Doyle signs health care transparency bill - The Business Journal of Milwaukee: -
Wisconsin health care consumers can now price-shop. Gov. Jim Doyle signed the Health Care Transparency Bill Tuesday at Children’s Hospital of Wisconsin in Wauwatosa requiring health care providers to disclose the cost of the most common procedures they perform. It will help consumers get price estimates prior to a procedure, help make apples-to-apples comparisons on prices and help determine out-of-pocket costs prior to services occurring. “Nowhere else are people asked to buy a product before they know what the price is,” Doyle said in a statement. “This bill is a practical step forward that will help people better understand what their health care costs are before making important health care decisions.” Nancy Wenzel, chief executive officer of the Wisconsin Association of Health Plans, said the legislation parallels the efforts of many health plans in the state to empower consumer decision making. “With health care services taking more money out of consumers’ pockets, health plans gave their insured members another tool for managing their health care budgets,” Wenzel said. “As access to health care cost information increases, we expect consumer demand for the information will grow.”
I'm speaking at South by Southwest. -
Sick Clicks: The Evolution of Health Online:
Will the Internet be the life support that saves the current U.S. health care system from death? As more people seek health information and alternative care through online mediums, a health care evolution is emerging where we are all the remedy.
Other speakers include:
Ted Eytan, MD (Kaiser Permanente)
Jay Bernhardt (CDC)
Caley VanCleave (FeelGoodNow)
So come see us…it’ll be awesome. I promise.
This visualization represents a year in color (summer is at the top, winter at the bottom).
via kottke
A nice interactive infographic from the AP that presents a few scenarios regarding how health insurance reform affects individuals. It doesn’t look pretty.
Montreal photographer Michael G. Manoukian has created a study titled ‘Form and Function,’ a series of images that combine human x-rays with various tools. The work elegantly represents the relationship between form(the human image) and function(mechanical tools), demonstrating how both are inextricably linked and inform our understandings of each other respectively. Showing restraint and consideration with his choice of imagery, Manoukian’s ‘Form and Function’ provides an avenue for thoughtful consideration by the viewer. (via Michael Manoukian ‘Form and Function’ | Definitive Touch)
NHIN Direct: Open Healthcare Records and Government as a Platform - O'Reilly Radar -
My comment:
While I think this sounds pie-in-the-sky pretty, it’s all theoretical. First of all, electronic medical records (EMRs…sort of like electronic mail!) exist to solve two problems. The first is a billing/transactional problem. They’re designed to maximize physician reimbursement via upcoding for office visits and procedures. Docs are paid for office visits and procedures via highly specialized codes, not for quality, value, communication, or data analysis. Second, they’re designed to protect a doctor in court. That’s why the majority of information within an EMR is irrelevant to the actual clinical situation at hand. 95% of it is legal fluff and the rest is pertinent clinical information. Billing codes that aren’t actual personal diagnoses are meaningless to patients. Giving patients access to codes for 3 to 12 office visits a year isn’t that meaningful. It’s not enough data to even be considered dirty data. That’s not even considering the fact that we spend 1 hour with doctors a year on average and 8,765 hours on our own. Health is much more about our everyday behaviors than the clinical interactions we have documented in our doctors offices. Giving patients access to medical records simply gives them access to billing data and tests. If we think that labs and billing data changes health behaviors, I think we’re delusional. The real issue isn’t the data, it’s the desire to pursue happiness (and health is only one component of happiness) on a daily basis. Why do we want to behave in a healthy way to feel good today and decades in the future? What are other examples of people changing behavior because of data? We do change behavior based on communication…not so much data. We’re creatures of habit. Ninety to 95% of our activity can be predicted based on a months worth of data. I know that life is more fulfilling and more human with more effective means of communication and being social, but I can’t think of a situation where looking at data about my daily life has changed in any significant way the way I live my daily life for the better. I’d like to be proven wrong…
Modern medicine has extended the life of Americans by 40 years in the past 100 years. We solved the problem of dying children with clean water, vaccines, and antibiotics…hence the extra 40 years of life expectancy. Now we’re stuck with the problem of decades of unhealthy behavior and how to prolong our lives as 80-somethings. I’d rather focus on maximizing happiness in the most exciting and active years of our lives. Happiness and experience until we naturally fade away is the new health. Modern medicine with their pills and stents is surely not.
Human ingredients
How to save a friend from the brink. -
I’ve been thinking a lot about how we can prevent our friends and loved ones from taking their own lives (due to the number of celebrity suicides lately), and CNN publishes this:
For five days, Alexis Moore carefully planned how she would take her own life. She’s not a violent person, so she knew handguns were out. She settled on vodka instead, to be followed by a bottle of Xanax. She did it methodically. First, she says she drank the vodka for two hours. Then she lined up the 20 pills on the kitchen counter, taking a few at a time, going to her bedroom to cry and then coming back for more Xanax. After about six pills, just when she was beginning to feel woozy and lethargic, Moore heard a knock on the door and someone calling her name. She ignored him, even though she recognized the voice as someone she’d meet three days before at a business event. Then the man came around and banged on her bedroom window. She got up off the bed where she’d been sobbing and let him in. They sat down in her living room. She talked. He listened. By the end of the evening, she decided not to take her life. In the five years since, she’s never tried to commit suicide again.
What to say and do:
Tell her you don’t want her to die.
Send a card.
Say “I’m here.”
Bring a meal.
Don’t leave her alone.
Don’t say “I know how you feel.”
Don’t say “Just snap out of it.”
Don’t say “There was an earthquake in Haiti. Your situation isn’t that bad.”
Don’t ignore it. Don’t keep secrets.
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Long-term use of osteoporosis drugs linked to hip breaks -
I believe one day we’ll look back on chronic disease medications we’re supposed to take every day for decades and finally realize that reductionist medicine via a simple pill never really worked.
A Pharmacist’s Jail Cell Interview – What Good Does Blame Do? -
via Mark Graban:
Here’s one to ponder and comment on – does putting a pharmacist in jail for six months and ruining his career and life do anything to bring back a two year-old girl? Does it do anything to make future patients any safer? Watch this video from CNN about Eric Cropp, an Ohio pharmacist who was convicted and put in jail for six months after a fatal process error…
In 2006, Eric Cropp was a pharmacist at a Cleveland hospital when 2-year-old cancer patient Emily Jerry was killed by the medical error of a pharmacy technician. She was given a chemotherapy drug mixed with a salt solution 23 times more concentrated than the normal dose. But because Eric Cropp was the supervising pharmacist and should have caught the mistake, he was sent to jail. And that’s where I found him, confused, and struggling with regret.
My sense of outrage is overwhelmed by my sense of sadness over this whole case, between the tragic death of the little girl, Emily Jerry (more about the case and the girl), and about how the reaction does nothing to make other patients safer.
It *feels* good, maybe, to put a guy in jail… to hold him accountable, possibly to make an example of him. Cropp claims he was overworked and the pharmacy was chronically understaffed. Has a CEO or other hospital leader ever been convicted for systemic problems in a hospital? Whose fault is it if the pharmacy is overworked? Who goes to jail for that?
Health care costs: How Maryland keeps its costs down | The Economist
In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients. For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charge $1,555…Since the program started, the Wall Street Journal reports that Maryland hospitals have enjoyed a steady profit margin, unlike hospitals in other states that often make more money during boom years and less during a recession…
What is most remarkable is how state regulation of prices has contained costs. When the program began in 1977, the state’s hospital costs were 25% higher than the national average. Today, Maryland’s hospital costs are 2% lower than the national average.
I love this picture. Me. Barbara Bush.
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