[…] But the government can create policies that make the good choices easier and less expensive than the bad choices, and that just might make a difference. Perhaps the next step in health care reform should be working to make Americans healthier to begin with, rather than trying to figure out how to fix us after we get sick.
doctors
Socioeconomic Status And Wait Times For Health Care
Critics of the current health care reform efforts have consistently pointed to the longer wait times to see a specialist when one is ill in Canada or Europe, compared with the US (of course, for people with no health insurance at all, wait times are probably considerable here too). Jason Shafrin has written an interesting article about wait times to see a specialist in Europe, and the role that socioeconomic status plays. […]
Pilot Programs Might Be The Key To Cost Control
[…] It’s easy to criticize the length of the health care reform bills (and I would agree that it would be more helpful if they were written in plain English), but perhaps they are so long simply because there is such a wealth of ideas contained within them. It will take the test of time to determine which of those ideas are true winners, but without including them in the language of the bills, we’ll never know.
An Office Visit In France
The Healthcare Economist’s Jason Shafrin has written an interesting article about how the French healthcare system utilizes hyperbolic discounting in order to avoid moral hazard. Basically, their system requires the patient to pay up front for a visit to the doctor, but then health insurance reimburses the patient 70% of the cost. This has two advantages over a system like ours which only requires the patient to pay their copay at the time of service. First, it conveys the value of the visit. Here in the US, people who have health insurance with copays for office visit are often unaware of the actual cost of the visit. They pay their copay and the rest is billed to the health insurance company. People who read their EOBs will see the actual billed amount and the amount that the insurance company paid, but I doubt that everyone reads their EOBs […]
Grand Rounds Vol. 6 No. 8
How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.
Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are […]
Health Wonk Review
Welcome to the Health Wonk Review. 2009 has been an exciting year for health care reform, and last Saturday’s passage of HR3962, the Affordable Health Care for America Act, has given us plenty to talk about. For anyone who hasn’t kept up on the details of the House reform bill, I want to start things off with a four-part series from Tim Jost, who holds the Robert L Willett Family Professorship of Law at the Washington and Lee University School of Law. His articles were published at Health Affairs Blog, and amount to an excellent primer, written in plain English, for people who want to understand HR3962, but don’t have time to read all 1990 pages […]
Imaging And Primary Care Doctors
[…] When Jay hurt his knee a couple years ago, an MRI was done prior to surgery. We have an HSA qualified health insurance policy, and at the time our deductible was $3000. So we paid for the MRI ourselves, and it amounted to more than a third of the deductible. And that was after Humana reduced the bill to the network negotiated amount. MRIs have helped to make medicine a much more exact science, but they are not cheap.
It seems that any system that pays physicians – directly or indirectly – to order additional testing will end up with excessive testing, adding to the overall cost of health care. Even doctors with the best of intentions are likely to be swayed by the knowledge that they can boost their paychecks by adding a few MRIs here and there.
I believe that the number of tests a doctors orders should not impact his or her income. And it seems that adding more medical imaging facilities in primary care offices will only increase our already burgeoning health care costs […]
Efforts To Reduce Never Events
[…] Ideally, we should have enough safeguards in place that “never events” truly never happen. But even if we eliminate the worst errors, there are still a lot of medical errors that could be prevented with extra checks and fail-safe systems in place. A trend towards not paying for mistakes could go a long way towards reducing the number of preventable medical errors in our hospitals.
Outcome Based Incentives For Doctors
[…] In order to truly provide quality care, a doctor is likely going to have to spend more time with sicker patients. This should be reflected in how the doctor is compensated, along with the outcome-based incentives. There are ways to implement an outcome-based incentive system for doctors while at the same time making sure that they aren’t encouraged to avoid the sickest patients.
