Let’s talk about health care

Getting to know you

I started this blog a little less than a year ago. I was so frustrated by the decline in our health care system and the rise in costs. After listening to me vent my grievances on oh-so-many occasions, my friends and family finally suggested, “Why don’t you blog about it?” So I did.

And it’s been fun! But our health care system is still in decline and the costs are still climbing. And I’m still frustrated.

My real purpose behind the blog, I think, other than letting off some steam, was to start a conversation.

I’ve … Continue reading

Saltwater costs how much?

hospital costsInflated hospital costs

I read an article in the New York Times yesterday that initially infuriated me. The journalist, Nina Bernstein, wrote something of an exposé on the outrageous hospital costs incurred by a group of about 100 people after suffering from an outbreak of food poisoning.

She focused on the fact that a bag of normal saline IV solution costs the hospital anywhere from $0.44 to $1.

Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for

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High prescription drug costs will be unsustainable

Drugs costs might be higher for some

I was reading in the New York Times today about yet another delay of an Obamacare mandate.

This latest delay is regarding the new out-of-pocket(OOP) limits that insurers can charge consumers. In 2014, all plans are supposed to cap OOP costs, including the deductible, at $6,350 for an individual and $12,700 for a family.

Certain group health plans that carry separate policies for prescription drugs have been granted a one-year delay on these OOP caps (have they really not had enough time to make this work?). Such plans will have two separateContinue reading

Farewell, catastrophic plans

Obamacare kicks catastrophic plans to the curb

I read on Kaiser Health News this morning that when

ehealthinsurance.com began notifying people in non-grandfathered [catastrophic] plans that they would have to change policies next January, they got so many calls that they shut down the planned week-long email campaign after one day.

“The people that received the email were not happy at all,” says Carrie McLean, the website’s director of customer care.

Yes! I thought. That is my situation and I’m not happy, either.

Traditionally, insurance companies have offered catastrophic plans to individuals that are relatively healthy and use little health … Continue reading

Pushing back against too much medicine

As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.

Here are some of my favorite health care blog posts and news articles from the last week.

“Testing Wisely” by Dr. Rob Lamberts 

Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading

The Sunshine Act

Shining a light on the physician-Big Pharma relationship

One of the little-known laws buried in the Affordable Care Act (ACA) is the Physician Payments Sunshine Act, which takes effect today.

I understand the impetus of this law, but I am less sure of its positive effect.

The Sunshine Act (the drafters no doubt had a mental image of exposing something slimy to the light) seeks to illuminate the financial relationships between doctors/teaching hospitals and drug companies/medical device manufacturers.

Conflicts of interest and questionable ethics have been problems for years as public funding has decreased and private industry money has … Continue reading

Lowering health care costs: It takes a village

Physicians have a role in lowering health care costs

The Mayo Clinic has been busy this month.

Last week researchers published a report in the Journal of the American Medical Association (JAMA) titled “Views of US Physicians About Controlling Health Care Costs.”

Also last week,  Mayo Clinic Proceedings published its conclusion that nearly 40% of current medical practices are of no net benefit and needlessly contribute to high health care costs.

The first study surveyed physicians’ attitudes about their role in reducing health care costs. Do they believe they can and should help rein in the cost of health Continue reading

Obamacare and dental health

Dental health is important, isn’t it?

Starting in 2014, the Affordable Care Act (ACA) mandates that all insurance plans cover “essential health benefits,” including vision and dental benefits for children.

Obviously pediatric eye and dental health are important to the crafters of the ACA; but what about adults? We have eyes and teeth, too!

Even though many preventive services, such as annual exams, mammograms, and even breast pumps are covered, routine eye and dental exams are not.

I posted a few months ago that I thought it a shame that preventive vision care had received so little support in health Continue reading

Weekly rounds July 12, 2013

How much does good health cost? Apparently less than we are spending…

Once again, a study has shown that although Americans far outspend other countries on health care, our health is poor in comparison.

The healthiest citizens, no surprise, are in the wealthier cities and states, and vice versa. And it’s not because they can afford better health insurance. Other studies have linked education and income level to better lifestyle choices – diet and exercise – rather than access to health care.

In my opinion, we should be spending tax-payer dollars on all levels of education (Congress, what about … Continue reading

Perverse incentives: Where’s the outrage?

perverse incentives in health careThat’s a good question!

H. Gilbert Welch, MD, the author of Overdiagnosed: Making People Sick in the Pursuit of Health, wrote a recent op-ed in the New York Times in which he wonders at what point will the high costs—and profits—of medical care in America be considered “a crime”?

Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufacturers — are the ones benefiting.

The crime of perverse incentives

Although … Continue reading

Overscreening for hepatitis C

Baby boomers get another screening test

I was  annoyed when the  US Preventive Services Task Force (USPSTF) announced last week that baby boomers, those born between 1945 and 1965 (myself included), should be tested for the liver infection hepatitis C (HCV) regardless of risk factors.

I think my age group is already subjected to too many screening tests of questionable value.

Related reading: Check and check again

Just last November the USPSTF issued a statement that only people at an increased risk of HCV—mostly IV drug users and anyone who received a blood transfusion before 1992—should be tested. Anyone … Continue reading

Weighing in on obesity as a disease

obesity as a diagnosisLast week the American Medical Association voted to recognize obesity as a disease, as opposed to just a symptom of an unhealthy lifestyle or sluggish metabolism.

Obesity is a huge (no pun intended) problem in the US; over 60% of adults and 30% of children are considered overweight or obese. Proponents of the decision argue that accepting obesity as a disease will focus more attention on the problem and allow physicians and patients greater access to and reimbursement of weight loss counseling, drugs and surgeries. Sounds good, right?

So why does this decision trouble me? Three reasons come … Continue reading

Weekly rounds June 21, 2013

June 17-21, 2013The HPV vaccine works

Positive news was reported in the Journal of Infectious Diseases: Since vaccination for the human papillomavirus (HPV) was introduced in 2006, the rate of HPV infection has dropped by 56%.

The study looked at infection rates in girls age 14 to 19. HPV can lead to cervical cancer or throat cancer later in life, but only about 30% of teen girls and boys are being vaccinated.

This report will hopefully result in a much-needed boost in the numbers of kids receiving the vaccine. Visit the CDC website for more information about the vaccine.

No one

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Weekly rounds May 17, 2013

Stock up on DEET?

Any report that contains the word “deadly” gets the attention of the media, and this report by the Centers for Disease Control (CDC) was no exception. Last year 5,674 cases of the mosquito-borne virus were reported, and 286 people died. In comparison, only 43 deaths were recorded in 2011.

Weather conditions that favored the mosquito – warm and humid – were probably factors in last year’s increase in cases.

This news reminds me that I want to spend some time researching insect repellents and then write a post about them. Does anything work as well as … Continue reading

Medicare publishes health care costs

It’s no surprise to anyone in the health care industry, but Medicare just released a report that shows the incredible variation of health care costs across the country.

Many patients are unaware of these price differences because, as I’ve posted about before, it’s nearly impossible for health care consumers to get information about the cost of a procedure before having the procedure done.

Coming so soon after Stephen Brill’s brilliant (yet depressing) Time magazine article, “Bitter Pill: Why Medical Bills are Killing Us, the numbers presented in the report will hopefully provoke consumers to demand more fairness and … Continue reading