Patients

A conversation about Health Policy with Elizabeth Rosenthal

By SAURABH JHA, MD

The acclaimed author of “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back” physician, and now Editor-in-Chief of Kaiser Health News, Dr. Elizabeth Rosenthal speaks to me about health policy and how it has changed over time.

Listen to our conversation at Radiology Firing Line Podcast.

About the author:

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner

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Pharmaview
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Pharmaview

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Barry Carol
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Barry Carol

I also think it would be useful if each state had an expedited arbitration procedure to resolve medical billing disputes between payers and providers. The process should use so-called baseball arbitration where the arbitrator chooses one side’s position or the other rather a split the difference approach. If the dispute is between an uninsured patient and a provider, especially a hospital, the arbitrator could have the flexibility to use some reasonable percentage of Medicare combined with the patient’s ability to pay based on tax returns and other documentation. Drug prices might have to be tackled in a different way perhaps… Read more »

pjnelson
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pjnelson

Just think of the behavioral economics involved. How many insurance companies or hospitals would want their ridiculous payment or pricing strategies on the front page of the WSJ? I have often thought that if we could cluster a group of behavioral economists at a hotel “annually” for 1 week, they would solve the social dilemma of our nation’s excessive level of health spending within 5 years. Nobel honoree Richard H. Thaler (MISBEHAVING, 2015) and 4 others of his choosing comes to mind along with Ben Carson, M.D. as its Co-Chairman. Maybe the Aspen Institute folks could organize it and arrange… Read more »

Barry Carol
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Barry Carol

I’ve said many times that there needs to be special rules that govern how much hospitals, doctors and other providers can charge for care that must be delivered under emergency conditions. If it were up to me, that number would be 125% of Medicare though 150% might still be within the zone of reasonableness. When patients receive huge unforeseen bills for out-of-network care in a hospital, I don’t see how such claims can be enforceable when there was never a meeting of the minds on price. Signing a financial responsibility form under duress is not enforceable consent to pay. Even… Read more »

pjnelson
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pjnelson

I am reminded, again, of the unusual business model for Pharma. 60% of their cash revenue is allocated to research and production expenses. The remainder is allocated to profit and promotion (aka, advertising). Their business model and its odd manifestations, especially around market share manipulation, are focused to sustain their stock market based corporate worth. Their Social Responsibility duties would be difficult to identify. But, as a portion of our nation’s health spending, its net increase has been steady at about 11%. Over-all, our nation’s health spending as a portion of our national economy (aka GDP) has increased from 5%… Read more »

pjnelson
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pjnelson

Once again we are faced with the realities of pricing and reimbursement strategies within our nation’s healthcare industry. So how is it that this institutional “co-dependent” relationship has evolved as it has? I offer a quotation from a book written by Elinor Ostrom and published in 2005: UNDERSTANDING INSTITUTIONAL DIVERSITY. From the first page, here is her definition of an institution. . “…the rules that humans use to organize all forms of repetitive and structured interactions including within families, neighborhoods, markets, firms, sports leagues, churches, private associations, and governments at all scales. Individuals interacting within rule-structured situations face choices regarding… Read more »

BobbyGvegas
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BobbyGvegas

i just downloaded her book. Will study it. Thanks.