We're all familiar with the accounts of America's healthcare "have nots," the tens of millions who get by with no health insurance and the hundreds of millions who are vulnerable to partial health insurance or capricious insurance companies. But what about the "haves," the lucky people with the gold-plated health insurance coverage? A study of primary care physicians finds the "haves" are undermining American healthcare. They're simply getting too much healthcare for their own or anyone else's good.
In a new poll of primary care physicians, nearly half of them said their patients received too much medical care and more than a quarter said they were practicing more aggressively than they'd like to.
That could mean ordering more tests, prescribing more drugs or diagnosing people with diseases, although they would never have experienced any symptoms.
"Physicians at the frontline of medical care are telling us that their patients are getting too much care," said Dr. Brenda Sirovich of the VA Medical Center in White River Junction, Vermont, who worked on the survey. "And we don't think we are just talking about the 627 physicians that we surveyed."
"We spend a lot on healthcare in this country, more than anywhere else," Sirovich, also at the Dartmouth Medical School, told Reuters Health. "We realize that this is unsustainable."
...So why would doctors order tests that they themselves believe are excessive?
Three reasons stood out in the survey, which is based on a random sample of U.S. doctors: fear of malpractice lawsuits, performance measures and too little time to just listen to patients.
Four in 10 also believed that other primary care physicians would order fewer tests if those tests didn't provide extra income. (Of course, just three percent thought that financial considerations influenced their own practice style.)
"I'm not saying that physicians do tests in order to make money -- there is a potential to be a real cynic here -- but I think that the reimbursement model for most healthcare encourages utilization in a variety of ways," Sirovich said.
Showing posts with label US healthcare. Show all posts
Showing posts with label US healthcare. Show all posts
Tuesday, September 27, 2011
Wednesday, March 24, 2010
NYT Calls Obama Health Bill an Attack on Wealth Inequality
According to the New York Times, the Obama health bill is the first significant measure to reverse the wealth gap between America's rich and poor that has been steadily expanding since 1970.
Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.
Nearly every major aspect of the health bill pushes in the other direction. This fact helps explain why Mr. Obama was willing to spend so much political capital on the issue, even though it did not appear to be his top priority as a presidential candidate. Beyond the health reform’s effect on the medical system, it is the centerpiece of his deliberate effort to end what historians have called the age of Reagan.
The "Age of Reagan"? Might as well call it the "Age of Ruin." When Ronald Reagan entered the
White House, America was the world's largest creditor nation. In the breathtakingly short span of but eight years Reagan transformed the U.S. into the world's largest debtor nation. Reagan and Bush I and II were the only presidents since the end of WWII not to reduce America's debt as a function of GDP. Under them it skyrocketed to the near ruinous state inherited by Obama.
The Age of Reagan saw Americans become utterly stupid, willing to believe fantastic ideas such as their ability to live in wealth due to the endlessly increasing value of their homes. It wasn't just "casino capitalism" that brought America down, it was also "casino consumerism."
There were two types of wealth in America - real wealth and mirage wealth. Real wealth was what accumulated at the top among America's wealthy elites. Mirage wealth was the illusion of prosperity conjured out of cheap foreign borrowing and a bubble economy. It was scam wealth although it bought all the trappings of genuine affluence - while it lasted.
The Age of Reagan ruined the country and ruined an awful lot of Americans' lives. It allowed Washington, Wall Street and the American people to dig a horribly deep hole to the point where, today, their only salvation in the short to medium-term is another economic bubble. That's like a junkie relying on the next fix to keep the throes of withdrawal at bay.
For Obama and the United States, measures to arrest and narrow the wealth gap can help heal the damage done to the country and its people. On March 13th I addressed the sinister side effects of wealth inequality in a post, "A 'Must Read' for the Liberal Right." That post covered the book "The Spirit Level" in which two prominent British epidemiologists looked at the relationship between income inequality on half a century of data covering everything from mental health, drug use, physical health and life expectancy, obesity, educational performance, teen births, violence, imprisonment and punishment and social mobility.
Spirit Level compared every Western, industrialized democracy and also put America under a spotlight on a state by state comparison. What they found, and linked most persuasively, is that all of these blights on society worsen markedly (and predictably) as income or wealth inequality worsened. As income inequality diminished so too did these troubles. The authors also showed this wasn't just about the poor. Everyone but the very wealthiest suffered the scourges resulting from income inequality.
There's little question that America's rabid social Darwinism leaks across the border and into weak minds like that of our current boss, Harper. You might recall that, prior to his recent transformation, Harper subscribed to every bit of this made-in-America nonsense and even rebuked Canadians for our backward ways, the same ways that kept Canada from falling into the fiscal abyss created by the Americans.
I hope the New York Times has this one right and, if so, I hope Obama succeeds beyond his dreams. There are some who believe healthcare reform will be the spark that ignites social change in the United States. Among their ranks lie many hardcore congressional Republicans now struggling furiously to find a way to douse that very spark before it can catch hold.
Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.
