Zane Safrit

Sen. Max Baucus' Healthcare Blueprint

Senate Finance Committee Chairman Max Baucus' (D-Mont.) has a healthcare blueprint.  From the NY Times article:

"Every American has a right to affordable, high-quality health care," Mr. Baucus said. "Americans cannot wait any longer." Far from being a distraction from efforts to revive the economy, he said, "health reform is an essential part of restoring America's economy and maintaining our competitiveness."

Mr. Baucus would create a nationwide marketplace, a "health insurance exchange," where people could compare and buy insurance policies. The options would include private insurance policies and a new public plan similar to Medicare. Insurers could no longer deny coverage to people who had been sick. Congress would also limit insurers' ability to charge higher premiums because of a person's age or prior illness.

God is in the details. But these terms are a great start. I liked how he starts with the a reminder of the obvious:

health reform is an essential part of restoring America's economy and maintaining our competitiveness.

Seems obvious, doesn't it? Do you know how we compete with an unhealthy workforce? Ok, let's say the employed get healthcare through affordable health insurance and a reformed healthcare system. Ok, great. What about their families, their sons and daughters and parents/grandparents and sisters and brothers who don't? Think their needs might be a distraction? What about a drain on their discretionary income? Hard to drive an economic recovery when a growing percent of our GDP is devoted to our healthcare or at least for those who can afford it.

The Washington Monthly shares more including links to others' thoughts on Sen. Baucus' healthcare blueprint.

Transparency in Hospitals: Paul Levy Gets It

From Hospital Impact, Most Transparent Hospital CEO...

"What we were trying to do is demonstrate to the public that we are willing to be held accountable for quality and safety improvements and establish metrics by which we’ll be measured, and to publish our results" - Paul Levy, CEO of  Boston's Beth Israel Deaconess Medical Center and Running a Hospital Blogger

Mr. Levy gets it: transparency, accountability, dependable metrics, evidence-based decision-making, improvements, trust. It all goes together.

Celebrating the Every Day Failures of our Health Care System

Poked and Prodded has a post by Dena Rifkin we all should read: I see the failure of the health-care system every day.

Let's celebrate it. Seriously. Dr. Rifkin articulates just a few of the failures of our health-care system so clearly that we see just as clearly where solutions are needed and who needs them.

That's the first step of finding a solution.  Providing clarity. Answering:

• Where a solution is needed.
• Who needs it.
• When is it needed.
• What will it solve.
• How will we be able to measure its success?

And let's celebrate briefly, the failures of our health-care system.

Why?

They are so egregious now. We can't deny them anymore. We can't pretend. We can't ignore. We can't say it only effects 'those' people whoever those are. And that's because the 'those' of the past are now us or our families or our neighbors or co-workers. And now we clearly see the answers to those questions.

Maintaining Your Health: Knowledge is Power

[P]atients have more than ever to gain by decoding the latest health news and researching their own medical care.

“I don’t think people have a choice — it’s mandatory,” said Dr. Marisa Weiss, a breast oncologist in Pennsylvania who founded the Web site breastcancer.org. “The time you have with your doctor is getting progressively shorter, yet there’s so much more to talk about. You have to prepare for this important meeting.” - NY Times, You're Sick. Now What?

The article's worth the time to read. It's another well-written reminder that we are the decision-makers for our health and its care.  The health care industry serves us, not us them. But at this point, it's only with the power that knowledge brings us that we can insure our interests are served.

Here's some pointers from the article which I hope you read:

The goal is to find an M.D., not become one.

Keep statistics in perspective.

Don’t limit yourself to the Web.

There’s more to decoding your health than the Web. Along with your doctor, your family, other patients and support groups can be resources. So can the library. When she found out she had Type 2 diabetes in 2006, Barbara Johnson, 53, of Chanhassen, Minn., spent time on the Internet, but also took nutrition classes and read books to study up on the disease.

Tell your doctor about your research.

Healthcare Victories: Negotiate

60% of the consumers who asked their doctor or hospital for a discount on the account balances they owed did receive one in exchange for faster payment.

