Tuesday, March 9, 2010

The Emperor’s New Health Clothes

Our president said "every idea has been put on the table. Every argument has been made." This is simply not true regarding health care.

As a result of the influence of our president, Congress, insurers and medical care givers the general public has misguidedly been focusing on health insurance coverage when the focus should have been on health itself. The complex content of the bill on insurance reform is not a bill to improve health and lower its cost. The president is on the verge of creating extremely expensive access to the “emperor’s new health clothes.”

There is little value in this proposed legislation to make health care high quality and affordable for everyone.

On one hand President Obama continues to blame insurers for rising costs and for skimming health dollars while at the same time he invokes insurance principles for reforming our health system. This conflict requires responsible resolution.

What about health itself, Mr. President? The health status of fully insured union members with low co-pays and deductibles and access to care at the best medical facilities is not good, and the union members do not know it. Neither do government workers who are led to believe their federal employee health plans are a model for the nation to follow. Medicare and Medicaid plan members also receive substandard care and they do not know it. Even worse, our health care providers are in the dark when it comes to the quality of health they achieve with their patients.

Simply put, our increasingly poor quality of public health is the cause of our high cost of health care. And hospitals, doctors, insurers, pharmaceutical companies, durable medical equipment suppliers and disease management companies make their income from poor health.

Information about the value of health care we receive is the discussion that will unite the American people, Democrats and Republicans, their physicians, and most of all Congress to understand what to do. When this ticking time bomb of useful information currently withheld by insurers and government is organized and made public, meaningful health reform will occur.

The idea to require existing state, federal, and local governmental agencies to mandate dissemination of aggregated population health data and individual data in confidential conforming format by all health plan administrators has never been put on the table by our president.

We should use our existing already paid for governmental apparatus to achieve what the employees are paid to do, protect the public’s health interest. Aggregating and sharing existing public health medical information by regions in the US will light a clear path for health reform in America and avoid the obscene expenditure of money and incurring of debt for essentially no value.

Without a baseline of today’s value there can be no measurement of future value. Let’s not purchase “The Emperors New Health Clothes.”

The Health Gadfly

Thursday, September 24, 2009

A Reason for Change: Letter to Dan Henninger Wall Street Journal

Dear Mr. Henninger,

I agree with your view “From Bismarck to Obama” http://bit.ly/16Tv8K except you did not include the big reason for change that would rally America to support meaningful health care reform. As you correctly asserted the reasons for change are not in misinformation that Obama refers to. The reasons for change are contained in what is not being shared by those who have useful information to influence the national discussion about health. All of us contribute to making our own health problem worse and we are not aware of the adverse impact of these actions on ourselves as individuals and collectively on the communities where we live.

First and foremost any strategy for containing runaway health must reduce the size of the pipeline of preventable financial and emotional catastrophic medical events that are bankrupting our country. Less than 50% of Americans undergo early detection of cancer even when they have insurance coverage, and similarly less than 50% of diabetic patients receive recommended care for their condition even when they too have insurance coverage. According to the Institute of Medicine an average of 5000 dollars of every hospital admission is spent for treatment of non identified adverse drug reactions. Similarly we waste enormous sums of money treating and diagnosing symptoms of adverse drug reactions on an outpatient basis that occur among as many as 20% of our population taking medications.

Cancer, diabetes, and adverse drug reactions relate to about 1/3 of our national medical bill.

The information to disseminate the gaps in care required to prevent advanced disease should be made available to every Medicare, Medicaid and privately insured person in America. Although available, this information has not yet been distributed. All the President and government administrators at the state and a federal level need to do is to require this personal health information to be shared with America. The impact of this information transfer will unify our country on a successful consensus driven course for health care reform. The conflicts of interest of those who benefit from the status quo will be eliminated. Dissemination of personalized accurate information will make us realize as a country that any citizen without access to care raises health expenditures for all of us.

I would be pleased to share with you very low cost available methodologies for making such information available.

The Health Gadfly

Health Care Can be Equal

N. Gregory Mankiw’s article “Why Health Care Will Never be Equal” http://bit.ly/2m0wzU describes only two legs of the three legs of health in America. He excludes from his equation the fact that compliance by individuals and their physicians with known guidelines for care can reduce medical risk and increase longevity at dramatically lower cost. These efforts can reduce as much as a third of the money spent today for health in America. This amount of money is more than enough to pay for everyone and even leave a little over for other items to reduce our national debt.

