November 8th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion, Video
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Like Tom Friedman, who lampooned some of this year’s unreasonable campaign rhetoric in a recent column, I, too, would be in favor of reality-based political campaigns, but that seemed to be too much to ask for this year. Instead of truth, we now have truthiness.
The joke news shows (and their joke political rallies) seemed to be more popular than the evening news. (I wish Jon Stewart and his 200,000 fans on the Washington Mall last weekend had stayed home, canvassing for their candidates of choice.) Fact-checkers told us that many political ads this season were in the “barely true” or “pants on fire” zones according to the Truth-O-Meter. But in the end, the buzzwords seem to have worked their magic, and many “insiders” are out, and “outsiders” are in.
The angry and the impatient on the campaign trail have, in some cases, adopted the line from the movie Network: “I’m mad as hell, and I’m not going to take this anymore,” perhaps forgetting that while that line garnered the Howard Beale character strong ratings, network bosses arranged for his on-air assassination when his ratings fell.
The Utopia tune below, “Swing to the Right,” comes to you from the Ronald Reagan era, and perhaps we are seeing the generational swing of the pendulum back to the right. It does seem to happen every 30 years or so. But don’t blame me — I’m from Massachusetts (home to a Democratic sweep on the recent election night).
The last two years have seen a tremendous amount of change in Washington. The question of the moment, of course, is: How will the election results affect implementation of healthcare reform? Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
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 5th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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Republicans who had opposed healthcare reform before the election are now elected officials with a say in how the programs are funded. At federal and state levels, the program’s opponents either have a larger voice or are now in charge of implementing elements of reform. Sen. Majority Leader Harry Reid said he’d consider adjustments to healthcare reform.
Frightened seniors flipped toward opposition to healthcare reform, while flipping on the issue may have saved a few Democrats. Exit polling showed 48 percent would repeal healthcare reform, 16 percent would leave it as is, and 31 percent would expand it.
Now that Republicans have a larger say in the matter, take a look at their plan for healthcare in A Pledge to America, starting on page 25, and decide for yourself. (New York Times, Kaiser Health News, Reuters, Wall Street Journal, Politico, CBS News, GOP.gov)
*This blog post was originally published at ACP Internist*
November 3rd, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion, Quackery Exposed
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Interesting [recent] front-page article in the Wall Street Journal (WSJ) about the American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC). From the WSJ:
Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.
The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement. […]
The RUC, as it is known, has stoked a debate over whether doctors have too much control over the flow of taxpayer dollars in the $500 billion Medicare program. Its critics fault the committee for contributing to a system that spends too much money on sophisticated procedures, while shorting the type of nuts-and-bolts primary care that could keep patients healthier from the start — and save money.
I’m glad to see the RUC getting some much-needed scrutiny, and skeptical scrutiny at that. But they miss the point with the “fox watching the henhouse” angle, or at least they paint with too broad a brush. Read more »
*This blog post was originally published at Movin' Meat*
