Healthcare Costs are Rising Fast. Need Reforms

NEWS: 24/9/2015 – Healthcare costs are rising so fast in advanced economies that they will become unaffordable by mid-century without reforms, according to a new OECD report.

Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives finds that going over budget on health spending remains endemic in most OECD countries. Maintaining today’s healthcare, and funding future medical advances, will be difficult without major reforms that will require health and finance ministries to work together, it says.

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Population Health and Patient Engagement

Could a Population Health System Improve Patient Engagement?

That was the question asked in an article by mHealthIntelligence.com, but after asking the question they gave no place to reply, so today’s post is my response, which is also posted on LinkedIn.

Money Stacked

America arguably has the best Medical care in the world, but we really don’t have a HEALTH care system.

According to the WHO, Americans live sicker and die younger while spending twice as much as other nations on medical care. So imagine the benefits of prioritizing Population Health, along with the public policies that could/should result.

Besides just understanding what contributes to poor health (poverty, obesity, stress, sedentary lifestyles, our food supply, a toxic environment, etc.), and crafting policies to address those contributors, we would also seek to understand what contributes to good health (nutrition, exercise, sleep) and find ways to improve those, including putting in place incentives that cause behavioral change. It makes sense, because as Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.” Read More …

FDA Patient Engagement Advisory Committee

Health Tech Policy

FDA Announces First-ever Patient Engagement Advisory Committee

By: Nina L. Hunter, Ph.D., and Robert M. Califf, M.D., 9/18/2015

Although it may seem odd in retrospect, the development of new technologies intended to improve patients’ lives has largely relied upon expert opinions rather than asking patients and families directly what they consider most important.

But that’s changing. We are entering an era of “patient-centered” medicine in which patients and their care partners participate actively in decision-making and priority-setting about all aspects of health care. Americans are becoming increasingly active consumers of health care, making choices about their doctors, diagnostics, treatments, and healthcare experiences rather than simply allowing health care providers to make the decisions for them. Moreover, FDA believes that patients can and should bring their own experiences to bear in helping the Agency define meaningful benefits or unreasonable risks for certain new devices.

Today we are excited to announce FDA’s first-ever Patient Engagement Advisory Committee (PEAC). This body will provide advice to the FDA Commissioner on a range of complex issues relating to medical devices, the regulation of devices, and their use by patients. It will give FDA the opportunity to obtain expertise on various patient-related topics, with the goal of improving communication of benefits and risks and increasing integration of patient perspectives into the regulatory process. Some questions that the PEAC may discuss include where and how best to engage patients across the device development and assessment lifecycle as well as how FDA and sponsors should communicate patient preference information to patients. Read More …

Republican Alternatives To The Affordable Care Act?

What Would Republicans Do Instead Of The Affordable Care Act?

By John McDonough and Max Fletcher

A new spate of proposals from Republican presidential candidates to repeal and/or replace the Affordable Care Act (ACA) raises the important question: Given an unobstructed opportunity, what would Republicans really do with the Affordable Care Act? Would they repeal the law wholly or just in part? With what might they replace it?

Some suggest that Republican Congressional leaders only advance full repeal to placate their Party’s conservative base, knowing well that repeal cannot survive a certain veto while Barack Obama is President. In January 2017, that obstacle will vanish if Republicans control the White House and both branches of the U.S. Congress. What then? Read More of this excellent article at HealthAffairs.org.

Patient Choices in the Used Car Lot of Healthcare

Used Car Salesman

Guest essay by Chris Oldenburg [with editor’s comments at the end]

In America we love our choices. Drive by any car lot and you might see 10 models that only differ in exterior color. We also love simplicity and service. Those cars had better have a clear cost taped to the windshield right next to a list of what’s included. Read More …

Top Priorities for Fixing America’s Healthcare System

Most of what I write is in response to articles posted elsewhere, usually in the mainstream press, which is why I urge you to follow me on Twitter, Facebook or Google+, since I almost always include links to articles I find interesting and responded to. When I think my response is thoughtful enough, I’ll turn it into a blog article on Modern Health Talk as I’ve done here today. Read More …

Another Essay on Health Reform and Insurance

Why is Health Insurance So Expensive?

By Jon N. Hall, 8/13/2015 (see full article)

“If insurance actuaries could predict with certainty that every year every house in Kansas would be destroyed by a tornado, how much would a Kansan be charged to insure his house against tornado damage? … After all, insurance is a business, not welfare; businesses exist to make profit.”

American Health Care is Snake Bit
The article makes the point that insurance always costs more than paying out-of-pocket if what is being insured is a certainty, and it argues that that’s what health insurance has become – essentially prepaid medical care. It concludes by saying, “If America wants to preserve the private health insurance business, then private health insurance policies need to revert back to being ‘catastrophic insurance,’ just as in the days of old. That means we’d all be paying more out-of-pocket.

