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Month: January 2008

QUALITY: CNN’s Glen Beck–not a delighted patient

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Looks like CNN’s Glenn Beck won’t say what his local hospital’s CEO would like to hear when Press-Ganey call him! He accuses the staff there of not caring.

At the hospital I was often treated more like a number than a patient. At times, staff members literally turned their back on my cries of pain and pleas for help. In one case a nurse even stood by tapping his fingers as if he was bored while my tiny wife struggled to lift me off a waiting room couch.

So far he hasn’t named names, but I suspect that when it gets out, it’ll be worse for the hospital than it having a bad overall mortality rating in some obscure state report. After all when Don Berwick and David Lawrence wrote about their wife and mother respectively, they went out of the way to praise the staff, while castigating the care system. Beck is not so kind.

I’m not sure Beck’s solution is too constructive.

That’s why I don’t want to hear anymore about universal health care or HMOs or the evils of insurance companies until each and every hospital in this country can look me in the eye and tell me that they their staff is full of truly compassionate people who treat their visitors like patients, not products. Hire and train the right people, and then and only then come talk to me about everything else you need.

But his complaints are echoed in a series of videos from Health care for All in Massachusetts which also start talking about problems with care quality. I wonder if Paul Levy will name names about the hospitals in the last two videos—Both prominent Boston teaching hospitals that both screwed up big time with medical errors

Final thought: perhaps Michael Millenson is finally influencing people….while he’s even still alive!

Creating a Facebook-like medical record

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By Bob WachterRobert_wachter

The explosive growth of Facebook and MySpace illustrates the market for electronic tools to enhance communication and collaboration. Could there possibly be another workplace more in need of social networking tools than the modern hospital?

If you are not familiar with Facebook, find yourself a teenager and take a look over his shoulder while he is using it (mine are available for rent if you get desperate; the best time to catch them is when they should be doing homework). In one thrilling, chaotic electronic e-universe, the site allows users to exchange instant messages with dozens of friends, to post pictures and videos, and to link to virtually everything on the Web – all at the same time. John McCain would be flabbergasted.

Continue reading…

POLICY: Can You Really Mandate People To Buy Health Insurance? by Robert Laszewski

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RobertlaszewskiThis evening THCB welcomes our newest contributor.  Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. Before forming HPSA in 1992, Robert served as the COO, Group Markets, for the Liberty Mutual Insurance Company. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog. Can you really mandate people to buy health insurance? That’s not so much a policy question as a practical question and it is what Hillary Clinton seems to be saying
is the big difference between her health care reform plan  and the health reform plan of Barack Obama. That’s why a news story this week out of Massachusetts caught my eye.

It seems that the Mass Department of Revenue is in the process of drafting new regulations to up the penalty for people who do not buy health insurance. If they are approved, the maximum penalty for those who do not buy health insurance would jump from $219 per year to a maximum of $912 in 2008. The penalty is estimated to be half the per person cost of the lowest priced health plan available.

Penalties would vary by age and the time a person was without health insurance.
A 26 year-old would have a penalty of $672 per year and those over 26
would pay $912. So, a family of two adults over 26 would pay about
$1,800 in penalties if they didn’t buy health insurance (a reader has correctly pointed out children are not covered by the mandate).

Continue reading…

Health Wonk Review Is Up! – Brian Klepper

Our good friend Bob Laszewski is host of this edition of Health Wonk Review, which consistently displays a collection of the best, most insightful health care writing around the Web. Maggie Mahar and yours truly are represented from THCB. Drop by Health Policy and Marketplace Review for Bob’s thumbnail sketches of each column. Indulge yourself for a half hour and read them all. It reminds you how dedicated and superbly thoughtful our colleagues are.

Leveraging The Doctor As A Trusted Authority – Brian Klepper

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Chefann_3
I was on the phone with my good friend Bill
Bestermann MD yesterday. Dr. B, a preventive cardiologist who is
passionate about the underlying mechanics of cardiovascular disease and
the horrific toll the American diet and lack of exercise is taking on
everyday people, lives in spectacularly beautiful, rural Kingsport TN.
He told me he was driving through town, channel surfing on his radio,
and he happened upon the station that broadcasts information for the
local schools. They were announcing the menu in the school cafeterias.
He said it was appalling. "Honeybuns and processed foods. It was all
the stuff I tell my patients to avoid."

Continue reading…

POLICY: Self-employed, and going it alone

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If you want to understand why an individual mandate in a community rated state won’t work without both significant reforms to the insurance systems and a whole new range of taxes and subsidies, read this experience of a healthy mid-20s writer in New Jersey who’s self-employed, and going it alone. Of course if she was living in California, she’d be able to buy a much cheaper policy–but then no sick person in California can get individual insurance.

Perhaps enough of this and it will dawn on people that we need a single pool funded by ability to pay….

On a side-note, any idiot can see that a single pool guaranteed universal system would help solo freelancers and small business people. And of course the NFIB leads the charge against it.

POLITICS: Just Saying No to crass politicization

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Yeah, I know it’s not likely that anyone will pay attention given the season, but I do feel that there are enough cases with which to bash insurers which are legitimate that John Edwards didn’t have to start politicizing one in which not only was the insurer’s argument pretty good, but about which a government-sponsored universal system would also have to make the same choices. So I’m up over at Spot-on about Just Saying No.

To separate himself from the Democratic front-runners former Sen. John Edwards has spent the last few days laying into insurance company, Cigna, for its failure to immediately approve a liver transplant for California teenager, Nataline Sarkisyan. That action, says Edwards, in concession speech after concession speech, is emblematic not just of the health care system’s break-down but of a failure of the current American political system.

Edwards like most Democrats wants a single payer health system and his plan is the closest of the three front-runners to providing one. But his advocacy of Natalie Sarkisyan’s case raise a question no one else seems to be asking.

Here’s the rest

POLICY: Ian Morrison–to be thrown out by the Paisley Fabianists club

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In a great article called The Fallacy of Excellence my old boss and friend Ian Morrison explains what we intuitively know. people don’t understand that more care is not better care. This is going to lead to lots of political problems as we get to righting the Wennberg-illuminated wrongs.

On the other hand, Ian’s lifetime membership in the Paisley Fabian Society will probably be revoked when they find out he’s been watching the Republican candidates debate…..

INTERNATIONAL: Those damn froggies beat us again

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Here’s one international comparison I’d missed when it originally. The US has fallen to last place amongst 24 developed nations in an index of preventable death–one presumably cooked up by a Marxist cell masquerading behind a front organization called the London School of Hygiene and Tropical Medicine and funded by that cabal of Trotskyites known as the Commonwealth Fund. We’ve fallen four places since last time and are now even behind the Brits & the Irish—who I’ve always thought encouraged preventable death.

What’s happened is that every other nation showed significantly better measures relatively quickly (over a 5 year period to the early 2000s) and the US didn’t improve much at all.Who came top? Yes, those darn French again.

And their President is shagging a super-model. It makes me long for the days of JFK and Marilyn Monroe.