You have the leverage, not them. So, call up your provider and low-ball them. Go ahead. Offer them less than what you owe and offer to pay it promptly. Remember, every second that they delay accepting payment costs them money, not you.- My Health Care is Killing Me

Health care solution: Negotiate. You have the leverage, not them.

Small Business CHOICE Act of 2008

Is this the solution? Maybe. Possibly.

But at the very least, the Small Business CHOICE Act of 2008 is a few steps in the right direction.

What is the Small Business CHOICE Act of 2008?

According to the Kaiser Foundation:

The House Small Business Committee introduced a bill Wednesday that would help small businesses provide their employees health insurance by allowing the companies to form health insurance purchasing cooperatives and by offering them a refundable tax credit of 65% of the cost of the insurance, the Wichita Eagle reports.

Committee spokesperson Jaime Zapata said, "It's a bipartisan piece of legislation ... and it takes the best elements" of the plans of presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) and presumptive Republican presidential nominee Sen. John McCain (Ariz.) (McLoone, "Small Business," Washington Post, 7/23). Zapata said, "It has both tax elements and a pooling mechanism. Unlike other legislation, however, the CHOICE Act creates a cooperative that can work with existing state law" (Wichita Eagle, 7/24).

The few steps in the right direction are:

* Bi-partisan sponsors.

Rep. Nydia M. Velazquez (D-N.Y.), who chairs the House Small Business Committee, and Rep. Joe Pitts (R-Pa.).

* Best parts of McCain and Obama's solutions.

* Pooling members into buying coops with stronger negotiating power...much like big businesses have now with their large group plans where costs from member claims are spread over a larger number of members and their premium payments.

* Bite-sized approach. It's not attempting to solve all problems with our current health care system.

* Doable today. Hold on. It's going to take a lot of work. There will be stumbles along the way. People will be unhappy and angry. (That's not really news, these days.) But...the tax credits, the pooling of members into existing coops, incentivizing small business, makes it doable...today.

Washington WATCH

PhoenixVille News

Small businesses are the backbone of innovation and job creation in our economy. In fact, small businesses employ a full half of all the private sector employees in the United States. They provide flexible environments that are often necessary as incubators of innovative. new ideas.

[ I liked this reminder of the importance of small business in our economy.]

DOTMed

Business and Legal Reports

US Restaurants Association  (They support it.)

The restaurant industry applauds the health-care bill introduced today by Chairwoman Nydia Velázquez and Representative Joseph Pitts and commends them for their bipartisan leadership and commitment to providing small businesses access to affordable health-care options," said John Gay, senior vice president of government affairs and public policy for the National Restaurant Association. "With 13.1 million employees, restaurants are the nation's second largest private-sector employer, and health-care costs are a tremendous weight on the future viability of the industry. If passed into law, this legislation will directly help restaurateurs and their employees afford health insurance.

International Franchise Association

The International Franchise Association (IFA) today applauded House Small Business Committee Chair Rep. Nydia Velazquez (D-NY) and Rep. Joseph Pitts (R-PA) for introducing the bipartisan Small Business "CHOICE" Act of 2008 to help small franchised businesses offer affordable health insurance to employees.

Health Care Solution: Be your best advocate

You're the patient (or could be); be your best advocate.

Ask questions. That's right. Arm yourself with knowledge.

Insist you be heard.

Keep your own records (offline).

And read Patient Empowerment blog byTrisha Torrey. She's got great ideas and tips and profiles and resources empower yourself as a patient or, even better, to avoid becoming a patient.

Health Care Solution: Fight the power

(Ok. A bit hyperbolic. So, sue me....SMILE.)

But for those who can afford health insurance, you do have rights and options to enforce those rights when your claim is rejected by your health insurance company.

About.com's Kelly Montgomery steps you through how to fight the power...or How to resolve your health insurance claims.

It's likely you're not alone in your need or your fight. One policy-holder's complaint resulted in 2,500 other policy-holders receiving compensation for their similar claims that had been rejected. Oh, and the insurance company was fined $1million for this and other violations. Links: Patient Empowerment Blog and Syracuse Times.

