As a retired IBM technologist, market strategist, futurist, consumer advocate, and founding editor of Modern Health Talk, I am please to respond to this FCC action and will describe my background afterwards. What follows is the detailed docket (16-46) with my responses inserted and key points highlighted. Read More …
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.
Computing 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.
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 (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 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 …
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 …
What 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 …
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.
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.
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 …
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 …
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 (with emphasis added), 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 …
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.
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 three times 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 …
By Carol Maher (original here)
With an estimated 100,000 health and fitness apps available on the two leading smartphone platforms, iOS and Android, it seems there is an app for everything – from tracking your bowel movements, to practising your pimple-popping technique.
However, a number of apps are starting to raise the ire of government regulators. Brain-training juggernaut Lumosity was recently fined US$2 million (A$2.7 million) for making unfounded claims that its app could improve work performance and delay the onset of Alzheimer’s. Read More …
Doctors Prescribe Single-Payer Health Care Reform
Well before Bernie Sanders entered the presidential race, a nonpartisan group of 39 leading doctors set out to fix the glaring problems in the Affordable Care Act (ACA, or Obamacare). The single-payer plan they proposed, essentially Medicare-for-All, has since been endorsed by over 2,000 physician colleagues and published in the American Journal of Public Health, according to this article in Huffington Post.
The HuffPost article generated lots of reader comments, and I just had to respond because this is the sort of debate I love to jump into. It brings together many different perspectives, especially those of consumers who too often aren’t heard from by politicians. Here’s a summary of my responses and answer to the question, “Is Medicare-for-All enough?” Read More …
The 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 …
Insurance Loopholes & Master Pricing:
How Surprise Medical Bills Knock Consumers Down
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.
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.
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 …
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.
Is FaceTime HIPAA Compliant?
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 …