Park first got a taste for the massive blockades hindering payment reform when he and his partner launched Athenahealth. Before it became a software company, Athenahealth was focused on maternity care. The team wanted to scale a model where instead of assigning a doctor to a pregnant mother, you also assign her a midwife, a nutritionist and a case manager. Though the upfront costs are slightly higher, studies found that this type of care radically reduces the chances of costly complications with the mother, which drives down costs overall by as much as 20 percent. So representatives of Athenahealth approached the major health insurance companies and proposed a new payment model: Instead of paying for professional services, the insurers would pay a global fee for all care — hospital care, physician care, lab care — so that if Athenahealth could keep the mother healthy, lower the rate of complications and therefore lower costs, it would be able to more than cover the cost of the additional upfront preventive care, benefit financially and in the process drive down the total amount of money the insurers had to pay out. A win-win for all. “The insurers said, ‘Look, we completely agree with your math,’” Park said. “‘We agree with the five-year study that shows this model will work, but we can’t rewire our systems to pay you differently from everyone else. We have to keep paying you on a per-service basis, even though we completely believe that this lowers cost for higher value.’ And that was my first fundamental lesson regarding the principles of how you pay for health care dictates how health care gets delivered. Because this model can’t scale, can’t become widespread, if it’s not supported by the payment system.”

You can follow me on Twitter or go ahead and hire me.

But there is one aspect that I think is being overlooked (at least I haven’t seen anybody write about it yet, which doesn’t necessarily mean that nobody has).

Amazon will be offering paid subscriptions to blogs. You pay like $1.99 a month to subscribe. Many have already pointed out that people won’t want to pay for content they can already get for free. But what I haven’t seen anybody mention is this:

What the hell use is a blog if you can’t click on outbound links?

Most — though not all — blogs rely heavily on linking to outbound sources. BoingBoing, one of the blogs you can subscribe to with this service, only writes about stuff that it can link to.

So let’s say that you subscribe and download Blog X, which is available through Amazon. Then, while reading Blog X, you notice that they’ve linked to Blog Y. So what happens when Blog Y isn’t one of the blogs offered through Amazon? If you’re not within wireless range (and I hear the wireless service isn’t very good anyway), then what use is Blog X to you if you can’t follow links?

Somebody please inform me if I’m just being ignorant here. Otherwise, that $1.99 you paid for BoingBoing will go down the toilet.

However, the article notes that this is because many of those dollars are transferring online. Technology blogs and websites are soaking up advertisement budgets. The article doesn’t seem to make the logic jump that the tech publishing industry isn’t dying, it’s simply changing.

Wired Magazines is a good example of a tech publication that is adapting to this change. They maintain a print publication that is also published online. Not only that, they also have web-only content that includes several blogs. As advertising bleeds from their print pages, they’re able to catch some of them as they go online. Of course, a good portion of advertising will be dispersed to thousands of blogs that receive fewer than a hundred visitors a day through Google’s Adsense program. One could argue that it would be better for one person to receive a full-time position than for 100 bloggers to get a tiny $30 every month from Google. But this really just increases the competition even more. Bloggers and tech writers have to achieve such a high quality of writing that they can get the majority of advertising dollars that are going online.

For instance, it’s rather silly that in order to use an iPhone you have to buy an AT&T phone plan, you should be able to choose any service you like.

Anyway, Google went into much more detail about their plan over at their official blog.

2. Voting Begins on USAToday.com For Simpsons’ Hometown: “Voting began today on the Web site of the USA Today newspaper for which of several Springfields will host the premiere of ‘The Simpsons Movie’ later this month.”

3. Gay Paper ‘Out & About’ Now Back In At Nashville Kroger Stores : “One month after Out & About Newspaper was removed from racks inside Nashville, Tenn.-area Kroger supermarkets, the regional gay and lesbian free weekly is coming back to some of the stores. In an announcement Monday, Kroger said DistribuTech, the free newspaper distribution company, had misinterpreted the supermarket chain’s policy against displaying free papers that promote specific religious, political or other agendas.”

4. Personal Traffic Alerts, With Made-to-Order Data: “For many people, getting away for a holiday means sitting in traffic while listening to staccato radio reports about rubbernecking delays and cascading backups. But during the next few days, as Americans extend their Fourth of July celebrations, tens of thousands of motorists around the country will receive up-to-the minute accident alerts and guidance on end runs around bottlenecks — without ever having to turn on a car radio.”

5. Can She Turn Yahoo Into, Well, Google?: A profile of Susan L. Decker, president of Yahoo.

***

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2. Even gay princes aren’t safe
3. The case of the mystery gadget
4. Why is Technorati so unreliable?
5. PR companies stalking journalists
6. The text-advertising wars
7. Journalists trying to investigate Chinese businesses

via buzz machine

via joe