I know he’s got a lot on his mind but leading liberal blogger Kevin Drum writing in his blog at The Washington Monthly actually wrote this in his post about HSAs:
These proposals sound pretty good, don’t they?
Did he start channeling Ron? Or was he just too lazy to go read the reams and reams of stuff written about HSAs, and figure out their one or two tiny flaws…
Who knows, but plenty of his commentators are ripping him a new one.
MrHISTalk’s deputy Billy "Biff" JutJaw brings you the results of the HISsies. About as straight as West Palm Beach election, but a damn site funnier!
And in my fantasy stock trading moments — Damn Damn Damn
But you might like my commment buried in a post over at Ezra’s when the stock was at $450, ooh as long ago as early last month!
Ezra’s one line post was Not that I don’t love my magazine and all, but I’m applying for a job with google. He was excited about the ncie work benefits and the stock options. My comment was “I’m thinking of going to work there, so long as the options they give me are puts.”
Once again—all talk no action at this end!
UPDATE: While I was mentally jerking off, this guy closed the deal using logic as well as intuition. But for some reason only went short 10 shares. Still he’s up $500 more than I am!
I’m so fond of analyzing "research" by AHIP that I’ve missed some from PCMA, the trade group of the PBMs. But if you go to their site you’ll learn that you, the consumer, are about to save $1.3 trillion over the next ten years because of our brave PBMs.
Well at least they haven’t taken to AHIPs trick of claiming savings for their consumers when their costs were going through the roof. I mean, who can dispute that the presence of PBMs is saving their consumers money? Well some people might but they can’t tell us what will happen in the future can they! After all, who knows what will happen in the future? No one! So what they say can’t be challenged!
You may guess that I’ll have a little more about this coming up. For now, hunt about in the section on PBMs in the CHCF report that came out yesterday, before I introduce you to some folks who’ve been overturning the rocks in the PBMs’ backyard.
For those of you too lazy to read Nick Kristof’s NYT column on why we’re so unhealthy, Pat Salber has summarized it for you.
Richard Paey was put in jail for 25 years basically taking pain pills, so that instead the state in Florida can fund his medical care. Oh the prosecutor said that he forged prescriptions, even though at first he wanted to go after his doctor. Well this shameful attack on a wheelchair-bound patient is finally getting some attention. Last Sunday is made it onto 60 Minutes.
Much of the thanks for this must go to John Tierney from the New York Times, who continually writes about the craziness of our war on patients and doctors. He pointed out in his column that the prosecutor is an earnest man who genuinely believes that he is doing the right thing, and claims that he made no medical judgments even though his entire case is based on his made-up "fact" that "no one could take 25 pills a day". He reminds me of the concentration camp guard, who was sure he was just following orders.
You’d think that, as Jeb Bush has a daughter who herself was in trouble for forging prescriptions, and apparently was just a regular addict, the wise Christian governor of Florida could find a little mercy in his heart.
So (finally!) the piece I co-authored with Jane Sarasohn-Kahn on the prescribing infrastructure has been published by the California Health Care Foundation. Please go take a look. It’s called The Prescription Infrastructure: Are We Ready for ePrescribing?
I’ll be writing more about the pieces that got cut from the report due to length considerations in THCB over the next few days.
So charging at the point of care, another Zombie of health care policy, isn’t just a problem for the poor here—although it’s going to get a whole lot worse. It’s also a big issue in that place that the US loony right thinks will be where they ascend to heaven (or at least I think that’s what they think about it…who can tell with that bunch of nuts?).
Read up about the problems of paying for care in Israel.
Meanwhile if you want to know more about health care Zombies, read this great speech from Morris Barer…
The American College of Physicians is out with its proposals for a better American health care system
The paper recommends voluntary certification and recognition of primary care and specialty medical practices that use health information technology, quality measurement and reporting, patient-friendly scheduling systems and other "best practices" to deliver better value and improve care coordination for patients, especially those with multiple chronic illnesses.While the specific criteria for being listed as a qualified advanced medical home will be developed later, ACP envisions that qualified practices will have the following kinds of services in place.* Primary care physicians would be responsible for partnering with their patients to assure that all of their health care is managed and coordinated effectively. This will be a major improvement from the fragmented health care system that we see today. They would partner with, and educate patients with chronic diseases, like diabetes, to help them manage their own conditions and prevent avoidable complications that would inevitably occur without long-range attention. These complications of diabetes include amputation, blindness, heart attacks and kidney failure.* The practice would use innovative scheduling systems to minimize delays in getting appointments.* Electronic health records and other health information technologies would be used to store all clinical data and test results, which would be immediately available. Physicians in the advanced medical home would use computerized, evidence- based clinical decision guidelines at the point of care to assure that patients get appropriate and recommended care.* Patients would have access to non-urgent medical advice through email and telephone consultations. The practice would have arrangements with a team of consultants and other health care professionals to provide the full spectrum of patient-centered services.
Now I know those physicians are very clever and all that, and I also know that they’re very jealous of how much cash the surgeons and radiologists pull down, but hang on a minute. Haven’t we heard something like this before on THCB? All care managed by PCPs; use of IT to coordinate all care; Choose and Book-type systems for patients; Access for all patients to NHS Direct — they’ve hit on the perfect system. It’s called the UK National Health Service.
Perhaps their members will be slightly less keen when they discover the average income of a GP in the UK, although with the state of the dollar these days it’s not as bad as it used to be if you consider it in American money!
THCB’s favorite surgeon is back with an interesting question on Medicaid “lookbacks”, and who should pay for long term care. Eric Novack writes:
In today’s Boston Globe, there is an article titled Medicaid proposal could hurt seniors. In it the Globe reporter makes the claim, along with help from representatives from the AARP, that “people who gave money to their church or helped a family member — are going to find themselves in trouble”.
This is ostensibly because of new rules that will be more stringent about examining a person’s assets when determining Medicaid eligibility. A 94 year old man in the article is quoted as saying, “[y]ou go into a nursing home and they take all the money”. In his case, he wanted to be able to pass on enough money to help care for his daughter. This asks the question of who, then, is responsible for taking care of him? Many on this site clamor for ‘universal coverage’ with ‘global budgets’.
I am interested in hearing who they think should be responsible? Is planning for the final years of life no longer the responsibility of the individual? Should retirement planning not have to include any provisions for illness or infirmity? Is it the responsibility of other citizens children and grandchildren to be taxed to provide care when people have assets in their homes and retirement accounts? The baby boom generation is booming, with hundreds of people reaching 60 years of age each day. This group has trillions in net worth. Even if housing prices do not continue to increase- or even decline slightly- many have hundreds of thousands of dollars of equity in their homes. Most, hopefully, will live healthy, productive lives for 30 or 40 more years. Most will incur significant healthcare costs over that time. Recent estimates are that people retiring today need to anticipate about $190,000 in healthcare expenses. The article makes the claim that a recent KFF study reported that, on average, only $8200 was transferred. $8200 times the millions on medicaid is quite a lot of money (over $8 BILLION per million). Should we not expect that those who will utilize the services be expected to use their assets to pay for their care?
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