Regardless of our political leanings, many of us will end up in a hospital some day with a problem or one of a loved one’s, wishing there was something more that could be done. Enter the ’08 race to solve our problems. Healthcare, or the lack of it, will be a topic of discussion over the next ten months. In fact it will be debated about more than any election in history. Right now we are stuck with a patchwork quilt of private plans, public safety nets and insurance schemes. A total of 46 million of US citizens have no medical coverage at all and millions more are poorly covered. Medical bills remain the number one cause of personal bankruptcy in the US and we suffer from the highest rates of heart disease and infant mortality in the industrialized world.
The question put forth in this year’s election is whether or not a for-profit healthcare system can meet the needs of society today and in the future. Can we be a great society if our fundamental approach to healthcare is that “You are on your own?” Is single payer healthcare, as opposed to a system that is a lot like car insurance, the way to go? Are we to go the way of Canada, the UK and France and offer “free” healthcare to every American?
These are the questions that face the ’08 election campaigners. We will need to look at the benefits of preventative care and the benefits of having every American covered. What will this look like tax-wise? It’s a complicated system that will be much discussed and looked at during the next presidential election. But will anything be allowed to change?
Monday, December 31, 2007
Friday, December 28, 2007
Healthcare Disaster Preparedness Poor
In spite of the federal government spending nearly $ billion for disaster preparedness since 2002, some believe that that the US healthcare system is poorly equipped to respond to a major disaster, saying that disaster planning is still sporadic and disconnected from organization to organization. A national study confirms this.
The study, based on interviews with top healthcare industry leaders said that while “significant progress has been made since 9/11, many gaps in care and preparedness continue to exist.
"When a disaster hits, Americans rely on a fragmented health care system to miraculously mount a timely, cohesive, and effective recovery effort," said the report by PricewaterhouseCoopers' Health Research Institute. "Yet, the carefully orchestrated and sequenced medical responses to disasters lean on a disjointed health system."
The report goes on to say that facilities and staff resources are limited, public health and private sector plans are poorly coordinated and that communications and tracking systems are incompatible with one another. Funding is not yet available to support the development of a sustainable infrastructure in the case of a national disaster.
In a related report by the Trust for America’s Health (TFAH), it was found that more work needs to be done on the nation’s emergency health preparedness effort.
"The improvements in state preparedness are encouraging, but the job of preparing the United States for major health emergencies is not nearly done," said Jeff Levi, executive director of TFAH. "And, just when we are beginning to see a return on the federal investment in preparedness programs, the president and Congress have continued to cut these funds. These efforts may seem penny wise now, but could prove pound foolish later."
The report found that seven states and the District of Columbia do not have the capabilities to test for biological threats; seven states have not purchased any antiviral agents to use during a pandemic flu, which TFAH said "places the entire nation at risk," and 21 state do not have statutes for adequate liability protection for healthcare volunteers during emergencies.
The study, based on interviews with top healthcare industry leaders said that while “significant progress has been made since 9/11, many gaps in care and preparedness continue to exist.
"When a disaster hits, Americans rely on a fragmented health care system to miraculously mount a timely, cohesive, and effective recovery effort," said the report by PricewaterhouseCoopers' Health Research Institute. "Yet, the carefully orchestrated and sequenced medical responses to disasters lean on a disjointed health system."
The report goes on to say that facilities and staff resources are limited, public health and private sector plans are poorly coordinated and that communications and tracking systems are incompatible with one another. Funding is not yet available to support the development of a sustainable infrastructure in the case of a national disaster.
In a related report by the Trust for America’s Health (TFAH), it was found that more work needs to be done on the nation’s emergency health preparedness effort.
"The improvements in state preparedness are encouraging, but the job of preparing the United States for major health emergencies is not nearly done," said Jeff Levi, executive director of TFAH. "And, just when we are beginning to see a return on the federal investment in preparedness programs, the president and Congress have continued to cut these funds. These efforts may seem penny wise now, but could prove pound foolish later."
The report found that seven states and the District of Columbia do not have the capabilities to test for biological threats; seven states have not purchased any antiviral agents to use during a pandemic flu, which TFAH said "places the entire nation at risk," and 21 state do not have statutes for adequate liability protection for healthcare volunteers during emergencies.
