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Posts Tagged ‘politics’

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.

4 Strong Pillars for Healthcare

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

According to a recent publication from the Institute of Medicine(IOM), Health care in the United States is at a critical point. Excessive costs are no longer tenable and mediocre outcomes are no longer tolerable. For 32 of the past 40 years, health care costs have grown faster than the rest of the U.S. economy. Federal health care costs—expected to reach $950 billion in 2012—will become the largest contributor to the national debt.

Change is highly needed. Policies and procedures needs another look. Strategies and management from the Healthcare leaders need to be well defined. We need strong pillars to sustain current healthcare and to build the future ones.

The 4 pillars of  a strong and long-term viable organizations are as under.

Foundational elements
• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing,
real-time learning
Infrastructure fundamentals
• IT best practices—automated, reliable information to and from the point of
care
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and
other resources
Care delivery priorities
• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for resource-intensive patients
Reliability and feedback
• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs

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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