The Health Care Blog – Page 657 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Can Health Care Be Bought and Sold on eBay?

Feb 29, 2012• 12

By John Goodman

We’re not quite there yet. But there is a new website that is getting close.

A small, emerging online service called MediBid is creating an actual market that puts doctors together with patients who need care.

Here’s the best thing about it. Patients who use this service can cut their health care costs in half. No, that’s not a misprint. Patients who obtain care through MediBid pay about half as much as BlueCross pays. Ditto for all the major employer plans as well as the other big insurance companies. Patients frequently pay even less than what government pays under Medicare.

Here’s the worst thing about it. Once ObamaCare kicks in, entrepreneurial ventures like this one will probably be nipped in the bud. That’s because the Obama administration doesn’t believe that patients can or should be able to buy care in an open marketplace. In fact, once they get through implementing the 2,700-page bill with 159 regulatory agencies and 10,000 pages of regulations, patients are unlikely to ever see a real price for any type of care.

At least for the time being, however, a market for medical care is emerging. Here’s how it works.

Patients who are willing to travel and able to pay cash, can request bids or estimates for specific medical procedures. They fill out medical questionnaires and they can upload their medical records. The patient’s identity is kept confidential until a transaction is consummated. MediBid-affiliated physicians and other medical providers respond by submitting competitive bids for the requested care.

Register for the February 29th Health 2.0 Show

Feb 28, 2012• 7

Join us February 29th for the first Health 2.0 Show of 2012. We’re working with our friends at HCPLive to bring you an exciting and packed show to kick off the new year. This episode will focus on innovative tools for physicians including products that transform and aid in everything from scheduling to follow-up. We’ll be joined by four specials guests who will discuss and demo their products:

Phil Carter, CEO, JiffPad
Daniel Kivatinos & Michael Nusimow, Co-founders, Dr. Chrono
Ben Chodor, CEO, Happtique
Steve Schelhammer, CEO, Phytel

We also have an interview and demo with Alexander Borve, founder and CEO of iDoc24 and leader of the Health 2.0 Stockholm chapter. Other agenda highlights include a demo from the popHealth Tool Developer Challenge winner, news highlights from Health2News.com and an update on the Health 2.0 Spring Fling Matchpoint in Boston this May.Continue reading…

The Status of Health Insurance Exchanges

Feb 28, 2012• 13

By Nicole Fisher

With less than two years before state-based health insurance exchanges are to be operational, most state legislators and health policy experts still cannot come to an agreement on how to set up, operate, monitor or fund state exchanges. However, despite persistent confusion and concerns surrounding health insurance exchanges, the White House recently released a report on the progress of state-level health insurance exchanges. This publication took a favorable and possibly misleading view of the headway being made by states that are creating their online insurance marketplaces.

The Administration claimed that there are currently 28 states making great progress in establishing an exchange. Even if that were true, this indicates that 22 states -or about 40 percent- are refusing to comply with the Patient Protection and Affordable Care Act (PPACA).

Although the report does not lie, it also doesn’t exactly accurately portray where most states stand either… The Administration chose to furtively count states that fall into a grey area as making progress toward setting up an exchange. Many states have, in actuality, refrained from any legislative activity or the state legislature has merely set up a committee to “study options”. What this really indicates is that many states are purposefully not complying with the PPACA mandate to create an exchange, but also managing not to violate it so that they are allowed to keep federal funding, at least until the January 2014 deadline.

The Cost of Coercion

Feb 28, 2012• 4

By John Schumann, MD

Nora, a third year medical student, came to me in moral distress.

Ms. DiFazio, one of the hospitalized patients on her Internal Medicine rotation, was frightened to undergo an invasive (and expensive) medical procedure: cardiac catheterization.

The first year doctor [‘intern’] with whom Nora was paired, Dr. White, vented to her:

“These patients come to us seeking our help and then refuse what we have to offer them,” Dr. White steamed.