Nearly every major aspect of the health bill pushes in the other direction. This fact helps explain why Mr. Obama was willing to spend so much political capital on the issue, even though it did not appear to be his top priority as a presidential candidate. Beyond the health reform’s effect on the medical system, it is the centerpiece of his deliberate effort to end what historians have called the age of Reagan.
The "Age of Reagan"? Might as well call it the "Age of Ruin." When Ronald Reagan entered the
White House, America was the world's largest creditor nation. In the breathtakingly short span of but eight years Reagan transformed the U.S. into the world's largest debtor nation. Reagan and Bush I and II were the only presidents since the end of WWII not to reduce America's debt as a function of GDP. Under them it skyrocketed to the near ruinous state inherited by Obama.
The Age of Reagan saw Americans become utterly stupid, willing to believe fantastic ideas such as their ability to live in wealth due to the endlessly increasing value of their homes. It wasn't just "casino capitalism" that brought America down, it was also "casino consumerism."
There were two types of wealth in America - real wealth and mirage wealth. Real wealth was what accumulated at the top among America's wealthy elites. Mirage wealth was the illusion of prosperity conjured out of cheap foreign borrowing and a bubble economy. It was scam wealth although it bought all the trappings of genuine affluence - while it lasted.
The Age of Reagan ruined the country and ruined an awful lot of Americans' lives. It allowed Washington, Wall Street and the American people to dig a horribly deep hole to the point where, today, their only salvation in the short to medium-term is another economic bubble. That's like a junkie relying on the next fix to keep the throes of withdrawal at bay.
For Obama and the United States, measures to arrest and narrow the wealth gap can help heal the damage done to the country and its people. On March 13th I addressed the sinister side effects of wealth inequality in a post, "A 'Must Read' for the Liberal Right." That post covered the book "The Spirit Level" in which two prominent British epidemiologists looked at the relationship between income inequality on half a century of data covering everything from mental health, drug use, physical health and life expectancy, obesity, educational performance, teen births, violence, imprisonment and punishment and social mobility.
Spirit Level compared every Western, industrialized democracy and also put America under a spotlight on a state by state comparison. What they found, and linked most persuasively, is that all of these blights on society worsen markedly (and predictably) as income or wealth inequality worsened. As income inequality diminished so too did these troubles. The authors also showed this wasn't just about the poor. Everyone but the very wealthiest suffered the scourges resulting from income inequality.
There's little question that America's rabid social Darwinism leaks across the border and into weak minds like that of our current boss, Harper. You might recall that, prior to his recent transformation, Harper subscribed to every bit of this made-in-America nonsense and even rebuked Canadians for our backward ways, the same ways that kept Canada from falling into the fiscal abyss created by the Americans.
I hope the New York Times has this one right and, if so, I hope Obama succeeds beyond his dreams. There are some who believe healthcare reform will be the spark that ignites social change in the United States. Among their ranks lie many hardcore congressional Republicans now struggling furiously to find a way to douse that very spark before it can catch hold.
Monday, October 26, 2009
America's Sick Healthcare System
A growing majority of Americans want a new, public healthcare system but the bloated and entrenched "for profit" healthcare industry is fighting back aided by an army of lobbyists, a powerful propaganda machine and heavily corrupted, "on the take" Congress.
Those who oppose public healthcare freely resort to scare tactics and claim that a government-administered system would be wasteful - money down the drain. These reprobates aren't going to be very happy with a report out today that shows that their system squanders up to 850-billion health care dollars a year. From Reuters:
The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.
...One example -- a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.
"It is waste when caregivers duplicate tests because results recorded in a patient's record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed," the report reads.
Some other findings in the report from Thomson Reuters, the parent company of Reuters:
* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 a year.
* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.
* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.
* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.
* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.
That last point is especially telling. Republicans use "preventable conditions" as a straw man to blunt demands for healthcare reform. They argue that the American health care system is simply a victim of preventable conditions such as obesity. Out of $850-billion wasted health care dollars, the Reuters Thomson report finds a very small fraction - $30-50 billion - the result of preventable conditions. In other words, the Republican's key argument is just so much lobbyist/kickback-driven bullshit.
Those who oppose public healthcare freely resort to scare tactics and claim that a government-administered system would be wasteful - money down the drain. These reprobates aren't going to be very happy with a report out today that shows that their system squanders up to 850-billion health care dollars a year. From Reuters:
The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.
...One example -- a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.
"It is waste when caregivers duplicate tests because results recorded in a patient's record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed," the report reads.
Some other findings in the report from Thomson Reuters, the parent company of Reuters:
* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 a year.
* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.
* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.
* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.
* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.
That last point is especially telling. Republicans use "preventable conditions" as a straw man to blunt demands for healthcare reform. They argue that the American health care system is simply a victim of preventable conditions such as obesity. Out of $850-billion wasted health care dollars, the Reuters Thomson report finds a very small fraction - $30-50 billion - the result of preventable conditions. In other words, the Republican's key argument is just so much lobbyist/kickback-driven bullshit.
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