41 Matching Annotations
  1. Nov 2019
    1. It needs to be fully repealed, because the first step out of the gate for Obamacare is a step in the wrong direction and that is for government control over every aspect of health care, so it’s hard to fix the system that they have put in place without ending that premise that government ought to be running and controlling health care.
  2. Aug 2019
    1. ObamaCare, is the product of a Conservative Think-Tank. 60% of citizens get private insurance from their employers, 15% receive Medicare (65 and older), and the federal gov’t funds Medicaid for low-income families (the allocation to this fund has been declining).

      Lucky, Trump removed that

    2. United States and its Health care:      The gov’t has some government-run programs and private insurance.

      U.S. health care system

    3. Health care spending was 12.4% of GDP in 2016. That is approximately $7,919.00 per person. There were 11.6% of people who skipped prescriptions because of cost.

      Switzerland Health Care System

    4. Mandate: The gov’t mandates that everyone buy health insurance, funding comes from payroll taxes.

      3

    5. Health care spending was 11% of GDP in 2016. Approximately $4,600.00 per person. 7.8% of patients skipped prescriptions because of cost. The life expectancy was 85.5 years in 2015.  

      France health care system

    6. 2-Tier: The gov’t pays two-thirds, and the private sector pays one-third.  

      2

    7. Health Care spending was 10.6% of Canada’s GDP in 2016 and 10.5% of patients skipped prescriptions because of cost.

      Canada health care system

    8. Single-Payer: The gov’t taxes its citizens to pay for health care.

      1

    9. Single-Payer, 2-Tier, and Mandate systems.

      three definitive models for Universal Health Care

  3. Mar 2019
    1. The HMO Act of 1973 changed that premise. It authorized for-profit IPA-HMOs in which HMOs may contract with independent practice associations (IPAs) that, in turn, contract with individual physicians for services and compensation. By the late 1990s, 80 percent of MCOs were for-profit organizations, and only 68 percent or less of insurance premiums went toward medical care.

      The HMO Act of 1973 resulted in for profit health care.

    1. Nixon signed into law, the Health Maintenance Organization Act of 1973, in which medical insurance agencies, hospitals, clinics and even doctors, could begin functioning as for-profit business entities instead of the service organizations they were intended to be. 

      In the 1970s health care was allowed to change from a non-profit to a for profit.

    1. a group of teachers created a program through Baylor University Hospital where they would agree to pre-pay for future medical services (up to 21 days in advance). The resulting organization was not-for-profit and only covered hospital services. It was essentially the precursor to Blue Cross.

      Baylor University's teacher's created one of the first "employee insurance companies" which turned into Blue Cross.

    2. Since U.S. businesses were prohibited from offering higher salaries, they began looking for other ways to recruit new employees as well as incentivizing existing ones to stay. Their solution was the foundation of employer-sponsored health insurance as we know it today.

      The result of the Stabilization Act of 1942 was for employers to provide health care benefits to employees.

    1. Because health benefits could be considered part of compensation but did not count as income, workers did not have to pay income tax or payroll taxes on those benefits. Thus, by 1943, employers had an increased incentive to make health insurance arrangements for their workers, and the modern era of employer-sponsored health insurance began

      After WWII companies started providing health insurance to employees. Somewhere along the way this translated into employers co-oping with private insurance companies to provide health insurance as opposed to paying the employees medical bills or providing their own doctors and clinics.

  4. Nov 2018
    1. Polls show that doctors are trusted by the public more than politicians, which means it’s hard for public policy to shape the healthcare system unless medical associations sign off on it.
    1. “It’s about embracing the inscrutable nature of human interactions,” says Chang. Evidence-based medicine was a massive improvement over intuition-based medicine, he says, but it only covers traditionally quantifiable data, or those things that are easy to measure. But we’re now quantifying information that was considered qualitative a generation ago.

      Biggest challenges to redesigning the health care system in a way that would work better for patients and improve health

    2. “Our biggest opportunity is leaning into that. It’s either embracing the qualitative nature of that and designing systems that can act just on the qualitative nature of their experience, or figuring how to quantitate some of those qualitative measures,” says Chang. “That’ll get us much further, because the real value in health care systems is in the human interactions. My relationship with you as a doctor and a patient is far more valuable than the evidence that some trial suggests.”

      Biggest challenges to redesigning the health care system in a way that would work better for patients and improve health

    3. Duffy points to the increase in health care interactions online and adds that he would like to see a pervasive culture of in-person care as last resort. “If every organizational decision, technology decision, process decision — assuming all the payment stuff, that’s kind of ticket of entry, transpires — if you view in-person as last resort, that will help pull systems across the country to a more consumer-forward Uber-like experience,” he says

      Biggest challenges to redesigning the health care system in a way that would work better for patients and improve health

    1. As with other forms of value-based health care, patient-centered care requires a shift in the way provider practices and health systems are designed, managed, and reimbursed. In keeping with the tenets of patient-centeredness, this shift neither happens in a vacuum, it driven by traditional hierarchies in which providers or clinicians are the lone authority. Everyone, from the parking valet and environmental services staff to c-suite members, are engaged in the process, which impacts hiring, training, leadership style, and organizational culture. Patient-centered care also represents a shift in the traditional roles of patients and their families from one of passive “order taker” to one of active “team member.” One of the country’s leading proponents of patient-centered care, Dr. James Rickert, has stated that one of the basic tenets of patient-centered care is that “patients know best how well their health providers are meeting their needs.” To that end, many providers are implementing patient satisfaction surveys, patient and family advisory councils, and focus groups, and using the resulting information to continuously improve the way health care facilities and provider practices are designed, managed, and maintained from both a physical and operational perspective so they become centered more on the individual person than on a checklist of services provided. As the popularity of patient- and family-centered health care increases, it is expected that patients will become more engaged and satisfied with the delivery of their care, and evidence of its clinical efficacy should continue to mount.

