Healthcare INFORM

Mess in Mass--- Focus on Market Solutions for Physician Shortage

2010-04-08T13:58:00.003-04:00

Massachusetts: A Regulatory Mess 50% of physicians choose to practice elsewhere

Mass residents having difficulty getting care rose to 24% from 16% between 2007 and 2008
33% of Mass state's primary care doctors now considering changing professions due to dissatisfaction with the current practice
US Medical students do not choose to enter a primary care specialty due to economics.
US Medical school debt is 155K on average
US Average income: family physicians is $173,000, oncologists $335,000, radiologists $391,000 and cardiologists $419,000.

Expanding the Primary Care Workforce. An Essential Element of Health Care Reform Ellen-Marie Whelan November 2009

2008 Physician Workforce Study by the Massachusetts Medical Society

Market Solutions At Glance : End Fee for Service

Increase Medicare payments to PCPs
Loan payment incentives
Assess new models of payment -medical home incentive, pay providers an additional bonus payment for assuming responsibility for and providing a full range of primary care services.
Include more control over the type of health care delivered deliver
Provide incentives to improve quality and outcomes

Parents Must Step Up-- USA TODAY

2010-04-08T13:07:00.002-04:00

Parents must step up

It's about time we implement a zero-tolerance policy for school bullying. As we all know, high school can be the cruelest and most unforgiving place on earth.
Like underage drinking, the only way parents and teachers will take notice and responsibility is when legal action and mortality are realized.
These children need to be publicly shamed, and their parents must take responsibility.

Meghan Mair Fitzgerald; Norwalk, Conn.

Healthcare Reform Take 4. Note Market Based Approaches..

2010-02-22T13:44:00.000-05:00

For those interested in cliff notes:

$950B price tag over 10 years (funded by healthcare fees, employers penalties)

Similar to health reform framework passed by Senate Democrats in December (which I called)

Mandate that requires individuals to purchase health insurance,

Subsidy for people who cannot afford coverage but taxes and fees to raise revenue

Market based approaches: health insurance exchanges and an ability to go across state lines and $40B in tax credits

Excise/Cadillac tax delay

Senate abortion language (not stricter house language)

Senate reconciliation permitted (legislation passes Senate with 51 votes, instead of having to clear the 60 vote threshold).

The Baucus Plan

2009-09-23T11:38:00.001-04:00

http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf

The Speech of Obamas Presidency

2009-09-10T16:46:00.000-04:00

Last night President Obama delivered a speech on healthcare that many have called the speech of his Presidency. This morning he is receiving praise from both slides of the aisle (and the stock market) on his words and clarity. I was on the ground in Europe where coverage was limited but positive. The Afghan war is top of mind in Europe and the upcoming elections.

Below please find a link to the transcript and video.

http://www.cnn.com/2009/POLITICS/09/09/obama.health.care.transcript/index.html

As we head back to class tonight for another semester of policy, two themes jumped out at me during this speech: morality and cost.

Obama referenced that we have a moral obligation to provide healthcare? Do you feel the same way?

The President also noted that this $900B plan (over ten years) will be cost neutral, not one penny or nickle to be precise will be added to our defecit. Do you agree that the necessary changes will happen (including a public option) without additional money?

Cheers- Meg

HEALTHCARE LEADER SERIES October 23, 2009-- German Healthcare and Considerations for US Healthcare Reform

2009-09-04T14:48:00.000-04:00

**Special Policy Speaker** Andrea Fischer (Former German Health Minister)

Expert in the field of health, health economics and the welfare state. She has held various positions including scientist at Berlin Science Centre, avisor to board of German pension fund, member of Parliament (1994 to 2002), secretary of health to German federal government (1998 to 2002), freelance journalist, member of board of IFOK.

http://content.healthaffairs.org/cgi/content/abstract/27/3/w204

The "Kennedy Effect" on Healthcare Reform

2009-08-27T12:57:00.000-04:00

As flags fly half-staff on Capitol Hill, the frenetic media coverage around the Lion of the Senate is focusing on his muliple crusades for better U.S. Health care. Despite your views, Ted Kennedy was a good for healthcare and politics which have morphed into one. When he took ill, several friends of mine in the Oncology field were contacted by his personal physician who served as command central, triaging the best options in our complicated system. Brain cancer found a formidable competitor in the Lion.

There is Kennedy irony in that he died of cancer. On December 23, 1971 (my birthday) a modified bill he sponsored providing over $1B dollars to the National Cancer Institute was enacted-- it was larger than what Nixon proposed. Also ironically during this period he turned downed Nixons offer for Universal Healthcare. And like today War consumed the political agenda which made getting healthcare done impossible.

In the end, the Senator got the best care and knew it. More importantly he wanted every American to receive the same treatment as an old famous U.S. senator could. On June 2009, Kennedy offered us his final work of health care art "The Affordable Health Choices Act" where despite alterations from both parties is expected so is a signed bill. Finally.

