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BI Lahey to buy Joslin Diabetes. I’m quoted in the Boston Globe

Goodbye independent Joslin

Diabetes is a costly illness that affects tens of millions of Americans. Joslin Diabetes Center is a world renowned specialist located in the heart of Boston’s Longwood Medical Center. It seems like it should be booming, but in fact diabetes treatment is not a great business and Joslin has not had strong financial performance.

Cancer, cardiology and orthopedics –with their invasive procedures– are much better for making money. But good diabetes care means coordinating lots of people to examine and guide the patient. That’s expensive to provide but not well reimbursed.

And standalone specialty hospitals, even prestigious ones, need strong connections to integrated health systems if they want patients.

So it’s no surprise that Beth Israel Lahey plans to acquire Joslin. As I told the Boston Globe (Beth Israel Lahey Health plans to acquire Joslin Diabetes Center), the deal makes clinical and financial sense and is unlikely to attract regulatory scrutiny.

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

The post BI Lahey to buy Joslin Diabetes. I’m quoted in the Boston Globe appeared first on Health Business Group.

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ICER founder Dr. Steve Pearson explains COVID-19 remdesivir pricing model

Dr. Steve Pearson

Drug pricing is the hottest topic in healthcare, and ICER founder Dr. Steve Pearson is the coolest person to discuss it with.

In this episode of the HealthBiz podcast, Steve describes how the Institute for Clinical and Economic Review (ICER) compiles and analyzes clinical evidence to estimate the fair value of treatments for cancer and other serious illnesses. ICER has been especially active during the pandemic, developing a pricing model for remdesivir and other COVID-19 therapies that’s being used in the United States and by health technology assessment agencies around the world.

For fun, he has been reading Paradise Lost by John Milton.

This is the second episode I’ve recorded on COVID-19 drug pricing. Check out the first one: Remdesivir powers activate! with Dr. Surya Singh.

The HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

Below is a rough (AI-generated) transcript of the episode.

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

  The post ICER founder Dr. Steve Pearson explains COVID-19 remdesivir pricing model appeared first on Health Business Group.

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Our email is down: Check this post for alternative addresses

The Health Business Group email server is down. It should be back up soon. Meanwhile, you can send emails to:

David Williams: dwilliams@mppllc.com Karen Donovan: kdonovan@mppllc.com

We will forward to the rest of the team as needed.

The post Our email is down: Check this post for alternative addresses appeared first on Health Business Group.

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Jean Mixer: Podcast interview with Boston Children’s digital health maven

Jean Mixer

Jean Mixer has been guiding Boston Children’s Hospital into the digital future for the past seven years, so she was more than prepared when the COVID-19 pandemic arrived and suddenly everyone was forced to go remote. I first met Jean at Boston Consulting Group in the 1990s when she led growth strategy projects in healthcare, financial services and consumer goods. We stayed in touch and reunited five years ago when Health Business Group helped Jean put the Children’s digital strategy in place.

In this episode of the HealthBiz podcast, Jean traces her journey from JP Morgan to BCG to her own consulting practice and then to Boston Children’s. She shares her experience as a director of public companies in biotech, medical devices, and banking. And she explains what she’d do if she had a time machine.

The HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

You can check out the rough (AI-generated) transcript below.

var podscribeEmbedVars = { epGuid: 'Buzzsprout-6225070', rssUrl: 'https://feeds.buzzsprout.com/1367974.rss', backgroundColor: 'white', font: undefined, fontColor: undefined, speakerFontColor: undefined, height: '600px', showEditButton: false, showSpeakers: true, showTimestamps: true };

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

The post Jean Mixer: Podcast interview with Boston Children’s digital health maven appeared first on Health Business Group.