Health Care Solution: Us, the Voters

That's right. You and me, your neighbors and co-workers, their family and yours...social-media practitioners, too.

Money is power. And lobbyists wielded about half-a-billion of that in 2007 to influence Congress, according to this report from Open Secrets: Center for Responsive Politics. And they did a fine job of representing their corporate clients and their goal: revenue growth. Costs for health care have risen faster than our national GDP. (Let's be honest. The power was wielded in a vaccum of silence from us, the voters.)

My friend Eric always reminded me that... Time and tide wait for no man. And there are signs the tide is turning (as time's running out) according to Health Care Blog in his post titled: Health Reform is possible; voters hold the power.:

One piece of evidence: the vote, earlier this month, on the Medicare bill, which surprised many observers. On his blog, Bob Laszewski called the landslide House vote, which went against the insurance industry, “the most amazing turn of events I have seen in 20 years of following health care policy in Washington, DC.”

When legislators saw powerful lobbyists representing for-profit insurers lined up on one side, and seniors and the AARP on the other side, they knew who to fear: the seniors.

(You see where I found my inspiration. His post reminded me that we still hold our fate in our hands or voting booths)

And our country's demographics are that more of us will be the seniors...or their/our caretakers in the coming years. And this was but another shot across the bow to see who will receive healthcare. Those who can afford private care or all of us. This Medicare vote wasn't about your grandparents or your poor community members across town. It was about all of you, all of us, all of our futures.

So....today's health care solution is...you, us, together, the voters.

( The alternative? We've seen the alternative.  largest federal deficit in history. If we allowed the greatest deficit in history to be created, we can certainly eliminate it and create the funds to provide working solutions that provide health care for all. )

Health Care Victory: Complaining, Transparently

I scanned through 130 blog posts from blogs devoted exclusively to the health care, medical, health insurance arena.

Lots of problems were discussed. Lots of conflicts of interests between Big Pharma and doctors/researched were covered. Lots of discussion over the problems with medicare and the rising costs of health care and people needing to choose gas for their cars to get to work over preventative health care, lots of articles on the fines insurance companies in California paid for illegally cancelling policies when their members called on them...

No one talked about solutions or plans or victories.

Granted, these discussions are a first step.

Maybe that's the victory for the week: lots of discussions and complaints from lots of people...all delivered in a transparent manner through the diligent efforts of MSM and bloggers in the medical community. As long as that's ongoing, heated, impatient, outraged...we can look to finding a solution for this situation we've all allowed to flourish.

Keep talking, ranting, complaining. The threshold to spur change hasn't been reached, yet.

Heath Care Victories: Transparency

A seemingly endless and discouraging profile of conflicts of interest in our health care system is reported with clarity and precision and cross-references at Health Care Renewal blog.

These stories and the many others like them are important to report, discuss and share. It's our system of free press, the veritable 4th estate, and free speech that offers the transparency that brings recognition, outrage (or praise), accountability and eventually solutions.

You have to engage to make it work. That's the only way we'll be victorous in creating a health care system worthy of acclaim.

Germany's Health Care for All Program

NPR's Morning Edition starts a series on the health care programs of other nations with their program on Germany's Health Care for All program. Listen to the program here.

All German workers pay about 8 percent of their gross income to a nonprofit insurance company...

Actually, it's about the same proportion of income that American workers pay, on average, if they get their health insurance through their job. The big difference is that U.S. employers pay far more, on average, than German employers do — 18 percent of each employee's gross income versus around 8 percent in Germany.

The system is tweaked every 3-4 years. German Doctors are kept on a budget.

And their system has been working pretty well for 125 years.

The other countries profiled in this series are France, Netherlands, UK, Switzerland.

If our system is the best in the world...why are 48 million Americans unable to afford health insurance? Why do the citizens in one 1st world, industrialized, capitalist nation, feel it's unacceptable to not provide affordable, comprehensive, health care for all of their citizens?

What are we missing?

Link from NPR Check.

