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THCB Reader -- April 10, 2021


THCB Reader

April 10 · Issue #108 · View online

Everything you always wanted to know about the health care system. But were afraid to ask.

I’m trying another experiment. This time it’s, does a Saturday morning email work better than Friday or Monday? Please bear with me!
This week on THCB Reader, Mike Magee reflects on where we’re at with Medicare for All, Kim Bellard wonders where health care companies are in the realm of Discord and learning from the gaming world, and Hans Duvefelt critiques how EMRs are set up for documenting timeline and history. 
Now for some interviews. Firefly Health is becoming a health plan, sort of, so on WTF Health Jess DaMassa interviews CEO Fay Rotenberg and Executive Chairman Jonathan Bush on becoming a “bloat-less Kaiser.” As you might expect, that one is a not-to-miss doozy. (Where would digital health entertainment be sans Jonathan Bush?)
On THCB Spotlight, I interview Jean Drouin of Clarify Health, which has linked (but anonymized) medical information on about 300m Americans, on the “new data stack.” There are also lots of deals on the latest episode of #HealthIn2Point00. 
This week, we took a break from THCB Gang - but instead, Jess & I hosted a new show called “Health Tech Deals” on Clubhouse. I tried to record it on Clubhouse but those clever techies changed their format so I couldn’t. We got a decent crowd by the end, although I’m not sure Jess enjoyed it too much! There is a THCB Clubhouse channel you can join if you’re on there (You have to hit the search button top left, then select “Clubs” then search “The Health Care Blog”)
Meanwhile #THCBGang & #HealthIn2Point00 are on our podcast channel. You can subscribe with an easy click on Apple or Spotify.

In health care tidbits this week, an old chestnut–and not a good one–reappeared in one hell of a Healthcare Dive headline about the good Ol’ US health care system taken from a recent Health Affairs study: “Nonprofit hospitals spent less on charity care than for-profit & government facilities.” Kim Bellard pointed out to me that this wasn’t new and that he wrote about it in 2017 and I told him that I first read about it in 1990–about 20 years after for-profit hospitals came on the scene. Did the non-profits imitate them or were they always as “bad”? It’s unclear but it’s a crazy way to run a system. John Moore from Chilmark Research pointed out that their non-profit status gives these systems huge associated tax breaks. I met Bill Peduto, the mayor of Pittsburgh, once and he complained to me that the biggest property owner and employer in his city-University of Pittsburg Medical Center–pays $0 in property tax (and the second-biggest is Carnegie-Mellon University which pays the same amount!). And we also let those non-profits build up hundreds of billions in reserves, which they use to gamble on the stock market or buy up competitors, so they can increase prices. Like much in health care and beyond there are so many issues and so little will to fix them–but surely this one needs another look.
Follow me on Twitter @boltyboy and THCB at @thcbstaff for more similar insights/nonsense (and even the occasional sensible idea)! Enjoy! – Matthew Holt
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April 5, Mike Magee
In the fog of the COVID pandemic, many are wondering what ever happened to prior vocal support for universal coverage and Medicare-for-All. Expect those issues to regain prominence in the coming months. The uneven pandemic response, as well as a continued epidemic of hate-induced gun violence, have only served to reinforce the need for an equitable national health care system with a capacity to address ordinary and extraordinary public health demands. Expanding Medicare eligibility is the fastest pathway toward accomplishing that important goal.
April 6, Kim Bellard
By the time you read this, Microsoft may have already struck a deal with the messaging service Discord. There’s been some buzz around Discord being in an exclusive acquisition discussion with an interested party, later revealed to be Microsoft. Still, Kim is wishing that a healthcare company (hey Teladoc and UnitedHealth Group) were in the mix. Healthcare desperately needs to prepare for its future by learning from the gaming world and by figuring out how to appeal to younger people (who may not yet be actively engaged with the healthcare system). 
April 7, Hans Duvefelt
The timeline of a patient’s symptoms is often crucial in making a correct diagnosis. Similarly, the timeline of our own clinical decisions is necessary to document and review when following a patient through their treatment. In the old paper charts, particularly when they were handwritten, office notes, phone calls, refills and many other things were displayed in the order they happened. Now, however, EMRs have made documentation clunkier and more time consuming somehow. 
One Drop is reimagining chronic condition care. Learn more at
One Drop is reimagining chronic condition care. Learn more at
Firefly Health’s CEO & Exec Chairman on $40M Raise & Becoming a Next-Gen Health Plan
Jean Drouin, Clarify Health
#Healthin2Point00, Episode 197 | BrightInsight, SteadyMD, CirrusMD, and Cleo
Hope you enjoyed the newsletter. As ever let me know if you have any comments or want to sponsor/advertise–this newsletter doesn’t write itself but about 17,000 people get it and 80-100K visit the blog every month!
Matthew Holt
Matthew Holt
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