Tag Archives: primary care

Health Alerts

What is the Health Care Debate Really About?

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Hint: It’s not about health care.

Ask yourself this question: What is the one health system characteristic every developed country has, except the United States?

If you answered: Every other country has made health care a right, you’re wrong. Citizens of Canada have no right to any particular health care service. They have no right to a CT scan or open heart surgery. They don’t even have a right to a place in line. The 100th Canadian waiting for heart surgery isn’t entitled to the 100th surgery.

If you answered: Every other country guarantees essential care to all its citizens, you’re wrong. Citizens of Canada and Britain are routinely denied prompt access to basic health care.

If you answered: Every other country guarantees access to care, regardless of ability to pay, you’re wrong again. In Britain people routinely go to the private sector and pay out-of-pocket for care they cannot get from the state. Canadians come to this country. In both cases, lack of ability to pay is a barrier to care.

If you answered: Other countries make primary care more accessible because there is no barrier of money, you’re wrong once more. Americans get more primary care than Europeans. Even uninsured Americans get as much or more primary care as Canadians get.

So what really is the difference?

httpv://www.youtube.com/watch?v=pCZNzydsLzU

What’s It All About Alfie

 

Continue reading What is the Health Care Debate Really About? →

Seniors

Medical Home Gives Patients Better Primary Care at No More Cost

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A Group Health Cooperative demonstration project finds that, at one year, patients at a medical home:

  • Had 29 percent fewer emergency room visits, 11 percent fewer hospitalizations that primary care can prevent, and 6 percent fewer in-person visits
  • Reported higher ratings on six scales of patient experience
  • Used 94 percent more e-mail, 12 percent more phone, and more group visits and self-management support workshops

They also received better health care, including needed screening tests, management of their chronic illnesses, and monitoring of their medications.

Medicare

Opting Out of Medicare

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This is from the New York Times:

In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before.

Those looking for a primary care doctor had more difficulty. A 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients only 38 percent of primary care doctors did.

Health Alerts

Health Care Down Under

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Kangaroo SignAccording to the Australian Medical Association, every public hospital in New South Wales is dangerously overcrowded, causing 1,500 unnecessary deaths each year. Patients stack up in corridors and emergency rooms waiting for beds. Hospitals routinely cancel elective surgeries. On September 8, 2008, 23 patients with government coverage were admitted to the Townsville hospital through the emergency department. As there were no beds for them, elective surgeries were canceled. [link] Psychiatric patients in other hospitals are routinely restrained and sedated due to an acute shortage of psychiatric beds. [link]

Some say that the entire Australian health care system is on life support. The government says that overcrowding can be solved by keeping people out of the hospital. [link] Continue reading Health Care Down Under →

Physicians

The Big Apple Adopts EMRs

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About 1,000 primary care physicians are participating, with subsidies from the city. [link] Among the benefits:

Cliffs Notes-style advice on how to handle medical problems based on a patient's age, sex, ethnic background and medical history. It prompts doctors to provide routine tests and vaccinations, advises them on appropriate treatment and medication for certain conditions, and warns of potentially dangerous drug interactions….

In April, the city will begin sending participating doctors report cards on how their preventive efforts compare to their peers.

Example of fictional diabetic patient benefiting. However, patients don't get to know their doctor's score. And only five doctors are giving patients access to their own records from home computers.

Health Alerts

Limited Benefit Insurance: It’s Becoming Respectable

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I have become increasingly intrigued by limited benefit insurance (covering primary care, but not hospitalization), even though it does the opposite of what most health policy wonks think insurance should do. See my previous posts here, here and here.

Blue Cross now offers a discount card to Florida residents. Its Web site lists likely savings on procedures. Blue Cross also has a limited benefit insurance plan, as does Aetna – which primarily markets it to employers with part-time and seasonal workers.

Pro Medical Plan, another insurer, charges $52 per month (individuals) and $130 (families). In return, people get "primary-care doctor visits for $10 and cheap basic lab tests at a variety of locations in Miami-Dade and Broward, plus a discount card for such things as specialists, pharmacy and vision."

What I like is that these products solve two big problems that are not solved, say, by Medicaid or SCHIP: (1) They offer access to primary care other than at public health clinics and emergency rooms and (2) they introduce price competition (and, therefore inevitably quality competition) into the primary care marketplace.

Interesting Links

Hits & Misses – 2008/11/25

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Pay for Performance Doesn't Work – Again. "Of the six measures initially rewarded by [P4P], only cervical cancer screening showed consistently positive returns."  [link] Hat tip to Jason Shafrin.

Mad DoctorsDoctor Angst. Nearly half of primary care does plan to cut their patient load or quit medicine entirely. About 60% would not recommend medicine as a career. [link] 

Free Diagnosis Online. We tried it, and it's actually pretty good. [link]

$1,000 Deductible. That's the new median for individuals in employer plans, according to a Mercer report [gated, but with summary].

Health Insurers: Force People to Buy Our Product and We'll Take Everybody. Lenin was wrong. The capitalists aren't going to sell the hangman's noose to their enemies; they're going to give it away. [link]

Health Alerts

Walk-in Clinics

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NEWS FLASH: Led by Pete Stark (D-CA) and Henry Waxman (D-CA), House Democrats today announced a plan to provide low-cost, high-quality, easy-access primary care to millions of low- and moderate-income Americans, including millions of the uninsured.  The plan: override a slew of anachronistic, bureaucratic, anti-entrepreneurial regulations that are thwarting the spread of walk-in clinics in drug stores, shopping malls and big box retail outlets and keeping them from realizing their full potential.  Among the regulations to be set aside is legislation authored by Stark himself.

Oops.  I was just day dreaming. Continue reading Walk-in Clinics →