Beyond that, the author offered no recommendations, so I chimed in with my own. Read More …

A Guide for Disabled Homebuyers

Fulfilling the American Dream: A Guide for Disabled Homebuyers

Your future as a homeowner is knocking.

by Christin Camacho, PR & Content Manager, REDFIN, a next-gen real estate brokerage

Having a home to call one’s own is a giant milestone millions of Americans strive to achieve. Becoming a homeowner brings with it a sense of pride and accomplishment, but the process of becoming one can be intimidating. This is especially true for those with physical or emotional disabilities wishing to attain homeownership. Read More …

Is FaceTime HIPAA Compliant?

Is FaceTime HIPAA Compliant? 

By Jon Taylor, President and Founder of Bayon Health FaceTime HIPAA Compliance

In the first part of this series we wanted to address one of the most common questions we get asked; “Is FaceTime a HIPAA compliant solution?” If one was to search the internet for this answer, you’d come across a lot of mixed answers and confusion. FaceTime is such an easy tool to use when it comes to video conferencing, so it’s only natural for us to want to use it, but with all the rules and regulations regarding HIPAA, healthcare professionals want to make sure they are compliant. We decided to do a deep dive into FaceTime, looking for any information that not only answers this question, but gives us resourceful information to make a conclusion ourselves. In this report, we are going to cover what it means to be HIPAA compliant, how FaceTime works under the hood, and how FaceTime is currently being used in the healthcare industry. Read More …

How can we make healthcare more productive?

How can we make healthcare more productive? was the topic of a LinkedIn discussion started by Joe Flower, author of the book, “Healthcare Beyond Reform: Doing It Right For Half The Cost.” It generated some lively discussion and prompted me to respond as well.

My response to How can we make healthcare more productive?

MotivationCHANGE THE TERMINOLOGY – America has excellent MEDICAL Care, if you can afford it, but we have a horrible HEALTH Care system and desperately need to focus more on health & wellness. We spend twice as much as other nations but still live sicker and die younger, per the WHO. That means we “should” be able to cut costs in half at least while simultaneously improving care quality, patient satisfaction, worker productivity, and GDP.

START WITH EDUCATION – We now teach new doctors how to diagnose and treat illness & injury, not how to prevent it, and that feeds into our fee-for-service SICK Care system that profits from doing more – more tests, more procedures, more drugs. Little time is spent teaching medical students about public health and the pillars of health (exercise, nutrition & sleep), because that doesn’t fit into our for-profit business models. Read More …

Hooray for Obamacare! How’s it doing?

No matter your politics, you must respect a Nobel Prize winning economist when he speaks in economic terms. The following is pulled from yesterday’s New York Times editorial by Paul Krugman.

Hooray for Obamacare!Paul Krugman

“Was I on the edge of my seat, waiting for the Supreme Court decision on Obamacare subsidies? No — I was pacing the room, too nervous to sit, worried that the court would use one sloppily worded sentence to deprive millions of health insurance, condemn tens of thousands to financial ruin, and send thousands to premature death.

It didn’t. And that means that the big distractions — the teething problems of the website, the objectively ludicrous but nonetheless menacing attempts at legal sabotage — are behind us, and we can focus on the reality of health reform. The Affordable Care Act is now in its second year of full operation; how’s it doing?

The answer is, better than even many supporters realize. Read More …

Supreme Court upholds Affordable Care Act… Again

BREAKING NEWS

Supreme Court says, "ACA OK"

The U.S. Supreme Court this morning ruled on the landmark King v. Burwell case about the legality of federal insurance subsidies. In their 6-to-3 ruling they saved coverage for more than 6M Americans.

According to FierceHealthPayer, Chief Justice John Roberts said, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Here at Modern Health Talk, we applaud the Court’s decision.

Insurance Cost = Premiums + Deductibles + Copays

Obamacare Enrollment Drive

MIAMI, FL – FEBRUARY 05: Aymara Marchante (L) and Wiktor Garcia sit with Maria Elena Santa Coloma, an insurance advisor with UniVista Insurance company, as they sign up for the Affordable Care Act, also known as Obamacare, before the February 15th deadline on February 5, 2015 in Miami, Florida. Numbers released by the government show that the Miami-Fort Lauderdale-West Palm Beach metropolitan area has signed up 637,514 consumers so far since open enrollment began on Nov. 15, which is more than twice as many as the next large metropolitan area, Atlanta, Georgia. (Photo by Joe Raedle/Getty Images)

OPINION by Wayne Caswell, founder & senior editor, Modern Health Talk

This is an obvious opinion piece that I posted on Huffington Post in response to another opinion piece, It’s Not Just You — Those Health Insurance Deductibles Are Getting Scary.

MY RESPONSE:

The article was well written but misleading because it failed to acknowledge that Total Insurance Cost = Premiums + Deductibles + Copays. Instead, it focused almost exclusively on high deductibles. Read More …

Telemedicine as good as a Doctor visit?

Video ConsultationVirtual doctor visits via video conference are starting to go mainstream, with some people putting them on par with a regular trip to the doctor’s office. UnitedHealthcare, announcing that they’ll cover virtual doctor visits through American Well, Doctor on Demand, and NowClinic, is the latest to jump on the telemedicine bandwagon.

