There has been a lot of interest in the Daily Beast article written by Dr Daniela Drake, about very frustrated primary care physicians (PCP.) She quoted both Dr Kevin Pho and myself. Dr Drake noted that nine of 10 doctors would not recommend medicine to their children as a career and that 300 physicians commit suicide each year. “Simply put, being a doctor has become a miserable and humiliating undertaking.” Dr Pho offered his own commentary here pointing out that “it is important to have the discussion on physician dissatisfaction….demoralized doctors are in no position to care for patients…To be sure many people with good intentions are working toward solving the healthcare crisis. But the answers they’ve come up with are driving up costs and driving out doctors.” Read More …
By Karen R. Thomas, President of Advanced TeleHealth Solutions
As incredibly innovative and efficient as telehealth is at providing greater access to care for consumers, lowering healthcare costs for both patients and healthcare systems, and improving outcomes, barriers have always existed that hinder the widespread adoption of telehealth. Yet recently, issues such as state requirement hurdles, reimbursement limitations, and a general resistance from physicians to learn and integrate new technologies into their care routines are quickly evaporating in the wake of the overwhelming proof of telemedicine’s many benefits. Read More …
Managing My Costs of Care is a well-written essay by Jay Warner.
I recommend it, because this one example shows just how easy it “should” be to cut healthcare costs in half to get down to what the rest of the world pays — for better care and outcomes — and save $1.5 trillion/year. It all comes down to getting the incentives right, because with employer-provided health insurance, Jay had no incentive (or ability) to comparison shop. Now he does.
The healthcare landscape is changing as payers pressure providers for more price transparency and seek other ways to contain costs and maintain profitability now that they can no longer cherry-pick the healthiest customers or cut them off when care gets too expensive.
Other disruptive changes include remote sensor monitoring (telemedicine) that can follow trends and identify problems earlier, remote consultations (telehealth) that can replace in-person office visits, medical tourism when it’s less expensive and has better outcomes than local surgeries, and an overall shift away from the fee-for-service insurance model. That model once served as pre-paid medical care, but now payers are starting to view insurance as protection against catastrophic illness and injury with consumers paying for the small stuff out of pocket. With that trend comes two others: (1) increased competition and (2) an increased focus on overall health and wellness, including nutrition, exercise, and sleep as it’s pillars.
A side benefit of wellness, beyond dramatic reductions in health care costs, is improved safety and performance. Restorative sleep, for example, is associated with improved alertness, attention, creativity, decision-making, focus, learning ability, mood, reaction & recovery times, and working memory, all of which contribute to better grades at school, better productivity at work and in sports, and fewer motor vehicle accidents and deaths.
Shared with permission from MEDCITY News, by Dan Verel, 7/25/2015
While much attention has been heaped on the public health insurance exchanges over the year, private health insurance exchanges “are experiencing hyper-growth” and enrollment could exceed that of public exchanges by 2017, “if not sooner,” according to Accenture. Read More …
This is Part 1 of a Series on The Crisis in Primary Care by Stephen C Schimpff, MD
The primary care physician (PCP) should be the backbone of the American healthcare system. But primary care is in crisis – a very serious crisis.
The first statement is my considered opinion and I will attempt to convince you of its truth. The second sentence is a simple fact.
Accounting for only 5% of all health care expenses, the PCP can largely control the “if and when” of the other 95% and hence can be the one to best affect quality of care and the totality of costs. This crisis limits the effectiveness of the primary care physician such that care quality is nowhere near what it could be or should be and the costs of care have skyrocketed. Read More …
Today’s short post features my response to a Forbes article by Dr. Robert Pearl, Offshoring American Health Care: Higher Quality At Lower Costs?, about the Cayman Islands, which are known for inviting coral-sand beaches, laid-back island culture and tax-free status.
Medical Tourism is a growing trend
This trend is not just in the Cayman Islands. Over 8 million people worldwide, and 1.3 million Americans, cross international borders for better and cheaper care. That trend will increase as insurers offer low-cost policies with high deductibles that encourage consumers to seek the best value in health care and lifestyle decisions. Read More …
EDITOR: Opinions of Obamacare, and whether it’s a glass half empty or half full, depend largely on one’s political viewpoint and sources of your information. Opponents of the law, including many in the medical industrial complex with lots to lose if health reform cuts costs, often cite articles hinting that it’s a failure, while proponents cite articles highlighting successes and progress. The mainstream media, in efforts to generate buzz and attention, seem to stoke the fires of controversy by avoiding the hard task of investigative journalism and simply publishing inflammatory stories fed to them by either political party without checking the facts. Then again, the official government numbers, which you can believe or not based on your politics, present a moving target. So, I’m more interested in the trends and the long-term implications and publish today’s byline article with some editorial comments added.
