Tag: "health care quality"

Headlines I Wish I Hadn’t Seen

Te1tu7pmwfxbajkvyuruhhe NSA collects 200 million text messages a day.

Electronic medical records: They don’t save money and they don’t improve quality, but they do allow hospitals to bill more. HT: Jason Shafrin.

Judge rewrites ObamaCare law to allow people to get tax subsidies in the federally run exchanges. See Background posted by Michael Cannon.

Latino (Free Enterprise) Medicine

A year old story that’s worth revisiting:

The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.

Clinicas-bodegas-1County health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide…

Visits to more than two dozen clinicas in South Los Angeles and the San Fernando Valley found Latino women in brightly colored nurses scrubs handing out cards and coupons that promise everything from pregnancy tests to tubal ligations. Others advertise evening and weekend hours, and, some 24-hour a day operations trumpet that they are “nunca cerramos” — never closed. That all-hours access — and up-front pricing — is critical, Latino health experts say, to a population that often works low-wage, around-the-clock jobs.

Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to a corner clinica, which is common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, vitamin solutions delivered intravenously and liberally dispensed antibiotics — that are frowned upon in traditional American medicine. (KHN/NYT)

High-Tech Innovations in Medicine

  • Virtual Care: Doctors in remote ‘command centers’ are increasingly keeping tabs on vital signs of patients in intensive-care units.
  • Medical Detectives: Got a hard-to-diagnosis ailment? Patients can now post their symptoms online and offer a reward for a diagnosis from a host of doctors.
  • Doctor on Demand: You can have a virtual consultation with a physician for nonemergency medical issues.
  • Personal Care: Bedside tablets let hospital patients text the nurse. Patients can check their own charts and lab results.
  • Transparency: New insurance tools let patients compare the price of care between hospitals and calculate out-of-pocket costs.

More on the WSJ.

Hits and Misses

Patieartificial-heartnt receives world’s first artificial heart.

McDonald’s tells employees to avoid fast food.

Can you get lifetime protection against the flu?

ObamaCare Christmas carol.

Moderate alcohol consumption boosts immunity.

Worm is a breakthrough for artificial life: Each cell is being simulated one-by-one, along with neuron links between them.

Headlines I Wish I Hadn’t Seen

521063-fish-oilModern day snake oil: Fish oil benefits oversold.

Massachusetts exchange having the same technical glitches as other states.

More than eight in ten U.S. cancer specialists have struggled to find the drugs they need to best treat their patients.

Britain’s NHS: Mothers were abandoned by their midwives during labour; serious hospital mistakes happen as often as five times a week.

More on the NHS: Over the last six months, there have been 37 cases of patients who received surgery on the wrong part of their body.

The Last of Life, For Which the First Was Made?

This is from a NBER Working Paper by David Cutler, Kaushik Ghosh, and Mary Beth Landrum:

Hutils-5587035ealth status in the year or two just prior to death has been relatively constant over time; in contrast, health measured three or more years before death has improved measurably…We show that disability-free life expectancy is increasing over time, while disabled life expectancy is falling. For a typical person aged 65, life expectancy increased by 0.7 years between 1992 and 2005. Disability-free life expectancy increased by 1.6 years; disabled life expectancy fell by 0.9 years. The reduction in disabled life expectancy and increase in disability-free life expectancy is true for both genders and for non-whites as well as whites. Hence, morbidity is being compressed into the period just before death.

HT: Timothy Taylor.

Would Medicare Pay for Robohand?

waldo-loves-robohandLeon McCarthy of Marblehead, Massachusetts, was born without fingers on one of his hands. When Leon was 10, his father Paul learned about the Robohand and purchased a 3-D printer to build one for his son.

Although the hand reportedly costs $500 to make, the printer required currently sells for $2,399. Even so, the Robohand is far less expensive than available finger prosthetics. Many of the Robohand’s parts can be reused when new fittings are printed as children grow. Though it not be as functional as some of the much more expensive creations available, people buying their own prosthetics are willing to trade some functionality for the Robohand’s lower cost.

Would Robohand be covered by Medicaid and Medicare? Probably not.

Medicare and Medicaid require a prescription to purchase durable medical equipment like hand prostheses. Leon did not have a prescription. He probably could not have gotten one since the Robohand is not an FDA approved medical device. His father obviously does not meet Medicare requirements for suppliers of custom fabricated and fitted prosthetic devices.

The next time someone argues that deregulation will do nothing to reduce health care costs, keep in mind Medicare and Medicaid durable medical equipment regulations, regulations that both raise costs and act as a competitive deterrent to people who might have ideas for products like the Robohand.

Is There Any Reason Why Generic Drugs Must Have Generic Labels?

brand-name-vs-generic-300x250In the context of what’s at stake in health care, the practice of giving drugs two names, a brand name and a generic name, makes no sense. Is there any other industry in which thousands of component parts are insistently given two dissimilar names, even though people can suffer, be hurt, possibly even die, if a mistake in names is made? Every drug with two names — and that means practically every drug in use — is a medication error waiting to happen. (NYT)

Can We Pay for Value, Not Quantity?

Paying physicians:

By 20Kolb17, physicians will be rewarded or penalized on the basis of the relative calculated value of the care they provide to Medicare beneficiaries.

But is this a good idea?

…[T]he practical reality is that the Centers for Medicare and Medicaid Services (CMS), despite heroic efforts, cannot accurately measure any physician’s overall value, now or in the foreseeable future. Instead of helping to establish a central role for performance measurement in holding providers more accountable for the care they provide and in informing quality- and safety-improvement projects, this policy overreach could undermine the quest for higher-value health care.

Read More » »

Hits and Misses

Funny robot sit with headphonesWould you like a bot that answers emails for you?

The next big thing: Personalized heart care.

Fruit flies with better sex lives live longer.

Tyler Cowen explains why he didn’t do 23andMe.

Can ObamaCare be sold at the mall?

Government tax and spending policies combine to redistribute more than $2 trillion from the top 40 percent of families to the bottom 60 percent.