Hospitals and Health Systems
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The Prescription for Revolutionary Healthcare Delivery Reform
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5 Steps to Get Americans on Board With Health Reform
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How NOT to Measure Healthcare Quality
Understand Healthcare Reform in 2 Easy Steps
Published November 01, 2009 @ 05:00AM PT
If you’re tired of ignorant political sound bites in the healthcare debate, I have the cure. Better yet, it’s virtually free of public and private insurance discussions, with their associated pointed fingers. The film Money-Driven Medicine explores the reasons why the US spends more than twice what the next developed country does on healthcare, with terrible health outcomes. The story is told by in-the-trenches doctors, patients and their family members, a physician healthcare improvement leader, and a medical ethicist. It’s unique, highly educational and fascinating.
Join the Watch-In! for America’s Health now through November 10 for a systemic look at what’s really driving the cost and quality of our healthcare. Find out what’s compelling our healthcare spending, and why tweaking around the edges of our public health disaster won’t change a thing. In a nutshell, our country is unique in turning patients into profit centers.
Why join the Watch-In? Because Money-Driven Medicine:
“help(s) viewers distinguish between structural change and sham reform. It will convince them that a sound, sustainable medical infrastructure is crucial not just to their personal futures but to the economy and society as a whole – why curing America’s healthcare crisis could be a matter of national life and death.”
I couldn’t have said it better myself. Make a pledge to join the Watch-In! for America’s Health today. Of course, if you can stand more discourse on the insurance industry and public versus private insurers and providers, read and watch on.
I made the mistake of watching T.R. Reid’s special, Can We Really Fix U.S. Healthcare?, about his experience exploring international universal healthcare systems, the night before the House revealed its new bill, HR 3962. As a result, I’m feeling a bit underwhelmed by Nancy Pelosi’s hard-fought victory. The LinkTV special is a summary of Reid’s book, The Healing of America, which explores both the how and the why of these healthcare systems. It’s an excellent primer on the 4 main types of healthcare systems, distinguished by who pays for and who provides the care. Watch it and be both entertained and sobered simultaneously, when you consider how far we have to go to even catch a glimpse of the best ones on the horizon.
Reid is also the creator of PBS’ special Sick Around the World, which gives an excellent summary of 5 international universal healthcare systems. No, it’s not just theory: he took his injured shoulder around the world with him, to see how each healthcare system would treat it.
But remember, before you click over to Reid’s insurer-patient-provider view of true developed nations, join the Medicine For Profit Watch-In for a refreshing, insurance-light look at some root problems in American health "care". Thanks to Change.org member CherokeeGirl for Change, who alerted me to both very worthwhile programs.
Photo http://farm4.static.flickr.com/3174/2689975613_187194cdaa.jpg //CC BY 2.0
Pay For Performance: Why You Should Care (Part 3 of 3)
Published October 27, 2009 @ 06:00AM PT
Part 3: What IS That Noise?
In Part 1, we introduced P4P and mentioned some loud screeching that now accompanies it (that’s Screech up above, by the way.) In Part 2 we showed you how to use its basis, quality measurements, to get better care regardless of where you live. But now back to the noise. As we know, the healthcare industry is notoriously resistant to change. The entrenched M.O. is to sit back, wait for it and reactively dig in heels -- with as much sensationalism as deemed necessary. Healthcare leaders know reform strategies have been studied and generally talked to death for the last 16 years. Still, most resist forcefully when innovation stops being voluntary and is instead mandated. Enter Massachusetts, stage right.
In 2005, it became the first state to require health insurance coverage for all residents, with hardship exceptions. Massachusetts is now drowning in healthcare costs. Its residents are covered and 70% of doctors support the program, but the great fee-for-service “quantity over quality” healthcare juggernaut rolls on. It’s time for step 2: rein in those costs with a combination of global payments and P4P – secret code for payment based on quality, coordinated care.
Pay for Performance: Why You Should Care (Part 2 of 3)
Published October 20, 2009 @ 06:00AM PT
Part 2: Empowered Patients
Last time we dug into what P4P actually is. Today we'll give you the P4P tools to become an empowered patient, and introduce you to their quality metrics basis. This will allow you to pay for quality versus average or sub-par care.
Ready? Quick! You’re having a heart attack. Your family called 911, and now the paramedics are asking which hospital you want to go to. How do you know? Your life may depend on it.
Pay For Performance: Why You Should Care (Part 1 of 3)
Published October 16, 2009 @ 07:00AM PT
Part 1: What Is It?
Earlier this year, amid all the yelling, name calling and finger-pointing, there was a small quiet force moving through US healthcare. It was the early adopter crowd of doctors, hospitals and health systems, girding up to become providers of coordinated, quality, and evidence-based care. I called this little-noticed movement the Silent Revolution. That loud screech I'm now hearing is the revolution reaching the mainstream.
We’ll get to the noise in Part 3 of this three-part series. First, today we’ll dig into what Pay For Performance (P4P) actually is, and in Part 2 we’ll look at how it can empower you as a patient.
Hospital Facility Fees Pick Your Pocket
Published October 14, 2009 @ 12:00PM PT
Imagine you board a flight on new carrier Post-Pay Airlines, where you pay a to-be-determined amount for your flight after you take it. Since it’s a “choose your own seating” model, you wander back and randomly select aisle seat 20C. Another passenger claims 20D across the aisle. When you arrive at your destination and deplane, a cashier hands you both a bill. Yours includes charges for the flight and the seat, $700 total, while 20D is charged $250 for the flight only. What?!
It turns out that the airline owns seat 20C, while an airplane mechanic owns 20D. Post-Pay claims it has to adhere to more stringent standards than the mechanic, though neither you nor your row-mate could tell the difference in seat quality. What’s more, the seats weren’t even labeled differently – there was no sign disclosing a surcharge. And unlike typical airline fees for baggage, food, drinks, and itinerary changes, sitting in the seat isn’t optional – it’s required to take the flight.
New Healthcare Versus Old Healthcare: Mirror Images?
Published October 12, 2009 @ 06:00AM PT
This weekend I was in the Bay Area for a trail race, but I got to experience more than the scenic views from the Oakland hills. The bonus was a personal evaluation of Berkeley’s emergency care (yes, only a healthcare consultant could possibly see it that way.) It earned a “C”, meaning it was average US healthcare: not really good, not terrible, and anxiety-producing for all the wrong reasons. So what would change under proposed healthcare reform?
First, some background. For two days before the race I had vague abdominal discomfort, but chalked it up to female cyclical issues. A few hours into the race I was no longer able to breathe, much less move, without severe, stabbing abdominal pain. I was bloated, nauseated, lightheaded, and clammy. Later I learned it was a large ovarian cyst, extremely inflamed by the constant pressure of my hydration pack belt. It left me unable to ingest anything so I became dehydrated, which made existing kidney stones symptomatic. My race was over, but the fun had just begun.