At the bedside, the intern demanded to know why Ms. DiFazio refused the procedure. When no reason beyond “I don’t want to” was offered, Dr. White told Ms. DiFazio that there was no longer cause for her to stay in the hospital.

By declining the procedure, Dr. White informed Ms. DiFazio that she would have to sign out ‘against medical advice’ (AMA). To signify this she would have to acknowledge that leaving AMA could result in serious harm or death. In addition, Ms. DiFazio would bear responsibility for any and all hospital charges incurred and not reimbursed by her insurance due to such a decision.

Contraception Conundrum

Feb 27, 2012• 13

By J.D. Kleinke

What makes the contraception coverage debate currently raging in Washington unusually problematic is that both sides are exactly right. Female employees who receive part of their cash compensation in the form of health benefits have the right to benefits that include FDA-approved birth control methods. Employers defined by their religious values—not just churches, synagogues, and mosques, but also thousands of hospitals, universities, and charities—should not have to compromise those values with their own money, and the government has no right to trample the First Amendment by compelling them to do so. The Obama administration’s “accommodation” —shifting the new federal requirement to the insurers who administer those organizations’ health plans—is a cynical shell game that ignores the most basic tenets of business accounting.

As the problem is no more complicated than two sets of equally valid rights in direct opposition, neither is the solution all that complicated, at least in principle: employment and health insurance should have nothing to do with each other.

Unfortunately, this arrangement—a relic of the World War II civilian wage freeze and enshrined in the tax code as soon as workers got a taste of this new-fangled “fringe benefit” of employment—is now an enduring part of the U.S. healthcare system. The entanglement of our health insurance with our employment goes a long way toward explaining not just today’s conundrum over the birth control coverage mandate, but myriad other economic distortions, market dysfunctions, and cultural conflicts that define much of what is wrong with the U.S. healthcare system.

The Obama administration’s ‘accommodation’ last week is a cynical shell game that ignores the most basic tenets of business accounting.

Welcome to the DMV. Your Clerk Will Be With You Shortly.

Feb 27, 2012• 5

By David Whelan

Have you ever tried to use Medicare data to research a hospital? If so, I bet you’ve been disappointed.

Let’s say you live in Las Vegas and you have heart problems. There are three hospitals nearby. You’d like to know the answer to a simple question. “If I ever have a heart attack where should I tell the ambulance to take me?”

Medicare’s Web site that holds this information is called Hospital Compare. If you visit and search for Las Vegas heart attack care, above is what you’ll find.

Is that helpful?

As you can see the three hospitals within your search are all rated “No Different than U.S. National Rate.” In other words, they are all average. Do the same search in every other city that has more than one hospital and you’re likely to find the same thing. Or you might find that there was not even enough data to calculate an average result.

If you want to find a hospital that’s exceptional, there’s no way to search for it. You can also can’t search for a dud.

KP CEO George Halvorson on His Organization’s Mobile App Strategy

Feb 27, 2012• 1

George Halvorson is the CEO who initiated and oversaw the biggest (private sector) EMR implementation ever. What’s Kaiser Permanente doing to expand on that? How is the new technology changing their thinking about care? How fast does George think the rest of health care is changing (very) and can others catch Kaiser (he thinks it would help Kaiser if they tried)? And what about getting other non-Epic apps on that KP system? I spoke with George at HIMSS12 yesterday, and his views are well worth a listen.

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First Amendment Doesn’t Apply to Junk Food Marketing

Feb 27, 2012• 11

By SAMANTHA GRAFF

Every year food and soft drink marketers spend billions of dollars tempting children with junk, fueling an obesity crisis that’s already reached epidemic proportions.

Why aren’t policymakers stepping in to help protect our kids? In part because food and media companies are successfully using the First Amendment as a shield.

But new research paves the way for government to take action to protect children from junk food marketing, building a strong case to establish that much of this advertising falls outside the scope of First Amendment protection.