Thursday, December 27, 2007
Healthcare Leads Cutting-Edge Careers
Those following the career market list healthcare as the number one cutting edge career in the years to come. As the human population ages, there is a growing healthcare demand. The job market is strong, particularly in certain areas and new growth is promised.
The US healthcare system is already overtaxed and is going to get tighter. As baby-boomers age, the need for more nurses and caregivers is going to increase. If there is a national healthcare plan that provides medical care to the millions of uninsured individuals, this will provide a greater influx of patients needing to receive healthcare. The hottest healthcare jobs include health informatics specialists that will develop expert systems to help doctors and other healthcare providers make evidence-based diagnoses and treatments.
Hospitals, insurers and patient families will desire to hire patient advocates to navigate the confusing pathways that healthcare brings to a family. Such advocates may help reduce confusion and lawsuits between patients and providers. There will be a need to hire more healthcare coders that will help with reimbursement from Medicare and insurance companies.
There will be an increase in illness prevention. People will move past personal trainers and hire wellness coaches to help not only with exercise and good eating but with smoking cessation, the drinking of alcohol and with stress reduction. Wellness coaches may become an option for the middle class and not only for the elite.
The US healthcare system is already overtaxed and is going to get tighter. As baby-boomers age, the need for more nurses and caregivers is going to increase. If there is a national healthcare plan that provides medical care to the millions of uninsured individuals, this will provide a greater influx of patients needing to receive healthcare. The hottest healthcare jobs include health informatics specialists that will develop expert systems to help doctors and other healthcare providers make evidence-based diagnoses and treatments.
Hospitals, insurers and patient families will desire to hire patient advocates to navigate the confusing pathways that healthcare brings to a family. Such advocates may help reduce confusion and lawsuits between patients and providers. There will be a need to hire more healthcare coders that will help with reimbursement from Medicare and insurance companies.
There will be an increase in illness prevention. People will move past personal trainers and hire wellness coaches to help not only with exercise and good eating but with smoking cessation, the drinking of alcohol and with stress reduction. Wellness coaches may become an option for the middle class and not only for the elite.
Tuesday, December 25, 2007
Future Health Policy to Include Individual Insurance Plans
If an individual works for himself, retires before Medicare is valid or don’t have health insurance through their employment, finding adequate healthcare that’s affordable depends on the state you live in. Some states chose to pass guaranteed-issue laws which forbid insurance companies from turning down someone because of their previous health status. This has resulted in high premiums for the sick and healthy alike.
With new healthcare policies, it should be easy for people to find coverage on their own, even if they have a pre-existing condition. Experts recommend going online and shopping for an individual policy. The site “eHealthinsurance.com” is a good resource and is somewhat of a national marketplace for health insurance policies. It allows the user the opportunity to compare a number of healthcare options. You can also use a local health-insurance broker. Brokers often know the local markets fairly well and can help you join the state’s high-risk pool, if necessary. The National Association of Health Underwriters can also let you know who the member agents in your area are.
Experts also recommend getting a list from the state insurance department’s web site. There will be a list of companies selling individual coverage locally. Many Blue Cross/Blue Shield plans don’t deal with brokers but prefer to deal directly with the company.
A total of thirty-three states have high risk pools that guarantee coverage to people who have been rejected by private insurers. Premiums in many states are limited to less than 150 percent of the cost of standard coverage. In the few states that don’t have open high risk pools, there is still healthcare coverage available through the HIPAA act of 1996. This Act requires that the states provide some kind of coverage even after you leave your job, regardless of health issues. You generally need to exhaust COBRA first. COBRA allows for eighteen months worth of coverage after leaving your job.
Find a new group plan by joining an organization that has group coverage. This can be established trade associations or other organizations. Short term policies provide a stop gap for up to 180 days and work until you get your own, more permanent, coverage. You can also consider health savings accounts to accumulate money in a tax sheltered account that can be used to pay the deductible on a policy.
With new healthcare policies, it should be easy for people to find coverage on their own, even if they have a pre-existing condition. Experts recommend going online and shopping for an individual policy. The site “eHealthinsurance.com” is a good resource and is somewhat of a national marketplace for health insurance policies. It allows the user the opportunity to compare a number of healthcare options. You can also use a local health-insurance broker. Brokers often know the local markets fairly well and can help you join the state’s high-risk pool, if necessary. The National Association of Health Underwriters can also let you know who the member agents in your area are.
