The other day I got an email from the salon where I get my hair cut. They wanted to let me know they're moving to a new location — a much bigger space. Uh-oh, I thought. And indeed, at the very end, the email said just what I suspected — that as a result of the bigger space, the cost of a haircut would increase $5. I’m not happy about the price increase, but I can't really blame them. They're doing what any business does: passing the cost of their higher rent onto the customer. I think health care works the same way.
Last week the Senate Finance Committee released its health care reform proposal. To pay for universal coverage, the committee’s recommendations mainly came down to pushing the cost of change back into the system. The proposal does little to fix why the costs are high to begin with. It offered no remedy for the high costs of prescription drugs (biologics can cost up to $200,000 per year); repeat billings for the same procedures (like having an MRI twice in the same month because your doctor’s don’t all know each other and talk to each other); and other issues that are plaguing health care.
See, the Senate Finance Committee's idea to pay for reform focuses on new fees on insurance companies and drug makers. This is like taxing car insurance because the mechanics and the factories that make car parts have increased the cost of fixing cars. We know who pays for everything in the end: us, the consumers.
Okay, I work for a health plan, but help me understand this: Doesn’t the Senate know that imposing a tax on health plans just makes coverage more expensive for people? Because the health plans have to pass on that cost of doing business. Sixty-one percent of private health plans are nonprofit — they don’t have a way to absorb this cost. And if the Senate thinks for-profit plans will just reduce dividends, they are not being realistic.
Would it be possible for my salon — where I love getting my hair cut — to keep their prices the same even if they're paying more rent? You know the answer.
Taxing the “messenger” of increased costs does nothing to reduce medical spending or fix the real problems with the system, plus it just makes private coverage more expensive for people. The cost problem will just continue to get bigger. That doesn’t sound like real reform to me.
Thinking about the “big picture,” what really matters? What will have a transformational effect?
Get ideas and share your thoughts at our Facebook page.
Sunday, September 27, 2009
Monday, September 14, 2009
Keeping the real health reform focus
Did you catch President Obama’s speech to Congress on health care reform last week? He gave an accurate summary of the problems people have in getting, keeping and affording insurance. He even mentioned that medical costs will swamp the federal budget. But he didn’t talk much about how to curb those costs, especially once everybody gets coverage.
And I was disappointed that when he reeled off the list of groups who were on board with reform, he left out health plans. That’s such a bummer because they were the first ones to the table, offering to reform their industry to get rid of the practices that people complain about: pre-existing conditions that prevent coverage or payment of claims.
All the insurer reforms the president mentioned were offered by the industry itself, yet he left the impression these changes are being “done to” the one part of the system that volunteered for reform.
I get it from the letters to the editor that some people think the only reform that matters is offering government insurance and/or getting rid of private insurance. But no matter what kind of coverage method we have, it’s really important to fix the whole system, not just who signs the check.
Here’s the deal: 87 cents of our health care dollar goes to doctors, hospitals, pharmaceuticals and other health care goods and services. That’s $8000 a year for each of us. Experts say maybe a third of that is wasted. That’s scary and reform has to fix that, too. So, where’s it going?
In a system of “disease care” 75 cents of each health care dollar goes to preventable chronic conditions
We use a lot of treatment that may not improve care and may expose us to risk: MRIs, CTs, etc
Quality issues can curb costs but they aren’t widely implemented, even simple ones like checklists, that reduce hospital-borne infections.
Doctors and hospitals are paid based on procedures, not better health; only last year, Medicare quit paying for “never” events like cutting off the wrong limb
Fraud takes tens of billions a year, a low estimate is 3% of all our health care dollars, from a variety of schemes: dummy companies getting Medicare funds for phantom equipment to unnecessary medical treatment.
Dollars wasted by duplication and uncoordinated care could be recovered with wide use of electronic medical records to put patient information in doctors’ hands.
Getting everybody covered is easy. Curbing costs so our country can afford it is hard. I don’t know about you, but I want to see health care reform accomplish both of these.
And I was disappointed that when he reeled off the list of groups who were on board with reform, he left out health plans. That’s such a bummer because they were the first ones to the table, offering to reform their industry to get rid of the practices that people complain about: pre-existing conditions that prevent coverage or payment of claims.
All the insurer reforms the president mentioned were offered by the industry itself, yet he left the impression these changes are being “done to” the one part of the system that volunteered for reform.
I get it from the letters to the editor that some people think the only reform that matters is offering government insurance and/or getting rid of private insurance. But no matter what kind of coverage method we have, it’s really important to fix the whole system, not just who signs the check.
Here’s the deal: 87 cents of our health care dollar goes to doctors, hospitals, pharmaceuticals and other health care goods and services. That’s $8000 a year for each of us. Experts say maybe a third of that is wasted. That’s scary and reform has to fix that, too. So, where’s it going?
In a system of “disease care” 75 cents of each health care dollar goes to preventable chronic conditions
We use a lot of treatment that may not improve care and may expose us to risk: MRIs, CTs, etc
Quality issues can curb costs but they aren’t widely implemented, even simple ones like checklists, that reduce hospital-borne infections.
Doctors and hospitals are paid based on procedures, not better health; only last year, Medicare quit paying for “never” events like cutting off the wrong limb
Fraud takes tens of billions a year, a low estimate is 3% of all our health care dollars, from a variety of schemes: dummy companies getting Medicare funds for phantom equipment to unnecessary medical treatment.
