Posts Tagged ‘Democrats’

President Obama appointed Dr. Donald Berwick to be the administrator of The Centers for Medicare & Medicaid Services (CMS) through a recess appointment that avoided a Congressional hearing.

Who is Donald Berwick? I’ve been hearing about him for years. He founded and led the Institute for Healthcare Improvement (IHI), a not-for-profit organization that has been pioneering efforts to improve of health care in the United States and elsewhere. His efforts have helped steer the U.S. health care system toward a greater recognition of the need to achieve health care excellence and, more importantly, have resulted in real, practical successes that have improved the care we receive in the U.S. health care system.

Some of Berwick’s detractors with respect to this appointment focus on statements he has made about rationing care and redistributing it to the people who need it most. Let me be very clear: health care will be rationed. It already is now, and the only question facing us as we try to address the spiraling cost of care is who will do the rationing in the future. Will we Americans choose to take responsibility to do it ourselves (by taking more responsibility for directly paying the cost of care), or will we leave it to insurers, politicians and other government regulators to do it for us?

So far it seems we don’t have the stomach to ration care ourselves, though I believe that increasing personal responsibility is the best way to control health care expenditures. If we are going to leave it to the government to control our health care costs, we could do a lot worse than having Don Berwick at the helm.

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In a July 19 article, Washington Post columnist Robert Samuelson describes Massachusetts health care reform measures as a model for the national health care legislation that passed Congress this year. He doesn’t paint a hopeful picture. True, marginally more people gained access to care — defined by having insurance coverage. But costs continue to spiral out of control.

The measures to control costs have been limited and largely ineffective. Wholesale changes in how doctors and hospitals would be paid were suggested, but without any specific plans. In Samuelson’s words, “The system’s fundamental incentives won’t change.” He raises the possibility of unpopular measures such as “accountable care organizations” or spending restrictions that would limit consumer choice of doctors and hospitals or raise the specter of essential care denied.

Samuelson leaves out the other path, the one that has been so successful in so much of the rest of the U.S. economy, a market-based approach in which consumers get to choose what care they want, but they must also face the economic impact of those choices. For more details, visit http://www.drscore.com and check out my White Paper on Health Care Reform.

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One way that recent health care reform legislation is supposed to help improve care while lowering costs is by encouraging more preventive care services to be offered. The Center for Medicare & Medicaid Services (CMS) announced new preventive health benefits created under the Affordable Care Act for seniors and persons with disabilities covered by Medicare.

Click here to learn more about these benefits.

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Campaign finance legislation failed to pass the Senate today.  Last year, U.S. Senators Chuck Grassley (R-IA) and Herb Kohl (D-WI) introduced legislation to require drug companies to publicly report money they give to doctors over $100 every year.

This is a wonderful idea. Greater transparency helps everyone.  At DrScore, this is a focus of our beliefs about U.S. medicine. Doctors have nothing to fear and much to gain from transparency, whether we talk about patient satisfaction scores or pharmaceutical company support. The last thing we doctors need to do is to raise suspicions by fighting efforts to improve transparency.

In fact, physicians should lead the way in support of more transparency.  Not only should we be supporting the Grassley/Kohl measure, but  we should encourage Congress to expand the measure to include payments to politicians and their campaign funds.  Senator Grassley hit the nail on the head when he said, “The goal of our legislation is to lay it all out, make the information available for everyone to see, and let people make their own judgments about what the relationships mean or don’t mean.  If something’s wrong, then exposure will help to correct it.  Like Justice Brandeis said almost a century ago, ‘sunshine is the best disinfectant.’”

This applies to both physicians and politicians.  I hope we find that politicians are as ethical as physicians are.  If so, the public will be well served.

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On Getting Better Health Care, physician Cynthia Koelker, M.D., describes practical ways people can lower their health care costs right now.

Koelker is author of the book 101 Ways to Save Money on Health Care.

We don’t need government to legislate health care reform to lower costs if we take some personal responsibility. Click here to listen to the show.

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Tribune Washington reporter Noam Levey reported that “the five largest health insurance companies racked up combined profits of $12.2 billion” in 2009 (http://seattletimes.nwsource.com/html/nationworld/2011050573_healthprofits12.html).

I’m sure there are many ways to spin this, but I’m not at all impressed that this is the cause of the high cost of health care. When the nation spends hundreds of billions, $12 billion in profit isn’t that striking. The article reported that profit margins for these large health insurers ran from roughly 3 percent to 7 percent, the higher numbers in part due to sale of part of the company. Growth in the stock market could have contributed as well.

We need to fix our health care system, no doubt about it. Demonizing one sector — like health insurers — is not the answer. Someone has to take responsibility for controlling costs. Right now, our third party payment system has taken much of that responsibility off of patients. That leaves high costs or rationing as the other options, neither of which is particularly palatable.

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I wonder if progress toward rational health care reform could be made if Congress would get some momentum moving forward by passing legislation everyone could agree on. So, I have decided to make a suggestion.

Aspects of good health care include:

1) giving patients instructions in writing, and

2) sending patients the results of any tests performed — whether the test found a problem or not.

These measures help ensure that patients have the information they need to be involved and responsible in their own care. I believe that linking payment incentives for quality to these measures would quickly change the culture of our medical system, which all too often fails to address these simple actions.

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The impact of the partisan debate hit home when someone told me she came in for care because she was worried that Obama would soon take away her Medicare.  How ridiculous is that I thought!  She went on to talk about how the proposed health care reform legislation includes plans to kill old people.  I had trouble believing that anyone would really accept such partisan nonsense, but here it was.

We could go into detail, but let me just say those ideas are ridiculous.  I don’t think the Democratic plan to solve our health care crisis is the right one, but ending Medicare or plans to kill old people are not the problems with it.  One thing we should keep in mind is that those people promoting health care reform, both Democrats and Republicans, are simply trying to help Americans get better care without going broke doing it.

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