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Even With Health Care Reform, Many Will Still Encounter Problems

Trudy LiebermanA couple weeks ago I walked the streets of Lincoln, Nebraska, talking to men and women about whether they thought Washington was listening to their economic concerns.  Jeff Melichar manages his family’s Phillips 66 gas station on the city’s main street, and one of his big financial problems happens to be health insurance.  The more we talked, the more I realized what a jam he could be in down the road because of a loophole in the health reform law, which has received almost no press coverage or public discussion: If you have health insurance from your employer, you may have to keep it whether or not it’s adequate or affordable.  Buying less expensive or better coverage from one of the state “exchanges” or shopping services will be off limits.  So despite all that talk about consumer choice, for many like the Melichars, there may be no choice.

Melichar’s wife is eligible for health insurance from the optical company where she works.   But the family waited until this fall to enroll when the firm offered coverage they finally could afford.  Their premium is Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Insurance Company Begins New Ad Campaign In The Face Of Health Reform

Trudy Lieberman Cigna launched a $25 million “GO YOU” national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014.   That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage.  If those uninsured folks don’t get coverage, they will have tax penalties to pay.

No insurer wants to be left behind in this expanding marketplace, so Cigna, by being first out of the gate, hopes to build brand awareness that will ring bells in 2014 when consumers must buy insurance.  It’s a smart strategy.  One industry consultant says “most insurers have not built enough brand equity with consumers.”

Cigna’s ad campaign positions health insurance as Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

How Is The Quality Of Healthcare Determined?

How do you calibrate care so that it is neither too much nor too little? In this collection of recent posts, health care professionals search for that “just right” level of care.

“I bet celebrities and other VIPs (as they’re known in hospitals) get some of the worst healthcare in America. And, when I mean worst, I mean the most,” says Jay Parkinson in a recent post. Parkinson explores what is publically known about Apple’s CEO Steve Jobs’ care and calls specific attention to “incidentalomas.” Parkinson describes these asymptomatic tumors, sometimes discovered by especially aggressive care, and suggests that they may be over-treated, leading to poor health outcomes.

Mark W. Browne asks, Is the health quality bar set high enough? Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

The “I Get It” Moment In Direct-Pay Primary Care

After seven years, my wife has finally stopped asking me for “The Power of DocTalker” story of the day. Now when I start with the details of the latest case report justifying the model, she stops me with “I get it, I get it! Go write the case report up and post it on your website for others to ‘get it,’ too.”

Case reports center on the mission of our medical practice, with points regarding care that include quality, accessibility, convenience, affordability, empowerment, trust, and price transparency. Because our patients pay us directly for the service and don’t necessarily expect any insurance “reimbursement,” we are a very unique practice. We adhere to the points in our mission and also outperform all our local competition — i.e. medical offices that accept insurance payment for service in order to survive as a business.

To the patient, our services cost a lot less than services available via the insurance model. About 40 percent of our clientele have no insurance, and the other 60 percent have insurance yet chose to use our services because they believe it’s worth paying directly in order to assume control of their care. (As a quick aside — my favorite clients in this group are health insurance executives and CEOs of large companies, who have the best health insurance in the country.) Read more »

Pay More, Get Less – The Certain Future Of Healthcare

Even with healthcare reform, Americans will increasingly be burdened with high deductibles, more financial responsibility, and less satisfaction with their health insurance for the foreseeable future. Why? Because the healthcare system is unable to transform its services in a manner that other industries have done to improve quality and service while decreasing costs. The two biggest culprits are the mentality of healthcare providers and the fee for service reimbursement system.

Doctors and patients haven’t altered the way they communicate over the past hundred years. Except for the invention of the telephone, an office visit is unchanged. A doctor and patient converse as the physician scribbles notes in a paper chart. Despite the innovations of cell phones, laptop computers, and other time saving devices, patients still get care through face to face contact even though banking, travel, and business collaboration can be done via the internet, webcams, and sharing of documentation. As Dr. Pauline Chen noted in a recent article, doctors are not willing to use technology to collaborate and to deliver medical care better, more quickly and efficiently. Mostly it is due to culture resistant to change. Partly it is due to lack of reimbursement. Both are unlikely to be addressed or fixed anytime soon. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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