In 2009, the federal government budgeted $30 billion to incentivize doctors and hospitals to install electronic health records and use them “meaningfully”. Here are the results from Boston’s Brigham & Women’s Hospital — one of the leading academic medical centers in the country:
Of 858 physicians, 540 (63%) were “meaningful users”. Meaningful use was associated with marginally better quality for 2 measures, worse quality for 2 measures, and not associated with better or worse quality for 3 measures.
Meaningful use of electronic health records was correlated with better control of cholesterol in patients with diabetes and of blood pressure in hypertensive patients. The meaningful-use group provided worse treatment of asthma and depression than the non-MU group did.
HT: Ken Terry, Medscape.
Tickets started at $500. Food and beverages totaling $258 were budgeted for each person. A lucky reveler went home with a $125,000 Lexus Luxury Hybrid Sedan, donated for the occasion. It was the November 8, 2011, nonprofit Cedars-Sinai Medical Center’s annual Board of Governors Gala at the Beverly Hilton Hotel.
Of the hospital’s $2.8 billion total revenue that year, the lavish party netted the hospital $780,000 — barely a quarter of the C.E.O.’s salary.
Most galas, says [Charles Rehberg, a former hospital C.F.O], “are part of a carefully crafted strategy to promote their ‘charitable’ image in the community and engage the community leaders in their market. Look at the board of the foundation. It is generally the community business leaders, politicians and thought leaders in the community. It is very difficult to serve on such a board and also criticize the hospital for their high costs, charitable conduct, etc. By engaging these leaders in their ‘mission,’ they buy their support.
Just two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it.
Although Act 48 required Vermont to create a single-payer system by 2017, the state hasn’t drafted a bill spelling out how to raise the additional $1.6 billion a year (based on the state’s estimate) the system needs. The state collected only $2.7 billion in tax revenue in fiscal year 2012, so that’s a vexingly large sum to scrape together…
Paying for this program would likely make Vermont the highest-taxed state in the nation, by quite a lot.
By our analysis, since 2002, risk enrollment at the publicly traded plans has fallen by over 14 million lives…The emergence of private exchanges that rely on a risk model (like the exchange product offered by Aon Hewitt) could help slow the loss of risk enrollment but the benefits of self-funding are so significant for many employers that we believe risk enrollment will continue to shrink.
“We’re at the highest level of growth since the slowdown began,” Paul Hughes-Cromwick, a senior health economist at the Altarum Institute, which tracks health spending. “You have to go back seven years to see growth like this.”
The results for the EITC are not pretty. The Internal Revenue Services estimates that 21 to 25 percent of EITC payments were issued incorrectly during the fiscal year 2012, totaling from $11.6 to $13.6 billion in too much money being paid out to taxpayers. As a result, the Office of Management and Budget has labeled the EITC a “high-error” government program. Projections by the government show that the rate of error is expected to remain stubbornly high.
…[T]he IRS estimates that 21 percent of those who are eligible do not claim the credit at all. And so the EITC cuts both ways: both too much being handed out to taxpayers and too little.
Have you ever wondered why poor people are poor? It’s not as though there aren’t plenty of role models around. Millions of people live highly successful, productive lives in this country. So why don’t people at the bottom of the income ladder copy the behavior of those several rungs above them and better their lot in life?
If this question doesn’t really interest you, that’s understandable. What’s not understandable is why it is not an interesting question for those who regard inequality of income the burning issue of the day.
For example, when is the last time you saw a Paul Krugman column on why poor people are poor? When Krugman writes about poverty, he can’t get more than a few sentences into the piece without launching into an attack on Republicans for being racists and indifferent to the plight of the poor. And that’s on a good day. When he’s in a bad mood, he depicts Republicans as actually delighting in the suffering of the poor. What motivates Krugman more: Concern for the poor? Or hatred of Republicans? You decide.
Okay. What about the rest of the paper? When is the last time you saw a New York Times unsigned editorial on why the poor are poor? How about any editorial in The New York Times?
Actually, there was one — just a few days ago. Under the heading “Where The GOP Gets It Right,” Nicholas Kristof writes that Republicans have been right all along — especially in stressing the role of strong families, job creation and education reform. (You wonder if Paul Krugman and Nicholas Kristof ever talk to each other.)
Yet good as it is, the Kristof column has one gaping hole: it totally neglects the role of incentives.
Out of the blue, the Census Bureau has changed how it counts health insurance — at the precise moment when ObamaCare is roiling the insurance markets.
Since 1987, the Current Population Survey, or CPS, has collected information on the health-insurance coverage status of Americans. The annual reports are widely cited because their large sample sizes improve accuracy, the data are gathered constantly, and they tease out state-by-state details. But this year the Census revamped the CPS household insurance questions, muddying comparisons between the pre- and post-ObamaCare numbers. The results of the new method will be disclosed this fall. (WSJ)