A Checkup on the Health of the Affordable Care Act Thus Far
By Paisley Hansen
What will be the ultimate impact–for good or bad–of the Affordable Care Act on Americans? Although it’s still too early to tell, a January 13 article by the Associated Press posted on AOL sheds some light on the health status of Obamacare thus far [2.2M through December, 2013]. Read More …
The FFS payment model was created long ago, during a time when physicians treated less-complex problems and offered only a few inexpensive therapeutic interventions. It worked back then but a significant percentage of patients today have multiple chronic conditions. Meanwhile, the number of complex and very expensive tests, medications and interventions available are practically unlimited.
Economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn’t hold true in medical care – not when the supplier also controls demand.
In health care, doctors can stimulate demand because (a) health insurance blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one.
As a result, we have seen a major increase in utilization of complex services over the past 20 years.
That’s a short extract from an important FORBES article, The High Cost Of American Health Care: You Asked For It. Everything in the article is consistent with my understanding of economics and long-held view that the problem with our healthcare system is perverse incentives in the payment model. I highly recommend it. Read More …
By Lucy Stewart, a financial counselor
for families looking to get out of debt
Forty-eight percent of middle-age adults provided support to their adult children in 2012, which is up from 42 percent in 2005, according to PewSocialTrends.org. Also up is the financial support they provide their aging parents: 21 percent said they provided some financial support to a parent age 65 or older in 2012, up from 19 percent seven years earlier.
Offering financial support to your adult children and 65+ parents does not mean that you give up your own financial plans and dreams. Family is family, but sacrificing your personal well-being won’t benefit anyone. Look for ways to cut expenses and create streams of income, and don’t assume you have to do this alone. Read More …
FierceHealthPayer.com recently published an article that looked at successful strategies to improve health care and lower costs. It mentioned
- bundled payments,
- global payments, and
- accountable care organizations.
But that’s as far as it went, so I added the following response to show other ways that the ACA and changes to the healthcare Payment system can disrupt the Deliver system. Read More …
As a member of the American Telehealth Association (Austin chapter), I too support the Telehealth Enhancement Act, however I see it as just a baby step and think much more is needed. Still, it’s a step in the right direction.
The proposed bill would modernize the Medicare program by allowing Medicare patients to be cared for remotely by a licensed healthcare provider from any state. That way, if you need medical help while on vacation, you could connect online or by phone with your own doctor back home without requiring that they be licensed in the state you traveled to. I urge Congress to adopt this bill and expand it beyond Medicare, to other federal agencies and health benefit programs.
We’ve published dozens of articles addressing that issue and have accumulated thousands of statistics in hundreds of Infographics. But today we include an important infographic that combines 12 charts created by Jan Diehm for The Huffington Post. Afterwards is a video description, a counter-point argument, and my own view of how Obamacare will address some of the issues.
Guest article by Albert Lester (editor enhanced)
Americans keep living longer. According to the CIA World Factbook, 26% of Americans are older than 55. Just more than 40% fall in the 25-54 age range, double the rate for those under age 14, and dwarfing the number of 15-24 year olds. Moreover, our population growth is less than one percent. For baby boomers, some of whom have already entered retirement, this brings an interesting question: will there be enough entitlement funds to help support them in old age, and will there be enough caregivers in the smaller generation groups that follow them to meet the demand? Read More …
By Caroline Montague
With an aging population and a generation of young adults struggling to achieve financial independence, the burdens and responsibilities of middle-aged Americans are increasing. Nearly half (47 percent) of these adults have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). In addition, about one in seven middle-aged adults (15 percent) are providing financial support to both an aging parent and a child.
