Untangled Health

Consumers Unite To Drive The Changes We Need

Tag: obamacare

Why We Need Universal Health Coverage

I am disgusted by the frequency of the statement: “Universal Coverage… We can’t do that… That would be Communist!”
As opposed to falling back to arguments relating to the Cold War (although Mr. Trump and Mr. Putin would be happy to re-engage past behavior) how about we look at EVERY OTHER INDUSTRIALIZED NATION IN THE WORLD and compare their health care financing strategy and health outcomes to ours. You see: We stand alone in the World. We are the only industrialized nation that refused to believe that the math of population health science (simple arithmetic) forces civilized nations to pool money and spread it across the entire population of infants, children, young adults, middle aged adults, young-old adults and old-old adults to bring the average cost of health care down to an affordable per-capita rate.
Here are the data from the 2016 OECD Report. You have heard of these folks haven’t you? They met in KOBE in 2016 to discuss global health.

The Study

How these countries finance healthcare

Nothing is different. The older you are, the more health care services you consume.

How long ago each country embraced Universal Coverage

Yes, the more you spend on health care the longer you live. But why is America so expensive?

The more you spend out of pocket the shorter your life span. The more Primary Care Doctors you have per unit of population the longer you live!

A reason we all need someone to watch over us when hospitalized!

As discussed in several posts between December 2015 and today I call upon healthcare consumers to “Learn the System”. The Service Excellence, scores, JCAHO ratings and next door neighbor reviews of your hospital mean little if you are a statistic. Infection Control, Readmission Rates and other measures of quality are available at: Medicare. Gov | Hospital Compare! Please write me if you have questions. Feel free to ask about the numerous Therapeutic Misadventures I have witnessed that will never show on a quality report.
The Trump Administration is doing everything it can to cut the legs out from the transparency tools that were put in place under the direction of the Obama Administration. These tools are all you have to evaluate the quality and safety of your institutions and providers.
Consumers step up and demand the care you deserve – AND PAY FOR!

Medicare Penalizes Group Of 751 Hospitals For Patient Injuries

The federal government Thursday lowered a year’s worth of Medicare payments to 751 hospitals to penalize them for having the highest rates of patient injuries.

More than half also were punished last year through the penalty, which was created by the Affordable Care Act and began four years ago. The program is designed as a financial incentive for hospitals to avoid infections and other mishaps, such as blood clots and bedsores.

Get The Data: See All 751 Hospitals Penalized

Is Your Hospital On The List?

Get the dataHere are the 751 hospitals hit with safety penalties for 2018.

The penalties again fell heavily on teaching hospitals, although less than before. A third of them were punished this year, a Kaiser Health News analysis of the penalties found. Last year, the penalty was levied on nearly half of the nation’s teaching hospitals.

The 115 penalized academic medical centers this year include Denver Health Medical Center, Grady Memorial Hospital in Atlanta, The Mount Sinai Hospital in New York City, Northwestern Memorial Hospital in Chicago, Stanford Health Care hospitals in California and the University of California-San Francisco (UCSF) Medical Center, according to federal records.

“Academic medical centers serve patients with more-complex conditions who are at greater risk of hospital-acquired infections (HAIs) compared to community health care providers,” Stanford Health Care said in a written statement. “Hospitals with a high rate of immunocompromised patients will always seem to have higher HAIs.”

Hospitals that treat large proportions of low-income people also were fined more than hospitals with a more affluent patient base, the analysis found. About a third of those safety-net hospitals were penalized, roughly the same as last year.

Can you believe this one?

“Obamacare has no value”…”Until it has value”

I assisted a man with insurance enrollment yesterday on healthcare.gov. He had recently lost his job and was looking at a $1000 per month COBRA rate.
A conservative fellow who didn’t support “Obamacare” now says: “For the first time I like this legislation and can see why it is needed!”
His rate while unemployed?
$85.00 per month for low deductible.
One down, thousands to go!

Thumbs UP and Thumbs DOWN, WAY DOWN
“Ah, to be one and twenty in the blush of my youth”: A high five to the anti ACA crowd. I hope, but doubt the American People will understand the impact of proposed “new service payment products” on their own health as they age and the health of those who become ill or have a chronic illness. You know; the impact of smaller populations managed under risk contracts dubbed “Health Plans” where: if you are not sick AND if you are not old AND if you do not smoke YOU get a policy for $150 per month!
I am a proponent of the health care collaborative when the governance of these entities assures continuing care at a mutually agreed on affordable price to all consumers in the collaborative regardless of “Health Status”.
Oh the trouble we weave into our future with short-sighted decisions. I call upon the American Diabetes Association, The American Cancer Society, The American Heart Association and others to stand up and describe the possibilities should these changes occur without assessment of the impact on access to care, cost of care and quality of care as it relates to those who actually consume health care services.
Perhaps this is an opportunity for a public and private sector offering. A Medicare for all and a private sector alternative. What that leaves us then is a taxpayer bail-out of the industry for catastrophe; In this case; it is a predictable catastrophe. However, such changes leave behind an opportunity for high profit in the privatized, low consumption, population health care financing product and a large burden to those paying for the 10% of our society that consumes 70% of the services. “Us”.

It is all at stake!

We all have our lives at stake in this battle. Unless we can learn to sacrifice; our children will suffer. You see…I do not believe that the human species has evolved to a point where individuals have the capacity to self-sacrifice; with the exception of extreme examples such as during war-time or in protection of one’s children.
For 32 years I have struggled to bite my lip and lay my tears on the kitchen table as I discussed the in-humanity and utter disregard for patients and their family systems. In many cases, the bitten lip did not provide enough negative reinforcement to keep my thoughts to myself. As many know, in our society the messenger is routinely sacrificed for the preservation of shareholders equity.
Life has delivered me here. Where I no longer worry what others think…I do not want their jobs and am ready to move on with what life I have.
Sleep escapes me some nights. Memories you see fuel my energy to protest the state of shameful dysfunction in American Healthcare. If we lose the progress established in the last three years, we will return. Return to a place I cannot forget.
In 1995 I was a clinical program manager for a ventilator weaning unit. We made our money through operating outside of the restriction of acute in-patient hospital care. In other words, it did not matter how long our patients were in the hospital as we were reimbursed for each day of service.
My job as Program Manager included traveling to hospitals in New York City to evaluate patients in hospitals that could not be weaned from their ventilators. If our facilities were capable of handling the needs of the patient we would transfer them two hundred miles to treat them in our acute rehabilitation hospitals. There was another criterion: We only admitted individuals with sufficient reserve wealth to cover our services.
So I stepped off of our company airplane one summer day in Boston to be greeted by our Senior Vice President. He asked me; “How was the trip Jeff, do you think we could take these ‘cases’”? I said: “The trip was exhausting Mr. XXXXXX, I believe we can take six of the eight we reviewed but don’t think we will be able to wean more than two from their life support.”
As Mr.XXXXXX reviewed the financial assets of each ‘case’ he asked me; “How about this one, how long do you think she will live?”
Thinking of the patient, her family who would not be able to visit and the loss of her personal property that was to be inherited by her grandchildren; I returned home for the evening, placed my head on my wife’s shoulder…and wept.