November 8th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion, Video
Tags: David Harlow, Doc Fix, Election 2010, HealthBlawg, Healthcare Policy, Healthcare Politics, Healthcare reform, Medicare SGR Cut, Swing To The Right
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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
Tags: Accountable Care Organizations, ACO, Barriers To Success, Complications of Chronic Diseases, Defensive Medicine, Dr. Stanley Feld, Government-run Healthcare, Health Insurance Industry, Healthcare Economics, Healthcare Policy, Healthcare Politics, Healthcare reform, Healthcare Reform Act, Hospital Systems, Lack of Patient Education, Lack of Patient Responsibility, Medicare, New U.S. Healthcare System, Overtesting, Preventive Medicine, Primary Care, Repairing The Healthcare System, Waste in the Healthcare System
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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 8th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
Tags: ACP Advocate, American College Of Physicians, Bob Doherty, Council of Subspecialty Societies, CSS, Family Medicine, General Medicine, Internal Medicine, Mr. Roger's Neighborhood, New U.S. Healthcare System, Patient-Centered Medical Home Neighbors, PBS, PCMH-N, Primary Care
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My image of Pittsburgh has been one of a blue-collar, rough-and-tumble town: Perogies, Heinz ketchup, steelworkers, football, and Roberto Clemente. But an exhibit in Pittsburgh’s airport the other day informed me that Pittsburgh also is the home of the iconic “Mr. Roger’s Neighborhood” — the gentle PBS show that entertained toddlers for generations. Mr. Rogers always started the show off with the following verse:
It’s a beautiful day in this neighborhood,
A beautiful day for a neighbor,
Would you be mine?
Could you be mine?
It’s a neighborly day in this beautywood,
A neighborly day for a beauty,
Would you be mine?
Could you be mine?
I have always wanted to have a neighbor just like you,
I’ve always wanted to live in a neighborhood with you.
So let’s make the most of this beautiful day,
Since we’re together, we might as well say,
Would you be mine?
Could you be mine?
Won’t you be my neighbor?
Won’t you please,
Won’t you please,
Please won’t you be my neighbor?
Fittingly, the same week that I was reminded of “Mr. Roger’s Neighborhood,” the American College of Physicians (ACP) released its “medical home neighborhood” position paper. The paper was developed by a workgroup of ACP’s Council of Subspecialty Societies (CSS), which is comprised of representatives of internal medicine subspecialty societies and related organizations.
Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
November 7th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
Tags: Dropping Healthcare Programs, Election 2010, General Medicine, Government-run Healthcare, GruntDoc, Healthcare Costs, Healthcare Economics, Healthcare Entitlement, Healthcare Policy, Healthcare Politics, Healthcare reform, medicaid, Republican Lawmakers, Texas Tribune
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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 7th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, Research
Tags: Aging Adults, Choosing the Best Treatment, Columbia University, Decision To Treat The Elderly, Demography, Dr. James Smith, Dr. John Mandrola, Elderly Adults in Britain, Elderly Care, Fear Mongering, Fury of American Medicine, General Medicine, Healthcare Economics, Healthcare reform, Healthcare Spending Worldwide, New York Times, Older Patients, Sherry Giled, U.S. Healthcare System
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I don’t consider myself a right-wing healthcare fear monger, but if I were this study would be worthy of amplification. As reported concisely in the New York Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, older Americans live longer once they make it to 70. Why would this be?
Is it because Americans who reach 70 are “heartier” than Britons, as Columbia University PhD (but now on leave and working at HHS) Sherry Giled says. Or is better survival of the American elderly one of the benefits of the “fury of American medicine?” Read more »
*This blog post was originally published at Dr John M*
