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, 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

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 (original here)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


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.

Fixing the Primary Care Crisis

Available in print form on for $14.95As 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 …

Wealth Inequality, Healthcare and the Economy

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.

Read More …

Insurance Cost = Premiums + Deductibles + Copays

Obamacare Enrollment Drive

MIAMI, FL – FEBRUARY 05: Aymara Marchante (L) and Wiktor Garcia sit with Maria Elena Santa Coloma, an insurance advisor with UniVista Insurance company, as they sign up for the Affordable Care Act, also known as Obamacare, before the February 15th deadline on February 5, 2015 in Miami, Florida. Numbers released by the government show that the Miami-Fort Lauderdale-West Palm Beach metropolitan area has signed up 637,514 consumers so far since open enrollment began on Nov. 15, which is more than twice as many as the next large metropolitan area, Atlanta, Georgia. (Photo by Joe Raedle/Getty Images)

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?

“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.

Read More …

White House Healthy Aging Policy Brief

White House Conference on AgingHealthy 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 …