American Health Care Act, a Summary

The American Health Care Act is the first part of Republican plans to repeal & replace the Affordable Care Act, also known as Obamacare.

By Wayne Caswell, founding editor

Here at Modern Health Talk, I can’t avoid getting political when it comes to healthcare. If you follow me, you know that I’ve been critical of both Obamacare and the medical industry, which spends three times as much on lobbying as the military industrial complex.

I’m all for replacing Obamacare with a single-payer system that cuts our $3.5+ Trillion/year spending in half and improves outcomes to match that of other advanced nations who provide healthcare as a right and pay half of what we pay (per capita or as a percent of GDP). Unfortunately, the American Health Care Act (AHCA) just shifts the financial burden to the poor, disabled, and elderly while giving a huge tax benefit to the wealthy. 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, [UPDATE: 24M per Congressional Budget Office]
  • Tens of thousands of American’s will die as a result,
  • 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 how Republicans can use the repeal to maintain control of Congress, the Presidency and the Supreme Court, even as a demographics shift works against them. 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 …

Disrupting Healthcare with Functional Medicine 2.0

Disrupting Healthcare with Functional Medicine 2.0

By Dr. Shaiv Kapadia, Chief Medical Officer and Co-Founder, Iggbo

The United States has the best and worst healthcare system in the world. Let me explain. If you are having a heart attack or stroke or a victim of an accident, there is no better integrated system of acute care delivery on the planet. Chronic disease, however, is a completely different story. [EDITOR: The medical industrial complex spends twice as much on political lobbying as the military industrial complex, to avoid disrupting healthcare as they know it. That’s because cutting costs to match what other advanced nations pay per capita would mean losing over $1.5 trillion/year in profits – profits that today mostly come from treating symptoms.] Read More …

Medical Marijuana Lowers Prescription Drug Abuse

Medical Marijuana Lowers Prescription Drug Abuse

Research Shows That Medical Marijuana Lowers Prescription Drug Abuse

Guest article by Helen Smith

The abuse of prescription opioids such as heroin, morphine and prescription painkillers is a global problem affecting up to 36 million people worldwide. Opioid addiction is of particular concern in the United States, with over two million people abusing prescription medications and around half a million addicted to heroin. The consequences of opioid abuse are immense; the Centers for Disease Control (CDCP) and Prevention notes that deaths via the overdose of prescription medications have risen four-fould since 1999; almost half of all opioid overdose deaths involve prescription medications. The most common medications which contribute to so many needless deaths, are methadone, oxycodone and hydrocodone. The CDC notes that around 1,000 people are treated daily in emergency rooms following the abuse of prescription drugs.

There may be a light at the end of the tunnel, though, with research showing that medical marijuana may curb the rate of prescription drug abuse. Read More …

The Big Heist – Become a Benefactor

The Big Heist, a satyrical documentary about our broken healthcare systemYou can be part of History by becoming a benefactor of The Big Heist, at any amount. This documentary-in-process is a satirical, follow-the-money film about healthcare, the status quo, and efforts to fix our broken system from the ground up.

The Big Heist blends the comedy & parody styles of ZDoggMD and The Daily Show — to entertain and educate with the goal of transforming the public’s understanding of our nation’s healthcare system, along with the causes of its dysfunction, and how to truly fix it. This has been my personal passion since founding Modern Health Talk five years ago. I’ve already published over 100 articles on different aspects of healthcare reform public polity, sharing my own technical & futurist perspective and insights, and I love hearing other viewpoints with similar aims. Read More …

Benefits and Risks of Artificial Intelligence

This image represents Artificial Intelligence, a digital mind that can learn and act on its own. According to a recent article in MedicalFuturist.com, artificial intelligence (AI) will redesign health care with unimaginable potential. The author sees great benefits, and so do I, but he dispels the risks – risks that visionaries like Bill Gates, Elon Musk, and Stephen Hawking warn against. They warn that full development of AI could spell the end of the human race, and I share that concern. That’s why I’m writing today’s article with a cautionary tone.

The accelerating pace of change

At issue is whether or not man will find ways to guard against the dangers of tech innovation accelerating exponentially and indefinitely. The questions start with, what will AI, automation and robotics eventually do to employment? Which jobs will be replaced first, and which are safe for now? What might AI do for (or to) government? I don’t share the author’s confidence and instead side with the visionaries. Here’s why. Read More …

Are Crypto-Currencies Safe?

Here's a Bitcoin - at least a representation of one since they're actually electronic

Here’s a Bitcoin – at least a representation of one since they’re actually electronic

Last week Yvonne and I closed on the sale of our Austin home and the purchase of another home in the Dallas area. The process was simpler than I remember from the past, and since we paid cash for the new home, we didn’t even need a notary. I just downloaded a few forms, signed them on the kitchen table, scanned into the computer, and sent them back to the Title Company through a secure email service. This experience foretells the future, but are crypto-currencies safe? Really safe?