Experts also recommend getting a list from the state insurance department’s web site. There will be a list of companies selling individual coverage locally. Many Blue Cross/Blue Shield plans don’t deal with brokers but prefer to deal directly with the company.
A total of thirty-three states have high risk pools that guarantee coverage to people who have been rejected by private insurers. Premiums in many states are limited to less than 150 percent of the cost of standard coverage. In the few states that don’t have open high risk pools, there is still healthcare coverage available through the HIPAA act of 1996. This Act requires that the states provide some kind of coverage even after you leave your job, regardless of health issues. You generally need to exhaust COBRA first. COBRA allows for eighteen months worth of coverage after leaving your job.
Find a new group plan by joining an organization that has group coverage. This can be established trade associations or other organizations. Short term policies provide a stop gap for up to 180 days and work until you get your own, more permanent, coverage. You can also consider health savings accounts to accumulate money in a tax sheltered account that can be used to pay the deductible on a policy.
Healthcare having an Important Year in 2008
Healthcare may have its biggest year yet, according to PricewaterhouseCooper’s Health Research Institute. Part of the excitement is related to the upcoming presidential election. Other changes include an adjustment to the Medicare payment system. "The future strategies of hospitals, commercial insurers, pharmaceutical companies and life sciences firms will be influenced by big changes ahead in government policies, market pressures and global trends," said R. Carter Pate, Global and U.S. health industries and government services leader. "With healthcare costs taking a bigger bite out of the assets of individuals, businesses and the U.S. economy, there is a demand for greater accountability from the health industries and a demonstration of the value they create."
Here are some of the expected changes: 1) Retirees will play a greater role in funding their healthcare coverage. Many executives believe that employees should no long fund the healthcare of the retired person. 2) The new Medicare payment system will create hospitals who win and hospitals who lose. Two hundred more diagnosis codes have been added that recognize the severity of illness among hospitalized patients. 3) Retail health clinics will challenge primary care models. There will be a number of retail clinics in discount chain stores and other stores throughout the US to handle minor illnesses. It’s possible that this could threaten the primary healthcare model. 4) Individual health insurance could become more prominent. There could be tax incentives for individually insured individuals and it should reduce the number of uninsured. 5) There could be an increased merger and acquisition activity between pharmaceutical companies and life sciences companies. 6) There could be an increased role of Asia in the pharmaceutical industry. This could increase issues of safety in pharmaceuticals. 7) The FDA is poised to tighten drug and medical device safety standards. 8) The IRS seeks a full accounting of hospital community benefits. They want the hospital to submit a full accounting of the benefits they provide to the community.
"The government and the public have high expectations that the health industries will deliver safe care and safe drugs and will meet consumer and patient demands for innovative products and services," said Dr. David Chin, partner and leader of PwC's Health Research Institute. "Now there is some real accountability behind many of these expectations."
Here are some of the expected changes: 1) Retirees will play a greater role in funding their healthcare coverage. Many executives believe that employees should no long fund the healthcare of the retired person. 2) The new Medicare payment system will create hospitals who win and hospitals who lose. Two hundred more diagnosis codes have been added that recognize the severity of illness among hospitalized patients. 3) Retail health clinics will challenge primary care models. There will be a number of retail clinics in discount chain stores and other stores throughout the US to handle minor illnesses. It’s possible that this could threaten the primary healthcare model. 4) Individual health insurance could become more prominent. There could be tax incentives for individually insured individuals and it should reduce the number of uninsured. 5) There could be an increased merger and acquisition activity between pharmaceutical companies and life sciences companies. 6) There could be an increased role of Asia in the pharmaceutical industry. This could increase issues of safety in pharmaceuticals. 7) The FDA is poised to tighten drug and medical device safety standards. 8) The IRS seeks a full accounting of hospital community benefits. They want the hospital to submit a full accounting of the benefits they provide to the community.
"The government and the public have high expectations that the health industries will deliver safe care and safe drugs and will meet consumer and patient demands for innovative products and services," said Dr. David Chin, partner and leader of PwC's Health Research Institute. "Now there is some real accountability behind many of these expectations."
