Posts Tagged ‘healthcare system’
Thursday, November 19th, 2009
The American healthcare system does waste money, and healthcare reform legislation could cure some of the inefficiencies. According to a Thomson Reuters report, the healthcare system wastes between $505 billion and $850 billion annually. The report notes that, “America’s healthcare system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial. That’s one-third of the nation’s healthcare bill. The good news is that by attacking waste we can reduce healthcare costs without adversely affecting the quality of care or access to care.”
According to the Thomson Reuters study:
- The paper-based records keeping system discourages information sharing and totals six percent of annual overspending.
- The overuse of antibiotics and lab tests to protect physicians against malpractice costs consumers $200 to $300 billion a year.
- Fraudulent Medicare claims, kickbacks for referrals for unnecessary service and other scams cost consumers up to $200 billion a year.
- Administrative inefficiency and double paperwork account for 18 percent of healthcare waste.
- Mistakes total $50 to $100 billion in unnecessary spending, or 11 percent of the total.
- Preventable conditions such as diabetes cost $30 to $50 million annually.
These findings help explain why American citizens spend more dollars per capita on healthcare and the largest percentage of GDP than any other developed nation. At the same time, the population is unhealthier, with high incidences of diabetes, obesity, heart disease and neonatal deaths.
Tags: GDP, healthcare cost, healthcare reform, healthcare system, President Barack Obama, Thomson Reuters
Posted in Healthcare, Hospital Systems | No Comments »
Monday, September 28th, 2009
One instructive lesson in reforming American healthcare may be to adopt the Swiss model, which is regulated by the Federal Health Insurance Act of 1994, and made health insurance compulsory for all residents. Previously, Switzerland had an American-style system, which became a national outrage when studies revealed that five percent of the population lacked any coverage.
Today, 99.5 percent of the Swiss people are insured with coverage funded by the individual who generally pays the full cost of premiums. Government subsidies are provided for the poor, with approximately one-third of all Swiss citizens receiving the subsidy. “These subsidies are designed to prevent any individual from having to pay more than 10 percent of income on insurance.” All insurance is private and physician compensation is negotiated between the insurance companies and doctors on a canton-by-canton basis.
The down side is that Swiss healthcare is expensive, with costs rising 10 to 20 percent every year. Monthly health insurance costs for a family with one child can amount to CHF 1,000 ($944). Deductibles can be adjusted, though, from CHF 300 ($283) to CHF 2,500 ($2,360). The state will help with the costs if income (married/without children) is around CHF 30,000 ($28,920) or (married/with children) around CHF 60,000 ($56,581). In those circumstances, the government pays half the cost of insurance. Options are available that will lower the monthly costs, similar to the American HMO model. In these plans, the person must consult with their physician prior to seeing a specialist.
“The mix that Switzerland represents between private enterprise and general state regulations that make healthcare accessible to everyone is really an interesting example for the United States,” said Felix Gutzwiller, a Radical Party senator and head of Zurich University’s department of public health. In Switzerland, administrative costs consume on average five percent of health insurance revenue. In the United States, it’s closer to 20 percent.
In terms of satisfaction, the World Health Organization puts Switzerland in 20th place in its rankings of healthcare systems around the world. The United States ranks 37th, sandwiched between Costa Rica and Slovenia.
Tags: health insurance, healthcare reform, healthcare system, HMO, public health, Switzerland, World Health Organization
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Wednesday, September 9th, 2009
Hospitals and medical office buildings must undergo a complete rethinking to move them functionally and architecturally from the 1970s to models that make sense for the 21st-century. Wanda Jones, healthcare futurist and president of the New Century Healthcare Institute, believes that we need to reinvent hospital design and construct linear-spine facilities that provide patients with more personalized medicine. This anticipates expansions, contractions, removal and replacement of patient towers by dividing the number of patient beds into two, three or four towers. This way, they can be incrementally changed without interrupting the others and are readily adaptable to specific programs.
