What are the 5 biggest myths?

The 5 biggest myths circulation around health care reform through all channels of media and confusing a whole lot of people are:

1. It would lead to a government take over

2. An overhaul would lead to rationing, where people face denials or delays in health care

3. The bills do nothing to address out-of-control cost growth

4. If you like your health insurance you can keep it

5. The bills are too big, and changes should be tackled one by one instead of all at the same time

These are some important myths that need to be answered before the public can agree with health care reform. Read the explanations or truths here

Oh politics... I don't think I will ever understand you

I like to think that I am a moderate when it comes to politics. I pride myself on the fact that I can see issues from both sides before making a final decision. However, lately the Republicans have been too much for me to deal with. It seems no matter what they are going to kill health care reform. What I can not understand is why.

Ok it will will be expensive. But isn't health care already too expensive. Medicare might be expanded. This can be good since Medicare as of right now might not exist in 8 years and bankrupt the country. A lot of people will be affected by new insurance policies. OK yes but the more people who have insurance, the more likely the cost will go down. Many doctors will have to change how they practice medicine. This can be good if quality and efficiency increases.

Oh maybe they don't want to support reform because it is not going to go their way, and they might not be re-elected. With the way they helped the economy drop, I guess I would be worried about my job too. (of course I am a big believer of new blood in the government)

The worst however is when they act like they want reform, and then behind the democrats back, they bash the bill and are no longer playing nice. Here is a nice example of that.

Another Reform Idea

Here is an interesting idea: pilot programs. We really have no idea what is and what is not going to work for reforming the health care system. We have some models around the country that consistently see high quality while lowering costs, but they have had years to perfect this technique. However, each area of the country faces their own unique challenges, opportunities and population variations. So maybe each area should use what works best for them instead of forcing everyone to do the same thing. As long as we all have the overall goal of reducing cost and increasing quality, maybe this could work.

Atul Gawande, surgeon and writer, suggests this strategy and some other needed reforms to payment and quality. He has been right in the past, so maybe he will be right again with health care reform.

Read his full story in the New Yorker

http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande?currentPage=1

Debating Health Care costs

Health care costs is the number one biggest debated topic for reform. Some say the costs will go down (after partially going up to get things moving) while other argue costs will just continuously increase after insuring more people. There is also a small number that believe costs and Medicare will operate the same after reform as it operates now- inefficient with lack of quality.

Most agree that we need to reform cost before reforming other quality issues in health care such as prevention or medical errors; however, no one can agree how it will all pan out once reform is passed.

Personally I think we should just let the experts figure it all out. I am not an economist, nor are the majority of politicians or Americans for that matter, so we should be concerned (obviously) but giving our opinions just confuse the topic more.

Check out this article for more information on both sides debating cost control

http://www.kaiserhealthnews.org/Columns/2009/December/120309Capretta.aspx

Another great cost containment concept

Waste and inefficiency is estimated to account for about 30% - 40% of total health care costs. Studies show that the largest drivers of waste are:

- fee-for-service incentives

- lack of consumer responsibility

- defensive medicine

- excess bureaucracy

- fraud

We don't need to create a whole new health care system, but we do need to address this waste in the system. Until we change how we do things, we will continue to waste our money and not see improved outcomes.

For more see this blog post by Philip K. Howard

How to Control Health Care Costs

Check out this great blog post by Stephen Shortell, PHD, MPH, MBA

He eloquently explains that reform will not work unless "we slow the rapid growth of health care spending". This can be solved not by expanding coverage, but by actually reforming the system. We need to focus on prevention and living a healthier lifestyle. We need to change the incentive program for hospitals and physicians. The system need to worker hard at comparing effectiveness of different techniques/procedures/drugs.

It is possible for costs to decrease by having a more efficient and effective health care system that focuses on what is best for the patient, not the financial gains.

Young adults Don't Welcome Health Insurance Mandates

Kaiser Health News reports that young adults do not like that the new health bills will require them to have insurance. Many young adults are healthy and feel they don't need health insurance. So why should they pay for it?

They should pay for it for the greater society as a whole. "Young adults are the balance to the new rule, which also forces those least likely to need medical care to participate in a health plan in order to keep prices from inflating" (Rodewald, 11/11).

If everyone has insurance, it helps lower costs of the overall insurance pool. Also it will help ER units in hospitals from overcrowding because everyone will (in theory) have their own doctor to go to for such ailments as the flu. Also preventative services will increase if everyone has insurance.

But what if they can't afford it? Thats what the insurance reform is suppose to fix, but more on that in another post.

KHN reported their summary from a Northwestern paper from Oshkosh, WI

Is the House Bill Better than Nothing?

Marcia Angell, MD, gives her recommendations for health care reform... not sure we need total government take-over but I do like how she writes that the House bill "simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry." I agree that we need changes in the health care system not seen in government debates, which are trying to reform insurance and not the complete system (which in my opinion is needed more).