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Friends do business together: Podcast interview with Clerio Vision’s Totterman and Zapesochny

Mike Totterman and Alex Zapesochny grew up on the same street of immigrants in Rochester, NY. Two decades later they joined with Sasha Latypova to co-found iCardiac Technologies, a high-tech success story that helped pharmaceutical companies measure cardiac safety in clinical trials. Now, with Clerio Vision they’re plotting to revolutionize the world’s eyesight with innovative contact lenses and a noninvasive procedure to replace LASIK. I’ve been along for the ride, as an investor and board member in both companies.

In this episode of the HealthBiz podcast, Alex and Mike talk about entrepreneurship, spinning technologies out of universities, making partnerships last, and what they do in their spare time. 

As I re-listened to the interview, I was struck by the wisdom they shared about how to turn a cool technology into a real business. It’s hard to do but there are some best practices to follow.

The HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

Show notes:

The Hard Thing about Hard Things by Ben Horowitz 

The Checklist Manifesto by Atul Gawande

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

The post Friends do business together: Podcast interview with Clerio Vision’s Totterman and Zapesochny appeared first on Health Business Group.

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Is ransomware unstoppable? No, it isn’t

This is stoppable

Chances are you’ve been hearing a lot about cyberattacks and specifically ransomware in healthcare lately. Attackers take over systems and encrypt files, demanding payment in Bitcoin. They often get away with it.

Attacks like the recent ones on Universal Health Services and ERT that make the papers are just the tip of the iceberg. No one wants to report that something like this happened to them.

Until recently, I had assumed that such attacks were really hard to stop. Some are. But it turns out there are often many ways to thwart ransomware, and often hours or even days in which to do so.

I asked security experts at Gamayan to analyze the UHS attack and was amazed that they found at least 28 ways it could be stopped. Check out the UHS ransomware case study that breaks down the attack and potential response step by step.

If you want to learn how to prevent such attacks at your organization, contact me.

Here’s the timeline of the attack:

Day 1

16:37 Bazar Malware Executed (Remote IP)

16:48 Domain discovery commands

17:06 Registry discovery commands

17:28 More domain discovery and network checks to domain controllers

17:41 AdFind used to map active directory

Day 2

18:49 checks again for domain trusts and AdFind using Bazar (FTP exfiltration to remote IP)

20:12 First lateral movement attempt with WMIC (SMB transfer, Multiple payloads tried)

20:23 P64.exe Cobalt Strike beacon run on beachhead host (Remote IP)

21:04 Second P64.exe Cobalt Strike beacon dropped on beachhead host (New remote IP)

21:09 Next lateral movement attempt via a service and PowerShell (First Successful Lateral Movement)

21:10-22:06 Continual lateral movement using Cobalt Strike beacons via SMB across the environment

21:43 Windows Defender begins to be disabled using Powershell commands

21:45 First RYUK ransomware executable transferred to the backup system (Ryuk Executed)

21:50-22:10 RYUK ransomware deployed enterprise-wide (Transferred via SMB, executed RDP commands)

—–

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

The post Is ransomware unstoppable? No, it isn’t appeared first on Health Business Group.

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The 30 Years’ War for value-based care: Podcast with Archway’s Dave Terry

When Dave Terry started his career in healthcare three decades ago, he noticed something odd and disturbing. The fee-for-service model meant doctors were paid for quantity, not for quality or cost effectiveness. Since then he’s been working to do something about it: for the first twenty years at American Practice Management, then Partners Healthcare and Harborside Healthcare. He made progress, but also learned the limitations of acting against entrenched interests.

For the last decade he’s gotten even more serious, co-founding Remedy Partners in the wake of the Affordable Care Act and then Archway Health, where he is CEO. Archway helps physicians jump into the meaningful risk-based payment models that are finally on offer from the Feds and private carriers.

I compared Dave’s quest to the Thirty Years’ War, but reminded him that there was a Hundred Years’ War, too, so he better gird himself.

The HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

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

The post The 30 Years’ War for value-based care: Podcast with Archway’s Dave Terry appeared first on Health Business Group.

