The ICD may have not been fully functional when the President was working on his health plan.
Thanks to SST for the tip!
Jan
29
Insight, analysis & opinion from Joe Paduda
Jan
26
There are over a dozen state and federal health care reform initiatives on the table today. To evaluate the various proposals, we have to agree on what we want to accomplish. Otherwise, we’ll spend our time debating which road to take when we don’t even know our destination.
What are we trying to accomplish with health care reform?
Lower costs today? A sustainable trend rate so care is affordable for the foreseeable future? Better outcomes, defined as healthier people and/or fewer avoidable deaths and/or higher levels of functionality? Coverage for all so no one goes without? Equitable reimbursement? Less interference in the doctor-patient relationship? Greater self-responsibility on the part of consumers? A reduced financial burden on employers, especially small ones and really big ones with lots of retirees? Ever healthier, longer-lived citizens?
All of the above?
Jan
25
Confirming my long-held opinion that Jason Shafrin is the smartest health care economist blogging these days is his post on the implications of Bush’s tax cuts…I mean health insurance reform policy.
Jason’s insight on the trillion dollar excess policy is brilliant.
He also provides a chart illustrating the financial implications of Bush’s plan – no surprise here; “the value of the health insurance tax deduction is worth more than 2x the value for the individual making $10,000,000 as for the person making $10,000.”
Jan
25
Genex, the work comp anaged care subsidiary of UNUMProvident, has been sold to an investment firm. Unum had had the company on the block for quite a while, so the transaction is not a surprise.
Jan
25
Health Wonk Review’s list of contributors is expanding edition-to-edition, and the latest hosted by Health Affairs’ Jane Hiebert-Smith continues the trend. There’s solid material from the State of the Union address and the various state reform proprosals, not to mention drug pricing and the new Congress.
Jan
24
Elected officials considering health care reform would do well to adopt the “first, do no harm” rule. So far, they haven’t.
Health care reform proposals circulating among the States run from the broad and all-encompassing (California) to the very narrow (Texas). The big ones suffer from an inherent problem – the broader they are, the more oxen they will gore. As every constituency works to protect and advance their agenda, the big proposals run the very real risk of the death by a thousand cuts (a particularly gruesome, excruciatingly painful Chinese execution, and therefore a perfect analogy).
Narrow, specific initiatives to address discrete issues have the opposite problem – they tend to fix problems caused by the system, instead of fixing the underlying problem.
Look at Texas.
Jan
23
So a lot of folks are finding good things in Pres. Bush’s plan to use tax policy to help uninsured people get health insurance.
Not me. I see it as the worst kind of incrementalism, on a par with consumer-directed health care. To the naive, it promises a quick solution using financial gimmickry that will not cost anyone very important much of anything, and may help a few folks get coverage thru a state program.
But it won’t do anything to fix the underlying problem – people who need insurance can’t get it, and if they can, many can’t afford it, leaving the rest of us to pay for their health care. Meanwhile, insurance companies compete not on the basis of how healthy they can keep us, but on how good they are at denying coverage to anyone who may have a claim.
Arrggh!
Jan
23
After the original post (below) I had a chance to review more carefully the recent releases from Texas re the adoption of medical treatment and guidelines and to gain more insight into the guideline selection process.
First, a clarification. ODG guidelines WILL be used for management of physical medicine, including physical therapy.
That said, if physicians or other stakeholders want to provide any type of treatment that differs from that recommended by ODG (surgery, therapy, etc), they can provide information to the payer/state justifying their position. And if their treatment plan is supported by other evidence-based medical guidelines, my sense is it will be approved.
Sources also indicate that MDA’s disability duration guidelines were selected primarily due to their accessibility; they are easier to comprehend and more “usable” for laypeople, while still backed by solid research and data. This accessibility may well make conversations among the stakeholders more productive and reduce confusion and mis-interpretation.
That’s good, as it allows providers and payers to have a discussion about treatment options with science-based guidelines as the ultimate test of appropriateness.
The latest state to adopt clinical guidelines for the treatment of workers comp injuries is Texas. While the adoption of guidelines is a good thing, Texas is clearly marching to its own mariachi band.
Jan
23
13,000 American civilians have suffered compensable injuries in Iraq and Afghanistan. These are handled through the Federal system, with the Department of Labor having jurisdiction. The volume of cases has grown steadily since 2002, with the DoL now seeing about a thousand cases a month from employers such as Halliburton, Dyncorp, Bechtel and others.
And many of these are not your typical lower back strains. Post-traumatic stress disorder, closed head injuries from IEDs, and shrapnel and concussion injuries, all injuries once limited to soldiers are now suffered by civilians. These injuries are not commonly handled by civilian providers or hospitals, and many claimants are finding it difficult to obtain adequate care for their condition.
Outside of the human cost, the financial implications are staggering. Truck drivers are making upwards of $100k a year, and their workers comp premiums can be as high as $25 – $40 per $100 of payroll. While there is no accurate count of the total number of contractors, at the low end it is 50,000.
Workers comp costs for contractors in Iraq and Afghanistan are over a billion dollars.
Way over.
thanks to the Workers Comp Executive News Digest for the original idea.
Jan
22
It looks like Pres. Bush is going to announce a major new health plan initiative during his State of the Union address, one that actually may make some sense. The pre-views indicate the plan will be individually-focused (not employer-focused), say very little about cost control, underwriting, or health care providers, and concentrate instead on tax policy.
I don’t like to disagree with people whom I highly respect, but I don’t see how Bush’s plan will work (defined as increase coverage and control expenditures).
