Up at the Healthcare Economist. Daniel Gilden's piece over here leads off, as it should!
It’s Not Just Doctors in Short Supply
Policy-makers involved in healthcare reform are making a mistake in disproportionately emphasizing our current doctor shortage while neglecting serious shortages of care providers in other fields of health. Rather than continuing a failed, piecemeal approach, the nation needs to establish a multi-professional, multi-disciplinary, national planning body charged with carrying out a comprehensive and coordinated national health workforce policy. National healthcare reform cannot be realized without effective national health workforce reform.
Op-Ed: A Social Democrat Weighs in on a Government Health Plan
I was born into a Berkeley family of Social Democrats—my father studied Swedish economic policies—then I trained in social-democratic Economics in Scandinavia, before cutting my career teeth in a Norwegian Labor Party think tank. I thereby personify the threat trumpeted by Republicans: the sinister spread of Social Democracy.
So I am cheering wildly for establishing a federally owned health plan, right? Wrong.
Not that I’m particular opposed, either: It’s just not a big deal. Either way, new government-run plan or not, there won’t be much impact on our nation’s enormous health care problems. Our health care dilemmas—high costs, poor access, and mediocre outcomes–stem from much more fundamental issues than who sits on the board of yet another insurance plan.
These include the perverse incentive structures for key decision makers in the industry, including insurers, providers and patients. Insurers earn money by serving the well rather than the ill who need their assistance most, providers don’t become rich by managing care over time but by medically over-treating the critically sick, and consumers are incented to both stay out of the insurance pool until they’re sick and to seek medical help late.Continue reading…
A Dream of Reason
The dream of reason did not take power into account…Modern medicine is one of those extraordinary works of reason…But medicine is also a world of power.
-Paul Starr, The Social Transformation of American Medicine, 1984
Today’s unveiling of a Declaration of Health Data Rights is an important action, long overdue, that represents a collaborative effort by a group of health care professionals – activists, entrepreneurs, technologists and clinicians – all colleagues we hold in high esteem.
The Declaration’s several points arise from a single, simple premise: that patients own their own data, and that that ownership cannot be pre-empted by a professional or an institution. And there lies its power, especially in the context of early 21st Century health care. It is a transformative ideal that currently is not the norm. But we join our colleagues in declaring that it should be.Continue reading…
Time to Revisit Wyden-Bennett?
With the Washington insiders at politico.com
reporting this weekend that health care reform appears to be in “real
jeopardy,” and the Senate Finance Committee so uneasy that they have
decided to delay reform bill markup until after the July Fourth recess,
it’s increasingly clear that an approach of layering more and more
fixes onto the present system isn’t going to work.
Opening Physicians’ Notes to Patients
Today’s Boston Globe ran a story (page one, no less!) announcing our grant to Beth Israel Deaconess Medical Center to run a three-site demonstration of opening up physicians’ notes to patients. That’s not just making labs, drugs, allergies, etc. available to patients – it’s giving them access to the actual notes that the physician records about a visit. Now these notes are technically available now – under HIPAA each of us has a right to our full medical records (of which physician notes are a part), but the process for obtaining them is often slow, cumbersome and even expensive in some cases. Under this project, called Open Notes, patients will receive a secure email after the note has been completed and they can see it right away. They’ll also be prompted to review the note prior to their next visit. So instead of limiting access to the very determined, access will be easy for anyone who’s mildly interested.
Why would we fund this? Several reasons, really. First, is that at the Pioneer Portfolio, we’re very interested in patient-centered innovation. Let’s face it: virtually every trend suggests that people are going to have to become much more engaged in their care and in taking care of themselves. And, as the pioneers of shared decision-making, patient centeredness, patient activation, online support groups and the health 2.0 community have shown us, real benefits come from this engagement. So much of the energy and excitement in health care today is coming from the patient/consumer side of the equation. So it’s a space where we believe we will find many innovations that can ultimately transform health.Continue reading…
Your AHIP Quiz Question of the Day
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This is something that’s been puzzling me for a few weeks. We all know that insurers are very good at making sure that they insure healthier risks than average. In the individual market they do this openly, by underwriting against poorer risks. Those “risks” (who are most of the people with the really tragic stories) end up uninsured or in massively over-stretched state major risk pools.
Eight Signs that Wellness and Prevention have become Health Reform Priorities
Health care reform alone won’t make
America healthier. We’ve seen this basic message as recently as yesterday,
in Ezra Klein’s piece for the American Prospect, “Wealth-Care Reform.” At the Robert
Wood Johnson Foundation Commission to Build a Healthier America, we’ve been studying prevention, wellness,
and the broader factors that influence good health for nearly two years.
And as the health care reform debate has heated up over the last few
weeks, we’ve seen eight signs that health reformers and leaders from
all sectors are starting to get the message that there’s more to health
than health care.
How Relevant is the American Medical Association?
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Like most doctors, I was busy seeing a full schedule of patients when President Obama addressed members of the American Medical Association at their annual meeting in Chicago. The speech was billed as a crucial confrontation over health reform, and anticipation had been building for quite some time. So I was too busy to learn anything about his remarks and the response until I got home.
Then again, I’m not a member of the AMA. I never have been. Neither are very many of my physician friends and colleagues. In fact, the odds are that your doctor isn’t a member of the AMA, because at best, only between 25-30% of the approximately 800,000 doctors in country belong to it. And a good percentage (up to half of members according to one report) of those include residents and medical students, who get big discounts on membership and a free subscription to a journal when they join.Continue reading…
The Dumbest Thing I Have Ever Seen An Insurance Company Do
And, I’ve been in the business for 37 years.First, let me
stipulate we really need a system of universal care where everyone gets
to have insurance. But we don’t yet so certain rules are unavoidable
until we do.
