Regulation of Telemedicine Costs Lives

 

Jason Shafrin writes:

In response to concerns about tele-medicine’s effect on patient safety, many states have begun prohibiting physicians from prescribing drugs without conducting a prior physical examination. In fact, more than 30 states have instituted this type of rule since 1998.

A paper by Cotet and Benjamin investigates this regulation which they call the physical examination requirement (PER).

The findings:

The adoption of PER is associated with a 1% rise in disease-related mortality rates the equivalent of 8.5 deaths per 100,000 people, presumably because it raised the implicit cost of, and thus reduced access to, medical care. In addition, the adoption of the PER is associated with a 6.7% reduction in injury-related mortalities, the equivalent of 2.5 deaths per 100,000 people. Thus, the reduction in injury mortality is smaller than the elevation of disease-related mortality, yielding a rise in overall mortality.

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May 18, 2012 | 6 comments | by

Health Insurers to Gain $1 Trillion in New Revenue under ObamaCare, and Other News

 

Health insurers will gain $1 trillion in new revenue over the next eight years under the 2010 health care law, assuming it is upheld by the Supreme Court.

Should parents be able to sue for ‘wrongful birth’?

How much do the nation’s preeminent hospitals cost Medicare? About 1% less.

Most likely reason for Lenin’s death: Stalin poisoned him.

A full genetic map is now about $3,000; it may soon be $1,000.

 

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May 18, 2012 | 7 comments | by

Debt, Debt and More Debt

 

Ryan has a good plan. I don’t think it goes fast enough. But the fact is he’s got a plan. The president won’t put out a plan. The Senate Democrats won’t put out a plan. It’s kind of like boxing with a shadow. You can’t ever hit it. But it doesn’t matter if you’re Democrat or Republican. The pain will get worse every year we don’t fix these things. And there will come a time when it won’t matter if you’re a Republican or Democrat. And I don’t have much faith right now that we’re up to the task of coming to agreement to fix this.

Tom Coburn interview with Ezra Klein on his new book, The Debt Bomb. Good throughout.

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May 18, 2012 | 6 comments | by

MLR Killing Off Business, Hurting Consumers, NAIFA Survey Says

 

Agent commissions have declined dramatically since the medical loss ratio (MLR) provision of the health care reform law went into effect, forcing many agents to reduce their services to clients, consider charging fees for services they had been providing at no additional charge and in some cases, laying off employees and leaving the health insurance market.

That’s according to a survey by the National Association of Insurance and Financial Advisors (NAIFA) of 861 of its members who sell health insurance. Seventy percent of respondents who sell health insurance have seen a decrease in commissions.

Almost a third are ready to leave the market. The survey reports that 30% say that if commissions remain depressed they will stop selling and servicing individual health policies and 22% say they will stop selling all health insurance.

How’s it going in your area?

Full article by Elizabeth Festa in LifeHealthPro.

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May 17, 2012 | 7 comments | by

How Good a Doctor Are You?

 

Getting a medical degree is not easy: It requires 10 years of medical education and 16,000 hours of clinical experience to get certified to provide treatment. Even so, most of us think we can make equally as good diagnoses as our doctors—as long as we have a little help from Google.

A Wolters Kluwer poll out this morning finds that not only are most consumers turning to the Internet to answer medical questions, but that they also put strong faith in their own diagnosis. Among college educated Americans, 63 percent say they have “never” misdiagnosed themselves. Add in those who have say they’ve “rarely” made a wrong call and the number jumps up to 84 percent.

More by Sarah Kliff at Ezra Klein’s blog.

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May 17, 2012 | 5 comments | by

Junk Science at JAMA

 

A recent prospective study published in the Journal of the American Medical Association suggested that exposure to perfluorinated compounds (PFCs) — chemicals commonly found in non-stick pans and food packaging — reduces immune responses to tetanus and diphtheria vaccinations among children aged 5 to 7 years old. But before you start worrying about protecting your children from these supposedly dangerous chemicals, it’s important to note that the research, led by Dr. Phillippe Grandjean of the Harvard School of Public Health, not only involved major flaws, but also reeks of junk science. Yet the study’s shortcomings aren’t even the most upsetting part of this story. What peeved us more was the fact that a reputable journal such as JAMA would even publish such nonsense.

More on this study in an ACSH’s article.

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May 17, 2012 | 5 comments | by

Cost Shifting is Real

 

Roughly half of Medicare beneficiaries under age sixty-five are also eligible for Medicaid. These “dual eligibles” have been the subject of much research because of their low income and poor health status. Previous studies suggest that some states seek to shift costly health care services for this group out of state-run Medicaid programs and into the federally funded Medicare program—for example, replacing nursing home care with hospital care. Using state-level data on dual eligibles under age sixty-five, we found support for this hypothesis. In states with below-average per capita Medicaid spending, corresponding Medicare spending was above average. These state-level estimates also revealed a nearly threefold difference in total—Medicare plus Medicaid—price-adjusted spending per person, ranging from $16,309 in Georgia to $43,587 in New York.

Study on state spending on “dual eligibles” in Health Affairs.

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May 17, 2012 | 4 comments | by

Mass: Insurance Doesn’t Lead to More Care

 

As did the Affordable Care Act, the Massachusetts reform incorporated substance abuse services into the essential benefits to be provided all residents. Prior to the law’s enactment, the state estimated that a half-million residents needed substance abuse treatment. Our mixed-methods exploratory study thus asked whether expanded coverage in Massachusetts led to increased addiction treatment, as indicated by admissions, services, or revenues. In fact, we observed relatively stable use of treatment services two years before and two years after the state enacted its universal health care law.

Full Health Affairs study on why expanded coverage alone will not increase treatment use.

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May 17, 2012 | 7 comments | by

Penny for Their Thoughts

 

Study: People like to talk about…well…themselves.

[Researchers] monitored brain activity among some volunteers to see what parts of the brain were most excited when people talked about themselves as opposed to other people…

In several tests, they offered the volunteers money if they chose to answer questions about other people, such as President Obama, rather than about themselves, paying out on a sliding scale of up to four cents…

Despite the financial incentive, people often preferred to talk about themselves and willingly gave up between 17% and 25% of their potential earnings so they could reveal personal information.

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May 16, 2012 | 5 comments | by

This is America?

 

The health reform law gave HHS the power to scrutinize “unreasonable” rate hikes in states that didn’t have robust review programs. But “scrutiny” doesn’t give the department power to actually block the rates from going into effect. HHS can use its bully pulpit to publicly shame insurers whose rates don’t pass its sniff test – and HHS has done just that, holding four media calls since November to scold insurers each time it’s made a new “unreasonable” determination.

The title of this article is “Jawboning by HHS Doesn’t Scare Insurers,” but maybe they should be scared.

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May 16, 2012 | 5 comments | by
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