We are overweight, comply with recommendations for diabetes management less than 50% of the time, and do not get screened for cancer when we should. These low cost non compliant behaviors insure the continuing supply of patients who wastefully consume our health dollars. We have become dependent on the bail out of expensive medicines and treatments instead of taking actions to avoid their use in the first place.

In addition, significant proportions of Americans who take multiple drugs have adverse drug reactions (not drug interactions) and are not aware of them. These idiosyncratic (Specific to each individual person response to medicines) reactions often lead to unnecessary tests and hospitalizations. In fact, the Institute of Medicine has reported on average five thousand dollars of every hospital admission is spent on the clinical presentation of adverse drug reactions.

Dr. Mankiw does not address the contributions to society that result from the investment in life years gained from treatment.

We could avoid the ethical dilemma raised by Dr. Mankiw, if our culture changed to simply follow a more logical approach to health using available information technology correctly.

The Health Gadfly

Monday, September 14, 2009

Pathway to Health Care Reform

HealthNewsDigest published “Pathway to Health Care Reform” written by The Healthgadfly and his colleague this past Sunday September 13, 2009.


Health News Digest is a member of the New York Press Club, The Association of Health Care Journalists and The Online News Association. This prestigious 10 year old Online Magazine publishes news stories on the Health Industry on a daily basis.

They are syndicated to thousands of major health industry Websites and wireless phone systems. Also, over 2,000 news editors, and health columnists subscribe and have free access to use any and all content.

The Health Gadfly

Thursday, September 3, 2009

Our President is on the Ropes

The Health Gadfly was again welcomed as a lead Op-Ed by The Health Care Blog on September 3, 2009. http://bit.ly/3nqGxu9

Thursday, August 27, 2009

Change Your Strategy, Mr. President

Emerging consensus is against another health plan sponsored by the federal government.

There is already much oversight at federal and state levels of all insurance programs, yet these programs experience unsustainable cost trends. Medicare, Medicaid and the Federal Employee Health Benefit Plans are modeled after private insurance plans and they do not work economically. In the instances where profit incentives have been removed from government-run programs such as the federal employee health plans, the trends in these plans are not significantly different from private insurance plan trends.

One sustaining aspect of our health system is the belief in the patient/doctor relationship. This bond between patients and their physicians continues to survive insurer, government, and other third party interference. This patient physician bond must be strengthened in any successful strategy for change.

Instead of continuing to list all that is wrong with American Health and coming up with new unproven expensive plans for change, the president should focus on practical ways to improve quality in health care by leveraging our patient physician bonds.

First he has to communicate the message to everyone that on average clear evidence indicates that Americans receive substandard basic health care. This circumstance is driving up our health costs because without basic care we often develop catastrophic expensive illness. Less than 50% of all Americans participate in early cancer detection programs whether or not they have insurance coverage. Similarly for diabetes, many people develop complications of stroke and kidney failure because they do not follow basic treatment recommendations of the American Diabetes Association.

Physicians and their patients, contrary to their perception, do not have useful up to date information when making health care decisions that involve everyday health care.

One powerful source of information to improve health, and strengthen physician and patient bonds has been available for years yet not shared. Medical claims, laboratory results, and pharmacy data stored in health plan administrators’ computers (Medicare, Medicaid, Private Insurers, and Third Party Administrators) are available and able to support individual and doctors efforts to narrow quality of care gaps. Proper organization of this data can link every diagnosis, test, and prescription for each patient in a way that each doctor and patient are unable to do for themselves. The government can make this happen by regulation.

Our President can no longer avoid sharing available and accurate health information that may be in conflict with some special interest groups that supported his campaign. Those involved in health plan administration must no longer withhold vital information about our health even though it may not be in their financial interest to disclose it.

Only with clearly understood reasons for change will change occur, patient physician bonds strengthened and special interests pushed aside. Changing the discussion to a “Moral Imperative” as mentioned today http://xrl.us/bfat4w does not give a practical incentive for change that is ultimately determined by the people of America. He has already won consensus on the need for change.

If our President does not get off the ropes quickly and change his strategy to improving health by strengthening the patient/doctor relationship he will get knocked out of the health care arena very much like his predecessors and the opportunity for “Change” regarding health care in America will be lost. The President and the nation risk losing much more than the battle for our nation’s health.

The Health Gadfly

Thursday, August 20, 2009

Government Intervention VS. Personal Responsibility in Health

The health Gadfly was welcomed by The Health Care Blog and they discussed health care reform!