In a recent interview for the Alter+Care Podcasts on Healthcare, Wanda Jones discusses the paradigm shift in terms of new technologies that will make obsolete the knowledge base on which healthcare systems, hospitals and physicians have made money up until now. Every surgical specialty will use robotics, and cures for cancer will be based on technology that has arisen out of the human genome project. The New Century Healthcare Institute is a research-and-development and educational foundation devoted to population-based planning and adaptation of the healthcare system to future conditions.
Wanda Jones on Revolution in Hospital and Office Design:
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Tags: Healthcare, healthcare system, hospital design, hospitals, linear-spine facilities, medical education, medical office, Medicare, patients, technology, Wanda Jones
Posted in Healthcare, Hospital Systems, Physician Recruitment | No Comments »
Tuesday, September 1st, 2009
Ted Kennedy’s passing deprives President Obama of a critical political ally in his efforts to reform healthcare. In his role as chairman of the Senate Health, Education, Labor & Pensions committee, Kennedy fought tirelessly for decades to reform a system that today deprives 47 million Americans of affordable, accessible healthcare coverage.
In The Guardian, Michael Tomasky notes that, “The heavens somehow conspired to make this Kennedy death, however expected it might have been, nearly as heartbreaking as those of his vigorous younger brothers. It’s not just that the great cause of the last 40 years of his life, reforming America’s healthcare system, sits at a perilous juncture, although it certainly is that, in part. But the tragic irony of the timing is even greater, because we see in the very healthcare debate that so needed his input the precarious state of the institution to which he devoted his life, and which he shaped and influenced more than probably any other senator in history.”
Kennedy, writing in the July 27, 2009, Newsweek, declared that healthcare reform is “the cause of my life”. “In 1973, when I was first fighting in the Senate for universal coverage, we learned that my 12-year-old son Teddy had bone cancer. He had to have his right leg amputated above the knee. The pathology report showed that some of the cancer cells were very aggressive. I decided his best chance for survival was a clinical trial involving massive doses of chemotherapy,” according to Kennedy.
“During those many hours at the hospital, I came to know other parents whose children had been stricken with the same deadly disease. We all hoped that our child’s life would be saved by this experimental treatment. Because this was part of a clinical trial, none of us paid for it. Then the trial was declared a success and terminated before some patients had completed their treatments. That meant families had to have insurance to cover the rest or pay for them out of pocket. Our family had the necessary resources as well as excellent insurance coverage.”
Other heartbroken parents were not able to pay for the continued treatment and that made Kennedy realize that “No parent should suffer that torment. Not in this country. Not in the richest country in the world.” So passionate was Kennedy that Americans have access to healthcare that he often paid for others’ treatment out of his own pocket when they could not afford it.
Kennedy made healthcare reform his lifelong passion, vowing “We will end the disgrace of America as the only major industrialized nation in the world that doesn’t guarantee healthcare for all of its people.”
Wherever you stand on the issue, there is no doubt that Kennedy was a great senator, a statesman that Republicans and Democrats respected and emulated. He did not live to see the healthcare bill passed, but perhaps his death will quell partisan dissension and bring us closer to a solution.
Tags: affordable healthcare, cancer, clinical trial, experimental treatment, healthcare bill, healthcare coverage, healthcare industry, healthcare reform, healthcare system, President Obama, Senate, Senate committee, Ted Kennedy
Posted in General, Healthcare, Healthcare Village | No Comments »
Monday, August 31st, 2009
President Barack Obama’s historic effort to reform the nation’s broken healthcare system has placed him at the top of Modern Healthcare magazine’s “100 Most Powerful” leaders for 2009.
Despite the fact that the Democrats are losing some steam on healthcare reform and the Republicans are looking stronger for the 2010 midterm elections, Modern Healthcare magazine has saluted the importance of President Obama’s initiative and his willingness to risk his significant political capital on the most difficult issue in America.
According to Modern Healthcare, “As the debate rages on over reform, it’s clear that the top man In this year’s list, President Barack Obama, will face many more hurdles as he works to broker deals with sectors of the healthcare industry to achieve cost savings in his No. 1 domestic priority, while herding a still-divided Congress into approving a bill that he can sign his name to and claim as a victory for his administration.”
