November 7th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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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 1st, 2010 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion
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You want to see a doctor? You’re going to have to wait. And I don’t mean like an hour in the office. I mean like 53 days.
It’s not some doomsday story from the future. It’s happening today here in Massachusetts. Massachusetts — the state whose 2006 law was the model for the federal healthcare reform law. Massachusetts — home to some of the world’s best medical centers and doctors. And, as the Boston Globe’s “White Coat Notes” blog reports, Massachusetts — home to doctor shortages and long waits to see a doctor:
When primary care patients do secure an appointment for a non-urgent matter, they have to wait to get in the door, the survey found. The average delay is 29 days to see a family medicine doctor, down from 44 days last year, and 53 days to see an internist, up from 44 days last year.
The report said shortages also exist in dermatology, emergency medicine, general surgery, neurology, orthopedics, psychiatry, urology, and vascular surgery.
But what about costs? If you make sure everyone’s covered, you’ve got the foundation for real cost control, right? Unfortunately, no. Healthcare costs have been booming in Massachusetts:
Costs are rising relentlessly for both families and for the state government. The median annual premium for family plans jumped 10% from 2007 to 2009 to $14,300 — again, that’s a substantial rise on top of an already enormous number. For small businesses, the increase was 12%. In 2006, the state spent around $1 billion on Medicaid, subsidies for medium-to-lower earners, and other health-care programs. Today, the figure is $1.75 billion. The federal government absorbed half of the increase.
So what are the lessons for the future of American healthcare? Read more »
*This blog post was originally published at See First Blog*
October 27th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Health Tips, Opinion
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“Why should I take my blood pressure medication,” you ask? The more I do this thing called hospitalist medicine, the more I appreciate the power of lifestyle choices we all make.
Every opportunity I get I give my patients my smoking lecture and charge their insurance a CPT 99406. Everybody knows that smoking is bad for you and it causes lung cancer. Nobody knows all the other stuff. They’re always shocked.
Maybe it’s time for me to start a blood pressure lecture. I often have patients who say: “Why should I take my blood pressure medication?” They always answer their own question with the same answer: “I was feeling fine. I didn’t see a reason to take my blood pressure medication.”
You see, these are people with insurance. These are people with the Medicare National Bank. These are people who don’t have to lift a finger or a dime to pay any out-of-pocket expenses for their healthcare. And yet, they still lack the motivation to care for themselves, even with incredible resources out there these days to help them — things like great online blood pressure chart sites for home monitoring.
Whatever the reason — whether it’s ignorance, laziness, lack of motivation, lack of remembering, or selfishness — people just don’t take care of themselves. Read more »
*This blog post was originally published at The Happy Hospitalist*
October 21st, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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It is important to listen to what physicians are saying. An article appeared in SERMO, a physicians’ social network, which expressed a physician’s frustration. It is appropriate to publish some of that physician’s thoughts:
“I first heard this statement over twenty years ago, when I was an intern in general surgery, struggling to find my professional self.”
“My chief resident said; “The patient owns the disease,” “You’re not trying to make them suffer, you’re trying to help. They’re sick, you’re not.”
“The human body is unpredictable. Disease complications happen.”
The author thought his chief resident was heartless and callous. In a way, he was but he was getting at the heart of the matter. What is the patient’s responsibility in the evolution of disease? Read more »
*This blog post was originally published at Repairing the Healthcare System*
October 18th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
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Those of you who’ve read this blog for any length of time know that I have been a pretty strong advocate for healthcare reform. This has been primarily motivated by my passion for universal coverage, but also with my frustration with the cost of the current healthcare system, the generally crummy outcomes, and the overall level of fragmentation in the whole affair.
Even today, I had to repeat blood tests on a cancer patient who came to the ER. He had had blood tests at the cancer center ACROSS THE STREET before presenting, but, so sorry, our computers don’t talk to theirs and it’s after 5pm now, so forget about getting those results.
So it’s with a mixture of enthusiasm and dread that I consider the coming onslaught of accountable care organizations (ACOs). What are ACOs? They’re the buzzword of the day, that’s for sure. Everybody knows they’re the next big thing. They’re coming. We’ll all be in an ACO by next Tuesday for sure. It’ll be nirvana. Right? Read more »
*This blog post was originally published at Movin' Meat*