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Pharma jumps into digital health: Podcast interview with Medullan CEO Ahmed Albaiti

The HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

The pharmaceutical industry is one of the last to be transformed by the digital revolution. But companies like Roche and Novartis have been experimenting for a long while, and the fruits are finally ripening.

Medullan CEO Ahmed Albaiti is a digital health pioneer. In this episode of the HealthBiz podcast, he takes us on a trip down the memory lane of digital health, sharing pharma’s successes and failures. We discuss the shock brought on by COVID-19 and why software is often classified as a medical device. He also shares his vision for an integrated and harmonized future for pharma, payers, providers –and patients.

I’m proud to serve as chairman of Medullan’s advisory board.

—–

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

The post Pharma jumps into digital health: Podcast interview with Medullan CEO Ahmed Albaiti appeared first on Health Business Group.

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Health Business Group Launches New Podcast: HealthBiz with David E. Williams

Weekly show features interviews with healthcare entrepreneurs and experts

BOSTON, October 14, 2020 – eTradeWire — Health Business Group (HBG), a healthcare strategy consulting boutique, launched a weekly podcast series titled HealthBiz with David E. Williams. Hosted by HBG’s president, the podcast presents interviews with healthcare business and policy leaders. Williams’ unique interview style fuses deep healthcare insight with engaging humor.

The first episode, Data Will Eat Public Health featured Shahir Kassam-Adams, a healthcare entrepreneur at Datavant. Kassam-Adams described how steps taken after 9/11 can inform our post-pandemic response. He explained how the collection and analysis of vast amounts of data has helped identify and mitigate threats, albeit at the expense of privacy.

For public health, there is an opportunity to leverage and synthesize disparate electronic data while protecting privacy. “Almost everything about public health is information based,” said Kassam-Adams. “The power of that information is going to make new public health professionals out of information technology professionals, or public health professionals will step up to become information giants. Data is going to eat public health.”

Guests on subsequent episodes include Dr. Surya Singh (entrepreneur and CVS executive), Daniel Kivatinos (DrChrono co-founder), Ahmed Albaiti (Medullan CEO) and Dave Terry (Archway Health CEO).

“Healthcare is critically important to the economy and to everyone as individuals. But it’s easy to be consumed by jargon and bore people to death when discussing the complexities and nuances,” said Williams. “I invite really knowledgeable and engaging people to HealthBiz, where we provide clarity and depth to inform and provoke.”

HealthBiz is an outgrowth of the Health Business Blog, where Williams has written thousands of posts about healthcare business and policy and conducted more than 100 podcast interviews since 2005.

HealthBiz with David E. Williams is available on Apple Podcasts, Spotify and other services.

About the Health Business Group

Health Business Group is a leading strategy consulting firm advising companies, investors, and non-profits in healthcare technology, healthcare services, and pharmaceutical services. Client service professionals average more than 20 years of healthcare consulting, industry and start-up experience. Visit www.healthbusinessgroup.com for more information.

David E. Williams is president of Health Business Group and an independent director of Clerio Vision, Home Care Delivered, and Vericred. He is chair of Medullan’s advisory board. Previously he worked at Boston Consulting and LEK Consulting. He holds an MBA from Harvard Business School and a BA in Economics from Wesleyan University. Follow David on Twitter @HealthBizBlog

The post Health Business Group Launches New Podcast: HealthBiz with David E. Williams appeared first on Health Business Group.

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Coordination of benefits. Which plan is primary?

Get your act together!

I received a couple of ominous looking letters from Boston Children’s hospital, letting me know that my claim has “been suspended” by my insurance carrier, Blue Cross Blue Shield of Massachusetts.

Unlike a couple months ago, when Blue Cross accidentally cancelled my family’s entire policy (oops!) while trying to remove an adult dependent at my request, this time it was due to a “coordination of benefits” issue.

Here’s the situation. Another dependent of mine is a college student in a different state. Our Blue Cross HMO doesn’t work out of state, so we buy an additional insurance plan from the college. (Also one more policy for varsity athletic participation, but that’s another story!)

