Comments on: The Demand-Side Approach to Changing What Doctors Do

By: Jerry

Jerry — Mon, 03 May 2010 18:31:55 +0000

John,
You are SO right! And I say the top two indicators the research revealed:

Leadership
Altering financial incentives

are the same two that Governor Daniels Utilized when he effected the greatest change in state employee health benefits: HDHP-HSA with 70% participation rate, and in Medicaid where he implemented the Healty Indiana Plan that gave eligible uninsured Hoosiers a Power account of $1100.00 plus a defined level of insurance.

Once again, you are right on target! Thanks for your passion and perseverence on all our accounts!

Jerry

Leadership
Altering financial incentives
Using measurement to provide a force for restraint
Engaging with the community to help others see “how much high costs and poor quality are harming the greater good.”

By: Why are Health Care Costs So Hard to Control? | John Goodman | NCPA

Why are Health Care Costs So Hard to Control? | John Goodman | NCPA — Mon, 03 May 2010 15:31:24 +0000

[...] Here’s the hitch. In order to find low-cost, high-quality medicine, you have to go to places where (a) the third-party payers are absent and (b) normal market forces have not been systematically suppressed. (The only exceptions to this rule are few and far between and appear to be distributed randomly.) [...]

By: The Politics of the Senate Health Reform Bill: Obama’s Two Mistakes | John Goodman | NCPA

Mon, 30 Nov 2009 16:31:37 +0000

[...] as in the field of education (see my previous Alert), the only reform that can pass is one that does little more than spend more [...]

By: Bob B

Bob B — Wed, 25 Nov 2009 18:25:00 +0000

This is an interesting discussion. I think the bottom line is that people,us, need to have skin in the game to make a difference.
go to http://www.robertblades.com and check the book for a great disertation on this subject.

By: Dave

Dave — Wed, 18 Nov 2009 14:05:41 +0000

At the risk of sounding like a conspiracy theorist, here is something that has occurred to me over the last six months. Vouchers could be an important means of solving the uninsured problem while working with, rather than against, competition in a very transparent way. But as important as this would be for solving the problem of the uninsured, the potential gain to our society of vouchers being used in education is far greater. We are literally a nation that is making itself dumber over time. That is not sustainable.

I believe one reason for the hostility toward implementing a voucher program as a part of SERIOUS health care reform is that having vouchers prove their mettle with respect to something as complex and important as health care is terrifying to the NEA.

By: Ronald Feldman MD

Ronald Feldman MD — Wed, 18 Nov 2009 04:08:28 +0000

Having spent a few days a year at Mayo Clinic Rochester and witnessed the incredible amount of expensive equipment, the number of special procedures and specialty consultations, and it’s opulent surroundings, it seems clear to me that it can’t really be cost effective.

It isn’t quite nervana. Cross dept. coordination is not always efficient. Physicians have been fighting amoung themselves over work output inequities for years.

Some things stand out to me. 1. Donations to the Clinic have left a huge endowment, along with royalties for trademarks. 2. People often come for short stays from all over the world, many paying large sums of cash. Long-term continuity is not the responsibility many of us face. 3. The cost of living in Rochester, Minn. is very low, allowing for a lower salary structure.4. Mayo’s response to Gawande’s articles was to say Mayo can’t make it on fee-for-service Medicare pay, just like the rest of us can’t.

By: John Goodman

John Goodman — Tue, 17 Nov 2009 22:48:07 +0000

The Ford Foundation just announced a $100 million grant to encourage education reform. The recipient? Teachers unions! See the Wall Street Journal editorial here. http://bit.ly/2HTLHg

By: Nancy

Nancy — Tue, 17 Nov 2009 13:53:13 +0000

I agree with David. There are walk-in clinics all over the country. They are reasonably priced and there is very little waiting. That’s why some are called “Minute Clinics.” There are also surgi centers and free standing emergency care clinics that are reasonably priced.

Major surgery is a totally different animal. For that you have to cross the border to find reasonable prices.

By: David R. Henderson

David R. Henderson — Tue, 17 Nov 2009 03:56:17 +0000

Jennie Fiedler asks, “What is “affordable” health care and where do you find it?” I answer, “Wal-Mart.”
Best,
David

By: Jennie Fiedler

Jennie Fiedler — Tue, 17 Nov 2009 02:24:26 +0000

I think the scary part is that all health care is expensive. If you’re poor you can eat top ramen instead of steak, live in a studio apartment instead of a house, ride a bike, take a bus or drive a beater if you can’t afford a new car, and hit the thrift stores for everything else. But where do you go for medical treatment? What do you do when you don’t make enough to “spend your own health care dollars?” And considering how quickly the middle class is disappearing and the number of “working poor” is rising, there are a good many of us that could end up in that boat. Where do you go when your employer doesn’t offer health insurance and you can’t afford an individual policy? This is becoming an extremely relevant question in this current climate, but I sure haven’t seen any answers. Free clinics? “Income-based” health care? What is “affordable” health care and where do you find it?