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 …
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.”
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?
By Jon Taylor, President and Founder of Bayon Health (original here)
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? 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?
CHANGE 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 …
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!
“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 …
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.
As I keep reminding people, Americans spend twice as much as other countries on health care yet still live sicker and die younger, according to the World Health Organization. At $3 trillion/year, that’s about 18% of the nation’s GDP, and it’s not sustainable, especially as our nation’s baby boomers approach retirement age and start needing more medical care in their later years.
I’ve known Dr. Stephen C Schimpff (electronically) for years and have published several of his articles here on mHealthTalk. I’m happy today to promote his controversial new book, Fixing The Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor. ($3.95 for the e-book and $14.95 for the print edition)
Dr. Schimpff begins his book with an overview of what primary care is and is not, why it’s in crisis, and why the American medical care delivery system is so badly dysfunctional. He then explores the concepts of integrative medicine, trust and the all-important issue of healing. Read More …
A Washington Post article last week concluded that People have no idea what inequality actually looks like, and that caused me to respond and to enhance this article, which was published here two years ago. It features some disturbing videos that help us understand the corrupting influence of big money in politics and the direct relationships between:
- Special interest lobbying and policies resulting in a widening of income & wealth gaps,
- Between the widening wealth gaps and poverty,
- Between Poverty and obesity,
- Between obesity and diabetes and other chronic illness,
- Between chronic illness and rising healthcare costs, and
- Between rising healthcare costs and our economic problems.
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.
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 …
“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.
Healthy 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 …
“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 …
“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:
Income levels for aging Americans are increasing,
but not as quickly as “The Cost of Aging in America.”
The infographic below was produced by the Milken Institute School of Public Health at George Washington University. It explores the serious financial burdens faced by aging Americans, their loved ones, and industry — as well as steps our health care system might take to counteract this trend. I gladly feature it today to complement other articles here about health reform, public policy, and the future of healthcare.
- The number of seniors 85 and older will triple by 2050, an important statistic because these are people who need the most expensive care.
- The cost of healthcare in America is already over $3 trillion/year, and that doesn’t even include the roughly $450 billion provided by unpaid family members.
- Paid caregivers earn just $18-20K per year, and while demand for their services will likely double by 2022, their wages likely won’t increase much.
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.
EDITOR: When seniors can no longer drive a car, they lose their independence and become dependent on others for the simplest things — shopping for groceries or Christmas gifts, getting a haircut, going the bank or doctor or the movies, and more. That can be devastating and even force them into institution care, ultimately shortening their lifespan. So it’s why I’m a fan of the autonomous, self-driving car, and Google, the company that’s so far leading the way. And it’s why I’m happy to republish this article by Zachary Shahan at FIX.com about cars for seniors who can’t drive themselves.
Hands-Free Driving: Google’s New Driverless Car
One of the biggest tech stories of the year is definitely the unveiling of Google’s driverless car. The general story is this: Google is manufacturing some completely self-driving cars – no steering wheels, accelerator pedals, or brake pedals. But the details are pretty fascinating, and even more interesting are the broad societal implications. Read More …
EDITORIAL: Who are we to believe? The news media that profits from sensationalism? Or federal and public health officials who are desperate to avoid panic? What is the truth about the Ebola virus? Right now it’s not clear who to believe, and we continue to wonder, “What is the Truth about Ebola.” Here are some of my thoughts and related articles, but I invite you to respond.
With the number of Ebola cases doubling, doubling and doubling every week or two, or three; how long might it take to reach millions, or billions? Not only is the number of cases grossly under-reported, but health officials and governments are grossly downplaying the risk and misleading the people. It seems like they’re lying, and that doesn’t help, because it erodes public trust and contributes to growing fears.
HOLES IN THE SAFETY NET(s)
Even with multiple safeguards, rapid spread of horrific disease (like terrible traffic accidents) can occur. This is the thought behind the “Swiss cheese” model of risk, developed by British scientist James Reason, and described by Vamsi Aribindi, a medical student who wrote Ebola in Texas: A fascinating story of system errors (referenced article below).
Make Sure You’re in the Safest Possible Operating Room
The Hazards of Hospitals
We all think of the hospital as a place we go to get better, but hospitals in the United States are making people sicker at alarming rates. Between overtired interns, germ-covered doctors, haphazard record keeping, and equipment failures, you might find yourself in more trouble than you were when you checked in. Here are some alarming statistics, followed by some patient recommendations.
- 1.7 million infections are contracted in hospitals each year.
- 1 in 5 patients suffer harm from medical errors, and 99,000 die from them.
- You’re 30,000 times more likely to die from a hospital visit than a plane crash.
- And more die from infections each year than from car accidents, breast cancer or aids.
The simple mention of having a medical procedure brings out anxiety in most people. It’s human nature to become fearful when preparing to undergo a surgical procedure that requires in-patient treatment, sedation and operating rooms, as it is associated with pain and mortality. Read More …