The Medical Cartel is Keeping Health Care Costs High

Watch "The Big Heist," a satyrical documentary about our broken healthcare system

In 2010, the small town of Collegedale, Tennessee had the dubious distinction of having the highest prevalence of Type II Diabetes in the world. Without a single endocrinologist in the small town, those suffering from this preventable and treatable form of the disease were unable to gain access to the treatment they needed.

Dealing with this issue firsthand, a local employer who operates a donut manufacturing plant decided to dedicate a portion of his warehouse to be used as a health clinic. By hiring an endocrinologist from Chattanooga to travel to his warehouse a few days a week, his employees were finally able to receive the help they so desperately needed.

The employer reasoned that the prices associated with the hiring of an endocrinologist were actually less costly for the company than the insurance expenses related to the disease.

The donut maker’s free market solution solved the problem of constrained supply of medical professionals for his employees. But this disconnect between supply and demand exists far beyond Collegedale. In fact, the country is experiencing a shortage of doctors in virtually all specialties and every state, which begs the question, where are all the doctors?   Read More …

Get the Health Incentives Right

Fixing our broken healthcare system, reducing costs, and improving care all comes down to getting the objectives and health incentives right.

Motivation - Fixing our broken healthcare system, reducing costs, and improving care all comes down to getting the objectives and health incentives right. This post is based on a comment I made when Pritpal Tamber called for “Creating a parallel system to health care” in MedCity News back in 2014.

At least for consumers, Modern Health Talk (www.mHealthTalk.com) can already be called the “Institute for New Health Thinking,” with well over 100 articles on Legislative, Public Policy, and Health Reform topics written for consumers, and over 700 on modern health topics in general.

I personally think fixing our broken healthcare system all comes down to agreeing on objectives and getting the INCENTIVES right, as I wrote five years ago when proposing a hybrid, public/private model of health care. The goal then was to exploit the different incentives of (1) capitalism and private sector organizations that measure success in business terms such as profit, ROI, and payback period, contrasted with (2) the public sector, which measures success quite differently and over much longer time periods.  Read More …

Politics and The Modern Killing Fields

Politics and The Modern Killing Fields

I begin with this widely shared Facebook post by Dr. Wallach that calls out unscrupulous doctors, and I follow with my perspective of the modern killing fields caused by public policy.

THE KILLING FIELDS…. Dr. Joel Wallach

“The United States had lost 56,000 military personnel in Vietnam over a ten-year period, for an average of 5,600 per year. Millions of people poured out into the streets to protest these lost lives. We had political anarchy for the last three years of the Vietnam war because of these deaths. And because of these deaths, God forgive us, we shot and killed American students at Kent State in Ohio, who were just exercising their First Amendment rights to free assembly and free speech. YET NO GROUP WAS OUT MARCHING IN THE STREETS WITH PLACARDS PROTESTING THE KILLINGS BY THE MEDICAL PROFESSION. Read More …

Fixing Healthcare – Searching for a Healthcare Unicorn

Fixing Health Care is more than Searching for the Healthcare Unicorn

By Brian Holzer MD, MBA, President, Kindred Innovations

[This blog post, originally published on LinkedIn, is based on my personal view and does not in any way reflect the opinions of the current organization I work for].

Last week I came across the article titled, “Cuts threaten rural hospitals hanging on by their fingernails” which reported that 673 rural hospitals were at risk of closing. The data came from the Chartis Center for Rural Health, which also cited that states including California, Oklahoma, Louisiana, Alabama, and Georgia were most at risk with as many as 79% of their rural hospitals facing possible closure.

Reports like these that imply an impending doom of the healthcare system, as we know it are almost a daily event. And the sensationalism of healthcare by politicians and the media only adds further distractions to a system that is starving for patience and unbiased pragmatism. There is also no shortage of articles professing solutions that say nothing more than we need to 1) create a system that ensures that everyone has access to health insurance; and 2) make sure that we contain the huge cost increases.