When this dependent had services at Boston Children’s, we listed the Massachusetts plan as primary. But at least according to the BCBS MA rep I spoke with today, the out-of-state plan should be primary because my dependent is the subscriber, unlike on our family plan where they are listed as a dependent. So even though the out-of-state plan is likely to deny the Massachusetts claim as out-of-network, we need that denial first before submitting to BCBS MA. Make sense?

Oh, and to make things a little more complex, the rep said I need to ask the other plan if they follow the “standard coordination of benefits rules.” Apparently some student plans don’t.

What fun!

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

The post Coordination of benefits. Which plan is primary? appeared first on Health Business Group.

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Congratulations to Boston Children’s new CEO, Dr. Kevin Churchwell

I met Dr. Kevin Churchwell, the new CEO of Boston Children’s Hospital a few years ago. He impressed me then, and I’m excited that he has been named as the new CEO, following the retirement of Sandy Fenwick.

He’s a physician and business leader, and has already run a prestigious pediatric academic medical center, the Nemours/Alfred I. duPont Hospital in Wilmington, DE.

As a parent of kids who have received incredible care there, I have a special fondness for Children’s. I’m excited by this choice of CEO.

Bravo!

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

The post Congratulations to Boston Children’s new CEO, Dr. Kevin Churchwell appeared first on Health Business Group.

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iPhone and iPad in healthcare: Podcast with DrChrono’s Daniel Kivatinos

he HealthBiz podcast is now on Spotify, Apple Podcasts, Google Podcasts and  many more services, making it easy to subscribe.

Daniel Kivatinos

Like many healthcare entrepreneurs, Daniel Kivatinos was a tech guy whose bad personal experience with the healthcare system led him to try to make things better. The founding of DrChrono a decade ago coincided with the birth of the iPad and iPhone, and the company has been closely linked to Apple hardware ever since. In fact, Daniel is such a hardcore Apple guy that he recommends buying two Apple watches so you can wear one while the other is charging!

In this edition of the HealthBiz podcast, Daniel charts the history of DrChrono and shares what’s coming next with the Apple Watch, artificial intelligence and more.

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

The post iPhone and iPad in healthcare: Podcast with DrChrono’s Daniel Kivatinos appeared first on Health Business Group.

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Remdesivir powers, activate! Podcast with Surya Singh

The HealthBiz podcast is now on Spotify and  many more services, making it easy to subscribe.

  Remdesivir powers activate! Wouldn’t it be great if remdesivir magically cured COVID-19? Too bad it doesn’t. So what should we be willing to pay for a drug that shortens hospital stays and might reduce mortality? In this episode of HealthBiz, physician and healthcare executive Surya Singh shares his take on drug pricing, ICER and the future of the pandemic.

Show notes

Surya’s LinkedIn profile 

Institute for Clinical and Economic Review (ICER) remdesivir pricing model 

Letter from State Attorneys General about remdesivir pricing 

Boston Globe article comparing MA and RI school reopening plans 

Remdesivir 

Inspiration for “Remdesivir power, activate!” 

Health Business Group 

David’s LinkedIn profile 

The post Remdesivir powers, activate! Podcast with Surya Singh appeared first on Health Business Group.

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Obamacare is about more than pre-existing conditions

I swear to uphold pre-existing condition protections

The Affordable Care Act (aka Obamacare) is a comprehensive law that affects every corner of the healthcare system. It’s unreasonable to expect voters to grasp every nuance of the law, but it is useful to go a step beyond the current public discussion that says, essentially, individual mandate: bad, coverage for pre-existing conditions: good.

Bottom line: opponents can’t simply get rid of Obamacare, declare pre-existing conditions covered and call it a day.