-Meg

For more on his timeline of achievements (and great healthcare history) visit: kaiserhealthnews.org. Also take the Kennedy Quiz on Healthcare below

http://www.kaiserhealthnews.org/Daily-Reports/2009/August/27/3khnstory.aspx

Reconsidering the Scope and Timing of Reform

2009-08-26T22:24:00.000-04:00

The latest on health care reform from John K. Iglehart, national correspondent for the New England Journal of Medicine

http://healthcarereform.nejm.org/?p=1635&query=TOC

Urbanization- An Emerging Humanitarian Disaster

2009-08-24T09:45:00.000-04:00

In 2008, the proportion of the world's population living in urban areas crossed the 50% mark. The current rates of urbanization suggest that in China, 870 million people — more than half the population — will be living in cities within less than a decade, and the capital of Botswana, Gaborone, will grow from 186,000 to 500,000 inhabitants by 2020.1 Most observers believe that essentially all population growth from now on will be in cities: the urban population is projected to grow to 4.9 billion by 2030, increasing by 1.6 billion while the rural population shrinks by 28 million.1
This transition is happening chaotically, resulting in a disorganized urban landscape. Although many expect urbanization to mean an improved quality of life, this rising tide does not lift all boats, and many poor people are rapidly being absorbed into urban slums. Urbanization, in fact, is a health hazard for certain vulnerable populations, and this demographic shift threatens to create a humanitarian disaster. The threat comes both in the form of rising rates of endemic disease and a greater potential for epidemics and even pandemics. To protect global health, governments and international agencies need to make commensurate shifts in planning and programs, basing all changes on solid epidemiologic and operational research.

Global health: Urbanization—An emerging humanitarian disaster, The New England Journal of Medicine, August 20, 2009. (Free full text)

Imagine if the U.S. decreased healthcare spend to 12% of GDP?

2009-08-24T09:43:00.000-04:00

http://www.milliman.com/expertise/healthcare/publications/rr/pdfs/imagining-16-12-RR02-01-09.pdf

China outlines plans on healthcare reform 2009

2009-08-24T09:12:00.000-04:00

Xinhua General News Service
July 23, 2009 Thursday 1:17 AM EST
China outlines plans on health care reform in 2009

BEIJING July 23

China's State Council Thursday issued a medical reform plan of 2009, as its first year's move of the three-year health care reform.
The plan called for acceleration in building basic medical insurance system and essential drug system, and promotion on primary health care facilities and pilot reform of state-run hospitals.
According to the plan, about one hundred state-run hospitals chosen from 12 cities will be designated as the pilot hospitals for the reform.
It also includes the access of nearly six million retirees from bankrupt stated-owned enterprises to the basic health insurance.
Moreover, the number of employees and citizens in urban areas joining basic health insurance is to reach 390 million by the end of this year, an increase of 72 million from a year earlier.
The standard of building primary health care facilities will be released this year, with 986 county hospitals, 3,549 town hospitals and 1,154 community medical service center to be established.
The nation unveiled a three-year plan on health care reform on April 7 this year. With 850 billion yuan (124 billion U.S. dollars) investment, the plan is considered to lay a solid foundation for equitable and universal access to essential health care for all in China by 2020.
July 24, 2009

Musings on Healthcare from the United Kingdom

2009-08-16T17:29:00.000-04:00

I am in the UK this week working on a new healthcare joint venture for my company. Within the EU, the UK represents the third largest market by drug spend (23B) and with an openness to cost containment, interest in clinical quality, our business plan as a lot to offer the 60 million inhabitants.

Unfortunately from a policy stand point it was a tough week to launch a "US Model". The US town hall fights included a jab the the UK system. A Financial Times article reported this weekend that "Daniel Hannan, a Conservative member of the European parliament has spoken out against the NHS, saying he, ‘wouldn’t wish it on anybody’ because of its far from perfect waiting lists and survival rates." His comments were in support of similar conservative movements (mostly) in the US bashing the UK as a scare tactic. This incited many in the UK who are proud and happy with their model of healthcare.

Regardless of opinion, this is a common perception in the UK. Read the Independent Article.

http://www.independent.co.uk/news/world/americas/the-brutal-truth-about-americarsquos-healthcare-1772580.html

Despite the public fight across the pond, as I pitch our business to the NHS (third largest employer in the world) many have said to me "aren't you the country with 47mm uninsured". Almost laughing they were dying to know what the Americans could share. Ironically it wasn't too long ago that the UK had 40+mm uninsured and a similar problem. They fixed it by introducing the NHS.

So my learning from this week is to be informed, humble and strategic about how our company (or any of us in research) helps the UK healthcare system. For me"reform" should mean less cost as a starting point NOT more. We clearly have a lot of waste.

Health spending as a share of GDP. Take away: we are not getting a good ROI in the US.
US 16% vs. UK 8.4%
Public spending on healthcare. Take away: Healthcare in the UK is not free.
US 45% vs UK82%
Health spending per head. Take away: There is a way to do this more cheaply and effectively.
US $7,290 vs UK $2,992

Cheers! Meg

2009-08-06T11:25:00.001-04:00

http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html

Two new United Hospital Fund reports provide important data about New Yorkers and their health insurance status:

2009-07-30T16:54:00.001-04:00

Two new United Hospital Fund reports provide important data about New Yorkers and their health insurance status:
• “Characteristics and Health Insurance Coverage of New York's Noncitizens” looks at similarities and differences in health insurance coverage patterns, not just between citizens (14.6 million) and noncitizens (1.9 million), but also, where possible, between documented (1.2 million) and undocumented (0.7 million) noncitizens.
• “Health Insurance Coverage in New York, 2006-2007,” an annual chartbook, provides an invaluable snapshot of the uninsured in New York—detailing income, employment status, age, and other demographic information, tracking the coverage distribution among workers and low-income New Yorkers, and estimating the number of uninsured New Yorkers who are eligible for public health insurance.
The reports are intended to inform current state and federal discussions about expanding insurance coverage. Both are available free of charge from the Fund’s website.

"Money Driven Medicine"

2009-07-30T16:47:00.000-04:00

The premier of the Alex Gibney documentary, “Money-Driven Medicine” will take place on Thursday, June 11 at 7PM at the New York Society for Ethical Culture.

Click here for more information and a clip of the film:
http://www.healthbeatblog.com/2009/06/reminder-ny-premiere-of-moneydriven-medicine-this-thursday-clip-from-the-film-below.html