What Canadians Think Of Their Health Care
Canada’s health care system has become a major talking point for both sides of the American health care reform debate. Proponents of public health insurance point to Canada as a shining example of a country where every citizen has access to health care. But people who want less government involvement in our health care system note that Canadians often face long waits for care. […]
Prevention Versus Early Detection
Much has been said about the merits of preventive medicine. It’s been a major talking point for politicians on both sides of the aisle throughout the health care reform debate. Whatever reform measures end up being enacted, there is likely to be an enhanced focus on screening tests. […] But does preventive medicine really help? […]
Some Claims Should Be Denied
What if they refused to pay for some of the CT scans being done at a clinic that purchased its own CT scanner and subsequently had a 700% increase in the number of scans ordered? Would the health insurers be held up as the bad guys, for not paying for the scans? I have to imagine they would, even though it’s likely that a good number of those scans were unnecessary. […]
Not Just Health Insurance That Needs Reform
Has anyone else noticed that the the term “health insurance reform” has started to be used in place of the term “health care reform”? Perhaps reform proponents are counting on the poor perception of the health insurance industry held by many Americans. By renaming the reform, perhaps they believe that more people will support it. […]
What Women Want
[…] Glenna’s article sheds light on what most of us (not just women) want when it comes to health care reform. We want something that is well-thought-out, focused on what works best for patients and health care professionals alike, and with a minimum of political grandstanding.
Surgery Might Not Be Best For Breech Births
[…] In the current quest to reform health care, everyone is talking about controlling costs. Lowering the rate of c-sections would have a significant impact on the cost of maternity care, since vaginal births are much less expensive than surgical births. Maternity care is something that most women eventually use, and lowered costs would translate to lowered health insurance premiums for all of us. […]
Health Care Must Be About More Than Money
[…] We all need to take a hard look at our motivations and what we consider to be our primary responsibilities. Anyone who puts making money at the top of the list might be better served in a different profession. Obviously, money will be somewhere on the list – we all need an income. But the health care industry isn’t a place where money should be the driving factor. […]
Some Government Can Be A Good Thing
I always appreciate it when someone actually throws a potential solution into the mix, rather than just complaining about the way things are/were/will be. The Happy Hospitalist has outlined his ideas for healthcare reform in a comment on his blog. I like his out of the box thinking, and the simplicity. But there are some issues that immediately come to mind […]
Yet Another Out Of Network Charge
[…] it’s all fine and good for a surgeon to have assistants, but doesn’t it seem that those assistants should be part of the same health insurance networks as the primary surgeon? After all of the effort we went through to make sure that we wouldn’t get hit with another out of network charge, this is frustrating to say the least.
Medical Mistakes
[…] I believe that most people who become medical providers do so out of a genuine desire to help people. But then they get caught up in paperwork, health insurance regulations, overcrowding and under-staffing, malpractice litigation fears, and a whole range of other things that don’t really have anything to do with providing care. I was struck by how many articles mentioned sincerely listening to patients as advice for providers.
Doctors And Government Health Insurance
[…] Our health care system is built around patients and doctors. Whatever health insurance reforms we consider – here in Colorado, and on a federal level – we need to make sure that we don’t create a system that is so distasteful to providers that they decide they’d rather spend their time doing something else instead of medicine.
Paying For An Office Visit
[…] Some people don’t have a car or health insurance, especially in our current economy. Programs like Medicaid and Colorado’s Child Health Plan Plus are very necessary, and I support efforts to expand those programs to more low-income families. But there are people willing to pay more than $150/month for a car, but hate the idea of paying $150 to see a doctor. […]
The Conscience Clause And Access To Healthcare
[…] Instead of requiring doctors to provide services that go against their moral beliefs, why not work to make sure that every community has providers who will perform a wide range of reproductive services? If clinics like Planned Parenthood get adequate funding, doctors practicing nearby could invoke the conscience clause without depriving the community of medical services.
Doctors and Patients and Healthcare Reform
[…] Our system doesn’t reward doctors who spend time with their patients. Instead it rewards doctors who see the most patients in the least amount of time (writing a prescription for an antibiotic is a good way to move patients along). Expecting change to come from patients isn’t fair. But it’s also not fair to expect change to come from the medical profession as a whole until we make some changes to how doctors are reimbursed for the services they provide.
Medical Home Pilot Program
[…] I’m curious to see what the outcome is for the IBM/United medical home pilot program. We work with United Healthcare here in Colorado, and are eager to see if United can come up with a program that would ultimately lead to lower healthcare costs (and thus lower health insurance premiums). If the pilot is successful, I imagine we’ll see other health insurance companies implementing similar medical home programs.
New Ideas In Healthcare Cost Management
[…] spreading healthcare costs over a large population doesn’t do anything to lower the actual cost of healthcare, and might be seen as putting a layer of paint on a crumbling wall. I’m not quite as quick to discount this idea, although I agree with Jaan that more needs to be done than simply increase the number of people paying into the health insurance system.