November 8th, 2009 by Richard Cooper, M.D. in Better Health Network, Opinion
No Comments »
Is poverty the major factor underlying geographic variation in health care? It assuredly is. There is abundant evidence that poverty is strongly associated with poor health status, greater per capita health care spending, more hospital readmissions and poorer outcomes. It is the single strongest factor in variation in health care and the single greatest contributor to “excess” health care spending. It should be the focus of health care reform but, sadly, many provisions in the current bills will worsen the problem.
Much of this is discussed elsewhere on this blog and in our recent “Report to The President and The Congress.” In this posting, I would simply like to tap into your common sense. We all know that poverty is geographic. There are wealthy neighborhoods and impoverished ones, rich states and poor ones, developed countries and developing ones. Sometimes poverty is regional, as in Mississippi, but sometimes it’s confined to “poverty ghettos,” as in the South Bronx. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 7th, 2009 by Toni Brayer, M.D. in Better Health Network, True Stories
1 Comment »
I took my son to the ER for a broken thumb. It was a minor injury but the thumb is the most important digit on the hand. The ER care was just fine…a quick look, an Xray and a small splint. We didn’t have to wait long and everyone was courteous.
Imagine my surprise to receive the bill from the hospital. Yes, I have insurance. My out of pocket expense was minimal but here is what the insurance company was charged:
- Hospital Misc.- $56.00 (could this be the splint?)
- Diagnostic Xray – $342.00
- Emergency Care- $952.00
- Surgery – $570.00
- Total $1920.00
Take a look…surgery? There was so surgery, no procedure. There was no break in the skin. The doctor component of the visit was about 7 minutes (mainly because I knew the doc and we chatted about politics)
This bill is unreal and is comprised of unreal health care costs. Read more »
*This blog post was originally published at EverythingHealth*
November 1st, 2009 by RamonaBatesMD in Better Health Network, Health Policy, Opinion
No Comments »
I am not as well educated in healthcare policy or politics as Dr Wes, Dr Val, KevinMD, Movin’ Meat, or Dr Sid Schwab. I keep reading and listening, trying to understand and decide where I stand. I seem to be more of a centrist (I think).
I was not able to attend any of the previous town hall meetings held in Little Rock on healthcare, but was able to attend the one today. It was sponsored by the Americans for Prosperity. The headline speaker was John Stossel. I am happy to note it was a civil discourse though that may be due to most of them leaning the same way.
I didn’t come away any clearer than before.
I do tend to agree with Stossel that “when insurance is paying” (and not the individual) “it changes behavior.” We aren’t as engaged in the decision making when someone else is paying. However, it is very difficult to get straight answers or even estimates when it comes to healthcare. It’s easy to say what an x-ray might cost. It is difficult to estimate all the drugs, surgeries, care someone might need who has been involved in a major accident. WSJ Health Blog provides links to sites that can help with cost questions. Read more »
*This blog post was originally published at Suture for a Living*
October 28th, 2009 by Happy Hospitalist in Better Health Network, Opinion
No Comments »
What we need is health reform, not health insurance reform. If we do nothing about health care inflation, we are all doomed. Every last one of us. Taking care of sick people is expensive. The only way to get rid of health care inflation is to stop spending money. At some point we will either have to
- decrease illness
- decrease treatment and/or
- decrease the cost of treatment
There are no alternatives. As an American which action plan would you rather see take hold? Realize that every cost action has a reaction. You can decrease disease by prevention. You can decrease treatment by bundling. And you can decrease the cost of treatment by making it more efficient or simply paying less until access becomes an issue. I am certain that keeping the financial stability of America will require all three. But the only one you as a patient have control over is #1. As a country, we can prevent 80% of diabetes, heart disease, stroke and cancer by taking care of ourselves with lifestyle modification. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 28th, 2009 by SteveSimmonsMD in Primary Care Wednesdays
No Comments »
Over 25 years ago I witnessed a crime, committed by my family doctor. I was waiting to pay for my visit when an elderly, dignified, but obviously poor woman pulled out her checkbook, clicked open her pen, and asked, “How much do I owe?”
The receptionist’s answer piqued my interest and admiration, “The doctor said no charge, we’ll just bill your insurance.” I still remember the gratitude conveyed by her body language as she said, “Thank him for me,” returned her checkbook to her purse and left. Naïve to the complexity involved in medical billing, I was unaware that anything wrong had been done and did not resent having to pay for my office visit since our family could afford to pay; however, he eventually served time in jail for what I have always considered crimes of compassion. Perhaps I lack the details of his legal case to properly consider his actions but I’ll never forget the respect shown him by my home town in rural Tennessee after his time had been served; my family among many he continued to care for. Read more »
