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Workers Compensation: A Model For The Future Of American Healthcare?

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There’s a country with an unusual healthcare system. In it, you often spend about as much time with your lawyer as you do your doctor. There are special courts set up to decide what kinds of treatment you are allowed to have. And doctors have to be careful that they don’t say or do the wrong thing, or else they risk being blackballed by insurance companies.

The country:  The United States of America.

You may not realize it, but if you hurt your back at work you end up in a different healthcare system than if you hurt your back at home. Sure, you may end up with similar doctors or hospitals, but your experience of healthcare will be completely different. Here’s why.

If you get hurt at work, you’re covered by the “workers compensation” system. That system has its roots over a century ago, when employers didn’t do much to take care of workers. So the system is based on laws that mandate employers to take care of injured workers, often for the rest of their lives. In exchange for this very comprehensive coverage, employers and their insurers get a great deal of control over what care workers get and where they get it.

Does the workers compensation system represent a model of how a future American healthcare system might work? It might. Read more »

*This blog post was originally published at See First Blog*

The Federal Coordinating Council For Comparative Effectiveness Research: What Is It?

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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*

The Rationing Of Healthcare

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Do you recall the severe rationing of food and water the Chilean miners had to endure to survive? The rationing was done to stretch their limited resources. I would argue the state of Arizona’s new policy to not cover organ transplants for patients on Arizona Health Care Cost Containment System (AHCCCS) or their version of Medicaid is a similar form of rationing.

AHCCCS, as many Medicaid programs, is underfunded. They are trying to operate on a limited budget. Something has to give. Sadly in this case, many (NPR reports 98) had already been granted approval for organ transplants which they may not receive.

Francisco Felix, 32, who due to hepatitis-C needs a liver transplant, is reported to have made it to the operating room, prepped and ready for his life-saving liver transplant when doctors told him the state’s Medicaid plan wouldn’t cover the procedure. The liver he was to receive went to someone else. Read more »

*This blog post was originally published at Suture for a Living*

Where’s My Government-Provided Healthcare?

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Freshman Republican Congressman Andy Harris, who was elected on a promise to repeal the Patient Protection and Affordable Care Act (PPACA), is outraged that he’s going to go a whole month before his government-provided health insurance kicks in. From Politico:

A conservative Maryland physician elected to Congress on an anti-Obamacare platform surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in.

Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1st –- 28 days after his Jan. 3rd swearing-in.

“He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” said a congressional staffer who saw the exchange. The benefits session, held behind closed doors, drew about 250 freshman members, staffers and family members to the Capitol Visitors Center auditorium late Monday morning.”

All the more embarassing because he’s a doctor, for Pete’s sake. You’d think he’d have a better idea of how insurance works. Guess the dude’s never heard of COBRA. Also, it’s pretty standard that this is how enrollment happens. And it’s idiots like this that want to repeal the PPACA. Read more »

*This blog post was originally published at Movin' Meat*

What Kind Of Physicians Does The Government Want To See?

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Here’s my [recent] commentary at KevinMD.  Let me know what you think. What kind of physicians DO we want for the future?

I was talking with a pre-med student recently. He had completed his very first medical school interview and was, understandably, excited. But he told me the interviewer had asked him what he thought would be the outcome of the current healthcare reform measures.

I laughed to myself. After 17 years in practice, even I don’t know the outcome, though I have my suspicions. It seemed a loaded, almost unfair question. After miring students in biology, physics, chemistry and every known application-padding activity, after expecting volunteerism and activism, I’m not sure why they would expect this young man to have any earthly idea about the reform measures from his current position in the medical biosphere.

But I wondered, since I’m not a medical educator, was there a right answer? And I wondered even more, what do we want in our future physicians? Read more »

*This blog post was originally published at edwinleap.com*

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