Health and Seafood

As the proposed merger between two Pennsylvania Blue Cross Blue Shield-affiliated plans comes closer to resolution, the answer to one question could determine its approval or rejection: What is a market?

Whether nonprofits Independence Blue Cross and Highmark Inc. are allowed to combine could come down to which perspective regulators believe is more germane: the distinct local markets each Blues plan works in now, or the regional and national markets in which the combined plan wishes to compete.

The merger would create one of the largest health plans in the country, with 7 million lives covered and an estimated $22 billion in annual operating revenue. It would be the third-largest health plan in the country, measured by premiums collected.

By some estimates, the combined company would hold more than 70% of the commercial health insurance market in Pennsylvania by combining Highmark's market share in western Pennsylvania with Independence's share in the eastern part of the state.

The Pennsylvania Medical Society and the American Medical Association are among those arguing that a combined company would hold far too much market dominance in the state. But the health plans say they currently don't overlap in Pennsylvania, so the market share effectively does not change. The companies also argue that they need to get bigger to compete for national business against the nation's largest for-profit plans, as more health insurers try to sell themselves as being able to handle a corporation's health coverage everywhere it is located.

[...]

The virtual physician visit is becoming a reality.

Companies that promise patients the chance to see a physician through video linkups are pushing into the mainstream. One is making it possible for anyone in the state of Hawaii to talk to a doctor of his or her choice via a webcam -- in a visit that could be reimbursed by the patient's health plan.

Meanwhile, in an effort to cut costs, a chain of retail clinics in Houston has replaced in-person visits to a nurse practitioner with online, webcam-enabled visits with doctors across town.

Telemedicine started as a way to remove access barriers. But it is now driven by people who value the convenience it offers, said Joseph Kvedar, MD, director of the Center for Connected Health, a Boston-based nonprofit group, affiliated with Partners HealthCare, whose stated mission is to expand the availability of medical care outside traditional settings.

The improved quality of the technology, the scale of adoption and the idea of health plans reimbursing for those visits have the potential to be game-changing, experts say. Proponents of telemedicine don't believe it will ever replace traditional practice-based care, but they do see it as a way to ease the load for busy physicians and overcrowded emergency departments, Dr. Kvedar said.

[...]

1 bag of split peas
2 onions
2 finely chopped carrots
1 or 2 cloves of garlic
1 teaspoon of salt
1 teaspoon of black pepper
1/2 cup of olive oil
2 tablespoons of butter
8 cups of water or chicken broth




Saute the onion and garlic in the olive oil and butter. When they turn yellow add the chopped carrots and the split peas. Continue to saute for 10 minutes. Than add the water or chicken broth. Cover the pot. When the soup starts to boil add the salt and pepper. You can add any other seasonings you prefer.

Serve with garlic bread or pita bread.







split pea soup
Turbo Tagger

Physicians are discovering that going green can save some green. Conversely, the desire to save some green can help them go green.

Take, for example, Richard Schoor, MD, a Smithtown, N.Y., urologist. He drives a 1999 Honda Accord on his daily commute, mostly because it uses less gas than, say, an SUV. The fact that it's also better for the environment is a bonus.

When Dr. Schoor saw his practice's energy bills triple in one year, he began taking small steps to cut energy consumption and met daily with his staff to ensure they were, too.

"I began cutting costs by turning off the lights when patients were out of the office and putting the computers on power-saving mode. You need to try and save every penny you can these days," Dr. Schoor said. "I don't keep the temperature ice cold in the summer or too hot in the winter, and when at all possible, I open the windows for fresh air. I'm on the second floor so there is no issue with people looking in."

While he has not seen a dramatic drop in his energy bills, he said they have remained steady, while energy costs for his colleagues have continued to climb.

Dr. Schoor is feeling good about how saving energy helps the environment and has taken other steps to reduce waste. His office has gone paperless, even though it would cost less to use paper than computers. And he says the practice has been vigilant about ensuring only medical waste goes into the medical waste bags, which also saves on disposal costs.

[...]

A medical wiki is launching this year as the result of collaboration between an Internet entrepreneur and some notable medical schools and research organizations.

Wiki is the term used for an open-source Web site where users can collaborate and contribute to the content. The new site, called Medpedia, will be modeled after the online wiki encyclopedia Wikipedia.com, but will differ in that it won't accept content from just anybody.

Its contributing writers and editors will be vetted to ensure they are working health care professionals.

Robert Lash, MD, an endocrinologist at the University of Michigan Medical School, said the involvement of Internet entrepreneur James Currier added credibility to the project and contributed to the school's decision to get involved. Harvard Medical School; Stanford University School of Medicine; and the University of California, Berkeley, School of Public Health; also are involved with the launch of the project.

Currier, who runs the San Francisco-based technology incubator Ooga Labs, founded the company Tickle in 1999. Originally called Emode, Tickle allowed users to complete psychological and personality tests. Its annual revenues reached $35 million before the employment site Monster bought Tickle in 2004 for about $100 million.

[...]