Dollars wasted by duplication and uncoordinated care could be recovered with wide use of electronic medical records to put patient information in doctors’ hands.
Getting everybody covered is easy. Curbing costs so our country can afford it is hard. I don’t know about you, but I want to see health care reform accomplish both of these.
Wednesday, September 9, 2009
Medical records: a better way
It's pretty amazing how many aspects there are to the ballooning cost of medical care. As I wrote in my last post, prescriptions are one place where we can be more savvy. Another savings area might be less obvious: the storing of medical information.
The root of the problem here is inefficient communication. Think about a time when you had to repeat the same information over and over again. Maybe you were calling your cell phone or credit card company to ask a question, and you kept getting transferred. It's frustrating, sure, and it wastes time — and we all know time is money.
For health care, the issue is medical records. How many times have you filled out forms for your medical history? We've all seen those floor-to-ceiling files of manila folders in each doctor's office. All that information is on paper, and there's no easy way to share it between different health-care providers. The result can be agonizing delays and costly duplication of tests.
Maybe your 85-year-old grandfather needs surgery. He goes to the hospital, but soon they realize they can't do the surgery because they don't have clearance from his cardiologist saying his heart can survive the strain. A few weeks earlier your grandfather went to a cardiologist, but the surgical team never received the records from that visit.
What to do? Wait? Or repeat the tests with yet another cardiologist? Two very inefficient options.
Maybe you’ve experienced this already. The doctor sends you for a test and follow-up to discuss it, but when you get to the follow-up, the test results aren’t back. So the inefficient system just wasted your time, your doctor’s time, your money and maybe resulted in the unnecessary duplication of tests.
A friend of mine recently moved halfway across the country. In dealing with the million details of her relocation, she never had time to visit all her doctors and get copies of her records. Every once in a while she remembers those files hundreds of miles away and worries that she'll have to repeat many of the same procedures again with new doctors. Another friend actually did send all her doctors the request for files to be transferred to a new doctor, but found out the hard way several years later that the files never showed up. She’s lost about 10 years of her medical history.
One study by a think tank estimated that $81 billion could be saved annually by computerizing patient records. Both the Bush and Obama administrations have pushed for the creation of a system for local hospitals and physicians to electronically share medical records, because it could save lives and money. So why hasn't it happened? True, there are upfront costs. But other perceived barriers, like concerns about privacy, shouldn't really be barriers at all. The banking industry has overcome them, which is why we can use ATMs anywhere. I can e-file my taxes and check my financial history online at a credit agency, so we know issues such as privacy, security, misplaced competition and compatibility across technology can be addressed.
A computerized system would mean doctors could immediately see lab results and read specialists' comments on their patients. It would mean that if you show up in the emergency room, your medical history is already there — your allergies, previous blood work, past Xrays and more. That sounds like a win-win for everybody, doesn't it?
What do you think? Share your ideas at our Facebook page.
— Susan with Regence
The root of the problem here is inefficient communication. Think about a time when you had to repeat the same information over and over again. Maybe you were calling your cell phone or credit card company to ask a question, and you kept getting transferred. It's frustrating, sure, and it wastes time — and we all know time is money.
For health care, the issue is medical records. How many times have you filled out forms for your medical history? We've all seen those floor-to-ceiling files of manila folders in each doctor's office. All that information is on paper, and there's no easy way to share it between different health-care providers. The result can be agonizing delays and costly duplication of tests.
Maybe your 85-year-old grandfather needs surgery. He goes to the hospital, but soon they realize they can't do the surgery because they don't have clearance from his cardiologist saying his heart can survive the strain. A few weeks earlier your grandfather went to a cardiologist, but the surgical team never received the records from that visit.
What to do? Wait? Or repeat the tests with yet another cardiologist? Two very inefficient options.
Maybe you’ve experienced this already. The doctor sends you for a test and follow-up to discuss it, but when you get to the follow-up, the test results aren’t back. So the inefficient system just wasted your time, your doctor’s time, your money and maybe resulted in the unnecessary duplication of tests.
A friend of mine recently moved halfway across the country. In dealing with the million details of her relocation, she never had time to visit all her doctors and get copies of her records. Every once in a while she remembers those files hundreds of miles away and worries that she'll have to repeat many of the same procedures again with new doctors. Another friend actually did send all her doctors the request for files to be transferred to a new doctor, but found out the hard way several years later that the files never showed up. She’s lost about 10 years of her medical history.
One study by a think tank estimated that $81 billion could be saved annually by computerizing patient records. Both the Bush and Obama administrations have pushed for the creation of a system for local hospitals and physicians to electronically share medical records, because it could save lives and money. So why hasn't it happened? True, there are upfront costs. But other perceived barriers, like concerns about privacy, shouldn't really be barriers at all. The banking industry has overcome them, which is why we can use ATMs anywhere. I can e-file my taxes and check my financial history online at a credit agency, so we know issues such as privacy, security, misplaced competition and compatibility across technology can be addressed.
A computerized system would mean doctors could immediately see lab results and read specialists' comments on their patients. It would mean that if you show up in the emergency room, your medical history is already there — your allergies, previous blood work, past Xrays and more. That sounds like a win-win for everybody, doesn't it?
What do you think? Share your ideas at our Facebook page.
— Susan with Regence
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