The real problem we are facing as a society is that Healthcare is a Unicorn…Healthcare is not the same as other markets. There is a widespread lack of transparency about both the costs and the effectiveness of treatments, and many other details that a customer or end consumer might use to make purchasing and utilization decisions in healthcare. If life were as simple as it is often taught in business school classrooms, fixing Healthcare should be as easy as learning from other industries and adopting best practices. So, let’s [apply lessons from] two industries-airlines and auto insurance. Read More …

Republican Sabotage of Our Health Care System

U.S. Congress sealDemocrats in the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions recently released a report warning that Republican actions are causing uncertainty in health insurance markets that is resulting in higher premiums and insurers pulling out.

A Manufactured Crisis: Trump Administration and Republican Sabotage of the Health Care System is summarized here with quotes from insurance companies and regulators across nearly 20 states. Read More …

Trumpcare will kill more Americans than Terrorists have

Trumpcare protesters say, "We need Care, not Chaos."

Today I commented on The Senate’s Trumpcare Bill Will Kill 50 Times More Americans Than Terrorists Have. This FORBES article frames the issue in a way that puts the large numbers in perspective.

According to the bipartisan Congressional Budget Office, “15 million people losing insurance translates to at least 18,000 preventable American deaths.” If Republicans simply repeal Obamacare instead, 38,400 would die – or 100 times more than Terrorists have killed. Do I have your attention yet?

My Comment:

Forget politics and ideology for a moment, and look at healthcare from a business perspective, but ignoring the spin of the industry itself. To improve profits, you can either cut costs or increase revenue, or do both. Read More …

A Single-Payer Healthcare System for All Americans

KISS - Keep It Simple, Stupid

K.I.S.S. – Keep It Simple, Stupid. (I got this cartoon on Facebook and decided to share.)

For most of us, getting healthcare in this country is way too hard, as the video at the end shows. So to those in Congress who would make it even harder, I say, “Keep It Simple, Stupid,” with a single-payer healthcare system for All Americans. Read More …

Let’s Change the way we see Health Care

Rather than a Wall, America needs to build a Giant Mirror to reflect on what we've become.

Rather than argue over who pays for what and who gets health insurance or access to care, and who doesn’t, maybe we need to step back and ask different questions, starting with…

“Is basic health care a human right, or is it an earned privilege?”

And if people can’t afford it, does that mean they aren’t working hard enough, aren’t determined enough, or are just Losers and don’t deserve it? Read More …

When Caregiver Robots Come for Grandma

Failing the Third Machine Age: When [Caregiver] Robots Come for GrandmaWhen Robots Come for Grandma is a long and thought-provoking article by Zeynep Tufekci, published in 2014. It builds a case against “caregiver robots,” arguing that they are both inhumane and economically destructive. She got me thinking, and I hope this has the same effect on you.

I would have liked to add my own perspectives and contrarian view with links to related articles here at Modern Health Talk. I’d start with Will Robots Take Over in Health Care? Unfortunately there was no space to add comments, so I use her article as a basis for mine and hope you’ll share your thoughts in the space I give below. Read More …

People Like the ACA, so it’s hard to Repeal. Here’s why.

It’s not surprising that so many people like the ACA (Affordable Care Act), and that it’s been difficult for Republicans to repeal.

ACA (Obamacare) versus AHCA

Here are 12 reasons people like the ACA (also known as Obamacare), along with detail in supporting charts that compare it with the Republican’s American Health Care Act (AHCA). Most of this work is attributed to The Century Foundation.

1.  The uninsured rate across all ages and income levels has fallen to the lowest level on record, thanks to the ACA’s health insurance exchanges, Medicaid expansion, and other provisions.

Read More …

Ask the Right Questions about Healthcare

Politicians Need to Ask the Right Questions about Healthcare (Photo credit: SupremePatriot.com)

By Wayne Caswell, Founder of Modern Health Talk

Politicians Need to Ask the Right Questions about Healthcare

In Healthcare: Mandatory Coverage or Universal Access?, Dr. Josh Luke presents one perspective – that of a hospital CEO. Readers should know that he represents the medical industrial complex, which also includes insurers, drug companies, equipment providers, and testing companies. Their collective interest is to protect the perverse profits that come from illness and injury, and the fee-for-service incentives that encourage ongoing treatment of symptoms. I found Dr. Lukes’ framing of the healthcare issue too partisan, so I had to respond. My responses form the basis of today’s posting.

