November 8th, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, News, Opinion
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Accountable Care Organization(ACOs) are not going to decrease the waste in the healthcare system. Waste occurs because of:
1. Excessive administrative service expenses by the healthcare insurance industry which provides administrative services for private insurance and Medicare and Medicaid. A committee is writing the final regulations covering Medical Loss ratios for President Obama’s healthcare reform act. The preliminary regulations are far from curative
2. A lack of patient responsibility in preventing the onset of chronic disease. The obesity epidemic is an example.
3. A lack of patient education in preventing the onset of complications of chronic diseases. Effective systems of chronic disease self- management must be developed.
4. The use of defensive medicine resulting in overtesting. Defensive medicine can be reduced by effective malpractice reform.
A system of incentives for patients and physicians must be developed to solve these causes of waste. A system of payments must also be developed to marginalize the excessive waste by the healthcare insurance industry. Patients must have control of their own healthcare dollars.
By developing ACOs, President Obama is increasing the complexity of the healthcare system. It will result in commoditizing medical care, provide incentives for rationing medical care, decrease access to care, and opening up avenues for future abuse.
The list of barriers to ACOs’ success is long and difficult to follow. Read more »
*This blog post was originally published at Repairing the Healthcare System*
November 7th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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Via the Texas Tribune:
Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.
Hmmm. Welcome to entitlement reality, Texas-style. Currently 20 billion a year and going to go up with expanded eligibility, the article does say the Feds pay 60 percent, but doesn’t say: 1) It’s temporary, then the Federal contribution goes down or away, and 2) The Federal component doesn’t come from magical money fairies — it’s money taken from taxpayers then funneled back into a particular program.
Medicaid is not loved or respected in medicine. Decreasing reimbursements coupled to increasing requirements mean it’s at a minimum inefficient for both patients and providers.
I’m not against kicking Medicaid to the curb, PROVIDED the state has some kind of replacement program — which I’m not sanguine about.
*This blog post was originally published at GruntDoc*
November 7th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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I don’t consider myself a right-wing healthcare fear monger, but if I were this study would be worthy of amplification. As reported concisely in the New York Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, older Americans live longer once they make it to 70. Why would this be?
Is it because Americans who reach 70 are “heartier” than Britons, as Columbia University PhD (but now on leave and working at HHS) Sherry Giled says. Or is better survival of the American elderly one of the benefits of the “fury of American medicine?” Read more »
*This blog post was originally published at Dr John M*
October 7th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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I used to defend pharmaceutical companies. ”What companies out there have contributed more good? Should care manufacturers make more when all they do is make transportation that breaks after a few years?”
It made sense to me that you should put a pot of gold at the end of the rainbow so that companies are motivated to invent more drugs and innovate. We throw a lot of money to athletes and movie stars who simply entertain us, shouldn’t we do better to those who heal us? I used to say that. I don’t anymore.
No, I don’t think the drug companies are “evil.” People who say that are thinking way to simplistic. These companies are doing exactly what their shareholders want them to do: make as much money as possible for as long as possible. That’s what all companies do, right? They are simply working within the system as it is and trying to accomplish the goal of making money. To say that they should “sacrifice” is foolish. They are simply playing by the rules that have been set out there. Those rules are the thing that has to change. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
September 9th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Nothing polarizes the heath care debate more than defensive medicine. A recent study from Health Affairs will only add more fuel to the fire.
Here’s what I wrote a couple of years ago in USA Today: “When you consider that rampant testing is a major driver of escalating health care dollars, addressing defensive medicine should be a primary goal of cost containment.”
Is that still true? Well, yes and no. Read more »
*This blog post was originally published at KevinMD.com*