Consider the example of a family friend whose  son was diagnosed with an auto-immune disorder in his early teens. It’s kept under control with a biologic drug that costs over $100,000 per year. There are other costs for diagnostic tests, specialist appointments, and the potential need for hospitalization and surgery. The parents are self-employed; they pay Blue Cross about $30,000 per year for insurance.

In a free market, the family would be uninsurable –or the “pre-existing condition” wouldn’t be covered and the family would face financial ruin. My guess is Blue Cross pays out $100,000 to $200,000 per year for this family –guaranteeing a big loss on the $30,000 premium!

It actually makes sense from the insurance company’s perspective to reject people with pre-existing conditions. After all, you can’t buy life insurance if you’re at high risk of death, you can’t buy homeowners insurance if your house is on fire, and you can’t buy auto insurance to cover a crash you just had.

Under Obamacare we decided as a country that pre-existing conditions would be covered. That wasn’t the consensus before.

But there’s more to Obamacare than just requiring insurance companies to pay for the treatment of pre-existing conditions. Consider some related protections that would evaporate if Obamacare were repealed or ruled unconstitutional.

Obamacare prohibited insurers from doing a lot of other things they used to do. Under the law:

You can’t be charged a higher premium because of pre-existing conditions

Your premium can’t go up and your policy can’t be canceled because you got sick

Insurers cannot impose an annual or lifetime cap on medical expenses

In order for such a system to work, everyone needs to have insurance. That’s where the mandates for employers and individuals to buy insurance come in. The mandates are not about taking away the freedom to decide whether to buy insurance, they are about making sure there are enough healthy people in the system to cover the costs of those who get sick.

The likely alternative to Obamacare isn’t a “free” market. People won’t stand for it. Rather it’s some version of Medicare for All.

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

      The post Obamacare is about more than pre-existing conditions appeared first on Health Business Group.

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Data will eat public health: Podcast with Shahir Kassam-Adams

The HealthBiz podcast is now on Spotify and will soon be on many more services making it easy to subscribe.

https://healthbusinessgroup.com/wp-content/uploads/2020/09/Shahir-episode-final-from-gb.mp3

Shahir Kassam-Adams

Shahir Kassam-Adams is one of the most knowledgeable and outspoken people in healthcare. In this episode, Shahir shares his initially unsettling but ultimately reassuring view that “data will eat public health.” He opines on interoperability and explains how his company, Datavant has promoted data sharing on COVID-19, leading to a plethora of interesting and potentially useful projects, including one that models the tradeoffs for specific American cities to reopen.

Check out the links:

Shahir’s LinkedIn profile 

David’s predictions about the pandemic 

Datavant 

COVID-19 Research Database 

Reopen Mapping Project 

The Fifth Risk by Michael Lewis 

American Gods by Neil Gaiman 

Seveneves by Neil Stephenson 

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

The post Data will eat public health: Podcast with Shahir Kassam-Adams appeared first on Health Business Group.

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Five pandemic predictions five months later. Was I right?

Looking back

In April, with the pandemic raging, lockdowns underway in the Northeast and West, and widespread panic about what the immediate future would bring, I tried to look over the horizon to see where we were heading. My 4 predictions for the next phase of the COVID-19 pandemic and Prediction 5: The end of immigration, distilled what I was seeing in Boston plus what I was hearing from healthcare and life sciences clients and physician and scientist friends in US hotspots and around the world. I didn’t put a timeframe on when this “next phase” would be, but with the summer behind us and a new school year getting going, now seems like a good time to take stock.

Judge for yourself, but overall I think I did well. Let’s review:

#1: Treatment, not testing will be key to reopening the economy Grade: B

I was right that testing wouldn’t be our savior, but also overestimated how quickly treatment would improve.

In April, everyone was talking about the need for millions of rapid turnaround tests to get things moving again. Other countries, like Germany and Singapore had deployed testing on a massive scale. But when I looked at what was going on in the US I was unimpressed. There were lots of announcements about capacity but little follow through.