Adult children, worried about costs and the loss of their parents’ independence, must make difficult decisions about the best options for care for their loved ones. Assisted living communities, such as Emeritus assisted living, allow individuals to remain independent as long as possible in an environment that maximizes the person’s autonomy, dignity, privacy and safety. These types of communities also encourage family and resident involvement. (Editor: Emeritus is one of the largest and most well known, but you can also compare facilities in your area by zip code.) Read More …
The rising cost of medical bills is a concerning issue, particularly if you are retired and are facing health challenges. As the cost of medical procedures increases, a large number of American adults are filing for bankruptcy. The high cost is expected to cause 1.7 million individuals and families to file for bankruptcy, reported Today.com. Although the numbers are troubling, it does not mean you do not have options to help improve your personal situation.
Check For Obvious Errors
Before you assume that the price given on your medical bill is accurate, read through the details and check it for accuracy. Roughly 80 percent of medical bills have an error, according to Mint.com. The errors can come from simple mistakes in inputting data, coding errors or bugs in the system. Read More …
Obamacare does so many things to give people better access to affordable, quality health care. The folks at Colorado Consumer Health Initiative just like to say THANKS OBAMACARE with this moving infographic about President Obama’s healthcare plan and how it actually helps people. Nothing is perfect, but we think there are a lot of positives that came out of this whole thing, and politicians focus only on negative talking points. ugh.
Paying health insurance can be a big financial burden. However, it is something that you need to have if you want help with the cost of medical procedures. Although it may not pay for everything, it can help to spread the cost of health care. It can seem like a lot of money disappearing each month, but you have to consider that it will cover the health costs for you and your family. There are some things that you can do though, to bring the cost down or make sure that it stays lower for longer as you age. Read More …
Most people over 65 will need some kind of help with the activities of daily living such as bathing, dressing, or moving around. The need for such help can stem from a chronic illness or the natural decline of eyesight, hearing, strength, balance, and mobility that comes with aging. It’s never too early, or too late, to start planning for long-term care.
Many people think the phrase “long-term care” refers to an insurance policy. While insurance may be part of your strategy, long-term care encompasses many other decisions. You will need to decide where you will live, how you will navigate the myriad of legal, family, and social dynamics along the way, and the many options for paying for everyday help. Though a number of government programs may help pay for some long-term care services, many people are faced with significant out-of-pocket costs.
In partnership with LongTermCare.gov, Huffington Post took a look at eleven myths that may be keeping some from planning for long-term care, and ways you and your loved ones can prepare for the future.
Myth 1: I won’t need it
About 70 percent of Americans over 65 will need some kind of help with the activities of daily living for months or years as they age. It may be due to an illness, chronic disease, or disability. But often, the care is required because of the natural decline due to aging of one’s eyesight, hearing, strength, balance, or mobility. Read More …
According to a new report from the centers for Medicare and Medicaid services, there are vast differences in how much you will pay depending on which hospital you use. Where one might charge $7,000 for a procedure, another just down the road may charge $100,000 or more for the same care quality. (see Secret Hospital Charges)
Now there are ways to find the Fair Price on your own. One is like the Kelly Blue Book of healthcare, and it’s appropriately called Healthcare Blue Book. If you’re dealing with some major healthcare procedures, it’s certainly worth checking out. It never hurts to get informed when it comes to dealing with health care providers.
In his 38-page TIME magazine special report, “Bitter Pill: Why Medical Bills are Killing Us,” Steven Brill dives into our health care system to understand why things cost so much, avoiding the more traditional question of who pays for what. What he found was both disturbing and telling. (His 3:38 min video introduction is at the end.)
His first story starts with the MD Anderson Cancer Center in Houston, a nonprofit facility of the University of Texas, as he follows a patient who had to prepay $48,900 for six days of testing just to determine his cancer treatment regimen, which could easily run half a million dollars. An analysis of the itemized list of confusing charges showed that they were inflated as much as 100 times over retail prices, even before the hospital’s leveraged buying power. Those costs were also way higher than what Medicare would pay for the same tests, procedures and drugs.
MD Anderson, with its 19,000 employees, is one of the city’s top-10 employers, and its CEO last year was paid $1,845,000. Four other hospitals in the 1,300-acre Texas Medical Center are also in the top-10. Clearly, healthcare is a big business, but who’s making the money if it’s not doctors, nurses and technicians? It’s the hospitals, insurance companies, drug companies, equipment providers, and testing companies. Read More …