Tag: "health care quality"

Why Don’t Doctors Take Sick Days?

A survey of British doctors back in the ’90s found that 87 percent of G.P.’s said they would not call in sick for a severe cold (compared to 32 percent of office workers who were asked the same question). In Norway, a 2001 survey revealed that 80 percent of doctors had reported to work while sick with illnesses for which they would have advised their own patients to stay home. Two-thirds of these illnesses were considered contagious. (NYT)

Headlines I Wish I Hadn’t Seen

Stfit-kids-smart-kids1-1024x683udy: Parents fitter than their kids.

30 to 40 percent of Healthcare.gov is still unfinished.

Plans in D.C. cover abortion, not hearing aids

Megan McArdle: Obama breaks the health law in order to save it.

Healthcare site crashes while Sebelius tries to sign person up at media event.

Worse Sentences I Read Today

Does no one at The Washington Post understand the concept of opportunity cost? This is Ezra Klein and Evan Soltas:

Americans spend 17.7 percent of GDP on health care. No one else spends even 12 percent. Let’s make that more concrete: If Americans only spent 12 percent of GDP on health care we would have saved $893 billion in 2012.

Opportunity-CostThe reason isn’t that Americans get more health care than anyone else. We have more uninsured than anyone else. We have fewer physicians per capita than anyone but the Japanese. We go to the doctor less often than anyone but the Swiss. We don’t have more hospital beds than other developed countries, and when we do go to the hospital, we don’t stay longer.

But we do pay more for the privilege. The average hospital stay costs more than $21,000 in the U.S. It costs only $8,363 in France. (See “Why an MRI costs $1,080 in America and $280 in France“.) Administrative costs in the U.S. are more than three times higher than in most nations with universal health-care systems.

Earth to Ezra: if we have fewer doctors, fewer hospital beds, etc., then we are not spending more than other countries. We are spending less. Remember: health care prices mean nothing. We have so suppressed the market in health care that no one ever faces a real price for anything. So the only way to know what countries are really spending on health care is to look at real resource. With fewer real resources, we are getting results as good or better that the average developed country. That’s not bad.

Oops. A Mistake on the Guidelines?

Last week, the nation’s leading heart organizations released a sweeping new set of guidelines for lowering cholesterol, along with an online calculator meant to help doctors assess risks and treatment options. But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs.

Source: Gina Kolata.

Israel’s Two Tiered Health Care System

Foreigners are in the top tier:

People from Easmedical-travel1tern Europe, Cyprus and the United States have been flocking to Israel’s public and private hospitals over the past five years for inexpensive, high-quality medical treatment.

But this cash cow for the Israeli health care system may be in jeopardy.

…[M]any worry that the lure of foreign money is creating a two-tiered medical system, where hospitals shift the best doctors and facilities to the high-paying customers and lessen service to Israelis. (USA Today)

Is This an Opportunity for Entrepreneurs?

Tom Scully thinks so. This is from the NYT Magazine:

Medicare, which picks up a majority of their health bills, encourages hospitals to discharge patients quickly after surgery, but it doesn’t offer financial incentives to choose one form of post-acute care over another. And because discharging a patient to home care requires a lot of extra work — ensuring that the correct equipment will be in the home, training family members and so forth — many doctors choose the easier option. They can simply ask a nurse to send the patient to a rehab facility, and everything is handled in about a minute. Medicare automatically approves payment for 20 days of recuperation in a nursing home, and many facilities simply treat the patient for the full allotment. “Miraculously, everyone is cured on the 21st day,” Scully says…

On average, Medicare’s fee-for-service model pays for about 2,000 days in a post-acute care facility for every 1,000 beneficiaries. By comparison, Kaiser Permanente, a provider of low-cost quality care, averages 600 days per 1,000 clients while achieving better outcomes.

Hits and Misses

Very funny Jon Stewart video on signing up for ObamaCare.

Why plants usually live longer than animals.

High cost hospitals appear to save more lives. HT: Jason Shafrin.

India Shows the Way

Necessity spawns innovation. Despite the pressing demand and constrained supply, a few relatively new Indian hospitals have devised ways of providing world-class health care…These hospitals target well-off patients, which forces them to provide care that meets global quality standards. But their purpose is to serve everyone, including patients with very low incomes, which Innovation-Raceputs pressure on the organizations to lower costs dramatically. Such a business model scales because the low costs of these hospitals attract large volumes of patients and allow the overall enterprise to be profitable. As a result, the hospitals are able to sustain their operations not through the usual government subsidies, charitable donations, or insurance reimbursements but through their revenues. Aravind Eye Care System, for instance, has paid for all its expansion projects from its profits, even though two-thirds of its patients receive free or subsidized care. These extraordinary private Indian hospitals should serve, we believe, as an inspiration to those in other developing nations and as a wake-up call to hospitals in Europe and the United States. (More)

See previous my posts on India here and here.

How Provider/Insurer Consolidation Is Making Things Worse for Patients

One patient, in the middle of treatment for lung cancer, said at a hearing before a State House of Representatives committee that she was prohibited from seeing her U.P.M.C. oncologist. Another, with the debilitating autoimmune disease scleroderma, said she was dismissed from the U.P.M.C. Arthritic and Autoimmune Center. A third, a five-year breast cancer survivor who needs follow-up care every six months, was cut off from the doctor who had been with her since she was first given her diagnosis. (More)

Headlines I Wish I Hadn’t Seen

Is 131002_jblm_bigthis favoritism? Obama closes down commissaries for military personnel but keeps his favorite military golf course open.

New study finds Obama administration most secretive since Nixon.

Sebelius and about 20 people armed with laptops and certified by the government to help consumers hold a photo op as they try to sign people up for health insurance. They fail.

A former NHS director died after waiting for nine months for an operation ― at her own hospital.