Sadly, we’re still doing poorly. Recent estimates suggest the need for 193 million tests per day; we’re only doing 21 million. In Massachusetts (one of the leaders in testing) it’s still hard to get a test if you’re not symptomatic. Test results elsewhere can take a week or even longer, if you can get tested at all. Bill Gates recently criticized the current state of US testing: too few, too slow to return results, wrong swabs.

The absence of rapid turnaround testing at scale and weak contact tracking has hampered the ability of scientists to inform policy makers and the public about what works and what doesn’t. This failure contributed to the rapid spread of disease in early hot spots. It also fed public confusion and undermined support for guidelines, which seemed vague, random and contradictory.

Remdesivir was already showing promise in April, and non-drug adjustments such as optimization of mechanical ventilation and turning patients on their sides were being tried. Intriguing stories of cardiovascular impacts and cytokine storms were emerging. I expected we’d have a bunch of drugs and other innovations that would make COVID-19 a manageable disease by now. The death rate is down, but treatment improvements have been incremental and some early hopes fizzled. Dexamethasone, an old steroid is the only drug beyond remdesivir with widespread evidence of effectiveness.

There are new possibilities ahead. Olumiant (baricitinib) appears to help patients on remdesivir recover faster and may gain emergency approval by the time you read this. And researchers are looking at new mechanisms, such as bradykinin storms to understand how COVID-19 does its damage and how to stop it. There are several other treatments under evaluation, too.

Bottom line: fatigue, denial and surrender were bigger factors in reopening decisions than I expected. The economy still isn’t fully reopened and we may need to wait for a vaccine to move back toward normalcy.

#2: Hybridization (virtual/in-person mix) will be the new reality Grade: A+

I’m proud of this prediction. At the time I made it, the consensus was that everyone would return to the office by summer and get back to school in September. That hasn’t happened. Instead, as spaces reopen, hybrid models are emerging everywhere to reduce density and decrease risk. You see it with schools, businesses, physician offices and clinical trials. Remote work and school are still happening, but work from home is no panacea.

I expect hybridization to outlive the pandemic as individuals and organizations learn that a mix of in-person and remote is best for most activities. But patients may have to assert themselves to receive the full benefits of hybrid care, because healthcare organizations have a tendency to revert to what works for them rather than what’s most convenient and affordable for patients. Telehealth was used for almost 70 percent of total visits in April before dropping to around 20 percent in the summer. Some patient-centric leaders, such as Boston Children’s Hospital have maintained rates at close to 50 percent.

#3: Public health post-COVID-19 will be like security post-9/11 Grade: B

When I started traveling again soon after 9/11, the sudden jump in security at airports, office buildings and public spaces was staggering. In the following months and years, security became a huge industry and an obsession.

In April, I wrote:

“Now that COVID-19 has struck, we can expect public health to be similarly elevated. It will become a pervasive part of our economy and society. Expect temperature –and maybe face mask and hand washing– checks at the office, school, and any public venue.  Contact tracers may call or visit our homes or scrutinize our cellphone records. Event managers and employers will need to hire a health team and devise a health/safety plan to prevent outbreaks and provide confidence.”

I’ve certainly seen this in the private sector. For example, many private schools require daily health attestations, temperature checks, masks, outdoor eating, etc. Stores announce, “no mask, no service” policies in their windows. Some states and counties have good contact tracing programs, but unlike 9/11 there is no nationwide approach, and no Homeland Security equivalent.

As more venues reopen I expect that this trend will continue. What’s not yet clear is whether public health will receive additional funding and just how central it will be to our future. Much depends on how quickly and completely the current pandemic is brought under control, whether new health threats emerge soon, and who occupies the White House in 2021.

#4: Federal government will grow even more powerful relative to everything else Grade: A-

This prediction was paradoxical. Those I reviewed it with at the time found it novel and counter-intuitive. After all, the feds failed to prepare for the pandemic and threw everything onto the states. The CDC embarrassed itself with its testing approach and then was sidelined.

