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Economic Costs Related to Overweight and Obesity

In Health, Healthcare, Medicine on September 14, 2012 at 8:00 am

As the prevalence of overweight and obesity has increased in the United States, so have related health care costs. The statistics presented below represent the economic cost of obesity in the United States in 2006, updated to 2008 dollars.

 

Q: What is the cost of obesity?

A: On average, people who are considered obese pay $1,429 (42 percent) more in health care costs than normal-weight individuals.

What is the cost of obesity by insurance status?

A: For each obese beneficiary:

  • Medicare pays $1,723 more than it pays for normal-weight beneficiaries.
  • Medicaid pays $1,021 more than it pays for normal-weight beneficiaries.
  • Private insurers pay $1,140 more than they pay for normal-weight beneficiaries.

What is the cost of obesity by the type of service provided?

A: For each obese patient:

  • Medicare pays $95 more for an inpatient service, $693 more for a non-inpatient service, and $608 more for prescription drugs in comparison with normal-weight patients.
  • Medicaid pays $213 more for an inpatient service,$175 more for a non-inpatient service, and $230 more for prescription drugs in comparison with normal-weight patients.
  • Private insurers pay $443 more for an inpatient service, $398 more for a non-inpatient service, and $284 more for prescription drugs in comparison with normal-weight patients.

 

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US Healthcare System: Needs Resuscitation

In Health, Healthcare, Medicine on June 9, 2012 at 8:00 am

The Problem Today

  • Defensive Medicine: Providers always overdoing to avoid malpractice law suits.
  • High Malpractice costs
  • Tough regulations
  • Reducing reimbursements
  • Increasing patient populations
  • Primary Care physicians taking all the burden and not getting paid well on top
  • Reducing enrollments in Medical Schools
  • Insurance-company restrictions resulting in less autonomy over how patients are cared for
  • Red-tapism

Doctors are being over-controlled and micro-managed  by the current regulatory systems. By training, doctors are innovators and independent thinkers. Taking away their thought process is making them into robots who just keep clicking computers to get their ends meet without any interest.

If government had to do something,

  • Why does it  not open more medical schools?
  • Why does it not make it easy for foreign trained doctors to come to US and practice medicine?
  • Why do they not cut the overwhelming malpractice costs?
  • Why do they not incentivze primary care services?
  • Why cannot they increase taxes on cigarettes, sodas and chips which are killing the Americans?
  • Why cannot they let physicians be independent and let them practice medicine rather than practicing computers?
  • Why can they not prosecute drug dealers who are contaminating the system?
  • Why do people get support from tax payers money when they can actually work but they choose not to?

It is a pain to practice such medicine in United States which boasts of being a Number 1 economy in the world. America has very poor ranking on overall health indexes as compared to other developed nations in the world. The only good part I see in Healthcare reform is the mandatory Health insurance which makes it fair for everyone. The concept of ACO and PCMH are great, but the overall goals are still very hard to achieve even with these models if the defensive medicine and malpractice costs are not taken care of. So, my appeal from all the healthcare providers and the government  is to change the Healthcare System for better rather than for worse. Make it easy for providers to practice medicine. Do not let those 1/3rd current physicians leave medicine, which they are thinking because of strict government regulations.

Every Doctor’s Dream…..

