January 19th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Opinion
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Even with healthcare reform, Americans will increasingly be burdened with high deductibles, more financial responsibility, and less satisfaction with their health insurance for the foreseeable future. Why? Because the healthcare system is unable to transform its services in a manner that other industries have done to improve quality and service while decreasing costs. The two biggest culprits are the mentality of healthcare providers and the fee for service reimbursement system.
Doctors and patients haven’t altered the way they communicate over the past hundred years. Except for the invention of the telephone, an office visit is unchanged. A doctor and patient converse as the physician scribbles notes in a paper chart. Despite the innovations of cell phones, laptop computers, and other time saving devices, patients still get care through face to face contact even though banking, travel, and business collaboration can be done via the internet, webcams, and sharing of documentation. As Dr. Pauline Chen noted in a recent article, doctors are not willing to use technology to collaborate and to deliver medical care better, more quickly and efficiently. Mostly it is due to culture resistant to change. Partly it is due to lack of reimbursement. Both are unlikely to be addressed or fixed anytime soon. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
January 18th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Tips, Opinion
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‘Let’s get us some of that REform!’
I must admit I’m a little weary of the entire debate on health-care reform. But something still haunts me. And that something is accountability. Of course, over the almost twenty years that I have borne the title ‘MD,’ I’ve learned a few things about accountability.
I understand that, almost without fail, the buck stops with me. The nursing home director knows the elderly lady wasn’t seriously hurt in that fall, but he sends her to the ER ‘just to check things out.’ That is, just to make sure that if a problem does crop up, someone else is accountable for finding it. Read more »
*This blog post was originally published at edwinleap.com*
January 13th, 2010 by BobDoherty in Better Health Network, Health Policy
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Much of the debate about the health reform has been on whether or not it will lead to government-run health care. But the fact is that the government’s share of health care spending already is growing at a faster rate than private spending, a trend accelerated by the recent economic recession.
A new report from Medicare’s actuaries, published in the journal Health Affairs, found that “Federal government spending for health services and supplies increased 10.4 percent in 2008 . . . and accounted for almost 36 percent of federal receipts, up considerably from 28 percent in 2007. By comparison, spending for health care by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance premiums paid for by employers” while “health care spending by households grew 4.3 percent in 2008, a deceleration from 5.9 percent growth in 2007” but still more than the adjusted personal income growth of 2.7%.
The current economic recession, the authors say, had two major impacts on health spending: Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
January 11th, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy
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The favorite sound bite of Dartmouth disciples is to compare some high cost locale with a low cost locale. First it was Miami vs. Mayo, then Birmingham vs. Grand Junction, then Los Angeles vs. Green Bay and now it’s Los Angeles vs. Portland. This time, Tom Brokaw delivered the message on Meet the Press: “At UCLA Medical Center, they spend $92,000 on the last two years of a life, but in Portland, Oregon, just north of there (it’s actually 825 miles north of there), they spend $52,000 because they’ve got better controls on Medicare. So until you begin to pay for value and pay for performance, health care reform is not going to work.”
What do Miami, Birmingham and Los Angeles have in common, and what do Rochester MN (home of Mayo), Grand Junction CO, Green Bay WI and Portland OR have in common. One thing is poverty. The maps below show the density of poverty in each (light green shows census tracks with 20-40% poverty and red shows tracks with >40% poverty). Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
January 11th, 2010 by DrWes in Better Health Network, Health Policy, Opinion
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With the turn of the calendar to the new decade, the reality of health care reform has set in for doctors and patients. Already cuts to physician salaries and patient access to care are becoming starkly apparent to those of us on the front lines of health care.
I wonder why doctors have been so ineffectual relative to the other special interests “at the table,” in the health care debate? One would think that those with the knowledge base and skill to manage their patients would be the ultimate power brokers in the efforts of health care reform. Yet here we are, watching the commoditization of our profession at the hands of lawyers and politicians in Washington, eager to avoid being perceived as the spoiler. Read more »
*This blog post was originally published at Dr. Wes*