You can read more of her recommendations in her blog through online news site Huffington Post at: http://www.huffingtonpost.com/marcia-angell-md/is-the-house-health-care_b_350190.html&cp

How much will Reform cost?

As Congress continues to debate about the details that will go into the health care reform bill, one pressing issue is how much will this cost? Much of what they project will be over the next 10- 20 years. I'm not going to lie, its a lot. About $900 billion. But how I see it, is that it will cost way more if we do nothing.

For more of a breakdown of the numbers, NPR does a good job here

Throughout the next couple of weeks, I will continue to post more media stories on cost, so stay tuned

Where are the young supporters now?

Last November the youth were a driving factor in Obama's election win, but now they have all disappeared from the health care reform debate? Where are they?

I find this to be most disappointing since any major changes in the way we pay for health care will substantially affect the young generation. We have a responsibility to understand why we need reform, what are the proposed solutions and how will this affect the national deficit.

The article below from The Huffington Post gives more detail on where the young Obama supporters have disappeared to.

http://www.huffingtonpost.com/jose-antonio-vargas/obama-online-where-are-th_b_331220.html

My perspective on health care reform

(previously posted on ICSI Healthcare Blog)

Even though any health care reform that may be passed after the current debate will affect my generation and those that follow the most, it seems no one is asking the young what they want. I feel I have no control over the end results. Maybe people think we are uneducated about health care and don’t understand the issues. Maybe we are not invested enough in the issue. Maybe they think we are still too inexperienced in life and do not know what is best. Or maybe we are considered too idealistic or that what we want is major reform that could shake this whole country upside down. But young or old I think we can all agree we just want a better health care system.

So who am I? I am a graduate student in the Health Communications MA program at the University of Minnesota working at ICSI as a summer intern. I have spent two years learning about the problems in our current system and the entire summer learning about some possible solutions. I am constantly reading online newspapers and blog posts from some pretty smart people who know their stuff. Now that does not mean I know the solutions, but I have an informed idea of some things that need to be changed.

Oh but that’s right, I’m young, so what do I know? I know that we cannot leave it up to aging politicians worried about next year’s election to make the right call. I know we cannot allow any lobbyists to be involved near Capitol Hill during the debates. I know that we need better health reporting, so the public can be educated on the complete problems and solutions with an unbiased tone. Just tell the facts.

I think that we need to use electronic medical records or personal health records to help standardize care. We cannot rely on memory alone. We need a system to ensure the appropriate ordering of evidence-based diagnostic imaging tests and a way to decrease medical mistakes in hospitals.

I think we need a way to end defensive medicine—not only in reforming malpractice lawsuits, but also changing the way Americans think about health care. More is not necessarily better, and we need to find a way to change that perception. It is not easy to change a culture but we can try. While we are at that, we need better health journalism. Why are Americans confused about health care reform? Ask your local television news station.

If we want our doctors to practice evidence-based medicine, then we need to include patients in the process. Shared decision making puts the patient in control of their health and gives them responsibility and accountability for the end results. Providers present the information for all the treatment options so the patient can weigh the risks and benefits according to their own preferences. When a patient is presented all the options, studies show that they will pick the least costly and invasive procedure (http://online.wsj.com/article/SB10001424052970203674704574328570637446770.html). In addition, health literacy is a real problem in this country, but shared decision making tools and videos help make the medical terminology easier to understand and help the patient pick an option that best fits with their values, which can help increase compliance and comprehension.

I think doctors should be on salary. In some industries, it makes sense to have a pay-for-service system in place, but for health care, I find that to be morally wrong. If this pay system was gone, we could have more coordinated care and patient appointments would not always be tied to an office visit. Doctors could converse about a patient and know that their time is being reimbursed. Nurses could do weekly follow-up calls when difficult cases present themselves. We could have a medical home system in place.

Lastly we need to support the value of primary care physicians in this country and focus on preventative medicine. Growing up I had a great doctor I saw every year for that annual check-up. I was naive to think every American had the same care. I think we need to build incentives for medical students to return to primary care and increase how much they are paid to help primary care doctors pay back their debt quicker. Plus we need to end the 15-minute or shorter appointment slots that the current fee-for-service system drives. Not only do doctors feel rushed, but also patients are unhappy. (This may be a contributor to why patients feel like doctors are not listening to them and doctors are forced to practice defensive medicine.) By focusing on preventative medicine, we can control chronic diseases like diabetes and work to make Americans healthier and not just intervene with drugs and expensive surgeries.

None of these changes will be easy, but if we want a sustainable system that will not crumble again in 20 years, we need to do this. I know I am young and inexperienced, but according to all the evidence out there, we need some major changes in health care. Any real reform will dramatically affect every industry and every individual, and maybe that’s what we need. Shouldn’t we change health care for the greater good? Shouldn’t we continue to strive for excellence in quality and care? Do we want our system to be ranked 37^th in the world, forever? Or am I being too idealistic again?