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Bend The Healthcare Cost Curve By Preventing Diabetes

By 2020, an estimated 15 percent of adults will have diabetes and 37 percent will have prediabetes, a total of 39 million people, compared with rates of 12 percent and 28 percent today, respectively.

Today, more than 90 percent of people with prediabetes, and about a quarter of people with diabetes, are unaware of it, according to a report from UnitedHealth Group, the provider of insurance and other health care services.

The health savings alone of preventing diabetes would bend the cost curve of health care spending in the country. Health spending associated with diabetes and prediabetes is about $194 billion this year, or 7 percent of U.S. health spending, the report said. That cost is projected to rise to $500 billion by 2020, or a total of almost $3.4 trillion on diabetes-related care.

Engaging the at-risk population could save up to $250 billion, or 7.5 percent of estimated spending on diabetes and prediabetes, in the next decade. Of that money, $144 billion, or about 58 percent, would come from savings in Medicare, Medicaid and health care exchange subsidies. Read more »

*This blog post was originally published at ACP Internist*

The Rationing Of Healthcare

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*

How Bad The Government Is At Selling Insurance (Or Is It?)

Did you know there is actually a “public option” in the health care reform law?  It’s true — it’s called the Pre-Existing Condition Insurance Plan (PCIP), and it’s designed to cover people who who have been unable to get insurance because of a pre-existing condition. To hear the stories about how big of a problem this is in America, you’d think a product like this would be a big hit. Except it’s been a big flop.

How big of a flop? Well, according to the Washington Post, they missed their sales targets by 98 percent:

Government economists had projected that people turned down by private insurers would flock to the new Pre-Existing Condition Insurance Plan, with 375,000 expected to sign up this year. But as of this week, a little more than 8,000 had enrolled, officials said.

According to the Post, it seems the government has figured out what they think the problem is: “sticker shock.” The price was too high. So they’re dropping the price by 20 percent and significantly enhancing the benefits. But can that really be the problem? Read more »

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

Employers Up The Ante For Workers’ Health

More than half of employers are likely to keep offering insurance rather than use state health insurance exchanges when they become available under health care reform in 2014, reported a survey by an insurance broker.

Willis Human Capital Practice released results of its Health Care Reform Survey 2010, which showed 55 percent of employers would keep their health plans in 2014 even if the new state exchanges offer competitive prices. The survey sampled 1,400 employers of varying sizes, industry sectors and geographies whose plans cover more than 9 million employees and dependents (including retirees).

Key findings from the survey include:

• 88 percent believe that group health plan costs will increase as a result of health care reform;
• 76 percent expect administrative compliance costs will increase;
• 72 percent plan to increase employee contributions in an attempt to offset higher administrative and premium costs. Read more »

*This blog post was originally published at ACP Internist*

“Unintended Consequences” Of Cheaper Generic Drugs?

There’s an article in the New England Journal of Medicine entitled the “Unintended Consequences of Four-Dollar Generic Drugs.“ Ever one to hone in on unintended consequences of all stripes, I quickly clicked through. Oh, dear! What bad could possibly come of making drugs significantly more affordable?

Were more people demanding prescriptions for drugs they didn’t really need now that they were so cheap? (Dream on. I’m still twisting arms to get my high-risk cardiac patients to take their generic statins.) Were pharmacies going out of business, no longer to make ends meet without massive markups on brand name drugs, contributing to skyrocketing unemployment and otherwise adding to the country’s general economic malaise? Were cardiologists’ incomes plummeting because of sagging rates of coronary disease now that everyone could easily afford their beta blockers, ACE inhibitors, and statins?

Or maybe it was something good. I guess, technically, “unintended” doesn’t automatically equal “bad.” What could it be? So I read. And what did I discover? Read more »

*This blog post was originally published at Musings of a Dinosaur*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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