November 22nd, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, News, Research
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What is the Federal Coordinating Council for Comparative Effectiveness Research?
The mission of the Federal Coordinating Council for Comparative Effectiveness Research will be to decide on best practices and most cost effective practices. The council will recommend cost effective treatments for diseases to the National Coordinator for Health Information Technology (NCFHIT). The NCFHIT will determine treatment at the time and place of care. It is charged with deciding the course of treatment for the diagnosis given by the doctor.
The U.S. Department of Health and Human Services (HHS) announced the formation and membership of the Federal Coordinating Council for Comparative Effectiveness Research that will be funded by President Obama’s stimulus program the American Recovery and Reinvestment Act (ARRA). The council was allocated $1.1 billion to set up comparative effectiveness of medical practice.
Why was this $1.1 billion funded from the economic stimulus package?
Unknown. The missions are based on the premise that practicing physicians do not have the ability to recommend the most cost-effective medical treatment for their patients. (See executive summary.)
Who are the members?
The members of the committee were picked without congressional approval immediately after the economic stimulus bill was passed. They are all bureaucrats working for the government in one capacity or another. There are no practicing physicians on the panel.
*This blog post was originally published at Repairing the Healthcare System*
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*
October 31st, 2010 by Stanley Feld, M.D. in Better Health Network, Opinion
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To: Bud Selig, Commissioner of Baseball
Dear Mr. Selig:
The World Series is an exciting time. It’s important to promote the national pastime. Kids play baseball all over the world. I have been particularly interested in the post-season games this season because my home team, the Texas Rangers, is in the World Series. They have been playing magnificent baseball.
I have been both a Yankees and Rangers fan ever since the Rangers came to Texas. In fact, my brother and I went to the first Rangers game in Arlington Stadium. I have been a student of baseball strategy for many years. Baseball is a fantastic game.
Baseball players are role models to kids all over the world. A baseball player’s behavior on the playing field should be exemplary. Baseball players have been poor role models as far as spitting and scratching their crotch. I have never become immune to these tasteless rituals. Read more »
*This blog post was originally published at Repairing the Healthcare System*
September 27th, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, News, Opinion
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An interesting debate occurred in the Washington Post between Michael Leavitt, former secretary of Health and Human Services and a member of the Medicare Board of Trustees from 2005 to 2009, and Dr. Don Berwick, the director of CMS.
Michael Leavitt wrote a scathing article criticizing President Obama’s Medicare Reform Act calling it an illusion. Don Berwick wrote a rebuttal to Michael Leavitt’s article.
Michael Leavitt starts off his article by stating: “Despite the report from Medicare’s trustees this month that the hospital insurance trust fund will not be depleted until 2029, 12 years later than was predicted just last year, Medicare is no better off than it was a year ago. “
The Medicare Trustees Report was strange. Nothing was done to change anything and all of a sudden, the hospital insurance fund was extended 12 years. I thought it was funny arithmetic.
Medicare Trustees is supposed to be an organization independent of the administration. Shortly afterward, Richard Foster, Chief Actuary for Medicare, who is independent of both the Medicare Trustees and the administration, wrote an “Alternative Report.” His report received little coverage in the traditional media. Read more »
*This blog post was originally published at Repairing the Healthcare System*
