November 16th, 2009 by DrWes in Better Health Network, Health Policy
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I don’t mind health reform. In fact, I believe we need it. But when reform bills fund projects that already exist, or fund special projects for other non-health care professionals, like lawyers, I have to wonder what Congress is doing.
The recently passed House bill (H.R. 3962 pdf) contains a multitude of grants and “demonstration projects.” I wasn’t sure what some of these grants were meant to support, so I looked them up. I was surprised to find that many of the grants duplicate programs or departments already in place. While this list is by no means comprehensive, I thought I would provide a few comments on a few of these grants shown in italics): Read more »
*This blog post was originally published at Dr. Wes*
November 12th, 2009 by drval in Health Policy, Opinion
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There hasn’t been much discussion about serious tort reform in the current healthcare reform debate. That’s probably because most policy experts don’t believe it will make a significant dent in healthcare costs. I happen to believe that tort reform would be a huge boon for healthcare (just ask Ob/Gyns in Texas) and save a lot in defensive medicine practices and unnecessary testing, but even if I’m wrong and it wouldn’t result in cost-savings, there’s another issue at play: access to primary care physicians.
We all agree that we’re in the midst of a major shortage in primary care physicians. Many different solutions have been proposed - everything from “let the nurses do it” to forgiving medical school loans to physicians who choose primary care as a career. However, solving the PCP shortage isn’t just about recruitment, it’s about retention. And with up to a half of PCPs saying that practice conditions are so unbearable they’re planning to quit in the next 2 years - Houston, we have a problem. Read more »
November 11th, 2009 by DrRichardCooper in Better Health Network, Health Policy, Opinion
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The Institute of Medicine (IOM) has addressed seven key health care reform questions and offered answers that capture today’s consensus. No surprises, but good clear analyses. But what if the underlying conceptual framework is not an excessive use of services by wrongly incentivized providers but the tragic over-use of services by the poor? Here are seven “what ifs” plus an eighth question.
1. Is health care too expensive?
What if health care is the economy, the major source of jobs and the basis for America’s worker productivity? And what if the problem is an unfair insurance system and inequitable distribution of fiscal responsibility?
2. How much too expensive is it?
What if regional variation is not a manifestation of excessive spending but of income inequality and the intersection of wealth and poverty? And what if differences in price and economic development, rather than waste and inefficiency, differentiate costs among countries? Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 7th, 2009 by DrToniBrayer in Better Health Network, True Stories
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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 6th, 2009 by DrJonathanFoulds in Better Health Network, Health Tips
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Every now and again I like to pick one of the classic research studies on smoking cessation in order to highlight some of the key findings. Today I’m going to focus on the part of the Lung Health Study.
The Lung Health Study is certainly one of the best smoking cessation studies ever carried out, partly because of the comprehensive nature of the assessment and follow-up of its 5,887 participants and partly because it was way ahead of its time in delivering a truly “state-of-the-art” intensive smoking cessation intervention which was compared in a randomized manner to the effects of “usual care”. The Lung Health Study (LHS) was a randomized clinical trial of smoking cessation and inhaled bronchodilator therapy in smokers 35 to 60 years of age who did not consider themselves ill but had evidence of mild to moderate airway obstruction. Read more »
This post, Classic Smoking Cessation Study Suggests You Can Save A Life For $2000, was originally published on
Healthine.com by Jonathan Foulds M.A., M.App.Sci., Ph.D..
November 6th, 2009 by GruntDoc in Better Health Network, Opinion
1 Comment »
Kevin, MD linked to this, and I really must comment.
Here’s the abstract, and I hope you’ll read it all:
For years I’ve heard friends describe experiences of being caught in a web of excessive and unnecessary medical testing. Their doctors ordered test Z to investigate a seemingly incidental finding on test Y, which had come about because of a borderline abnormality on test X.
I often wondered why test X was done in the first place. As a primary care physician, I would have treated them for the likely diagnosis and done diagnostic tests — especially a series of diagnostic tests — only if they didn’t respond as expected…. Read more »
*This blog post was originally published at GruntDoc*
October 27th, 2009 by DrWes in Better Health Network, Health Policy, True Stories
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I had an interesting visit with the husband of my niece last evening. He works as an ER doctor that is self-insured group of 60 physicians that cover the ER needs of four hospitals in Clark County near Las Vegas.
What is interesting is they are self-insured to save costs. As a group, then, they know how much per patient they must collect to assure liability care for every patient that comes to their emergency rooms.
That amount is $17 per patient per visit.
Guess how much their group receives for care they render to a Medicaid patient for a “level two” visit (minor problem: ear ache, sore throat, etc.)
Fourteen dollars per visit. Read more »
*This blog post was originally published at Dr. Wes*
October 22nd, 2009 by admin in Better Health Network, News, Opinion
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By Robert Stern, M.A.
Almost a decade ago, I had a simple idea — deliver fast, accurate medical news to clinicians in a format that was easily accessible, and turn that news into a “teachable moment.” Almost five years ago, that idea became reality with the launch of MedPage Today.
Monday through Friday (and if news is happening, Saturday and Sunday, too), MedPage Today delivers on our promise of “Putting Breaking Medical News into Practice.”
Our reporters and editors not only scan prepublication copies of top medical journals seeking medical news that is likely to influence daily clinical practice, but also travel worldwide to report medical news delivered at scientific meetings.
These gatherings are important as a primary source of medical information. New medical information, or as we call it: News. Read more »
October 18th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
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If you read nothing else this morning, please read Margaret Polaneczky, MD’s (aka “TBTAM”) excellent post that vividly summarizes our current health care reform efforts underway while offering insights as to what real reform should look like:
Real reform won’t happen until the American people take their seat at the head of the table and invite doctors, ethicists and healthcare experts (not industry lobbyists) to bring their best knowledge about what interventions are most important, most effective and most cost efficient. Then we can sort out our priorities (you can call it rationing if you want) and create a budget.
Only then we can begin to negotiate with third parties (insurers, Big Pharma, etc) to sell us what we need at the best price. That’s called competition, and it’s what American capitalism is all about, right?
The problem is, the American healthcare consumer (and I include myself here) still thinks someone else is footing the bill. Who that someone is, I don’t know. Maybe the rich. Maybe our employers. Maybe the Federal Government.
What we have yet to get is that there is no “someone else”. The deep pockets are our own pockets, and they are empty. Our tax dollars. Our pensions. Our companies going bankrupt from paying employee health care costs.
Until the American people get it that it is our responsibility to get our spending in line, and until our representatives have the guts to turn away the industry lobbyists and represent their constituents instead of their campaign bankrollers, we will continue to have uncontrolled health care spending.
… and that’s just part of it. Read the whole thing.
*This blog post was originally published at Dr. Wes*
October 12th, 2009 by GruntDoc in Better Health Network, News
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EMS/ED frequent fliers are both a bane and (supposedly) another cost of doing business for EMS systems. Maybe not.
My city of Fort Worth is trying to do something about it, proactively and correctly (emphasis mine):
MedStar program sends paramedic to homes of some repeat callers before they dial 911 | Fort Wor…
FORT WORTH — Last year, MedStar was called more than 800 times by 21 people.
Those “frequent fliers” weren’t necessarily facing life-threatening emergencies. Some may have needed primary care but didn’t have a regular doctor or transportation. Read more »
*This blog post was originally published at GruntDoc*
