October 11th, 2011 by DavedeBronkart in Health Policy, Opinion
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Last week the New York Times reported that some health insurers have applied to regulatory agencies to push premiums sharply higher – usually double-digit increases, while citizens are suffering. This falls on top of the 11 year history reported last year by the Kaiser Family Foundation: wages and inflation are up ~40%, while health costs and worker contributions were up 138% and 159%:
No wonder we feel squeezed. (Last week’s announcement comes on top of this history.)
This has enormous human impact. Read more »
*This blog post was originally published at e-Patients.net*
October 1st, 2011 by Jessie Gruman, Ph.D. in Opinion
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Emerging from a foggy year of treatment for stomach cancer, I am vividly aware of how much time and energy it takes to meet the daily demands of a serious illness. When I think back over the past 35 years and my treatment for now four different cancer-related diagnoses, I am amazed by how much has changed. The diagnostic and treatment technologies are light years more sophisticated and effective.
I am also taken aback by how much more we, as patients, and our loved ones who care for us, must know and do to organize and administer our own care in response to a serious diagnosis.
From an economic standpoint, this makes sense: the marketplace drives innovations to become simpler and cheaper. In modern American health care, this means that new drugs, technologies and procedures are re-engineered so they can be offloaded from expensive professionals to patients and those who care for them – and who work for free.
Think about it: Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 22nd, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
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Every day in the U.S. countless experts discuss plans and policies to contain the cost of health care using words and concepts that run counter to our (the public’s) experiences with finding and using care. Most of us ignore the steady stream of proposals until one political party or the other crafts an inflammatory meme that resonates with our fears of not getting what we need. At which point, we leap into action online, in town meetings and in the voting booth. As Uwe Reinhardt noted in his Kimball Lecture at the recent 2011 ABIM Foundation Forum, researchers and policy makers “cannot even discuss the cost-effectiveness of health care without being called Nazi(s).”
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that:
… if the doctor ordered it or wants to do it, we must need it.
… talking about less expensive treatments makes us feel that others are trying to bargain-shop our care and that scares us.
… clinical care does not vary much among our own doctors and hospitals.
… when we talk about the “quality” of health care we are referring to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 14th, 2011 by Jessie Gruman, Ph.D. in Opinion, True Stories
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“My doctor can titrate my chemotherapy to the milligram but can’t tell me when I am going to die,” a friend who was struggling with his treatment for cancer complained to me a couple years ago.
Had he lived, he might have been reassured by the announcement last week of a new scale that allows clinicians to estimate the time remaining to people with advanced cancer. He was spending his final days “living by the numbers” of his white blood cell count, the amount and size of his tumors and suspicious lesions, the dosage of various drugs and radiation treatments. And he was peeved about what he saw as a critical gap in those numbers. He believed (hoped?) that because his cancer was quantifiable and the treatment was quantifiable, that the time remaining should be similarly quantifiable. He needed that information to plan how to use the time that remained.
Many of us would make a different choice about knowing how long we will live when we are similarly ill. But most of us are attracted to the certainty we attach to the numbers that precisely represent aspects of our diseases.
It is not just when we are seriously ill that numbers dominate our experience with health care. Advances in technology have made it possible to quantify – and thus monitor – a seemingly infinite number of physiological and psychological health-related states. For instance: Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
August 31st, 2011 by PreparedPatient in Health Policy, Research
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It’s not just about money – Americans Face Barriers to Health Care Beyond Cost. A study released recently in Health Services Research found that while financial concerns prevent 18% of Americans from getting needed health care, more Americans – 21% – delay health care for nonfinancial reasons. These barriers include getting to the doctor, getting a timely appointment and taking time out of other responsibilities. Lead author Jeffrey Kullgren, M.D. adds what he believes is the crux of the issue: “We need to think about how to organize the existing resources we have in ways that are going to improve access to care.”
In Would You Lie to Your Own Doctor?, Connie Midey of The Arizona Republic reports on a common practice that can “compromise [doctors’] ability to diagnose and treat patients effectively.” The reason? Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
