Category — Editorial

In the heady days of Medicare cost cuts, national competitive bidding, healthcare industry protests, the political healthcare reform proposals of Clinton, Obama, McCain – as well as the Michael Moore take on all these things – here is a cost cutting solution from the prosperous central European country – the Czech Republic.

Formally free doctor visits for patients are now $1.85, the same for prescriptions, and a hospital stay is about $3.60 per day. (Comparison for US readers – a gallon of gas costs upwards of $8).

There is an annual cap of $300 for the patient fee. Of course the indigent are treated for free anyway (why wouldn’t they be).

The result is that prescriptions have fallen 40%, the public insurer (read Medicare equivalent) has saved $100 million and providers have increased revenues by $62 million in the first three months of the new program.

Health care fees trouble Eastern Europe

Both events are conveniently located in Paris this year.

May 27 - 30, 2008

Hopitalexpo-Intermedica is a combined meeting of the FFH (French Hospital Federation) which represents 2000 major hospitals in France and Intermedica which is composed of the major national trade organizations.

June 11 - 13, 2008

Autonomic is a trade and consumer meeting which focuses more on the growing homecare sector.

Contact Frank Barlin at Sibaya Healthcare.

Guest blogger Arnon Krongrad, MD

What do these people have in common: 1) a 39-y old stay-at-home mom in Florida, 2) a web master in Melbourne Australia, 3) a gay Broadway producer, 4) the Clinical Director of Psycho-Oncology at the Winship Cancer Center at Emory University, and 5) a dentist in Ottawa? They are all new members of the New Prostate Cancer InfoLink social network.

Prostate cancer is a global problem with no apparent global solution. It is also a chronic and multi-faceted clinical challenge. Be it matters of early detection or treatment selection or management of clinical complications and loss of partner intimacy, there is more to consider than any one doctor or specialist can. Moreover, with the numbing quantity of online information, there is more than any single site can efficiently deliver. Patients drown in useless information while seeking the bit that relates to them.

To address what we perceived a poorly constructed online delivery, we recently resurrected what in 1995 was launched as the world’s first prostate cancer web site, the Prostate Cancer InfoLink. We kept its best parts, including the simple articles and interactive “Ask Arthur,” and launched the new version with modern tools: blog, syndication, and social network.

The New Prostate Cancer InfoLink sites bring friendly interactive mechanisms for helping the individual man and his partners and friends. For example, the “Ask Arthur” has been expanded to be Ask Arthur, Ask Amy, and Ask Arnon, which represents 50 man-years of prostate cancer experience. The social network has uniquely brought together urologists, radiation oncologists, psychiatrists, writers and more. Discussion has been thoughtful and in many cases supremely well informed.

We’re new in existence and new in concept. Please have a look. And if you run a web site or blog, please post links to:

http://prostatecancerinfolink.net articles, blog, and online support

http://prostatecancerinfolink.ning.com social network

# # #

Guest blogger Arnon Krongrad, MD, is Founder and Medical Director of the Krongrad Institute for Minimally Invasive Prostate Cancer Surgery and co-Founder of the New Prostate Cancer InfoLink.

Brian Sterner is thrown from his wheelchair by police in the state of Florida, United States.

UPDATE: February 16, 2008:

Hillsborough County Deputy Charlette Marshall-Jones, 44, turned herself in and was booked into the Orient Road Jail early Saturday, jail records show.

Reuters and more at CNN.

Per-Gunnar Borhaug, CEO Handicare AS and Hardy Brännström President Romedic AB announce the acquisition of Romedic by Handicare.

Handicare AS acquires RoMedic AB in Sweden and strengthens its position internationally within lifting-, transfer- and positioning products for elderly and handicapped.

Handicare’s revenues are estimated at over 225 million Euros ($320 million) putting it in our top 3 European homecare companies (similar category).

Handicare which is owned by the Ferd Private Equity Fund has been selectively acquiring higher value product companies in the Homecare space, including Freelift and Movingpeople in the Netherlands.

We originally wrote about Nordic companies on the acquisition trail end 2005 “The Return Of The Homecare Vikings”.

Seems like they have done pretty well from my vantage point.

or, who should US voters vote for?

According to AAHomecare even more cuts are planned.

It’s also about Asian sourcing, low barriers to product development and market entry - and who takes what and how much in the value chain.

Invacare has just announced (HME News) that they will no longer sell powerchairs to the Scooter Store. This follows last weeks announcement from the Scooterstore recommending that higher end rehab power chairs be included in the the (divisive - according to the majority of the industry) - national competitive bidding process (pdf download).

While the reason for the split from the Invacare perspective is related to their commitment to individual independent homecare dealers this is symptomatic of a much bigger issue.

What are the key factors…

The power wheelchair manufacturers (and others) have seen dramatic cuts in Medicare reimbursement in this category. Furthermore the new competitive bidding process is also sure to have a negative impact on margins. It also pits traditional manufacturers against the dealer distribution channel as to who and how will both parties participate in this new (coming -already here) environment.

In fact, everything that the major payers (reimbursement agencies, governments and de facto “consumers”) desire.

In order to deal with prices that continue to fall, the major manufacturers, started a few years ago, outsourcing heavily to Asia - as other industries have done when confronted with cost issues (or to increase their margins).

The issue for the manufacturers however is that they outsourced products with little or no intellectual property attached to them - only manufacturing know how. As one would expect, now that Asia has learned (with the help of the manufacturing industry) how to make rehab products - these same Asian companies are doing two things:

• Firstly they are establishing their own operations in the US and other markets. Some examples being Shoprider and Merits. Of course what these Asian companies have is products largely developed with the help of the US domestic manufacturers over the years - but what they still don’t have a great deal of is dealer and direct consumer customers.
• Still no big surprise - except that these (and several others) not only supply the traditional manufacturers with power chairs and other products, now have their own US direct operations, but they also supply national and / or large distributors with product, competing with the self same traditional manufacturers that essentially put them in business.

What’s next.

The competitive bidding process and the lines between manufacturer, importer, distributor and dealer are going to become increasingly blurred.

Companies like The Scooter Store, essentially breaking conventional ranks is a sign of things to came, not only in the US but also in other big rehab markets, like Germany - in fact its already started.

So, unless rehab “manufacturing” companies have IPOD (r) type patents and distributors of enhanced OEM rehab products have lifetime guaranteed customers - be ready for rapid change.

Or better yet be the change maker - and prosper.

Update January 28, 2007: Doug Harrison from the Scooter Store getting more isolated - maybe not. Lou Slangen from Invacare notes

“This is the most defining moment we’ve had in our industry on rehab products”.

Invacare and Scooter Store Heat Up Rhetoric - hmetoday