Monday, December 24, 2007
The Impact of Healthcare Reform on Rural Healthcare
The election year means that we may be on the verge of another healthcare reform. In general, healthcare reform ignores the plight of rural healthcare and rural healthcare suffers. In fact, rural healthcare is at risk with or without healthcare reform. Currently, healthcare in America is not for and it cannot continue in the ways we have known it but it is particularly unfair to rural peoples. While every approach to healthcare reform has tradeoffs, the ones who tend to suffer are the elderly and the rural areas.
While it seems simple, we must beware of healthcare reformers who promise to do it all. If it is too good to believe, it is truly not worth believing. Many different ways of changing healthcare are possible and all affect key interests and goals differently. Some competing goals address costs, the uninsured, quality, fairness, choice and making communities healthy. Rural healthcare needs are often in direct competition with the needs of suburban and urban healthcare needs.
Rural healthcare reform needs to address access to quality healthcare, access to hospitals, access to specialists and emergency medical concerns. The way the current system is set up, it is difficult for rural peoples to enjoy the same access to healthcare as those living in urban centers. There is no incentive for doctors to practice in rural areas and quality of life for doctors in rural healthcare systems is perceived to be lacking. Rural healthcare’s many successes are a testament to the endurance and creativity of rural communities. Reform needs to build on that strength and not weaken it.
While it seems simple, we must beware of healthcare reformers who promise to do it all. If it is too good to believe, it is truly not worth believing. Many different ways of changing healthcare are possible and all affect key interests and goals differently. Some competing goals address costs, the uninsured, quality, fairness, choice and making communities healthy. Rural healthcare needs are often in direct competition with the needs of suburban and urban healthcare needs.
Rural healthcare reform needs to address access to quality healthcare, access to hospitals, access to specialists and emergency medical concerns. The way the current system is set up, it is difficult for rural peoples to enjoy the same access to healthcare as those living in urban centers. There is no incentive for doctors to practice in rural areas and quality of life for doctors in rural healthcare systems is perceived to be lacking. Rural healthcare’s many successes are a testament to the endurance and creativity of rural communities. Reform needs to build on that strength and not weaken it.
Friday, December 21, 2007
Research Overwhelms Electronic Patient Information Systems
Until recently, it was difficult for researchers to access hospital and clinical information on patients for research purposes. Now, with electronic information systems, the collection of patient data for research is possible—except that the demand for such information has overwhelmed the electronic data sources. The systems in existence, however, which is used for accreditation and other purposes, is simply too primitive to keep up with increasing demands. Enter the Analytical Healthcare Repository (AHR), a collaborative framework designed to centralize the information on patients for analytical purposes.
The AHR is designed to give doctors and researchers active information on a variety of patients centralized to a single source. It offers a new approach to analytical healthcare applications and addresses the full spectrum of analytical needs a researcher might have by delivering a data warehouse comprised of electronic medical record data (EMR). Genomic information and patient billing data are included as well. The use of EMR is supported by public systems like JCAHO, which require the showing of quality and safety standards. This has pushed hospitals into reporting via some sort of EMR.
Hospitals, however, lack the comprehensive quality recording and the infrastructure necessary to support a diverse set of analytical applications needed for the management and distribution of data. Data is often missing or inaccurate and it is difficult for researchers to find cohorts for their studies. This makes the AHR especially enticing. From the identification of cohorts to aggregate operations assessments and quality performance analyses, the AHR is designed for centralizing data aggregation and research applications that can meet the growing demands while using a minimal amount of resources.
The AHR is designed to give doctors and researchers active information on a variety of patients centralized to a single source. It offers a new approach to analytical healthcare applications and addresses the full spectrum of analytical needs a researcher might have by delivering a data warehouse comprised of electronic medical record data (EMR). Genomic information and patient billing data are included as well. The use of EMR is supported by public systems like JCAHO, which require the showing of quality and safety standards. This has pushed hospitals into reporting via some sort of EMR.
Hospitals, however, lack the comprehensive quality recording and the infrastructure necessary to support a diverse set of analytical applications needed for the management and distribution of data. Data is often missing or inaccurate and it is difficult for researchers to find cohorts for their studies. This makes the AHR especially enticing. From the identification of cohorts to aggregate operations assessments and quality performance analyses, the AHR is designed for centralizing data aggregation and research applications that can meet the growing demands while using a minimal amount of resources.
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