But the federal government has essentially unlimited spending power, which it used to prop up the economy with the $2+ Trillion CARES Act, and the stock market (via the Federal Reserve). Meanwhile, states had to come begging –quite literally—to the president for help, and our world-leading universities and colleges found themselves in desperate straits and unable to reopen.

In short, the federal government’s failures have weakened the rest of US society much more than the federal government itself has been weakened.

The reason I give myself an A- instead of an A is that I didn’t address what would happen relative to the rest of the world. The US federal government has lost international standing during the pandemic with its poor response. The country was rated as the most prepared for a pandemic –but botched things anyway. The withdrawal from the WHO weakened our hand, and our slow economic recovery means we’re losing ground on China and others.

#5: The end of immigration Grade: A

Crises present major opportunities for governments to enact policies they wouldn’t be able to get away with in normal times. The current Administration has made no secret of its disdain for immigration.  It had taken some dramatic steps before the pandemic, such as curtailing the H1-B program for highly skilled workers and attempting to build a wall along the Mexican border.

In April, the president tweeted his intention to suspend all immigration. That’s about as dramatic as it gets and would have drawn much more fire even a month or two earlier. But with lockdowns and travel bans throughout the world, and a virus floating in the air, it was harder to argue against. Consider some of the additional actions taken against immigration during the pandemic, including bans on asylum seekers and refugee resettlement, a ban on international students coming to the US if their classes were not in person (rescinded after pushback), and more restrictions on H-1B lottery winners.

The pandemic has also made the US a less attractive destination for would-be immigrants, even without all of the explicit actions. That won’t be reversed quickly.

What’s next?

There are big questions for the next few months and years, including:

When will vaccination make a decisive difference? This includes when vaccines are approved, how quickly and rationally they are distributed, how well they work and for how long, and what the uptake is.

What will the economy of the early 2020s look like? Will travel and leisure return? Education at all levels? Office work? What new industries will emerge?

What will be the US’s role in the world? Much of this hinges on the results of the 2020 election and its aftermath.

I’ll offer my commentary on these topics as the situation continues to unfold. Check the Health Business Blog and HealthBiz podcast for updates.

In recent months, my strategy consulting firm, Health Business Group has helped our healthcare and life sciences clients factor the implications of the pandemic into their growth and M&A strategies. Would you like to discuss your own organization’s plans and how Health Business Group can help? If so, please email me: dwilliams@healthbusinessgroup.com.

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Why does Trump want foreign countries to set Medicare drug prices?

Trump put us in charge!

Does anyone else find it ironic that the “America First” president has issued an Executive Order that says foreign countries will set drug prices for the US? President Trump has ordered Medicare to literally cede drug price decisions to France, Germany, Japan or New Zealand –where prices are dramatically lower than here. Yes, the idea is to take the lowest price that any of the other rich countries negotiate and use that as Medicare’s price.

What’s next? Will the EPA adopt France’s emission standards? Will the SEC let Italy set the rules for Wall Street? Will Medicare chip in to fund the cost of comparative effectiveness research and negotiations currently borne by foreign governments? Of course not.

So how do we understand this apparent transfer of power overseas? Two ways:

First, the president is trying to find any path he can to get an achievement on drug prices before the election. This one is simplistic, understandable and dramatic.

Second, it’s not really about following the lead of other countries. Rather it’s about forcing drug companies to raise prices in other countries in order to avoid losing out on the big US market. It is distinctly Trumpian in that it punishes our allies and blames them for “freeloading.”

It does make sense for US payers, including Medicare, to employ value based pricing mechanisms like those developed by the Institute for Clinical and Economic Review (ICER) and to negotiate prices. But we should reward true innovation and be willing to pay up for breakthroughs -yes, even paying hundreds of thousands or millions per patient for great products. I don’t want the US to leave those decisions to anyone else.

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

The post Why does Trump want foreign countries to set Medicare drug prices? appeared first on Health Business Group.