Is health care stuck in 1994?
Is the face of the new uninsured/under-insured changing?
How can technology help us?
Monday, March 17, 2008
Healthcare 2.0 and Doctor 2.0: An Interview with Jay Parkinson, MD
Wednesday, March 12, 2008
What do You Call a Doc Who Spends Enough Time with Each Patient?
From Kevin, M.D.:
"What do you call an internist who spends enough time with each patient?"(Love the first comment..."What do you call a 50-year-old obstetrician? A gynecologist!")
Poor!
Traditional Medicare is More Efficien than Medicare Advantage Plans? So Says MedPAC Chair Hackbarth
Overall, it may be true.
But the good, cost-effective, high-value Medicare Advantage plans (which often are tightly managed by virtue of a risk-sharing structure) are getting a bum rap by being lumped in with the FFS Medicare Advantage plans.
Guess what?
The fee-for-service versions of these plans aren't managed as tightly, and have more cost! It doesn't take a rocket scientist to figure this out!
From a recent MedPAC report:
"...However, most of the enrollment growth was in private FFS plans—whose enrollment more than doubled last year. Yet, private FFS plans have no requirement to coordinate care or report quality measures, and their payments and inefficiency are even greater (117 percent and 108 percent of FFS) than the MA program as a whole."
Pharmacists Help in Controlling Diabetes
At $60-$90 for a 30-minute session, I'd do it too.
Oh, but then again, I can't as a physician....I'm legally required to accept the Medicare rate (or non-rate, as payment for patient education and prevention is often denied).
The fact that the pharmacy also cashes in on the margin from selling the meds can't hurt either, huh? No Stark Laws here.
Seriously, I think anyone/everyone in the health care team must play a role in chronic disease management, so I'm happy for that. But this phenomenon is one of those un-intended consequences of a dysfunctional reimbursement methodology.
Want to Live Longer? Be White...It'll Be Alright!
Racial disparities in health care continue to be a problem.
Don Berwick has even commented on them.
In the Institute of Medicine (IOM) report, "Unequal Treatment", it's made clear that "...many people of color receive lower quality of care than whites, even when presenting with the same health problems and the same health insurance."
Why the fuck didn't the Department of Health and Human Services want to include this in their recommendations?
("Duh...Gee...I thought those people were all killed off by Katrina?")
Down with the Anti-Vaccinists!
I've said it before...
The anti-vaccinists are selfish bastards, that think nothing of leeching off of the rest of society. Belgium has taken a hard stand on this, and rightfully so, jailing Belgians that refuse polio vaccine.
Polio is a horrible disease. The World Health Organization's efforts at eradicating it started in 1988, and they've done a pretty damn good job: 99% reduction.
Both medical experts and bioethicists agree:
"...unlike other medical problems, in which rejecting treatment only affects the individual, refusing a vaccine for a transmissible disease like polio puts others at risk as well."
"Ethicists argue that people who refuse vaccinations are taking advantage of everyone else who has been vaccinated. Once the majority of a population is vaccinated, there are few susceptible people the disease can infect, thus lowering the odds of an outbreak.
People who refuse to be vaccinated are 'free riders,' Harris said. 'They can only afford to refuse the vaccine because they are surrounded by people who have fulfilled their obligations to the community.'"
So, listen up you fucking selfish dumbshit anti-vaccination cocksuckers! Just because you're rich enough to both "afford" and waste the luxury of health care in this country doesn't give you the right to potentially inflict harm on the rest of the population.
...and once and for all, despite the media bullshit, vaccines don't cause autism.
Bite me...self-indulgent assholes.
Saturday, March 8, 2008
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