      Cultural shift to patient-centered care

    1. Koh et al. (11) detailed a cycle of crisis care elaborating the nature of high medical costs, possibly resulting from fear and denial. First, an individual is in need of medical help, so he or she goes to a physician's office where the staff asks the individual to fill out a complex and confusing form. The physician examines the patient and explains the condition and treatment options using medical jargon. Numerous prescriptions, laboratory tests, and referrals are given without confirmation of the patient's comprehension. The staff sends the patient home with complicated instructions. Inevitably, the patient may consume medication incorrectly or miss follow-up appointments, and his or her condition worsens. Eventually, the patient presents to the emergency department, and the hospital staff develops a new treatment plan. Again, no one confirms the patient's understanding. When the patient is discharged, he or she is likely to get sick again and repeat the cycle (11)
  5. Sep 2018
    1. medical care

      Improve medical care infrastructure and inter-provincial agreements to be able to cover LC-LD workers and their families in source, host and hub communities in a timely manner. the improvement of such services should be flexible enough to adapt to the ups and downs of the predominant industries.

  6. Aug 2018
    1. Anomie (/ˈænəˌmi/) is a "condition in which society provides little moral guidance to individuals".[1] It is the breakdown of social bonds between an individual and the community, e.g., under unruly scenarios resulting in fragmentation of social identity and rejection of self-regulatory values.

      I can't help but see this definition and think it needs to be applied to economics immediately. In particular I can think of a few quick examples of economic anomie which are artificially covering up a free market and causing issues within individual communities.

      College Textbooks: Here publishers are marketing to professors who assign particular textbooks and subverting students which are the actual market and consumers of those textbooks. This causes an inflated market and has allowed textbook prices to spiral out of control.

      The American Health Care Market In this example, the health care providers (doctors, hospitals, etc.) have been segmented away from their consumers (patients) by intermediary insurance companies which are driving the market to their own good rather than a free-er set of smaller (and importantly local) markets that would be composed of just the sellers and the buyers. As a result, the consumer of health care has no ability to put a particular price on what they're receiving (and typically they rarely ever ask, even more so when they have insurance). This type of economic anomie is causing terrific havoc within the area.

      (Aside: while the majority of health care markets is very small in size (by distance), I will submit that the advent of medical tourism does a bit to widen potential markets, but this segment of the market is tiny and very privileged in comparison.)

    1. The technical and theoretical details underlying clinical informatics are beyond the scope of this chapter. What follows is a concise introduction to topics and resources of general interest in this field, presented to help clinicians use information technology for the benefit of patient care.

      This is interesting!

  7. May 2018
    1. There are many resources available to help you and your health care proxy develop a care plan. These are merely suggestions to get you thinking about possible scenarios and topics to discuss. I hope you found this blog informative, and urge you to share it with anyone who does not have a health care proxy. We always think it will never happen to us, but what if it does? It's best to be prepared!

      The article highlights the importance of what a good health proxy looks like and how they go about helping a patient in their most sensitive moments of health and later on in their lives. Potentially, this could be a good chance for a client's wishes to be fully respected by someone who knows of their values and preferences. It also encourages the reader to be prepared incase they are faced with this decision some day. Many members of the elder population are asked about healthcare proxies during the beginning of any hospitalization. More awareness of what a health proxy is and what social supports a patient can count on helps to assure quality care and dignity in health and death.

    2. Further, a doctor, medical center, hospital, EMT, and even assisted living staff can make decisions regarding your healthcare, treatment methods and type of medical care to provide you if you are not married, over 18 years old, and do not have a health care proxy in place

      Medical decision making has very specific in rules to protect the rights of the patient. The rules can vary according to a patient's age, marital status, and wether or not they signed a health care proxy document in the first place.

    3. Who would decide what was best for you? Who would advocate on your behalf?

      This is a scary question that most people in the United States have to consider at one point in their life. Trust in the person in charge of making medical decisions is essential.

    4. Health care proxy: An advance medical directive in the form of a legal document that designates another person (a proxy) to make health care decisions in case a person is rendered incapable of making his or her wishes known.

      The medical definition of a health care proxy- a legal medical document that transfers power of medical decision making from a patient to a trusted person.

    1. The question each proxy should ask when making decisions on behalf of others is, who am I truly serving — the patient or myself?

      This article really high lights the potential negatives of the concept of healthcare proxies and provides real life scenarios to help the reader relate.

    2. When the patient is unwilling or unable to make medical decisions, the health care proxy is activated and he or she is obligated to make all health choices on behalf of the patient. These may be related to withdrawing or withholding life support, instituting artificial liquid feeding, attempting resuscitation and even whether or not to participate in autopsy and organ donation.

      Any decisions regarding the care and body of the patient are headed over to their health proxy, who assumes any medical decision making responsibilities from there.

  8. May 2017
    1. Section 139A of the Internal Revenue Code of 1986 is amended by adding at the end the following new sentence: “This section shall not be taken into account for purposes of determining whether any deduction is allowable with respect to any cost taken into account in determining such payment.”.

      This is important.

  9. May 2016
    1. that doesn't mean the drugs can't be immensely profitable. Treanda is an orphan drug but also Teva's second-best seller, racking up $740 million in sales last year, according to Teva's annual report.

      Isn't the whole point of an orphan drug classification that of limited commercial viability? So if they're not commercially viable how are they profitable?

  10. Sep 2015