What’s the DIFFERENCE between Universal Healthcare and Universal Access? Republican politicians have promoted Universal Access, confusing it with Universal Healthcare. Access, however, only means you can get health care if you can afford it. That’s like having the ability to buy a luxury yacht or summer home, but only if you have enough money to afford it. Progressives instead want Universal Healthcare, a concept I endorse here at Modern Health Talk. It’s efficient and what other advanced nations have. So let’s reframe the issue by asking different questions.  Read More …

American Health Care Act, a Summary & UPDATE

 

By Wayne Caswell, founding editor

UPDATE 3/24/2017 — Not enough Republicans agreed to pass the American Health Care Act, which would repeal much of Obamacare and kill thousands of Americans by leaving them without health care, so they pulled it.

UPDATE 3/24/2017 — Republicans in the U.S. House of Representatives scheduled a critical vote today but could not secure enough votes within their own party to pass the American Health Care Act. So Speaker Paul Ryan and and President Trump decided to pulled it. The bill to partially repeal Obamacare would partially fulfill a campaign promise and give tax breaks to wealthy benefactors, but it would also steal from the Medicare Trust Fund, gut Medicaid, and result in the deaths of Americans by leaving them without health care. Pulling the bill was a better option than facing angry constituents, 85% of whom were against it. Read More …

Healthcare as Public Utility

healthcare as a public utility - image of health care practitioner with handheld mobile deviceComputing functions once associated with PCs are moving back to big servers in the Internet Cloud, leaving mobile client devices to handle the user interface (UI) but not the data storage and analysis. I find this shift especially interesting, having grown up in the mainframe world at IBM as computing functions moved to PCs.

In the case of speech recognition and Apple’s SIRI artificial intelligence, even the UI function is now split between client & server. This has huge implications for healthcare, with IBM’s Watson and AT&T’s analytics engine aimed at different parts of the healthcare problem.

The networked mobile device (phone, tablet, etc.) will serve as a health gateway between a host of medical & environmental sensors and cloud-based services that collect & analyze the collected data. The benefits will not just target individual patients but be applied across large populations.

Read More …

Why Republicans Want to Repeal Obamacare

Robert Reich on Why Republicans want to Repeal Obamacare

Here’s what Reich says about an Obamacare repeal:

  • 32 million people will lose coverage, [23M-24M if replaced with Senate or House versions, per CBO]
  • Tens of thousands of American’s will die as a result (over 50 times as many as killed by terrorists),
  • Medicare and Medicaid will be left in worse shape, and
  • The rich will get richer in a massive redistribution of wealth.

Missing from this list, and discussed after the video, is what appears to be racist resentment of having a black President in the White House, no matter how qualified. Repeal is also pragmatic, because it helps Republicans contain a demographic shift works against them and maintain control of Congress, the Presidency and the Supreme Court. Read More …

Influencing Healthcare Policy – Lobbying, Incentives & Insurance

Benjamin Franklin is credited as saying, "An ounce of prevention is worth a pound of cure," but policymakers seem more influenced by the money he's pictured on.

Ben Franklin said, “An ounce of prevention is worth a pound of cure,” but policymakers seem more influenced by the money he’s pictured on.

By Wayne Caswell, Founding Editor, Modern Health Talk

As President Trump’s administration transitions from the Obama era, a conservative ideological shift will influence healthcare policy, but so will other factors. They are discussed here, based on my response to “The Past, Present and Future of Healthcare Policy” at ReferralMD.

Influencing Healthcare Policy

Although The Patient Protection and Affordable Care Act, more commonly known as ObamaCare, has flattened the curve to the lowest annual cost increase in decades, it still has not reduced overall costs for many reasons. These include (1) special interest lobbying to protect industry revenues & profit, (2) misaligned incentives, and (3) an insurance middleman that adds more cost than value. It is unlikely that any “repeal and replace” strategy can live up to Trump’s promises because of these three factors. Read More …

US Healthcare System has Cancer. Can Trump Fix it?