While these consultations previously would cost $40-50 per call, United members will only be charged a regular co-pay, making virtual medicine more affordable for more people. Coverage of the virtual visits will only be available only to UnitedHealth’s self-funded customers, as opposed to those with employer-funded plans, but the feature will expand next year to most members, showing just how fast telemedicine is taking off. Read More …

Is American Health Care the Best?

“Is American Health Care the Best?” The answer to that question might depend on whom you ask, but by almost all measures we aren’t even close. That was the message of this article on Vox that says people who believe our health system is the best are “measuring it wrong.” Here’s some measures we should be considering, followed by some supporting graphs and videos and my perspective:

  • Costs: America spends vastly more than any other nation, often more than twice as much.
  • Access: Tens of millions of Americans remain uninsured. Even after Obamacare, we’ll be behind.
  • Satisfaction: Patients here are less happy with their system, and nurses & doctors are too.
  • Mistakes: Hospitals are dangerous places, given the number of infections & medical errors there.
  • Outcomes: Americans live sicker & die younger. Longevity is shorter and infant mortality is higher.

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White House Healthy Aging Policy Brief

White House Conference on AgingHealthy Aging Policy Brief

 By White House Conference on Aging staff, 4/10/2015

Older Americans are calling for a shift in the way we think and talk about aging. Rather than focusing on the limitations of aging, older adults across the nation want to focus instead on the opportunities of aging. Older adults are seeking ways to maximize their physical, mental, and social well-being to remain independent and active as they age.

Healthy aging means living a long, productive, meaningful life and enjoying a high quality of life. Research has shown that older adults who adopt healthy behaviors, use preventive health services, and are involved with their family, friends, and communities, are healthier and more independent.

Remembering that we are essentially the same people we were at our physical and productive peaks, just somewhat adjusted to accommodate the years, allows us to visualize lives of possibility with an overlay of wisdom. (Molly D., Georgia)

Americans are living longer and better than ever before thanks to major medical and public health advances and greater access to health care. Life expectancy at birth in the United States has reached a record high of 78.8 years. A 65 year-old man can expect to live another 17 years and a 65 year-old woman another 20 years. With increased longevity, older Americans have more time to engage in the workforce, in civic and volunteer activities, and in enriching their communities. Read More …

Telehealth Legal Obstacles Delay Home Healthcare

Doctor Robot

DOCTOR ROBOT: Technology like this RP-VITA device at Mercy San Juan Hospital in Carmichael, Calif., lets doctors beam themselves to remote patient bedsides, but government rules need to catch up. (AP / Rich Pedroncelli)

Home telehealth” technology promises to be a critical component of providing quality care to the growing number of Americans who need long-term services and supports to “age in place” at home. Home telehealth and related technology can make it cheaper, easier and more comfortable for seniors to remain at home and avoid nursing facility placement.

But government regulations lag behind telehealth technology, according to this article in the National Law Journal. This is disappointing because “24-hour monitoring would allow Americans who need long-term care to ‘age in place’ at home.”  Read More …

Top Ways Our Healthcare System seems Evil

America is Snake Bit“A Lot Of People In This Industry Are Just Evil”
(Jeff Kushner, founder Of Oscar Health)

That provocative quote from Josh Kushner at the 4th annual Clinton Health Matters Initiative, was aimed at the healthcare industry and reported by Forbes contributor Dan Munro. Josh was one of four panelists in a 90‒minute opening Plenary Session moderated by Former President Bill Clinton.

Clinton opened by lamenting that technology adoption in healthcare can take as long as 17 years and sarcastically said, “By all means let’s wait 17 years and let people die in the meanwhile.” He then asked Josh to begin a discussion of the issue. But what’s behind his claim of excessive greed or evil? I can’t speak for Josh directly, but here are the top 10 ways our healthcare system seems evil.

Excessive greed (evil?) is natural for an industry that:

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Precision Medicine vs Prevention & Wellness

Health iconsPresident Obama and the National Institutes of Health have announced a Precision Medicine Initiative that complements other programs for Prevention and Wellness. That’s important because too many diseases don’t have a proven means of prevention or effective treatments.

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Lack of Fast Internet threatens Telehealth Future

I responded to an online discussion of a call for Congress to Expand Telehealth Services to Improve Patient Access and Outcomes and Decrease Healthcare Costs. Key to delivering telehealth is the availability of high-speed Internet access, and that prompted me to comment on an online conversation of this HIMSS problem description.

The enormous potential of telehealth or telemedicine to positively transform healthcare delivery in America is not being realized due to numerous impediments. These include out-of-date public and private reimbursement structures, inadequate broadband availability, and varying licensure and practice restrictions between some states. … In many areas of the country, there are not enough health professionals to provide in-person visits or appropriate follow up care, especially for mental health and highly specialized services like pediatric critical care. In other areas, distance or unavailability of transportation presents impediments to care.

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