YOUR DAILY WEEKLY READER: capital Healthcare, horse-faced endorsements, safe Targets


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THE NEW HEALTHCARE FRONTIER MEANS ALLOWING A LOT OF PEOPLE TO DIE? ALSO, CAPITALIZING ON NON-CAPITALIZATION IS HILARIOUS: “Self-described "lunatic-fringe disruptors" depict U.S. healthcare like one of Ayn Rand's dystopias. The $2.7 trillion industry lacks accountability for exorbitant costs. The system incentivizes doctors (and hospitals) to do tests and procedures, instead of paying them to do their jobs—keeping people healthy. It's like paying carpenters to use nails. "I believe we are on the cusp of an oil rush—a fabulous revolution of profit-making and cost-saving in health care," disruptor Jonathan Bush told a rapt audience at the Aspen Ideas Festival last week. In the Rand comparison, Bush might be John Galt—were he not exuding as much benevolence as relentless capitalism. And he's not giving up on the system; he's trying to upend it. Last week I moderated a discussion that became heated—by moderated-panel standards, and by no part of mine—between Bush, Toby Cosgrove (CEO of the Cleveland Clinic), Rushika Fernandopulle (CEO of iora health), and Dena Bravata (CMO of castlight health). It ended in an emphatic plea by Bush to never donate money to a hospital.  That was met with equal parts laughter and applause. From Cosgrove, seated three inches to his right, neither. To Bush, CEO and co-founder of the $4.2 billion health-technology company athena health—(apparently among health tech innovators, using capitalization betrays adherence to the old order)—healthcare is a business, driven by markets like any other. Altruism and profit-driven business need not be at odds. It's incomprehensible and unsustainable that people have no idea what their care costs and have no incentive to consider cheaper options. "Profit is a dirty word among the corduroy-elbow crowd in the research hospitals and foundations," Bush wrote in his recently-released book, Where Does It Hurt? "But just like any business, from Samsung to Dogfish Head Brewery, this industry will grow and innovate by figuring out what we need and want, and selling it to us at prices we're willing and able to pay." In Aspen, Bush mentioned Invisalign braces and LASIK surgery as procedures that have been driven by the free market. These things started off exorbitantly expensive, but prices fell and fell. For LASIK, the procedure was "$2,800 per eye [in the 1990s]; now it's $200 per eye, including a ride to and from the procedure." The oft-cited, disquieting numbers—the U.S. spends the largest percentage of its GDP on healthcare of any country (by far) but ranks 42nd in global life expectancy and similarly underwhelms in many other health metrics—are projected to worsen. Massive hospitals systems are buying out their competition across the country, charging exorbitant premiums without incentive to cut costs or optimize the care they provide. Bush's gushing proposition is that when patients can "shop" for healthcare based on quality and price, it will drive innovation and better care. Innovation will inevitably disrupt the bloated status quo. But the current system has to be allowed to fail. That might sound bleak, but to innovators like Bush, Fernandopulle, and Bravata, it's an opportunity for reinvention.” (via the Atlantic)


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BECAUSE HEALTH CARE AND JOBS ARE THE LAST THINGS THAT PEOPLE OF FLORIDA NEED. OH, WAIT. THEY’RE THE FIRST THINGS: “The White House has a Medicaid expansion argument for Gov. Rick Scott and Florida Republicans: It creates jobs. A state-by-state report to be released Wednesday (an advance copy was provided to the Tampa Bay Times) estimates that Florida would generate 63,800 jobs, mainly in health care, from 2014-2017. That’s the three years that the federal government would have paid the entire cost of providing health care to 848,000 people. The study by the Council of Economic Advisers -- titled "Missed Opportunities" -- is part of an ongoing push by the Obama administration on a central part of the Affordable Care Act. " It makes a number of other claims evaluating states that have expanded and Florida and 23 others that have not. It claims, for instance, that the number of Floridians experiencing depression would drop by 68,000. Or that 38,00 fewer people would see “catastrophic out-of-pocket costs in a typical year." The report relies on the Urban Institute among other sources. “Today’s report is yet another reminder that access to affordable health care makes a real difference to families, hospitals and state economies across the country," President Obama said in a statement. "I applaud the governors and state legislatures of both parties who have done the right thing and expanded Medicaid in their states, and I urge the governors and state legislatures who have not yet expanded Medicaid to put their constituents’ health over partisan politics and give millions more Americans the access to affordable health care they deserve.” (via Tampa Bay Times)




OLD HORSE-FACE IS BACK, THIS TIME ENDORSING THE MAN HE ONCE COMPARED TO TONYA HARDING! FLORIDA POLITICS AHOY: “Bill McCollum, the former congressman and state attorney general upset by Rick Scott in the 2010 Republican primary for governor, endorsed his ex-rival Tuesday for another four years as Florida’s chief executive. The Scott-McCollum clash was the most expensive primary fight in Florida history, with the winner shelling out $50 million of his own money to the loser’s $23 million in cash mostly from corporations and party leaders. It was also a nasty battle to the bitter end, inspiring the Florida Democratic Party on Tuesday to recall that Scott dubbed McCollum the “Tonya Harding of Florida politics” for his steady barrage against him four summers ago. Following his defeat, McCollum never emerged with a Scott endorsement in 2010. McCollum, now a lawyer-lobbyist who spends a lot of his time in Washington, D.C., reflected only slightly on his history with Scott in his endorsement. “In 2010, Governor Scott and I competed in a very close and hard fought primary,” McCollum said. “Over the last four years, Gov. Scott has done a great job for Florida families and served our state very well. “His record on helping Floridians create jobs and supporting education has helped families throughout our state, and I am proud to endorse him for re-election today.” The alliance also gave the Scott campaign a fresh voice to add to its continuing demand that Democratic rival Charlie Crist release the tax returns of his wife, Carole. Crist has released 10 years of personal tax returns, but not those of his wife. Scott and wife, Ann, have released three years of joint returns. “Gov. Crist always was proud to be known as ‘Mr. Open Government,’” McCollum said. “I find his recent refusal to release his and his spouse’s tax returns very surprising and disappointing. Government in the sunshine has been the law, and transparency has been a bedrock principle of Florida government and Florida politics for many years.” (via Palm Beach Post)



FINALLY, TARGET TARGETS CRAZY GUN WAVERS INSTEAD OF TERRORIZING ITS ACTUAL CLIENTELE: “Moms, babies, guns? Not a safe mix, Target said Wednesday. After a spate of weekend protests - prompted by nationally-circulated images of heavily armed Target shoppers -Target announced a change in policy. "But starting today we will also respectfully request that guests not bring firearms to Target – even in communities where it is permitted by law," said the company's interim CEO, John Mulligan. "This is a complicated issue, but it boils down to a simple belief: Bringing firearms to Target creates an environment that is at odds with the family-friendly shopping and work experience we strive to create," Mulligan said. Target's decision, fanned in part by Moms Demand Action for Gun Sense in America's social media campaign, is the latest in what appears to be a leave-your-gun-at-home retail movement. had been urging Target to follow Starbucks, Chipotle, Chili's, Sonic and Jack in the Box when it comes to customer safety "Semi-automatic assault rifles don't belong in the baby aisle -- or anywhere else in Target," the website says. "Yet gun extremists around the country have made it a point to bring their rifles into Target stores. Moms don't want to feel unsafe and intimidated when we go shopping with our children... "Nearly 90 percent of our customers are women; they need to know we expect them to get gun sense." (via The Arizona Republic)


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