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Rethinking The United States ’ Military Health System
During Operations Enduring Freedom and Iraqi Freedom (2001 – 2014), the United States’ military health system completely transformed its approach to casualty care, achieving the highest rate of survival from battlefield wounds in the history of warfare. It is one of the most remarkable accomplishments in the history of US medicine.
Ironically, the same health care system that worked miracles “down range” in Iraq and Afghanistan faces mounting criticism at home. How can this be? In part, it is because the military health system has two distinctive missions: support combat and humanitarian assistance missions ove...
Source: Health Affairs Blog - April 27, 2017 Category: Health Management Authors: Arthur Kellermann Tags: Costs and Spending Featured Organization and Delivery Population Health Quality American College of Surgeons Department of Veterans Affairs Jonathan Letterman military health care National Defense Authorization Act TRICARE Source Type: blogs
Health Policy ’s Gordian Knot: Rethinking Cost Control
Medical spending has resumed its long-term rise. After several years of deceptive stability in the last, deep recession’s wake, health spending rose by 3.7 percentage points more than general inflation in 2014, then by 5.8 percentage points more in 2015, to a 17.8 percent share of the US economy.
Not only does this spending rise threaten the United States’ fiscal stability and capacity to address other needs; it is undermining the promise of health care for all. To manage rising costs, insurers are hiking premiums, narrowing their networks, and raising deductibles and copayments, making purchase of coverage less appeal...
Source: Health Affairs Blog - April 26, 2017 Category: Health Management Authors: Gregg Bloche, Neel Sukhatme and John L. Marshall Tags: Costs and Spending Drugs and Medical Technology Health IT Insurance and Coverage Payment Policy intellectual property patents Research and Development value-based payment Source Type: blogs
Is Healthcare a Right? A Privilege? Something Entirely Different?
By BRIAN JOONDEPH, MD
Election Day 2016 should have been Christmas morning for Republicans. Long awaited control of the White House and both houses of Congress. A chance to deliver on an every two-year election cycle promise to repeal and replace Obamacare. In 2010 Republicans needed the House. They got it. In 2014, it was the Senate. Delivered. But we still need the White House they said. Asked and answered with President Donald Trump.
So, what happened a few weeks ago when the House bill fizzled like a North Korean missile launch? Disparate factions within the House couldn’t unify behind Speaker Paul Ryan’s plan, des...
Source: The Health Care Blog - April 8, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Brian Joondeph Source Type: blogs
What Now?: A Four Step Plan For Bipartisan Health Reform
As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind. While it will not be easy, we ought to applaud these gestures and, as health care stakeholders, demonstrate our preparedness to support efforts to improve health care access and reduce costs.
With that in mind, I have compiled here a range of sensi...
Source: Health Affairs Blog - April 4, 2017 Category: Health Management Authors: Billy Wynne Tags: Featured Following the ACA Insurance and Coverage Medicaid and CHIP Quality bipartisanship Congress house v. price MACRA section 1333 Source Type: blogs
Health Care: What Should a Populist Do Now?
Conclusion
The most common response to the suggestion that private contracts could be useful in reforming the health-care system for the benefit of ordinary Americans is the observation that people—ordinary Americans in particular—cannot reasonably be expected to read, let alone understand and compare, the multiple contracts they would confront. This point, however, while valid, is beside the real one, which is to give adequately subsidized consumers meaningful choices with respect to the cost and content of their future health care and enough reliable help in making them that they can be reasonably content with their ...
Source: The Health Care Blog - April 1, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
After the American Health Care Act
BY JOHN IRVINE
We asked THCB’s editors and bloggers for their reactions to Friday’s news. Here are their reactions.
DANIEL STONE, MD
The late UCLA Professor Richard Brown, once commented that the Clinton healthcare initiative failed because the status quo was everyone’s second choice. Some of that logic applies to today’s failure to vote on the AHCA. Additionally, no one ever lost money betting against the rollback of an established entitlement program.
The Republicans opponents of the ACA have not yet faced the fact that the reason coverage is so expensive is because the care is so expensive. You can’t ...
Source: The Health Care Blog - March 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized John Irvine Source Type: blogs
How Trump Can Kill the Cancer In Obamacare Without Congress
By BRIAN JOONDEPH, MD
Cancer is a devious and devastating disease. All it takes are a few bad cells to grow uncontrollably, first destroying organs, then an entire person. It can also lie dormant for years after supposedly being cured, then at some moment awaken from its remission slumber to resume its search-and-destroy mission. Even if cancer is controlled, it can still leave its victim in a weakened or debilitated condition, a shadow of its former robust self.
What if the Affordable Care Act, affectionately known as Obamacare, was unintentionally infected with cancer back in 2010 when it was voted into law? What if the ...
Source: The Health Care Blog - March 13, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Bringing on-demand rideshare to medical transport. Interview with Veyo ’ s CEO
Uber and Lyft have transformed (and largely destroyed) the taxi industry. Now startup companies like Veyo are applying similar approaches to the medical transportation field. I interviewed Veyo’s CEO, Josh Komenda to get his take.
1.How is non-emergency medical transportation (NEMT) defined? What’s included? How big is it?