By Wayne Caswell, founding editor, Modern Health Talk

Dr. Sudip Bose says, "The epicenter of health care is the doctor-patient relationship."

Opening his January 16, 2017 Huffington Post article, Dr. Sudip Bose said, “One thing is certain about the future of Obamacare, and that is that it will change under a Donald Trump presidency.“ Given his public statements, Trump will clearly make sweeping changes sooner than later, but what those changes will be is anything but clear. That’s why today’s article describes what I hope for, if not what I expect.

The US healthcare system has cancer – a malignant form that started way before Obama became President, and it has taken decades to grow to its current condition, where our very existence is threatened. It’s my hope (remember Hope & Change?) that healthcare reform under Trump will not just treat the symptoms of a growing healthcare cancer, like the lack of insurance competition or price transparency. I hope Trump will recognize the need to treat our healthcare system’s cancer aggressively, naturally and holistically. Will he? Read More …

Universal Healthcare Opposition

Obamacare Protest Sign shows Universal Healthcare OppositionWhat is REALLY behind universal healthcare opposition? It’s the fear of helping “LOSERS”

I felt compelled to comment on this article in MedCity News. The article said FEAR was a dominant reason some Americans find it so hard to support the kind of universal healthcare that all other advanced nations have. The dark side of this belief is that “Nobody wants to pay for FREE healthcare for anyone who doesn’t work hard enough, doesn’t have enough determination, or is a Loser” and doesn’t deserve it. The US stands out in this regard, since we are the ONLY one among the 33 advanced nations that does not provide universal healthcare.

While these other countries see healthcare as a basic right and thus a social responsibility, in the U.S. it doesn’t seem to matter whether these ‘losers’ are old people or little kids, are people who lost their jobs, are people with serious health problems through no fault of their own, or are people bankrupt by a serious injury. Those who are afraid to help ‘losers’ speak of defunding the government or killing Obamacare, with no apparent concern that the OECD reports that 17% of US households live below the poverty line, or that they can’t afford healthcare and have an average lifespan 20 years less than those in affluent neighborhoods on opposite sides of the same town.  Read More …

Corporate Behavior and Rising Health Care Costs

As the dust settled from the Supreme Court ruling on the Affordable Care Act (aka Obamacare), one of my LinkedIn groups got into a debate about what it all means and what needs to happen next. I got such a positive reaction from one of my comments that I thought I’d share it here, followed by details of the documentary I mentioned.

My Comment

The aging population adds significantly to healthcare costs, but that’s a global problem and not specific to the US, so what is it about our nation that makes our healthcare system the most expensive in the world by far and without the positive outcomes to justify it?

As a consumer advocate, I believe our problems are rooted in our politics and societal beliefs and find it quite telling that, according to the HBO documentary “The Weight of the Nation,” public health officials can accurately gauge one’s average weight and BMI by zip code. It’s also telling that longevity in poor neighborhoods can be over 20 YEARS LESS than in affluent neighborhoods on the other side of the same town. Watch the video and see the stats at http://www.mhealthtalk.com/2012/06/americas-obesity-epidemic-a-big-problem-updated/.

I especially feel for children born into poor families or the “new poor” that were once middle-class families, but where the parents lost their job and/or home at no fault of their own, got hit with a health emergency, and have since burned through any retirement and capital investments they once had. Poor families often have:

  • Less access to healthcare, even from pre-birth,
  • Less access to affordable and nutritious foods,
  • Less exercise opportunity, with fewer places to safely play,
  • Inferior public schools (college seems out-of-reach),
  • Fewer job opportunities, and
  • Less say in government.

Read More …

Envisioning the Future of Health Care

Envisioning the Future of Health Care

At the end of each New Year, it seems everyone has a list of top trends, as Dr. Meskó did in The Most Exciting Medical Technologies of 2017.

MORE PREDICTIONS: I too have made predictions (http://www.mhealthtalk.com/101-minitrends-in-health-care/) and often point to the hidden opportunities that lurk at the intersections of MiniTrends. Most futurists miss those if they just extrapolate obvious trends without factoring in the many market accelerators and obstacles that determine how quickly a preferred version of the future appears. Read More …