrual?

4) Last but not least, Medicare will go broke in 2013 and will be completely bankrupt by 2019. We should have thought about it before passing Medicare part D that is almost completely funded through taxes.

In the evening we met with Marc McClellan who talked million miles per hour on FDA and their shoestring budget of $1.9 billion. He mentioned thou the policy making process of bio-generics and associated challenges. We also briefly talked about fees paid to FDA for drug approval and registration. Unfortunately due to time limitations we only covered drugs and in closing remarks we heard about other issues like pet food and imported food safety.

Technorati tags: Owenbloggers.com, Owen Graduate School of Management, Business School, Vanderbilt, Healthcare, Medicare, Politics, Democrats, Republicans, Elections 2008

Day 2 - You met whom?

No one really. We did attend the Tennessee Tuesday, a meeting with Lamar Alexander and Bobby Corker, but this was more a photo opportunity then an actual meeting. They were there to look good to their constituents. This is a spectacular example of how Washington operates. We did meet with one of their aids though, a lady that deals with healthcare issues for Senator Alexander. What was interesting is that she didn’t seem to care about changing US healthcare for the better, it was more about which bill it’s strategic to pass or just get on the agenda. Someone said that it’s about nudging the change in the right direction. But how fast can you nudge before it breaks? It’s like chasing a race car with a bicycle, but it’s not a distance race, it’s a timing thing. We are tying not to make it blow up in our face and it sure seems that it will. Soon.

I am more disillusioned about the state of the affairs. I mean people claim that lobbyists run the country and from the horse’s mouth we heard how happy they are they can influence people on the Hill to vote for their causes. Now that is scary.

But more to the point. After that meeting we went back to Deloitte’s offices and spent some time talking to Martha Priddy Patterson, Principal at the Deloitte's Human Capital Practice, and a layer, about politics and policies. We had yet another view,  completely different form the Senator’s aide, on the same subject. We were in for a treat, because last night we had a reception with a lobbing arm of a large HC service company and they were talking about their perspective on change in policy, influencing their change and how they see it all.

After spending the day listening to three opposing views on the same subject, I am amazed that anything gets done in the government. But I am not surprised when people say that change in HC won’t come. It will, just not fast enough.

Technorati tags: Owen Graduate School of Management, Owenbloggers.com, MBA, Washington DC, Politics, Business School, Vanderbilt

Day 0 - Price is not the issue here

We arrived in DC just to find out that the hotel reservation had us coming in the next day. Luckily there were rooms available, however yours truly needs to change rooms later on today. Yes, I’m SO excited… We are staying at the Sofitel in Lafayette Square. I wouldn’t mind so much if this wasn’t such an overpriced piece of real estate. First of all there is no wireless here, I mean there is but for additional 10$ a day. This is less then 3% of the room price, so come on! Include it in the price and let no one be the wiser! Have you ever stayed at Hampton Inn? Middle of no where in Arkansas and there was free wireless and a WSJ waiting outside the door. Here, not so much. Again, this is such tiny fraction of the price that no one would notice if you hiked it a bit. I would say it’s the French, but I know too many French hoteliers to insult French owned hotels lightly. Then again, all of my friends worked for Sheraton and  such.

Yesterday we had a chance to explore DC a bit. It was a gorgeous day and we walked around the area. The South Lawn was open to visitors so we got to see the White House gardens. In the evening we walked a bit more, discovered some local night life, found the Deloitte building and had a drink or two. Over all, it was a very enjoyable day.

Technorati tags: Owen Graduate School of Management, Business School, Vanderbilt, MBA, hotels, travel

Short course, long week

This year Owen introduced an extra set of courses during a week long break between mods one and two. In the beginning I was opposed to it, I would have much rather spent that extra week with my family in Poland then here. But that was in the beginning. Now that the short course is almost upon me, I am quite excited about it. I’m going to be spending the next week in Washington DC talking to the big wigs in healthcare industry. Everything is organized with the help of Deloitte’s Center for Health Solutions, especially Paul Keckley (yes, the one that got bashed by Michael Moore). Guest speakers will include Tommy Thompson, Mark McClellan, William Winkenwerder, and General Harry Raduege – just to name a few.

So what’s the purpose of the whole thing? To better understand the interconnections in HC industry focusing on policy, regulations and governmental reform and their effects on state and federal level. If, as some presidential candidates claim, Medicare assumes responsibility for the uninsured what will happen to the system as a whole. Will it go bankrupt? Will our taxes increase to pay for those additional services? What will happen to the wait times for services and procedures? Will the system be overburdened because people won’t behave optimally and abuse it (i.e. visiting a doctor with every cold)? And I hope someone will mention what are the more optimal solutions for this situation. And no, purely socialized medicine is not the answer.

Aside of ton of reading, we will be looking at the political platforms of presidential candidates as they relate to HC. I’ve started looking, but so much of it is gibberish and political “feel good” that it’s hard to sieve through. Take a look at Ron Paul’s spiel, even though many of the statements are correct economically, there is plenty of “all profits go to pharmaceutical companies and HMO’s” inserts. If that is not playing the public, I don’t know what is.

As for healthcare issues that he is willing to put in writing, it seems that the only thing he stands for is curbing the power of the FDA and against vaccinations. Yes, vaccinations are evil, because they are treating kids like puppies, oh wait, vaccinations save puppies from fatal diseases. Any possibilities they could do the same to kids?

Technorati tags: Owen Graduate School of Management, Business School, Vanderbilt, Politics, Healthcare