September 22nd, 2011 by Happy Hospitalist in Health Policy, Opinion
No Comments »
Ask yourself this question: Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care? I would. That’s what one hospital system in Massachusetts is offering to provide. It is, essentially, a concierge hospital plan. You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.
What a great idea. In fact, it’s an idea I have thought about previously for Happy’s hospital. Why shouldn’t Happy’s hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing? I’d sign up. My health insurance premiums cost over $12,000 a year. In the eight years of my practice, I’ve probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.
It’s a concept who’s time has come. In fact, direct concierge hospital plans also offer patients and their employers the opportunity for tiered pricing for special amenities (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking, door-to-door service, and 24 hour special access to their physicians and nursing staff).
No more worries about Read more »
*This blog post was originally published at The Happy Hospitalist*
September 22nd, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
1 Comment »
Every day in the U.S. countless experts discuss plans and policies to contain the cost of health care using words and concepts that run counter to our (the public’s) experiences with finding and using care. Most of us ignore the steady stream of proposals until one political party or the other crafts an inflammatory meme that resonates with our fears of not getting what we need. At which point, we leap into action online, in town meetings and in the voting booth. As Uwe Reinhardt noted in his Kimball Lecture at the recent 2011 ABIM Foundation Forum, researchers and policy makers “cannot even discuss the cost-effectiveness of health care without being called Nazi(s).”
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that:
… if the doctor ordered it or wants to do it, we must need it.
… talking about less expensive treatments makes us feel that others are trying to bargain-shop our care and that scares us.
… clinical care does not vary much among our own doctors and hospitals.
… when we talk about the “quality” of health care we are referring to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 19th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
No Comments »
As we get closer to January 2012, the originally scheduled implementation date for Accountable Care Organizations (ACOs), the time has come to reexamine the showpiece of President Obama’s Patient Protection and Affordable Care Act (PPACA) of 2010.
The final rules for ACO’s are now scheduled for release on January 2012. The implementation was originally scheduled for January 2012. As the original rules are being studied and interpreted the program for ACOs implementation became more confusing. Dr. Don Berwick (CMS Director) has refused to discuss the final rules until they have been published in the Federal Register.
“The ACO program is based on the hubristic assumption that the federal government can design the best organizational structure for the delivery of care, foster its development, and control its operation for the entire country.
The federal government has big-footed health system reform. Although there is no one right way to organize care, the federal government (Dr. Don Berwick and President Obama) thinks it has found one—and exerts top-down, bureaucratic control through PPACA to implement it.”
ACOs are supposed to be organizations that improve coordinated care. If an ACO decreases the cost of care Read more »
*This blog post was originally published at Repairing the Healthcare System*
September 11th, 2011 by DrWes in Health Policy, Opinion
No Comments »
It was supposed to be one of a series of “measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management.” Instead, the wearing of red “tabards” by nurses that read “Do Not Disturb” while they distributed medications has proven to be the straw that broke the camel’s back in England. While the “Do Not Disturb” message on the tabards was replaced with a message that reads “Drug Round in Progress,” isn’t the message the same?
Directive Number 99365.23a: “In the Name of Safety, Do Not Bother Me While I Hand Out Medications.”
It seems almost too incredible to believe and yet, this is how it’s playing out now in England’s National Health Service. Read more »
*This blog post was originally published at Dr. Wes*
September 6th, 2011 by DrRich in Health Policy, Opinion
No Comments »
A recurring theme of the CRB is that the rising cost of healthcare is the main internal threat to the continued viability of the US. Indeed, the very title of this blog reflects the chief mechanism which is being employed, fruitlessly and disastrously, in the attempt to reduce those costs.
Recently, DrRich pointed out that there are four ways – and only four ways – to reduce the cost of healthcare. He did this as a service to his readers, so that when politicians describe in their weaselly language how they will get the cost of healthcare under control, you will be able to figure out which of the four methods they are actually talking about.
While DrRich’s synthesis has been generally well-received, a few readers did offer one particular objection. DrRich, they assert, left out a fifth way to reduce the cost of healthcare, and the very best way at that. Namely, just get rid of the waste and inefficiency.
DrRich has talked about this before, but obviously it is time to revisit the issue.
It is, in fact, a central assumption of any healthcare reform plan ever proposed that we can get our spending under control simply by eliminating – or at least substantially reducing – the vast amount of waste and inefficiency in the healthcare system. Conservatives propose to do this by Read more »
*This blog post was originally published at The Covert Rationing Blog*