Modern Healthcare’s top five healthcare leaders for 2009 include:
1. Barack Obama, President of the United States, Washington, D.C.
2. Kathleen Sebelius, Secretary, Department of Health and Human Services, Washington, D.C.
3. Nancy-Ann DeParle, Director, White House Office of Health Reform, Washington, D.C.
4. Max Baucus, U.S. senator (D-MT) chairman, Senate Finance Committee, Washington, D.C.
5. Chuck Grassley, U.S. senator (R-IA), ranking member, Senate Finance Committee, Washington, D.C.
Tags: Congress, Democrat, healthcare indust, healthcare reform, healthcare system, political capital, President Barack Obama
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Thursday, August 13th, 2009
If healthcare reform is to successfully overcome the realities of Washington politics, there is one problem in covering the millions of Americans who lack insurance coverage - the physician shortage. Currently, there is a 30 percent shortage of primary-care physicians, and with less than 10 percent of 2008 medical school graduates choosing that career track. When Massachusetts enacted mandates for universal health insurance in 2006, the state’s primary-care physicians
were overwhelmed. A similar scenario could occur on a national scale.
Nurse practitioners — who have advanced nursing degrees, are licensed by the state and often are allowed to prescribe medications — may fill that void because they can treat and diagnose patients at less cost than physicians. Medicare reimburses nurse practitioners at 80 percent of what they pay doctors for similar services.
Nurse practitioners are vital to healthcare reform because they focus on patient-centered care and preventive medicine. The House of Representatives has listed nurse practitioners as primary-care providers on their healthcare reform legislation bill. The profession lobbied intensely to include this legislative language so they can play an important role in a revamped health system.
“We seem to be healthcare’s best-kept secret,” said Jan Powers, health policy director for the Academy of Nurse Practitioners. Although nurse practitioners typically have less medical education than physicians, they are well trained in skills such as bedside manner and counseling. “In the United States, we are so physician-centric in our health system. But it should be about wellness and prevention, not about procedures and disease management,” said Rebecca Patton, president of the American Nursing Association.
Tags: Disease management, health insurance, health system, healthcare reform, healthcare system, medical education, medical school, Medicare, nurse practitioners, physician shortage, physicians, prevention, preventive focused, primary-care physician, wellness
Posted in General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Wednesday, July 22nd, 2009
The House of Representatives has proposed a $1.5 trillion package that would make healthcare coverage a right and a responsibility for all citizens. If passed, medical providers, employers and the wealthy would pick up the tab. The United States is the only developed nation that lacks healthcare coverage for all citizens, and approximately 50 
million people do not have access to insurance.
“We cannot allow this issue to be delayed. We cannot put it off again,” says Representative Henry Waxman, a California Democrat and chairman of the House Energy and Commerce committee. “We quite frankly cannot go home for a recess unless the House and the Senate both pass bills to reform and restructure our healthcare system.”
President Obama is promoting healthcare reform every chance he gets. In a Michigan speech about spending for community colleges, he said, “There’s going to be a major debate over the next three weeks. And don’t be fooled by folks trying to scare you saying we can’t change the healthcare system. We have no choice but to change the healthcare system because right now it’s broken for many Americans.”
Organizing for America - Obama’s campaign organization - is launching a series of 30-second television ads on healthcare reform that will air in Washington D.C., on cable networks nationally and on local stations in eight states. The ads depict ordinary citizens telling their stories about problems with the current healthcare system.
Tags: American, Democrat, Healthcare, healthcare reform, healthcare system, House Energy and Commerce committe, insurance, medical providers, Michigan, Obama campaign, President Obama, Senate, United States, Washington DC
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Tuesday, July 21st, 2009
Patrick Sweeney, M.D., spinal surgeon, inventor and owner of the Center for Minimally Invasive Surgery in Mokena, IL, believes that private 
practitioners are under enormous stress right now, primarily in terms of overhead and contracting with insurance companies and other referral sources. Dr. Sweeney says there is a strong possibility that traditional private practitioners may become a thing of the past over the next five to 10 years, given the way the healthcare system is evolving.