Health Care Solutions for Small Business

There are solutions for small businesses looking to offer health insurance as an employee benefit. They demand time and attention, a little creativity and flexibility, and a lot of communication with your employees. And as any small business leader, that's the huge advantage small business has over their larger brethren.

From the the Wall Street Journal (no sub'n required) Providing Health Benefits on a Budget.

Health Care Victories for the Week Ending June 27, 2008

* Effective Treatment for Parkinsons. Dancing with Parkinsons from Running a Hospital blog

* Debate. There's an excellent discussion at Health Care for All on the merits of transparent, publicly available, pricing for hospitals. Is it a good thing? How? Does it help their customers make better buying choices? Will it cause prices to rise, decline? I'm of the opinion that it's a great first step and at the worst...it'll provoke discussions that will lead to positive change. As one commenter said:

So if this information doesn’t help the individual consumer, it may start the ball rolling toward a more sane health care payment system. The current one is certifiably insane, all will agree.

Can I get a witness?

* Congressional Health Care Plan.  Each of our elected representatives for US Congress or Senate enjoy a wonderful, all-expenses paid, health care plan. Why can't we? And each time one of these same representatives votes against universal health care, claiming it's of socialist origin or too expensive we should ask them...but what about your coverage? You have universal health care...all of you and yur families are covered. It's not too expensive....right? Then it shouldn't be for us.

(Ok, that last point isn't a victory for this week. But it would be a victory every week if Americans enjoyed the same universal health care and quality of care that our elected representatives enjoy at our tax expense.)

Health Care Victories for the Week Ending June 20, 2008

* Matching Physician Rankings with Co-Pay Requirements.  Massachusetts Insurers are ranking doctors, making those rankings public and rewarding their customers with lower co-pay costs who choose higher-rated doctors. Heaven is in the details. What are the criteria for their rankings? How transparent is the ranking process? Who's doing the ranking?  But, it's a start. (Imagine the American Marketing Association ranking ad agencies, publicly?) - Kelly Montgomery's Health Insurance Blog, Massachusetts Insurers Rank Doctors Despite Opposition.

* Eating Locally.

[It] really is astounding how much better freshly picked lettuce, tomatoes, strawberries, peaches, apples, broccoli, green beans—pretty much all vegetables and fruits—taste when you harvest them ripe and don’t have to transport them in a semi-frozen, unripe state for several days. It makes you want to eat them more.

Another way that local food could potentially have a major public health impact is through food safety. The Times reported that the FDA is asking for an additional $275 million in next year’s budget to increase inspections of food shipped in from overseas and hire more inspectors throughout the country

How can the idea of healthy, tasty food grown in your community and sold at cheaper prices than you'd find in the supermarket be elitist? Rudd Sound Bites: The Pros of Eating Locally.

* Caring Nurses. Links from Boston.com and Running a Hospital blog.

Health Care Victories...Anyone?

What are your victories in finding health care for your family, your small business, your community...yourself?

What's worked to improve your health?

What's worked to save you money?

Where did you find better coverage, better care, better treatment?

Health Care Victories for the Week Ending June 13, 2008

Publix Pharmacies Launch Free Prescription Drug Program in All Operating Areas

LAKELAND, Fla., Aug. 6, 2007 — Beginning today, Publix Super Markets chainwide is offering a free prescription drug program at its 684 Publix Pharmacies for the following oral antibiotics

• Amoxicillin
• Cephalexin
• Sulfamethoxazole/Trimethoprim (SMZ-TMP)
• Ciprofloxacin (excluding ciprofloxacin XR)
• Penicillin VK
• Ampicillin and
• Erythromycin (excluding Ery-Tab).

These antibiotics account for almost 50 percent of the generic, pediatric prescriptions filled at Publix. New or current customers simply need to provide their Publix pharmacist with their prescription, up to a 14-day supply, and it will be filled at no charge. Publix is not limiting the number of prescriptions customers may fill for free.

Ok. You can see the date of this press release is Aug. 6, 2007. But it's news to me. And it was brought to my attention in a comment in last week's list of health care victories.

Health Care Victories for the Week Ending June 6, '08

* Research Your Hospitals Treatment Tendencies.

