This was a rather comical organizational chart that I ran across on a congressman's website. While pretty ridiculous, it is worth a laugh. This is apparently being circulated among Republican congressional leadership as a visual representation of what those Democrats are up to in their government takeover plans.
Enjoy: http://fleming.house.gov/uploads/Org%20Chart%20of%20Dem%20Health%20Plan.pdf
Sunday, October 11, 2009
Thursday, October 8, 2009
The Decline of The Professional??
In reference to our discussion on Wednesday (10/07) about the changing dynamics of the health care profession, here is the NY Time's article discussing the changing public opinion of The Professional that has possibly contributed to those dynamics.
http://www.nytimes.com/2008/01/06/fashion/06professions.html?scp=4&sq=Profession&st=nyt
One particular paragraph sums up one opinion on the shift: "This decline, Mr. Florida argued, is rooted in a broader shift in definitions of success, essentially, a realignment of the pillars. Especially among young people, professional status is now inextricably linked to ideas of flexibility and creativity, concepts alien to seemingly everyone but art students even a generation ago." If definition of success is the ability to be flexible and creative, then I think that the Professional can still be viewed as an icon of success - it takes more than an understanding of physiology to be a good medical practitioner, in fact, I've heard medicine referred to as an art form as much as it is referred to as a science. That being said, maybe it's not only a shift in the ideals of success that have led to a decline of The Professional....
Thoughts?
CBO and the Healthcare Plan
I found this to be an interesting contemporary article regarding the use of policy analysis. We don't hear about the Congressional Budget Office (CBO) very much in the news, or in our day to day lives, but when they give support to a bill, or champion a legislators belief or value system, it is touted as a triumph.
If the CBO found that the plan would not have decreased the deficit, or if it was found to increase the deficit slightly with the same coverage estimates, do you think it would be a NYT newsworthy article? Do you think it would still be championed by the Dems,? Do you think it would actually have any impact on legislative process or decision-making regarding the Baucus Plan itself?
http://www.nytimes.com/2009/10/08/health/policy/08health.html?_r=1
If the CBO found that the plan would not have decreased the deficit, or if it was found to increase the deficit slightly with the same coverage estimates, do you think it would be a NYT newsworthy article? Do you think it would still be championed by the Dems,? Do you think it would actually have any impact on legislative process or decision-making regarding the Baucus Plan itself?
http://www.nytimes.com/2009/10/08/health/policy/08health.html?_r=1
Wednesday, October 7, 2009
NPR Series called "Health Care: Are You Covered?"
Here is a shout out to all you NPR fans out there!
I was listening to NPR yesterday morning and heard another story from their series called "Health Care: Are You Covered?"
I have realized over the past few weeks that I have been listening to these stories with great interest, so I wanted to share them.
The series is a set of personal stories from people all over the US about how they pay for health care costs for themselves and their families. It covers stories of people from the uninsured to people who have the best coverage one could ask for.
This website is where you can go to just listen to a few people and read their stories:
http://www.npr.org/templates/story/story.php?storyId=112867626
I think something like this is a good way of getting people's personal stories out there, for others to relate to and learn from. Let me know what you think!
I was listening to NPR yesterday morning and heard another story from their series called "Health Care: Are You Covered?"
I have realized over the past few weeks that I have been listening to these stories with great interest, so I wanted to share them.
The series is a set of personal stories from people all over the US about how they pay for health care costs for themselves and their families. It covers stories of people from the uninsured to people who have the best coverage one could ask for.
This website is where you can go to just listen to a few people and read their stories:
http://www.npr.org/templates/story/story.php?storyId=112867626
I think something like this is a good way of getting people's personal stories out there, for others to relate to and learn from. Let me know what you think!
Monday, October 5, 2009
Eveeryone in the US has been looking for new models of health care systems for a long time. Journalists alternately cling to and tear apart systems in various countries while academics and analysts write whole tomes trying to draw lessons applicable to the USA. Just when it seemed we'd run out of countries (Britain, Canada and France are such old news, and Cuba's politically off-limits), Switzerland started getting more attention.
On Sept 30th the NY Times ran an article about the benefits of the Swiss health care system and how perhaps they could provide answers to the US (http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?_r=1&ref=health). Other news agencies have been and are running similar stories (Here's NPR's from July 08). The gist of the argument is that the Swiss are managing to insure the entire population using only private insurance companies. Competition is maintained, coverage is mandatory and everything runs more or less smoothly, or so it seems. The NY Times quotes Regina Herzlinger, Harvard Business School professor, as saying, “What I like about it is that it’s got universal coverage, it’s customer driven, and there are no intermediaries shopping on people’s behalf. And there’s no waiting lists or rationing.” Outcomes are quite good, with a high life expectancy (79/84 m/f - http://www.who.int/countries/che/en/) and overall satisfaction with the system is good, but how much of a utopia is it really? Some news articles touched on the ideas of high costs...both overall (While it's no USA, Switzerland's health care still costs 11% of GDP) and individually. Premiums are paid mostly by individuals and are regressive, though the government does step in to help the 35-40% of households paying more than 8% of their income to premiums. (NYTimes) Cost-sharing (copays etc) are also higher in Switzerland than other countries. But for all that, it might be worth it if the system works?
The thing is, it's not working. At least not perfectly. The Neue Zurcher Zeitung, one of Switzerland's main newspapers, ran this article today with the headline "Health Insurers have too little reserve; Premiums of 18 funds could increase in the summer." The article talks about how the private insurance companies are struggling and how at least 18 of them will most likely raise their (already very high) premiums within the next year or risk folding completely. It looks as though even this country, then, is not as much of a model as we'd hoped.
