March 22nd, 2010 by Debra Gordon in Better Health Network, Health Policy, Opinion
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My alarm clock is set to “radio” and my radio is set to the local NPR station. Now, I’m not one of those people who leaps out of bed when the alarm goes off. Instead, I lie in bed slowly waking up to about 15 or 20 minutes of the morning news.
This morning however, the news just made me want to pull the covers over my head and never get out of bed. That’s because the focus was healthcare reform, and the amount of misinformation — and, yes, I have to say it: stupidity — out there about what the current proposals will or won’t do is making me literally sick to my stomach. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*
March 22nd, 2010 by Shadowfax in Better Health Network, Health Policy
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We use a little company called Assurant to administer the employee health insurance plan for our business. We have about 50 employees, not all of whom are on our insurance (some get theirs through a spouse), so we are in a particularly undesirable segment of the small-business market. Ironically, we have had a fair amount of difficulty in getting coverage which was affordable and sustainable. A lot of insurers wouldn’t even bid on us. Funny, right? The doctors can’t get health care insurance! Hysterical! So we wound up with an unusual sort of self-funded plan administered by Assurant, which was working OK.
Recently, however, a couple of our doctors wound up taking family members to the ER for various reasons — nothing serious, but common and reasonable presentations for an ER. And Assurant denied payment for the claims. They didn’t deny it outright, actually, just imposed a $500 “penalty for non-emergent use of the Emergency Room” on top of the usual co-pays and deductibles. Read more »
*This blog post was originally published at Movin' Meat*
March 19th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
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The Jobbing Doctor, a primary care doctor in the UK, writes about the British version of what Americans call “Pay for Performance,” or “P4P.”
He says something I’ve said many times before (like here, here, and here). Which is this: incentives fail because they try to treat medicine as an assembly line process, when it’s not.
But what’s most interesting about his post is that it could have been written by a doctor from anyplace on the planet Earth.
The Jobbing Doctor talks about a UK program that started in 2004 called the Quality and Outcomes Framework, or “QoF.” Now, the American “P4P” is a much more catchy name, so score one for American marketing. But it doesn’t matter what you call it – that which we call a rose would, by any other name smell as sweet. Read more »
*This blog post was originally published at See First Blog*
March 17th, 2010 by Debra Gordon in Better Health Network, Opinion
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Gather round boys and girls. Today’s lesson is on “risk pools.”
Before you pull out your iPhone to ward off the boredom you assume will come, know this: the concept of risk pools is at the heart of today’s healthcare reform debate.
To understand risk pools, you first have to understand the basic concept of insurance. Insurance is something you buy in case something happens. The more people buying the same type of insurance, the less risk the insurer faces that it will have to pay out for that aforementioned “something.” Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*
March 17th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
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In my last post I encouraged everyone to watch the health care debate at Blair House mediated by President Obama. For this, I must apologize — I ignored the maxim that one should neither watch sausage nor laws being made. I had arranged to work from home that February 25 since I planned my next post to be a review of this much touted debate. As the proceedings began, I felt cautiously optimistic as I watched our politicians gather to supposedly mediate their differences; yet as the sun set that day I was incognizant of any path towards meaningful reform that our elected leaders could set upon as a result of their interaction.
Webster’s online dictionary lists two meanings of the word debate, with the first being: “a variance of opinion on a matter,” which best describes my recollections of that day. However, the other definition: “a careful weighing of the reasons for or against something,” may better explain my hopes of what would transpire because of the debate, but fails to describe what really occurred that day. The realization of this fact only deepens my disenchantment with what Washington has created and now dubs “Healthcare Reform.” When I try to recall the actual debate, I hear within my mind lots of static and background noise yet I can recall nothing of significance. What I hear reminds me of the voice of the schoolteacher from the Charlie Brown cartoons I watched during my childhood. Read more »