The controversy over whether government has the right to regulate food marketing to kids came to a head last summer, after a group of federal agencies proposed a set of voluntary recommendations suggesting how food companies could market to kids more responsibly. Food, entertainment and advertising lobbyists launched a massive campaign to derail the recommendations, arguing that the First Amendment protects industry from any government action involving food marketing to children.

The Fall of a Pink Giant?

Feb 26, 2012• 5

By Rachel Kerestes

The move a few weeks ago by the Susan G. Komen Foundation to stop providing grants to Planned Parenthood, the quick reversal after widespread backlash, recent staff resignations and ongoing controversy exposed a weakness in a brand many once thought unassailable. But women’s health may be better off for it.

As the self-described “global leader of the breast cancer movement,” Komen carries the weight of the breast cancer brand on itsshoulders. And women—the brand’s core constituency—took to the social media airwaves to decry what they perceived as hypocrisy by Komen. The breast cancer brand, many women argued, is built on supporting and improving women’s health and defunding Planned Parenthood flies in opposition of that mission.

Komen fell into the classic trap of seeming inauthentic to its audience. Despite pursuing an aggressive strategy to lay claim to the title of sole women’s health brand, thus allocating other causes and conditions to the margins, the foundation seemed surprised to find that it was viewed as representing the voice of women’s health.

Now that the dust is settling the question of damage remains. Will this misstep loosen breast cancer’s grip on its leadership position? And if so, is what’s bad for the breast cancer brand good for women’s health?

Make no mistake—breast cancer is the biggest brand in the history of disease. Everyone from the NFL to Yoplait to American Airlines attempts to get a piece of that brand equity each October by pink-washing themselves in solidarity. As the face of the breast cancer movement, the Komen Foundation is the main benefactor of all that attention raising an estimated $35 million each year from marketing partnerships.

It’s We, the Public, Who Are Flip Floppers

Feb 25, 2012• 7

By Peter Ubel, MD

As I pointed out in a previous post, Theda Skocpol’s wonderful book, Boomerang, provides many telling details about Bill Clinton’s futile efforts to reform the U.S. health care system in the early ’90s. The book details many of the mistakes that the Clinton team made in drafting and promoting the legislation. But the failure of health care reform does not rest solely at the president’s feet. Instead, we, the general public, are also to blame. We ultimately got the policies we deserved.

Skocpol relates a powerful anecdote that nicely captures the sense of public confusion surrounding the general public during the Clinton reform efforts. It was March of 1994, and the Clinton team was trying to convince reluctant legislators to craft a bill consistent with its general approach to health care reform, which was a politically moderate bill that shunned the single payer plan preferred by liberals in favor of a bill based on “managed competition,” an idea embraced early on by moderate Republicans. Around this time, a Wall Street Journal/NBC news poll asked people what they thought of a plan that would “guarantee a standard private health benefits package… and promote competition… and require employers to buy insurance” for their employees. This description fit the Clinton plan to a “t,” and 76 percent of the public viewed it favorably. The dude had found the policy sweet spot!

Only one problem. When that same poll asked people if they approved of the “Clinton plan,” only 37 percent demonstrated support.

Public contradictions over health care reform run even deeper than antipathy to anything Clinton-esque. In its own polling, for example, the Clinton team learned that any plan they crafted that emphasized guaranteeing people “standard or basic” health care benefits would fail, because people wanted “comprehensive benefits,” feeling like it was only these more generous benefits that would be relevant to their own lives. (The administration also learned that the words “plan” and “program” were, ahem, program killers!) At the same time that the public clamored for comprehensive benefits, people also expressed their skepticism that a Democrat like Clinton could craft a health care reform bill that wouldn’t burden the taxpayers with a huge new expense. Well, of course Clinton couldn’t do that. It’s kind of hard to give everybody a Lexus at Hyundai prices!