Subject: Jail versus Nursing Home

Jail versus Nursing Home

By Patrick Joseph Roden, PhD at aginginplace.com LLC (original at AginginPlace.com)

One of the many lessons that one learns in prison is, that things are what they are and will be what they will be. (Oscar Wilde)

My colleague, Emory Baldwin AIA, sent this thought-provoking piece his father shared with him; after contemplating the merits of institutional living. This will get you thinking about how society treats its “interned.”

Subject: Jail vs. Nursing Home

FOOD FOR THOUGHT: Let’s put the seniors in jail, and the criminals in a nursing home. Read More …

Presidential Report on Independence Technology

Independence TechnologyIn an 80-page report issued this week, the President’s Council of Advisors on Science and Technology (PCAST), made several recommendations to address America’s aging population with independence technology. They include:

  • mHealth innovation,
  • remote patient monitoring,
  • telehealth expansion and reimbursement,
  • broadband access for seniors,
  • more sophisticated wheelchairs, and even
  • home designs for sustained independence.

What follows is a highlighted extract from the report’s Executive Summary. Read More …

HEALTH or SICK Care?

 

Health or Sick Care

Dr. Sachin H. Jain wrote a good article in Forbes calling for Redesigning Health Care to Meet the Needs of Our Sickest Patients, and I’m publishing my response here.

“While I understand the need to improve care of our sickest and most frail elderly patients, my view conflicts with that of the medical industry, which we mistakenly call the “healthcare” industry.  Read More …

Will 2016 see connected health transformation?

Will 2016 be the year of connected health transformation? That was the topic of a LinkedIn discussion that I weighed in on with the following comment.Digital Mind

Domain experts often make bad predictions (see http://mhealthtalk.com/cazitech/home/favorite-quotes/). Better is to hire futurists who look at many scenarios, extrapolated trends, R&D status, patent portfolios, hiring patterns, and market accelerators & inhibitors to understand what levers can help clients encourage a “preferred” version of the future. A better question is, “WHAT health transformation do you WANT to occur in 2016, and how do you get that?”

DRIVERS include public policy and consumer awareness that our profit-driven, fee-for-service model is broken. Add the “potential” of cutting spending in half (We spend twice that of other advanced nations) while also improving outcomes (We live sicker & die younger). That $1.5 trillion per year savings could help reduce the debt, lower taxes, fix infrastructure, or fund education and other public investments. While other policy decisions may save billions over 10 years (results not realized while politicians are in office to take credit), true health reform can save trillions EVERY year a politician is in office, a huge incentive. BUT, there’s a catch.

INHIBITORS include the corrupting influence of big money in politics and the fact that the medical industrial complex (hospitals, insurers, drug companies, testing companies & equipment providers) spend twice as much the military industrial complex on lobbying to protect their $3 trillion annual revenue, which is 18% of GDP. Overcoming that resistance requires a strong public outcry. Will that happen in 2016?

I have dozens of articles on this topic at Modern Health Talk, but the most relevant to this discussion include:

Transforming Our Flawed Healthcare System

Data shows how most of healthcare’s inflation has resulted from increased administrative spendingData shows how most of healthcare’s inflation has resulted from increased administrative spending.

According to a Forbes article by Dave Chase, “The current U.S. healthcare system is a deeply flawed and wasteful system that has caused enormous damage to our economy and society. It has decimated household incomes, retirement accounts, education budgets, government services budgets, and more. It’s estimated that nearly half of all spending in the current healthcare system is waste. However, a generational transformation is happening right now to change this system.” Read More …

Chipping Away at Healthcare Special Interests Yet?

Is it just “One Step Forward and Two Steps Back?” or is something bigger happening?

Last week I read an excellent article in Huffington Post by Charles Francis, and it inspired today’s post about public interests versus special interests. In this article I’ll reflect on the healthcare progress consumers are making despite politicians working against them. But first, more on the obstacles we face.

Special Interests Pull Puppet Strings

In How Mindfulness Meditation Can Transform Health Care, Charles examines the need to change consumer behavior toward healthier lifestyles, so I thought about the role of incentives and awareness education. I’ve written about that before, but today I’ll take a broader look at the many factors influencing the health and productivity of our nation’s workforce and why I remain guardedly optimistic that we’ll overcome political corruption. Included are links to many related articles and this list of over 130 past articles on healthcare policy. Read More …

Texas has the Highest Uninsured Rate

Uninsured Residents - Red States versus Blue StatesThe data is in from a WalletHub analysis of 2015’s States with the highest & lowest uninsured rates, and as an Austin resident, I’m again embarrassed to say that Texas has the highest uninsured rate.

Having insurance is vital to the health of your family and your wallet. It can significantly reduce your out-of-pocket medical expenses, the leading cause of personal bankruptcy in the U.S. Today, however, 11.7 percent of all Americans — many of whom earn a low income — remain without coverage.

For the second year in a row, WalletHub’s analysts drew upon the most reliable data to estimate the rates of uninsured pre- and post-Obamacare for the 50 states and the District of Columbia. For a broad perspective of those rates, they broke the national figures down to the state level and other categories, including age, race and income level. A summary of their findings are included below. Read More …

Proposed Legislation to Make Homes Accessible

The City of Austin last year passed a law requiring all new homes be more visitable and accessible to people with mobility disabilities. Now U.S. Representative Jan Schakowsky has introduced a bill that would do the same nationally, at least for homes built with federal dollars. Maybe someone will amend it to catch up with where Austin has been for nearly two years now. Let’s hope so.

Eleanor Smith Inclusive Home Design Act Will Make Homes Accessible

Wheelchair Lady doing LaundryBy Jan Schakowsky, U.S. Representative for Illinois’s 9th congressional district (original on Huffington Post)

9/28/2015 — Today, I introduced the Eleanor Smith Inclusive Home Design Act, which would require new homes built with federal dollars to meet accessibility standards — including a zero-step entrance, wheelchair accessible doorways and bathrooms, and climate controls that are at a height reachable from a wheelchair. Above, I announced the introduction of this legislation to advocates at a Rally with the National Council on Independent Living. They support the legislation. Read More …

Consumers Screwed with Insurance Loopholes

Insurance Loopholes & Master Pricing:
How Surprise Medical Bills Knock Consumers Down

Medical Records (photo courtesy of CX2)

Most of us know which local hospitals and doctors are covered by our insurance providers, but even when we make sure that we only see an in-network physician or surgeon, nearly one-third of privately insured Americans are still hit with higher-than-expected medical bills, often because their in-network hospital brought in or contracted out to an out-of-network service provider. How did we get to the point where so many consumers have so little information about what to expect when their hospital bill arrives? (read full article)

Consumers Screwed with Insurance Loopholes

As explained in this excellent article, even though Obamacare intended to address rising prices by promoting prevention, price transparency, and competition among payers & providers – and there has been progress – the system remains hopelessly complex and in need of serious and more aggressive reform.

I’m more convinced than ever that we need to move toward a single-payer system like Medicare-for-All, modeled after other nations that pay half as much and have better outcomes. Meanwhile there may be a role for the new Consumer Protection Agency, because complexity always allows the greedy to find loopholes and screw consumers, while it makes it more difficult for consumers to protect themselves. But if we rely too much on that, the agency could grow immense.

Most consumers, I think, are willing to assume more personal responsibility and Want to seek the best value in care, but that’s difficult to impossible under America’s current and convoluted Sick Care system, which has perverse incentives to view patients as paying customers and treat their symptoms, thus keeping them coming back, paying.

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.

Read More …

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 …

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.