November 11th, 2011 by Jessie Gruman, Ph.D. in Opinion, Research
Tags: Beta Blockers, CAHPS, Concerns, Consumer Assessment of Healthcare Providers and Systems, Consumer Reports, Cost information, Electronic Health Records, Health Insurance, Hospitals, Jessie Gruman, Performance Data, Public Reporting, Questions, Rand, Research, Safety, uninsured
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Our ailing economy has boosted the number of people who are unemployed, without health insurance or with minimal coverage. The popularity of high deductible health plans is soaring as employers and individuals look for affordable insurance. Twenty-nine percent of bankruptcies are said to be caused by medical bills. Many of us now choose health care services and providers carefully, trying to stay within tight budgets.
The American people, long protected from the price of health care by insurance, are now forced to act as consumers. This situation is a free marketer’s dream. According to this model, we will rationally calculate the price/quality trade-offs of each doctor visit, procedure, test and drug. We will stop overusing services. We will demand better care. And the result will be reduced health care costs for the nation while the quality of care and the health of individuals will remain the same, if not improve.
There’s nothing like a good theory.
But the theory can only be tested if a) It’s easy to find publicly reported, relevant quality information about the services we need, matched with what we would pay out of pocket; and b) We use that information as the basis of our health care decisions. Neither of these conditions can be met today.
A new Cochrane review Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
November 10th, 2011 by DavidHarlow in Health Policy, Opinion
Tags: Accountable Care Organization, Age, Budget, Bundled Payment Initiative, CMS, Government, health care, Health Reform, medicaid, Medicare, Medicare Eligibility, Medicare Physician Fee Schedule, Physicians, Policy, Spendng
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On my way to the annual two-day blowout health law seminar put on by Massachusetts Continuing Legal Education (MCLE) on Monday — I was second in the lineup, speaking about post-acute care and some of the innovations in that arena for dual eligibles, among other things — I heard a fascinating piece on NPR on one of the ideas floating around the supercommittee charged with cutting $1.2 trillion from the federal budget. The idea: increase the minimum age for Medicare eligibility from 65 to 67, and save a bundle for Medicare in the process.
The problem with this deceptively simple idea (Social Security eligibility is migrating from 65 to 67, too, so it seems to be a sensible idea on its face), is that while it would save the federales about $6 billion, net, in 2014, it would cost purchasers of non-Medicare coverage (employers and individuals) about $8 billion, net. Why? The 65 and 66 year olds are the spring chickens of Medicare — they actually Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 10th, 2011 by KerriSparling in Opinion
Tags: Animas, Community, Diabetes, Friends, Inspired, Life, Lifescan, Living, Real, Support, Type 1
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Last week (was it only a week ago? My time-space continuum is completely off kilter these days), I was out in San Francisco for a quick visit at the Lifescan Town Hall meeting.
Okay, I was actually in Milpitas, which is a nice little place that the driver from the airport inadvertently described as, “Why are you going there?” Not exactly the same excitement as the home of the Golden Gate Bridge and other sights I saw from the car, but close.
I was asked to come out and talk about life with diabetes to a large group of Lifescan employees (they make the One Touch meters and they clearly like people who play guitar because Crystal Bowersox and B.B. King are their buddies, so I felt a little musically inept). I wasn’t asked to talk about my meter, or my pump, or to pimp out any partnerships, etc. They just wanted to hear about life with diabetes. Plain life. Real life.
Because I don’t have a formal bone in my body (all of my bones are in sweatpants and baseball caps), and because I didn’t have any airs to put on, I just stood on that stage showed them our community. I showed them some of our blogs, and talked about some of our meet-ups. I showed them that while life with diabetes can be challenging, Read more »
*This blog post was originally published at Six Until Me.*
November 10th, 2011 by KennyLinMD in Health Policy, Opinion
Tags: Arrests, Cocaine, Detention Center, Drug Abuse, Drug Dealers, Heroine, HIV Transmission, Interventions, Jail, Judicial System, Law, Marijuana, Needle Exchange programs, Policy, Portugal, Prison sentences, Prosecutions, Public Health, Public Policy, Serving time, War on Drugs
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A couple of years ago, I served for several weeks on a grand jury for the Superior Court of the District of Columbia. Mine was designated a RIP (Rapid Indictment Protocol) jury, assigned to efficiently hand down indictments for small drug-related offenses. These cases usually involved undercover officers posing as customers making purchases from street dealers, or uniformed police stopping suspicious vehicles and searching them for drugs. Although rarely we heard testimony about defendants caught with thousands of dollars of contraband, the vast majority of offenses were possession of small amounts of marijuana, heroin, or cocaine for “personal use.” Many of the latter defendants had multiple such offenses, which had resulted in probation, “stay away” orders (court orders to avoid certain neighborhoods where drugs were highly trafficked), or brief stints in jail. Few, if any, had received medical treatment for their addictions.
After a few weeks of hearing these cases, my fellow jurors and I grew increasingly frustrated with this state of affairs. We felt like a cog in a bureaucratic machine, fulfilling a required service but making little difference in anyone’s lives. A young man or woman caught using drugs would inevitably return to the street, violate the terms of his or her probation or “stay away” order, and be dragged before our grand jury again for a new indictment. We openly challenged the assistant district’s attorneys about the futility of the process. They would just shrug their shoulders and tell us Read more »
*This blog post was originally published at Common Sense Family Doctor*
November 9th, 2011 by Lucy Hornstein, M.D. in Opinion
Tags: Active treatment, Cancer, Chemotherapy, Choices, Discrimination, End Of Life, Help, Hospice, Medical, Oncology, Palliative Care, Prolonged Life, Quality of Life, Treatment
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Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously dysfunctional either/or approach to palliative care and hospice we’re stuck with in this benighted country.
The problem is that in order to qualify for hospice, patients must not only have a certified life expectancy of less than six months, but they must also not be undergoing any active treatment for their malignancy. When you stop to think about it, though, this is actually quite discriminatory. We don’t require people on hospice with other diagnoses to discontinue their life sustaining medications. Patients with COPD are allowed to continue their bronchodilators; CHF patients don’t have to stop their ACE inhibitors and digoxin. But if a cancer patient wants to qualify for hospice, they have to forgo curative treatments like chemotherapy.
So what if the oncologists call it “palliative” chemo instead? Read more »
*This blog post was originally published at Musings of a Dinosaur*