The US Department of Health and Human Services (HHS) is soliciting research papers related to blockchain applications in healthcare. Blockchain is the enabling technology behind BitCoin and other crypto-currencies, and it’s catching on fast — maybe too fast. Judge for yourself. Read More …

The Future of Healthcare? It’s In The Past

The future of healthcare is impacted by the ripple effects of past developments, trends, market drivers, and market inhibitors

The future of healthcare is largely affected by politics and population health successes of the past, including vaccines, clean water, safe food, sewer systems, public education, and the environment, each causing its own set of ripples in the system. But dampening these positive effects is special interest lobbying aimed at protecting profits. (Wayne Caswell, mHealthTalk editor)

By Tim Perry, MPA, MS, CPHIMS, PCMH CCE, CISSP

Look Back to See Where We Are Going

To celebrate its 200th anniversary, the New England Journal of Medicine published an article in June 2012 titled, “The Burden of Disease and the Changing Task of Medicine“. The authors did a wonderful job of looking not only at clinical data on disease but also shed light on changes in society that affected the prevalence of diseases. A particularly interesting part of the article is a chart depicting the Top 10 Causes of Death in 1900 vs 2010. Notice the changes. Read More …

Health Care Reform – Progress and Next Steps

Obama and White House staff react to passing of the ACA.

President Barack Obama, Joe Biden and the White House staff react to the passing of the Patient Protection and Affordable Care Act (ACA, or Obamacare) on March 21, 2010.

A special issue of JAMA, The Journal of the American Medical Association, on July 11, 2016 published this summary of the Affordable Care Act (ACA), by President Barack Obama, describing successes, challenges, and next steps. JAMA encouraged current and future presidential candidates to submit their own ideas on how best to reform healthcare, so here’s my list of What to Ask Clinton and Trump.

Obama’s article, included below in its entirety, was accompanied by three editorials from Peter Orszag, former director of the Office of Management and Budget under President Obama; Stuart Butler, a senior fellow in economic studies at the Brookings Institution and former director of the Center for Policy Innovation at The Heritage Foundation; and coauthors Jonathan Skinner and Amitabh Chandra, economic and government professors at Dartmouth and Harvard. Read More …

What to ask Clinton and Trump about Healthcare?

I responded to a Huffington Post article about proposed changes to Medicare and questions that should be asked of Hillary Clinton and Donald Trump, but I went deeper into the serious healthcare issues, citing an article I posted yesterday about The Ideal Healthcare System. It referenced differences between public and private sector organizations but primarily spoke of the need to better align incentives to the nation’s health goals. Therefore, my questions to Presidential candidates relate to that larger view of health and healthcare.

What to ask Clinton and Trump about Healthcare?

What would YOU ask Clinton and Trump about Healthcare? (please comment below and share with others)

Read More …

Ideal Healthcare System is Somewhere Between the Extremes

America's Ideal Healthcare System is Somewhere Between the ExtremesKevinMD.com published a good article by internal medicine physician Suneel Dhand. He had worked under UK, Australian and American healthcare systems and brought a broad perspective to suggest that the ideal healthcare system is somewhere between the extremes. He makes good points, and I wanted to respond, but unfortunately comments are closed. That prompted me to post my response here on this blog.  Read More …

Let the Health Care Reform Debates Begin, Again

Let the Health Care Reform Debates Begin, Again

Click the image to see some of our other articles on public policy and health reform.

Editorial by Wayne Caswell, Founding Editor, Modern Health Talk

According to Forbes, House Republicans released this week a 37-page draft of their plan to “replace Obamacare and reform entitlements.” To that I say, Let the Health Care Reform Debates Begin, Again.

Even though Obamacare has slowed the rising costs of healthcare as our population ages, significantly more work needs to be done to bring our total costs in line with what other advanced nations pay, and with better outcomes. Doing that – continuing to reform health care – has the potential of cutting our $3.4 trillion/year costs in half, thus saving well over $1 trillion/year. Those savings can then be redirected to other purposes, such as lowering taxes, paying down debt, or making strategic investments in education, poverty, research, and infrastructure. The aim of such reforms is to help all Americans regardless of age, income, or socio-economic status.

But powerful opposition to true reforms comes from within the medical industrial complex that stands to lose over $1 trillion/year in revenue and so spends twice as much on political lobbying as the military industrial complex. It’s important that the public keep House Republicans from being tempted to cave into the lobbying pressure. So what should our goals be? Read More …

The Disruptive Force of Technology in Healthcare

A LinkedIn discussion of mHealth argued that, “Technology is Just a Tool. It’s Not The Solution to Healthcare’s Problems” — I couldn’t disagree more and posted this response…

Those in the Ivory Tower should worry about the disruptive force of technology in healthcareMy Editorial Opinion

Okay, Technology is not the end-all, but it’s MUCH MORE than just a tool for solving healthcare’s problems. The accelerating pace of tech innovation is a disruptive force that’s breaking business models and helping to move us away from the fee-for-service model that’s primarily responsible for Americans spending twice as much as those in other advanced nations for healthcare. (See Moore’s Law and the FUTURE of Healthcare.)

Those at the top of the healthcare mountain, especially those resisting more rapid adoption of disruptive technology, are most at risk of obsolescence. As noted in 101 Minitrends in Health Care, 429 of the original [1955] Fortune 500 companies are no longer in business today.

As medical devices keep getting cheaper, smaller, more accurate, and easier to use; more & more functions once associated with doctors in hospitals will move down-market toward consumers at home, office or wherever they are. Telehealth video calls and telemedicine sensor monitoring will extend across town, across state lines, and across international borders as payers (including Medicare) realize that medical tourism often offers better outcomes at less cost.

All of these trends will democratize healthcare, increase competition, and help move the emphasis away from sick care and toward health & wellness. As Benjamin Franklin said, “an ounce of prevention is worth a pound of cure.”