In a recent interview for the Alter+Care Podcasts on Healthcare, Dr. Sweeney noted that “A few powerful payers control a good share of our reimbursement market.” Reimbursement issues also are luring younger physicians to work in large hospital-owned practices — where the financial risk is limited — and in lower-pressure specialties with less legal exposure and shorter work hours. That’s bad news because it means that fewer new physicians are choosing to specialize in essential fields like general surgery, OB/GYN, ENT and neurosurgery, areas where critical shortages already exist.
To listen to Dr. Sweeney’s full interview on the challenges facing today’s and tomorrow’s physicians, please click here.
Tags: Dr Patrick Sweeney, ENT, financial risk, healthcare system, hospital-owned practices, Illinois, insurance company, inventor, Mokena, neurosurgery, OB/GYN, physicians, private practitioners, referral sources, reimbursement market, spinal surgeon
Posted in General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Tuesday, July 21st, 2009
The Republican National Committee’s (RNC) response to the Obama Administration’s and Congressional Democrats’ efforts to pass healthcare reform legislation was to sponsor a “Hillarycare revisited” fund raising effort.
The RNC warned against “Obamacare” and pointed out that the government “already run
s car companies, banks and mortgage companies. Republicans believe that the last thing the American people want is government telling them when and where - or even whether - they can get medical treatment for their families.” “Hillarycare” refers to former President Bill Clinton’s failed attempt at reforming healthcare during the 1990s, an effort led by his wife, Hillary Clinton.
Republicans like John Boehner (R-OH) have raised the specter of a “bureaucrat standing between you and your doctor.” Perhaps it’s worth considering that we currently have an insurance company bureaucrat performing the same role. Also, government administered health options are almost uniformly popular. The World Health Organization ranks France’s healthcare system as the world’s finest, contrasted to the United States, which scored 37th. The United Kingdom’s combination of publicly and privately funded healthcare ranked 18th in the World Health Organization’s survey.
Tags: American, banks, bureaucrat, car companies, Congressional Democrats, doctor, France, government, government administered health, Healthcare, healthcare reform, healthcare system, Hillary Clinton, Hillarycare, insurance company bureaucrat, John Boehner, legislation, mortgage companies, Obama administration, Obamacare, President Bill Clinton, R-OH, Republican National Committee, Republicans, RNC, United Kingdom, United States, WHO, World Health Organization
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Tuesday, June 30th, 2009
The solution to America’s healthcare crisis might just lie in deviant thinking. This is the message of Dr. Atul Gawande, this year’s commencement speaker at the University of Chicago’s Pritzker School of Medicine. Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, an associate director of their Center for Surgery and Public Health, an associate professor at the Harvard School of Public Health and at Harvard Medical School.
His concept of positive deviants identifies those communities and physicians who discover innovative ways to reduce costs and improve care to deliver better outcomes.
Gawande cites a nutritionist who spent his career attempting to reduce hunger in Vietnamese villages. This man asked villagers to identify which families had the best-nourished children to determine a “positive deviance” from the norm. The answer was that those children’s mothers did not act in accordance with accepted village wisdom had the best outcomes. Rather, they fed their children even when they had diarrhea; fed them several small meals daily rather than one or two large ones; and fed their children foods that others considered low class but were nutritious such as sweet potato greens.
In the American healthcare system, the positive deviants resist the tendency to view patients primarily as revenue streams - but as human beings. Rather, these physicians deliver high-value healthcare without focusing too strongly on their practices’ bottom lines; they neither over-treat nor under-treat their patients with extraneous but profitable tests and procedures.
To quote Gawande, “Look for those in your community who are making healthcare better, safer and less costly. Pay attention to them. Learn how they do it. And join with them.”
Tags: America, best-nourished, Boston, Brigham and Women's Hospital, Center for Surgery and Public Health, children, community, cost reduction, Dr Atul Gawande, endocrine surgeon, family, general surgeon, Harvard Medical School, Harvard School of Public Health, healthcare crisis, healthcare system, improved care, innovation, low class, nutritionist, patients, physician, postive deviance, Pritzker School of Medicine, reduce hunger, University of Chicago, Vietnamese villages
Posted in Economics, General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
