The Daily Rise: Tuesday, March 29

A New Kind of Insurance Company

Bob Herman of ModernHealthCare.com reports that some venture capital firms are exploring the health insurance market.

“Entrepreneur Vivek Garipalli has a dim view of the way health insurance companies treat providers and patients,” Herman writes. “Patients develop trust with doctors and hospitals, and he thought insurers should be the ‘glue’ between them instead of creating friction.”

A patient-first insurance model? We’re listening…

“It’s abundantly clear that today’s health insurance market is broken,” First Round Capital founder Josh Kopelman wrote this past September when his venture firm poured $4 million into Clover Health. “When it comes to technology, the giants shaping the industry are trailing 20 years behind. They have vast stores of data, but aren’t leveraging them to improve the standard of service or care.”

Clover Health has attracted $135 million in investments, which sells “only Medicare Advantage plans and has enrolled 16,000 members as of this month. It differs from UnitedHealth Group and other giants, Garipalli said, in the way it uses real-time patient data to connect seniors to the care they need. The plans also provide free primary-care visits, and notably, don’t charge extra for seeing out-of-network providers.”

This is still a relatively new type of insurance company, but it’s exactly the kind of innovation and competition that we need. We need to drastically reform our health insurance system to put patients first.

An Ounce of Prevention Doesn’t Cure All

“An ounce of prevention,” wise old Ben Franklin used to quip, “is worth a pound of cure.” Yet, somewhere along the way, some well-meaning public health professionals misremembered that quote.

That’s the only way to explain why more than 70 public health schools and programs complained that Vice President Joe Biden’s cancer moonshot failed to prioritize prevention over cures.

“While curative treatments often appear more exciting to the public, investments in public health and prevention research hold even more promise for both short- and long-term reductions in cancer incidence and mortality rates,” a letter from a group of public health schools wrote. “Developing cancer cures is essential, but controlling cancer is also a policy and public health challenge.”

Education programs are good. Prevention efforts are great. But, they’re not a solution. It will cost billions of dollars and take many discoveries to find cures (notice the plural) for cancer. The moonshot project isn’t the place for prevention programs, which will siphon off important dollars from research and development.

Reforming Mental Health Services

How can Medicaid expansion better serve patients with mental health and substance abuse disorders? US News and World Report’s Kimberly Leonard recaps a new report published by the White House on Monday that tackles that subject.

“The conclusion is clear: If states are serious about tackling mental illness and opioids, then expanding Medicaid offers a unique opportunity to do so,” said Richard Frank, assistant secretary for planning and evaluation at the Department of Health and Human Services.

But, experts on mental health say that Medicaid expansion alone isn’t the answer to the country’s mental health problems.

“We absolutely believe Medicaid expansion is going to help a lot,” Theresa Nguyen of Mental Health America told US News And World Report. “Access to any insurance will move people’s barriers, but we’ve been saying for a while that access to insurance does not mean access to treatment.”

Longer Wait Times for Medications

In response to the abuse of opioid painkillers, health regulators are considering plans “to require doctors to log in to pill-tracking databases before prescribing painkillers and other high-risk drugs.”

Yet, the Obama administration’s plan to require prescription databases is facing stiff opposition from the nation’s doctors, the Associated Press reports.

Dr. Steven Sacks, president of the American Medical Association, told the Associated Press that a mandatory database is likely to have negative consequences for patients, who will “face longer waits and less time with their physicians.”

“There really is a patient safety and quality-of-care cost when you mandate the use of tools that are not easy to use,” Sacks said.

Count us among those worried about the unintended consequences of new regulations and a government-controlled database of patients. Cyber-security is an ongoing concern. The government has a poor track record of keeping its data safe and secure.

Moreover, we shouldn’t ask patients that are suffering to prolong their suffering while a bureacrat checks the national government database. Wait times are a real concern and will have real consequences for patients.

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