In Health, Healthcare, Medicine on June 4, 2012 at 9:30 am
  • All available appointments are full.
  • All staff showed up for their shifts.
  • No one burns toast in the toaster oven and sets off the fire alarm.
  • None of the staff show up to work wearing flip-flops or pink underwear beneath their white scrubs.
  • All patients have been reminded about their appointments so they all show up.
  • Patients calling for same-day appointments are able to be worked-in appropriately.
  • No patients give false information at check-in.
  • Established patients arrive on time with their insurance information and co-pay.
  • New patients arrive on time to complete their paperwork, and give their insurance card, photo ID and co-pay to the receptionist.
  • Patients with fasting appointments arrive having fasted.
  • All patients arrive bringing their bag of medications.
  • Patients in wheelchairs and with difficulty ambulating are accompanied by caregivers.
  • Patients who do not speak English or are deaf have notified the office prior to the appointment and the appropriate technology or interpreters are available for the appointment.
  • Patients with procedure appointments have followed their pre-procedure instructions.
  • Patients with procedures have been pre-authorized by their insurance carrier and their personal financial responsibility has been discussed with them and payment arrangements have been made.
  • Patient eligibility has been checked and those unable to be authorized have been called before their appointment to gain further information about their payer source.
  • If computers go down, there are paper procedures in place to enable staff to continue seeing patients.
  • No patients arrive saying “I forgot to tell you, this is Worker’s Comp/ an auto accident/ a liability case and I was told by my lawyer not to pay anything.”
  • None of the patients pee on a waiting room chair.
  • Neither JCAHO nor any state or federal officers show up.
  • The copiers and faxes all work.
  • No subpoenas come in the mail.
  • It’s not your very first day live on electronic medical records.
  • All phone calls are answered before the third ring and no one has to leave a message.
  • No patients walk in the door with severe chest pains and say “I knew the doctor would want to see me.”
  • Patients remember to call the pharmacy for refills.
  • Providers all run on time and seem in particularly good moods.
  • Patients get their questions answered with callbacks within two hours.
  • Someone delivers sandwiches, drinks and brownies to the practice for lunch. There is enough for everyone.
  • No bounced checks come in the mail.
  • Providers spend so much time in the exam room listening to their patients that the patients leave feeling that every question they had (and a few they didn’t know they had) was answered.
  • Providers circle the services and write the diagnosis codes numerically on the encounter form, remembering that Medicare doesn’t pay for consults any more.
  • Sample medications that providers want to give patients are in the sample closet.
  • Records that providers want to reference are in the chart and are highlighted.
  • No one calls urgently for old medical records that are in the storage unit across town.
  • There are no duplicate medical records.
  • Patients checking out never say “But he was only in the room for 5 minutes!”
  • The patient restrooms don’t run out of toilet paper.
  • No bankruptcy notices come in the mail.
  • All phlebotomists get blood on the first stick.
  • No kids cry.
  • Congress announces that the SGR formula has been revoked and a new reasonable model for paying physicians has been discovered.
  • Everyone goes home at 5:00 p.m., glad to have a job, glad to be of service, and happy with their paychecks.

WISH IT HAPPENED IN REAL WORLD.

Healthcare in US: When is it going to be Cost Effective?

In Health, Healthcare, Medicine on May 20, 2012 at 11:04 pm

It is important as a healthcare consumer to understand the history of the healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system.  We are all consumers of healthcare.  Yet, in many instances, we are ignorant of what we are actually purchasing.  If we were going to spend $1000 on an appliance or flat screen television, many of us would research the product to determine if what we are purchasing is the best product for us.  The same state should be applied to purchasing healthcare services.

As the United States resumes debate over options for achieving universal health coverage, policymakers are once again examining insurance systems in other industrialized countries. More recent attention has focused on countries that combine universal coverage with private insurance and regulated market competition.

A Basic Screenshot of what US healthcare is Comprised of

Medicare: Medicare is a social insurance program for the elderly, some of the disabled under age 65, and those with end-stage renal disease. Administered by the federal government, the program is financed through a combination of payroll taxes, premiums, and federal general revenues.

Medicaid: Medicaid is a joint federal-state health insurance program covering certain groups of the poor. Medicaid is administered by the states, which operate within broad federal guidelines. States receive matching funds from the federal government, varying among states from 50 percent to 76 percent of their Medicaid expenditures.

Private insurance: More than 1,200 not-for-profit and for-profit health insurance companies provide private insurance. They are regulated by state insurance commissioners. Private health insurance can be purchased by individuals, or it can be funded by voluntary premium contributions shared by employers and employees on an employer-specific basis, sometimes varying by type of employee. Employer coverage is the predominant form of health insurance coverage. Some individuals are covered by both public and private insurance.

Out-of-pocket spending: Out-of-pocket payments, including both cost-sharing insurance arrangements and expenditure paid directly by private households, accounted for 12 percent of total national health expenditures in 2007, which amounted to US$890 per capita.

Based on the fragmented development of US health care, the system is based on individualism and self-determination and focusing on the individual rather than collectivistic needs of the population. For example, there are over 20 million citizens who have type 2 diabetes, a chronic and serious disease that impacts how your body breaks down food to obtain energy. This chronic disease has severe complications if not treated appropriately. Unless something is done to prevent this insidious disease, there will be 35 million heart attacks, 13 million strokes, 8 million instances of blindness, 2 million amputations, and 62 million deaths over the next 30 years.

Both private and public participants in the US health delivery system need to increase their collaboration to reduce these disease rates. Leaders need to continue to assess our healthcare system using the Iron Triangle to ensure there is a balance between access, cost, and quality.

Although the Health Care Reform intends to take away the flaws the current system is infested with, the journey is going to be long and tough. But it will  definitely lead to a better outcome as compared to current situation.

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