June 2nd, 2011 by Toni Brayer, M.D. in Health Policy, Opinion
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It is my job at EverythingHealth to steer the reader to great information. For this reason I am providing you with a Link to The New England Journal of Medicine article titled “The $650 Billion Dollar question – why does cost effective care diffuse so slowly?” I have retitled it “Why Health Care Costs So Much”.
The United States spends much more on health care than other industrialized nations with no improvement in outcomes or health status of it’s citizens. If we enacted some of the policies that other nations use, we would have $650 Billion to spend on education, infrastructure, social security and other societal needs. Why can’t we get there?
Read here to understand the barriers. It isn’t simple. Resistance to change and instituting cost effective care has many stakeholders including legislators, doctors, hospitals, drug and equipment manufacturers, academic training centers, insurance companies and even the media. We, the public, are also to blame for not understanding that reform which lowers costs would benefit all of us. There is no free lunch. When the cost of care goes up for employers, that keeps our wages stagnant. When millions are uninsured, the cost of their care is born by everyone and it is inefficient care.
The article authors tell us: Read more »
*This blog post was originally published at EverythingHealth*
March 30th, 2011 by Emergiblog in Health Policy, Opinion
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We hear so much about health care fraud and how much it costs us all in terms of higher Medicaid, Medicare and private insurance costs, and if we could just rein in this fraud we could make our health care system pay for itself.
My trusty Mac widget dictionary defines fraud as:
- a person or thing intended to deceive others, typically by unjustifiably claiming or being credited with accomplishments or qualities and
- wrongful or criminal deception intended to result in financial or personal gain.
Well, I’m wondering, what is actually considered fraud?
Let me give some examples, and help me understand whether or not this is fraudulent behavior. The examples are purely hypothetical and do not represent any known individuals, living or dead, or specific situations in any known emergency department, living or dead. Read more »
*This blog post was originally published at Emergiblog*
November 24th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
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Hey there, big, smart, good-looking doctor…
Are you tired of being snubbed at all the parties? Are you tired of those mean old specialists having all of the fun?
I have something for you, something that will make you smile. Just come to me and see what I have for you. Embrace me and I will take away all of the bad things in your life. I am what you dream about. I am what you want. I am yours if you want me…
Seduce: verb [trans.] attract (someone) to a belief or into a course of action that is inadvisable or foolhardy : they should not be seduced into thinking that their success ruled out the possibility of a relapse. See note at “tempt.”
(From the dictionary on my Mac, which I don’t know how to cite.)
If you ever go to a professional meeting for doctors, make sure you spend time on the exhibition floor. What you see there will tell you a lot about our system and why it is in the shape it is. Besides physician recruiters, EMR vendors, and drug company booths, the biggest contingent of booths is that of the ancillary service vendors.
“You can code this as CPT-XYZ and get $200 per procedure!”
“This is billable to Medicare under ICD-ABC.DE and it reimburses $300. That’s a 90 percent margin for you!”
This is an especially strong temptation for primary care doctors, as our main source of income comes from the patient visit — something that is poorly reimbursed. Just draw a few lab tests, do a few scans, do this, do that, and your income goes up dramatically. The salespeople (usually attractive women, ironically) will give a passing nod to the medical rationale for these procedures, but the pitch is made on one thing: Revenue. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
May 25th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
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Like Ezra Klein, smart people keep saying foolish things about the health insurance business. This time it’s a pair of bloggers talking about the largest expense that health insurers face — their “medical loss ratio.”
According to Richard Dale at the Venture Cyclist:
[W]hy do they call it Medical Loss Ratio? Why is looking after me (or you) called “Medical Loss,” when the whole point of a healthcare system is to look after me (or you)?
(Sigh.)
Alan Katz, one of the leading health insurance bloggers, surprisingly links to this with approval, saying “words matter.” The problem? The word “loss” is probably one of the four oldest words in the insurance industry. I’d say the others are probably “premium,” “commission,” and “profit.” Should we start outlawing these words, too? Read more »
*This blog post was originally published at See First Blog*
May 12th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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A common problem in healthcare is the number of times that small adjustments are needed in a person’s care. Often for these little changes, a physical exam and face-to-face time have nothing to do with good medical decision making.
Yet the patient and doctor are locked in a legacy-industrialized business model that requires the patient to pay a co-pay and waste at least half of their day driving to and from the office, logging time in a waiting room, and then visiting five minutes with their practitioner for the needed medical information or advice.
Today I’d like to visit the case of a patient I’ll call “DD,” who I easily diagnosed with temporal arteritis (TA) through a 15-minute phone call after she’d spent four weeks as the healthcare system fumbled her time with delays and misdirection via several doctors without establishing a firm diagnosis. Read more »
It is my job at EverythingHealth to steer the reader to great information. For this reason I am providing you with a Link to The New England Journal of Medicine article titled “The $650 Billion Dollar question – why does cost effective care diffuse so slowly?” I have retitled it “Why Health Care Costs So Much”.