Non-Emergency Medical Transportation (NEMT) is a transportation benefit for Medicaid or Medicare members who need to get to and from medical services, but have no means of transportation. NEMT provides eligible patients with trips that are non-emergency in nature, meaning there is no i...
Source: Health Business Blog - March 9, 2017 Category: Health Management Authors: dewe67 Tags: Entrepreneurs Patients Podcast Technology medical transportation NEMT rideshare Source Type: blogs
Peter Navarro, Harvard Ph.D. Economist, Trade Warrior
Peter Navarro, director of the newly-established White House National Trade Council, gave a speech last week to the National Association for Business Economics, which he condensed into anopinion piece for theWall Street Journal. The analytical errors and the fallacies portrayed as facts in that op-ed are so numerous that it is bewildering how a person with a Ph.D. in economics from Harvard University —and a potentially devastating amount of influence within the White House—could so fundamentally misunderstand basic tenets of introductory economics.Almost every paragraph in the op-ed includes an error of fact or interpr...
Source: Cato-at-liberty - March 7, 2017 Category: American Health Authors: Daniel J. Ikenson Source Type: blogs
R & D Costs For Pharmaceutical Companies Do Not Explain Elevated US Drug Prices
That pharmaceutical companies charge much more for their drugs in the United States than they do in other Western countries has contributed to public and political distrust of their pricing practices. When these higher US prices (which are sometimes cited as being two to five times the prices in Europe) are challenged, the pharmaceutical industry often explains that the higher prices they charge in the US provide them with the funds they need to conduct their high-risk research.
This claim—that premiums earned from charging US patients and taxpayers more for medications than other Western countries funds companies’...
Source: Health Affairs Blog - March 7, 2017 Category: Health Management Authors: Nancy Yu, Zachary Helms and Peter Bach Tags: Costs and Spending Drugs and Medical Innovation Payment Policy Big Pharma drug pricing Source Type: blogs
Invisible High-Risk Pools: How Congress Can Lower Premiums And Deal With Pre-Existing Conditions
As Congress and the Trump administration move forward with plans to repeal and replace the Affordable Care Act (ACA), they are looking for proven state-led reforms that maintain access for those with pre-existing conditions in the current exchange market while also lowering premiums for everyone buying insurance in the individual market.
Maine faced similar challenges in 2011 as it sought to unwind failed experiments that pushed its market into a long-term death spiral. But by creating an invisible high-risk pool and relaxing its premium rating bands, Maine policymakers were able to cut premiums in half while still guarant...
Source: Health Affairs Blog - March 2, 2017 Category: Health Management Authors: Joel Allumbaugh, Tarren Bragdon and Josh Archambault Tags: Following the ACA Health Policy Lab Insurance and Coverage ACA repeal and replace high-risk pools pre-existing conditions Source Type: blogs
Value Assessment Frameworks: How Can They Meet The Challenge?
Rising health care costs and pharmaceutical prices in particular are among the main factors that have prompted a steady flow of scholarly and lay press articles about moving from paying for volume to paying for value. Proposals from groups such as the Center for American Progress advocate drug pricing based on assessments of comparative effectiveness.
If implemented, value-based assessments of drugs and other health care services would influence payer, provider, and patient decision making, and likely patient outcomes as well. Each of these approaches assumes that some calculus of value could reliably be measured, would ap...
Source: Health Affairs Blog - March 2, 2017 Category: Health Management Authors: Robert Dubois and Kimberly Westrich Tags: Costs and Spending Drugs and Medical Innovation cost effectiveness analysis ICER value-based insurance design value-based purchasing Source Type: blogs
As US Attorney, Labor Secretary Nominee Enabled Drug and Biotechnology Executives ' Impunity
The new Trump administration nominee for US Secretary of Labor is a former US Attorney for the southern district of Florida. In that role, he seemed to uphold the ideas that certain big corporations, particularly big pharmaceutical and biotechnology corporations, are too big to jail, and that top executives of big corporations should not be held accountable for their corporations ' actions.He had central involvement in three bigsettlements of charges of corporate misbehavior which held no individuals accountable for enabling, authorizing, directing or implementing the bad behavior. The settlements imposed only ...
Source: Health Care Renewal - February 21, 2017 Category: Health Management Tags: bribery Bristol-Myers-Squibb deception Donald Trump Genzyme GlaxoSmithKline impunity kickbacks legal settlements manipulating clinical research Sanofi-Aventis Source Type: blogs
How Can We Increase The Use Of Palliative Care In Medicare?
In August, 2016, a 93-year-old woman—the grandmother of one of this Blog post’s authors—died of congestive heart failure, five weeks after she underwent surgery to receive a pacemaker. There were alternative care options, but they were not offered to her and her family in a timely manner, at least in part because of Medicare’s long-standing payment rules that value procedures over discussion of goals and alleviation of symptoms. Medicare paid for the surgery and pacemaker with no questions asked, even though the procedure was, in retrospect, unproductive, wasteful, and even harmful from the family’s persp...
Source: Health Affairs Blog - February 13, 2017 Category: Health Management Authors: Donald Taylor, Matthew Harker, Andrew Olson and Janet Bull Tags: End of Life & Serious Illness Medicare Alternative Payment Models Dying in America Medicare Part B Palliative Care Source Type: blogs
