Health Care’s Perverse Incentives

A federal judge’s recent ruling that elements of the health care bill are unconstitutional has heightened the health care debate. Republicans, feeling their oats and perceiving a mandate, are threatening to repeal the Patient Protection and Affordable Care Act.It was only after my friend and colleague Dr. Bala Chandrasekhar explained most of the information in this post to me that I first came to understand the fundamental problem. Our medical community suffers from perverse incentives. The system does not reward results; it rewards the extension of care.In the world’s best hospitals, such as the Mayo Clinic, physicians collaborate, in a finite space, where information is shared and decisions are made. In the overwhelming majority of cases, patients are shuttled around, from general practitioners, to specialist, and from one laboratory to the next. Information about the patient’s medical history is rarely shared, an approach that does not support the best medical outcome for patients.The advent of electronic medical records and new rules governing payments is the impetus to consolidation in a business so unsophisticated, that many medical files and prescriptions are managed with a piece of paper, pen and fax machine. The institution of medicine needs to undergo radical change, and the prospects of larger organizations managing our care means that the stakes are getting higher.Unlike professionally managed businesses, there are massive variations in best practices in medical groups. Physicians hate oversight, and we pay the price in an estimated 100,000 people a year dying in U.S. hospitals from pure negligence (errors).It is intuitive to all of us that raising medical care costs are unsustainable, yet the numbers are daunting. The convergence of an aging populace and exponential health care inflation will double Medicare costs within a decade. By 2020, Medicare and Medicaid are projected to increase from 21% to over 30% of federal spending (non-interest payments), and that doesn’t include massive spending by state and local governments. Proponents argue that we have the best medical care in the world; but at what cost? A knee replacement that costs upward of $40,000 in the U.S., costs $5,000 in Germany. We all want the best health care, but at some point common sense must prevail.According to the bipartisan congressional report -Restoring America’s Future, “slowing the growth of health spending is realistic. Other advanced countries have substantially lower health spending as a share of GDP, while still achieving measures of access and quality that often exceed those in the United States. Although a uniquely American approach is required, these comparisons show what is achievable.” Health care reform focuses on capping costs for doctors and reforming various forms of insurance coverage (including universal coverage). It does little to reform the underlying behavioral issues that are driving up health care costs. The fee for service model is dated and irrelevant.If these costs are not constrained, our fiscal mess will get much worse, and our businesses and personal wealth will be drained by massive tax increases. Small business owners, who bear the brunt of a bloated health care bureaucracy in the form of inflated health insurance premiums must advocate for more meaningful reforms. Our economic future depends on it.

Personal Medical Journal – Take Charge of Your Health Care

Research suggests that patients who take a more active role in visits with their physician may have a greater sense of control and much better health outcomes. Participation in your own health care can be dramatically increased through the use on a personal medical journal. Here are several additional benefits of using this powerful management tool.o Better Health Status – It has been observed that more effective gathering by patients, and more conversation by patients with their physician during office visits was related to better health status.o Prevent Duplication of Tests – Keeping track of all tests and treatment history will save your time and money by avoiding duplication of tests and procedures. Repeating tests and procedures are not only costly but they can also expose you to potential medical errors.o Increased Partnership with Physician – A personal medical journal will be your personal tool to effectively enter into a full partnership with your physician and many other health care professionals. A good partnership with your doctor begins with open communication. Keeping a complete and accurate record of your history will strengthen communication with your physician as you can provide them with useful information.o Become Empowered – Information is the key to patient empowerment. As you gather information about your condition you will become more informed about treatment options. This will allow you to manage your condition more effectively and increase your sense of well being. You will then become empowered rather than victim to your condition.o Improve Chance of Correct Diagnosis – According to the American Society of Internal Medicine, 70% of a correct diagnosis depends on what the patient tells the doctor. The use of a personal medical journal will help you share vital information with your physician about your symptoms. Having more data available will help your physician make better decisions. With this information-rich data at hand you may be able to provide your treatment team with the one crucial item of information that helps secure a correct diagnosis.Take charge of your own health care with the use a personal medical journal. This will allow you to “collect and share” valuable health information with all of your providers. Use this powerful tool to help you get the best of what our health care system has to offer.

Getting the Right Health Care Insurance for Your Pet

Usually most pet owners visit the vet at least twice a year and spend about $250 on medical treatment and medication. However, if you have a cat at home, your expenses can be less. These are normal expenses that you incur when you visit the vet for sterilization or vaccination. They take minimal time and you are out the vet’s office in less than 15 minutes. Your expenses can be high if your pet is suffering from a serious problem and the pet has to spend more time on your pet to understand their problem.Most people who understand this problem prefer getting health care insurance that will take care of high medical bills. Health care insurance for pets is similar to human health care insurance. When you take health care insurance for your pet, you have to pay either annual premium or monthly premium to insurance companies. These insurance companies will reimburse your medical expenses after deducting compulsory and voluntary excess.Before you take out health care insurance policy, it is in your interest to get quotes from a few insurance companies. Visiting the office of every insurance company may be difficult. You can get help from the internet to find out details of the premium charged by the insurance company. Before you start getting quotes from insurance companies, it is good idea to make a wish list of what you expect from the policy. Some of the things that your policy must have include low deductibles, annual checkups, spaying, prescription coverage and anything else that you consider important. Most companies will not offer you plans that cover all your requirements. So check what the company has to offer and make a list of coverage that you consider essential. Another factor that you should consider when getting health care policy is the amount that you are willing to spend. Avoid getting an expensive policy that you cannot afford.When you use the internet to search for companies that offer pet health care policies, try visiting their websites to get details of the policy offered by them. Check the coverage offered and the premium charged by the companies. Try to narrow down the list to companies that meet your requirements but don’t overcharge you.Before you get a policy, it is good idea to call the vet to find out if they accept policies from the insurance company that you plan to deal with. If the vet does not accept insurance from the company that you have selected, you have to select another company.