Tag: "socialized health care"

Many of the ACA Quality-Enhancing Ideas Have Previously Failed

One of the many pilot projects of health reform is to reduce the number of readmissions within 30 days of Medicare patients discharged from a hospital. The problem: it’s already been tried by the VA Health Administration and failed to lower the number of readmissions, according to a report in The Washington Post.

The Veterans Health Administration, the largest integrated health care system in the country, has long employed many of the approaches Medicare is pushing on all hospitals to reduce unnecessary readmissions. But new data show VA hospital patients are just as likely to end up back in a hospital bed as are patients at private hospitals. The new statistics underscore how hard it may be for hospitals to stop patients from rebounding back through their doors, a major goal of Medicare as it seeks to curtail the nation’s ballooning health costs.

HT: Kaiser Health News

NHS Nurses Wear “Do Not Disturb” Uniforms

This report on the British National Health Service is from the Daily Mail:

A row has broken out over a hospital trust’s decision to give nurses ‘Do Not Disturb’ uniforms to wear during routine ward duties to prevent patients from speaking to them…

The hospital says interruptions, such as patients asking questions about toilets and meal times, stop nurses from doing their jobs properly and could lead to patients being given the wrong medication.

Bitter pill to follow: Ward manager Penny Searle wears the controversial tabard during a drug round.

Canadian Health Care: Free But Unavailable

So I used the Health Care Options Directory on the same government website. This allows you to plug in your postal code and find all family doctors listed within a certain radius. It is a particularly soul-destroying experience.

The opening page lists no names or phone numbers, just the number of doctors at each address. It takes more clicks to get the contact information. And after you go through those steps and make the calls, you find that none of the doctors are accepting patients.

I phoned all 84 doctors who were listed as practising within 10 kilometres of my home. Some of their receptionists were polite. Some were surly. All rejected me.

But for $3,000 you can find a doctor at the drop of a hat! Editorial here. HT: David Henderson.

We’re Becoming Like Canada

Nationwide, the average wait time to see a doctor last year was 23 minutes, according to the health care consultants Press Ganey. Neurosurgeons have the longest wait times (30 minutes) and optometrists the shortest (17 minutes), according to the report.

In urban areas and among certain specialties, however, the waits can be much longer.

Full article on doctor wait times.

Canadians Also Wait for Drugs

A recent study by the Fraser Institute found that Canadian federal and provincial government bureaucracies are taking more than two-and-a-half years on average to approve new prescription drugs, thereby depriving many Canadians of the latest in new medicines.

 

Findings include:

  • Only 23 percent of new drugs approved as safe and effective by Health Canada in 2004 had been approved for either full or partial reimbursement under provincial drug plans as of June 9, 2011, compared to 98 percent that had been covered by at least one private insurer.
  • Compared to its international counterparts, Health Canada takes longer to certify new drugs.
  • From 2006 to 2009, Health Canada’s performance was worse than that of the EMEA, Health Canada’s European equivalent.
  • Health Canada’s performance was worse than that of the U.S. Food and Drug Administration in five of the last six years studied (2004 to 2009).

Is ObamaCare Costing Jobs?

This is from the Heritage Foundation:

Contrary view below the fold.

How Risk Adjustment Can Backfire

We show that firms reduce selection along dimensions included in the risk-adjustment formula, while increasing selection along excluded dimensions. These responses can actually increase differential payments relative to pre-risk-adjustment levels and thus risk adjustment can raise the total cost to the government of providing the public service. We confirm both selection predictions using individual-level data from Medicare, which in 2004 began risk-adjusting payments to private Medicare Advantage plans. We find that differential payments actually rise after risk adjustment and estimate that they totaled $30 billion in 2006, or nearly eight percent of total Medicare spending.

Full article on how risk adjustment affects selection and differential payments.

The Insurance Czar

It is easy enough for those of us who are debating the merits of ObamaCare to lose track of just how profoundly this law has changed everything about health care and health insurance.

Take just one element — the regulation of health insurance, which is is no longer a state, but a federal responsibility. This one change would have been unthinkable just a couple of years ago. Since the founding of this Republic, insurance regulation has always been left to the states. The one break in that history came in 1944 when the Supreme Court ruled in United States v. South-Eastern Underwriters Association that the Commerce Clause authorized Congress to regulate insurance. This was part of the massive expansion of the Commerce Clause that took place in the decade between 1935 and 1945.

States and Medicaid, and Other Links

Two Visions for Health Reform

How can the federal government encourage low-cost, high-quality medical care?

There are basically two approaches: a bottom-up, market-based approach and a top-down command-and-control approach:

  • The former is based on competition, markets and economic incentives; the latter is based on rules, regulations, fines and penalties.
  • The former gets the economic incentives right for all of the individuals in the system, but does not try to dictate or even predict the final outcome; the latter decides in advance what the end result should look like and tries to free people to achieve it, even if it is not in their self interest to do so.
  • The former pleads ignorance about how medicine should be practiced — letting that be determined by competition in the marketplace; the latter decides in advance how medicine should be practiced and tries to impose it from above.
  • The former depends for its success on the intelligence, creativity and innovative ability of thousands of doctors, nurses and hospital personnel; the latter depends for its success on a small group of experts having all the right answers.

In the bottom-up world, 778,000 doctors, 2.6 million registered nurses and thousands of hospital and facilities personnel get up every morning and ask themselves, “How can I make costs lower and quality higher today?” In the top-down world, all of those people get up every morning and ask, “How can I squeeze even another dollar out of the third-party reimbursement formulas?”

Of these two approaches, which do you think the Obama administration is following? I’ll give you a minute to decide, then check your answer below the fold…tick,…tick,…tick, …tick,…

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