On Sept 30th the NY Times ran an article about the benefits of the Swiss health care system and how perhaps they could provide answers to the US (http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?_r=1&ref=health). Other news agencies have been and are running similar stories (Here's NPR's from July 08). The gist of the argument is that the Swiss are managing to insure the entire population using only private insurance companies. Competition is maintained, coverage is mandatory and everything runs more or less smoothly, or so it seems. The NY Times quotes Regina Herzlinger, Harvard Business School professor, as saying, “What I like about it is that it’s got universal coverage, it’s customer driven, and there are no intermediaries shopping on people’s behalf. And there’s no waiting lists or rationing.” Outcomes are quite good, with a high life expectancy (79/84 m/f - http://www.who.int/countries/che/en/) and overall satisfaction with the system is good, but how much of a utopia is it really? Some news articles touched on the ideas of high costs...both overall (While it's no USA, Switzerland's health care still costs 11% of GDP) and individually. Premiums are paid mostly by individuals and are regressive, though the government does step in to help the 35-40% of households paying more than 8% of their income to premiums. (NYTimes) Cost-sharing (copays etc) are also higher in Switzerland than other countries. But for all that, it might be worth it if the system works?
The thing is, it's not working. At least not perfectly. The Neue Zurcher Zeitung, one of Switzerland's main newspapers, ran this article today with the headline "Health Insurers have too little reserve; Premiums of 18 funds could increase in the summer." The article talks about how the private insurance companies are struggling and how at least 18 of them will most likely raise their (already very high) premiums within the next year or risk folding completely. It looks as though even this country, then, is not as much of a model as we'd hoped.
Sunday, October 4, 2009
Flying Doctors
This time around I thought I'd write about an incredible federally-funded program I learned about in Australia called the Royal Flying Doctors Service. The Service provides aero-medical emergency and primary care assistance to Australians living, and traveling, in the remote lands of the outback, many of whom make emergency calls from satellite radios provided by the Flying Doctors Service. They fly to over 660 patients per day and span an area equal in size to Western Europe.
One of the most impressive features of the Service is its focus on preventative services. Doctors, flight nurses, and other practitioners staff over 30 clinics spanning remote Australia (several thousand kilometers) offering vaccinations, checkups, and dental exams. They also provide radio or telephone consultative services 24 hours a day, which are available for emergency or routine health concerns. One of my favorite components of the program is that they extensively provide 3500 "medical chests" to isolated properties, indigenous communities, cattle stations, etc. These chests contain numerous drugs and supplies with which patients can treat themselves with telephone assistance from a nurse or doctor. They even hold regular field days to educate children and adults on how to incorporate health promotion in their everyday lives.
I toured their Central Operations office while in central Australia and it's like a well oiled machine. Their quality metrics are excellent and they have an impressive safety record. I wonder if we can use some of the values and goals of the Royal Flying Doctors Service in some of our domestic health policy considerations. We may not need airplanes to reach our remote, immigrant, or less educated populations, but I think we can learn a lot.
If you want to read about this some more, here is the site - www.flyingdoctor.net
One of the most impressive features of the Service is its focus on preventative services. Doctors, flight nurses, and other practitioners staff over 30 clinics spanning remote Australia (several thousand kilometers) offering vaccinations, checkups, and dental exams. They also provide radio or telephone consultative services 24 hours a day, which are available for emergency or routine health concerns. One of my favorite components of the program is that they extensively provide 3500 "medical chests" to isolated properties, indigenous communities, cattle stations, etc. These chests contain numerous drugs and supplies with which patients can treat themselves with telephone assistance from a nurse or doctor. They even hold regular field days to educate children and adults on how to incorporate health promotion in their everyday lives.
I toured their Central Operations office while in central Australia and it's like a well oiled machine. Their quality metrics are excellent and they have an impressive safety record. I wonder if we can use some of the values and goals of the Royal Flying Doctors Service in some of our domestic health policy considerations. We may not need airplanes to reach our remote, immigrant, or less educated populations, but I think we can learn a lot.
If you want to read about this some more, here is the site - www.flyingdoctor.net
Saturday, October 3, 2009
Making prescription drugs more affordable, or sneaky marketing tactic?
A recent article in the Wall Street Journal discussed how “a growing number of dug makers are offering [discount and rebate] coupons that help reduce out-of-pocket costs of some prescription drugs.” According to the article, the coupons are mostly for newer brand-name drugs, and they can lower or even eliminate co-pays for the drugs, depending on the insurance plan.
On the consumer advocates side, the argument is that these coupons help patients save both on drugs they are already using and on new therapies that the patients may want to try. Essentially, they view these coupons as “co-pay assistance.” The other side argues that these coupons may undercut insurers’ cost-control measures, because they may steer consumers towards brand-name medicines that aren’t on the preferred list of pharmacy-benefit plans with tiered formularies. While a coupon could eliminate the patient’s co-pay for a new, brand-name drug, the insurer still has to pay the negotiated wholesale price. This means that there is the potential that use of these coupons could “lead to higher premiums in the long run.”
Here’s the link to the article…
http://online.wsj.com/article/SB125339394529025429.html
On the consumer advocates side, the argument is that these coupons help patients save both on drugs they are already using and on new therapies that the patients may want to try. Essentially, they view these coupons as “co-pay assistance.” The other side argues that these coupons may undercut insurers’ cost-control measures, because they may steer consumers towards brand-name medicines that aren’t on the preferred list of pharmacy-benefit plans with tiered formularies. While a coupon could eliminate the patient’s co-pay for a new, brand-name drug, the insurer still has to pay the negotiated wholesale price. This means that there is the potential that use of these coupons could “lead to higher premiums in the long run.”
Here’s the link to the article…
http://online.wsj.com/article/SB125339394529025429.html
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