Consumer Reports offers a new tool, based on the Dartmouth Atlas findings, that pinpoints where individual U.S. hospitals (except VA hospitals and very small hospitals) fall on the scale of agressive/conservative care.

From June 1 edition of  USA Today

* Combining Research and Innovation. Hope Labs:

Hope Labs combines rigorous research with innovative solutions to improve the health and quality of life of young people with chronic illness

From Cathryn Hrudicka on twitter.

* Massachusetts Health Care Reform: One-Year Later Some Successes and Challenges Emerge .

Between expanded private and public coverage, out-of-pocket expenses for all adults dropped, as did the number of adults who said they had difficulty paying medical bills, while more people received routine preventive care.

Before the law went into effect, roughly 600,000 residents lacked coverage.  Of those, 355,000 now have coverage, according to the Urban Institute study, reducing the uninsured rate to 7%.

From Progressive States Network.

* More Sources for Discounted Drug Prices. Wal-Mart Offers More Discounted Discounted Drugs

The Associated Press reports that Wal-Mart is planning to offer a 90-day supply of certain generic drugs for $10. This will help consumers save even more money on prescriptions...

From Kelly Montgomery at About.com's health insurance blog. 

Granted, this but a step, a respite if you will. But every little bit helps when you read that health care costs will nearly double in the next 9 years. Article in Managed Care.

* Some Coverage is Better Than None. New Florida Law Allows Low-Cost [low benefit] Health Policies. NY Times article quoted below:

The low-cost plans have to include preventive services, office visits, screenings, surgery, prescription drugs, durable medical equipment and diabetes supplies.

Some options offered by insurers have to include catastrophic and hospital coverage. But an insurance company could, for instance, choose to limit the number of days of hospitalization it will cover or place a dollar cap on reimbursing certain services.

*  Transparency. Researchers Fail to Reveal Full Drug Pay, NY Times article quoted below:

A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

* Non-profit Organizations. Cover The Uninsured.

This is a project sponsored in-part by the Robert Woods Johnson Foundation. It offers facts on the changing trends in each state for health care coverage, costs, employee sponsored benefits and more. And, there's a fairly comprehensive discussion about pending legislation.

The last 5 solutions are not game-changing solutions. These are incremental solutions, baby-steps of decisions and innovations to bring a simple solution, that's easy to implement to bring immediate relief. These  decisions allow change and growth to continue, without the disruptions usually associated with innovation. Almost beta-solutions, really. Do it, test it, improve it, keep moving forward.

The first two solutions have the potential to create  a game-changing solution.   Researching your hospital's treatment tendencies (and results, costs) can serve to create a groundswell, if you will, towards a solution. And bringing research AND innovation to focus on a specific disease can create a model or template that could be applied elsewhere.

The main thing is that there are solutions out there. There needs to be more and there needs to be more discussion about them and how to increase their numbers and speed. I'm an art major. I'm a health care consumer. My role is to push the conversation along.

Health Care Victories for the Week Ending May 30 '08

The ratio is worse this week. Last week, I estimated the ratio was 10:1. 10 blog posts on health care must be read in order to find one that offers a solution.

This week,  I scanned through well over 80 posts on health care blogs and news outlet feeds to find these 4. 

* Creditable Coverage. What is Creditable Coverage? It's a...way to avoid waiting through a preexisting condition exclusion period before your full benefits begin... Federal law states that almost all kinds of health insurance coverage are creditable.

Knowledge is power.

Link from Kelly Montgomery's Health Insurance blog.

* Doctors on Twitter. A rss feed for twitter posts of doctors. At least...we'll know what they're thinking regardless of their handwriting. Doctors on Twitter feed link. It's created by EfficientMD

* Paid Leave for Medical Missions.  This is a sound policy for creating an inspired and engaged workforce. That makes it nicer that it's applied to those who take care of us. From Running a Hospital.

* Life Hacks for Doctors. We should all watch this slide show. But it's maybe more important for doctors. They hold our lives in their hands, sometimes and then it's often literally.

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