Tag: Affordable Care

Blog Posts (5)

September 16, 2016

Outside the Comfort Zone

I always feel a little nervous for the folks who sign up to be contestants on “Dancing with the Stars” because despite any prior fame or achievements they are spectacularly and uniquely vulnerable on the dance floor. Stepping outside their comfort zone is perhaps what we admire about these celebrities – they are suddenly vulnerable to a different and unfamiliar scrutiny. Mastering new skills alongside an assigned partner we hope for the best as the dancers put their best effort on display. There are criteria to be satisfied (need to show enough Viennese Waltz and Foxtrot moves), and judges to score how well they met these standards. While there is no small amount of entertainment value to the evaluation of the contestants, what is interesting is that the public votes too. This may be a reach, but as healthcare faces new standards measuring quality under the ACA, we see some interesting parallels.

Like our intrepid celebrity dancers, healthcare institutions need to adapt to an evolving set of quality measurements under the ACA. As healthcare institutions brace for the uncertain impact of the ACA regulations on the day to day operations and finances, those responsible for assuring the delivery of care are focusing on not only the cost per patient, but also on improving how patient experience care, and how the health of the community at large can be improved. Like the dancers finding their footing, the ACA challenges the healthcare industry to serve patients with agile and efficient practices in order to not be left behind. An increased the number of patients who now have access to health insurance coverage in states with expanded Medicaid; there is good reason to anticipate a continued increase in the demand for healthcare services. At the same time, the ACA reimbursement requires added accountability for healthcare outcomes, packaged as a blend of incentives and penalties.  An article published in the Annals of Internal Medicine in 2014 (Ryan AM and Mushlin AI. The Affordable Care Act’s Payment Reforms and the Future of Hospitals, Ann Intern Med: 2014; 160(10): 729-730) reminds us that the US healthcare system has navigated change before, and will likely be able to do so again, though the initial phases may require tolerating uncertainty and fiscal caution. We will have to step outside the comfort zone, hope for skilled partners in healthcare leadership, and giving our best effort.

March 12, 2015

The Unique Challenge of Healthcare Reform in the US, and Why it Might All Fall Apart

<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Those of us who aspire to eventually having an affordable, quality, accessible healthcare system for all citizens, or even for most citizens, must first face an obvious but under-discussed challenge that uniquely American: The major players in the US healthcare system—including private insurance companies, pharmaceutical companies, medical device and equipment makers, medical specialties and sub-specialties, healthcare organizations and their executives and shareholders, and all of their lobbyists—are motivated by their own economic self-interests first and foremost. Which means our aspirations must be viewed as a long-term struggle.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Healthcare in American is simply unfettered capitalism at work. Let me hasten to add, this is not to say that all of these entities don’t do some remarkable work—I owe my life to the U.S. healthcare system as do millions more. But the fact remains that much of the extravagantly high costs of medical care in the U.S. healthcare system has nothing to do with improving or adding quality care for patients and producing good outcomes. Rather it’s a reflection of how these key players pursue their own entrenched financial interests, while creating narratives to the public that the services they provide is essential for quality healthcare. Interestingly, over time, this bloated, inefficient system has been generally accepted by the public and therefore gained a façade of legitimacy that makes it virtually intractable to reform.</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"> </span></p>
December 14, 2014

Patients Abandoned—Who is to blame?

<p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">The vast majority of developed nations in the world provide universal healthcare coverage for its citizens. The only developed nations that do not are “…<a href="http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/">a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world</a>.” </span></p> <p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Yet the United States (US) has the most expensive healthcare system in the world, by far—there really isn’t a close second—spending just under 18% of GPD and around $8,500.00 per person on healthcare. One might assume that given that type of expense, we would be getting a lot more than other countries in return for our investment. According to the research provided by <a href="http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror">Mirror, Mirror</a>, from the Commonwealth Fund, the US sadly underperforms and often fails relative to other developed countries on major measures of performance. </span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
July 1, 2014

Health Care and Crowdsourcing: A CrowdCry For Help.

<p class="MsoNormal">Crowdsourcing seems this month’s health care buzzword. It is everywhere. I’ve seen it used in three different health care contexts over the last months: 1) as a means to raise money for treatment, 2) as a means to gain access to treatments, and 3) as a means to help medical diagnoses.  In thinking about these contexts I found myself asking: Would I use it, or would I not? I am curious to hear if you would use the tool of crowdsourcing, after I give my ideas. Please feel free to comment at the end of my post.</p> <p class="MsoNormal"><strong>What is crowdsourcing?</strong></p> <p class="MsoNormal">The dictionary defines crowdsourcing as: <a href="http://www.merriam-webster.com/dictionary/crowdsourcing">“the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people and especially from the online community rather than from traditional employees or suppliers”</a><span class="ssens">. </span>In my own terms, crowdsourcing is an appeal to the online crowd/public to assist in a specific endeavor, like the above. Crowdsourcing is about ‘power in numbers’.  It could be an appeal to the public to raise money, signatures, or to gather information/expertise. </p> <p class="MsoNormal"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
May 11, 2014

A New State Law That Will Harm Women: Why do lawmakers ignore facts and expertise?

<p>Recently, the Governor of Tennessee signed into law a bill, <a href="http://www.capitol.tn.gov/Bills/108/Bill/SB1391.pdf">SB 1391</a>, which criminalizes a woman who has had a baby with drug-related complications.  As a result babies born with addictions due to drug use by the mother during pregnancy will be grounds for the mother being charged with aggravated assault, which could result in sentence of up to 15 years in prison for the mother. The concerns of the state legislators who promoted and passed this bill were over a condition in newborns called neonatal abstinence syndrome (NAS).  This condition results from exposure to addictive drugs while in the mother’s womb. In 2013 the Tennessee state Health Department reported 921 babies born with NAS and 278 cases so far in the past four months. The stated goal of the law was to reduce the number of babies born with this condition. But is criminalizing drug use during pregnancy, in this first of its kind state law, the most effective way of accomplishing this goal?</p> <p>It is important to note that the bill was <a href="http://www.nytimes.com/2014/04/15/us/politics/specialists-join-call-for-veto-of-drug-bill.html?emc=edit_tnt_20140414&amp;nlid=58349537&amp;tntemail0=y&amp;_r=2">passed against the strong objections</a> of women’s rights groups as well as health care and addiction specialty groups. First of all these experts agree that cause more harm to babies as pregnant women will be afraid to seek medical care.</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>