Monday
Jul062009
10 Items For Health Care Legislation
Monday, July 6, 2009 at 8:52AM
Fireworks are done for another year, the president is traveling in Europe, Congress is coming back to Washington and the nation is gearing up for two big events in the House and Senate. Next week begins the Sotomayor hearings for the ninth Supreme Court seat and the legislation on health care. President Obama has had two health care town hall meetings and has promised openness in the process of reforming health care, but the bill is being written behind closed doors in committee rooms in Congress. Until the hearings begin we will have no idea what really is in store of the American public for health care reform.
However, I want to offer a guide to what to look for in the bill and the debates. Here are 10 items to watch for in health care legislation:
1. Does the health care bill offer a chance for the consumer to compare costs? Because of my age and family history, my internist prescribed a breast MRI. Having great insurance
I scheduled the test at huge radiology practice and was charged a whopping $7500, which my insurance company refused to pay. Accompanying someone to a biopsy I found out that a famous radiologist in private practice in the same city charges $2,400 for a breast MRI. It was the same procedure with a better physician at less than a third the cost.
2. How does the bill intend to even out costs around the country? From the available Medicare data we know that costs vary widely and have little to do with living in Manhattan or other large expensive cities. Some rural areas have astounding costs.
3. Does the health care bill deal with the medical equivalent of NIMB (not in my backyard) that stops so many local building projects? Does the bill have a way of addressing the blocking of other professionals from the doctor's guilds? Does the bill have a way of making sure state licensing boards accept competent foreign medical school graduates (many of them older Americans)? How about nurse practitioners and physicians assistants?
4. How are the costs for end of life care addressed? One of the biggest costs is end of life care: Care that is provided when it is clear that there can be no real benefit to extra tests and treatment. Are there provisions to extending and paying for quality hospice care?
5. Will heath care records be accessible to the patient? The advantage of a computerized record is that patients can shop around and get a second opinion via the Internet. They can even do their own medical research online.
6. Where are the incentives to health care providers to promote wellness and reduce drug usage? Having spent 15 years in the mental health area, I saw a huge overuse of drugs at great costs and an increase in addiction. Simple meditation and breath work reduces the need for drugs for anxiety and depression. Hospitals and physicians have no reward built in to work with patients to reduce costs and numbers of visits.
7. Does the bill promote comparative research in other countries? Why is our infant mortality rate so high compared to other westernized countries? Why is mortality from strokes so high?
8. Are we being sold a bill of goods by the cost estimates? Massachusetts has a health insurance requirement for every resident. It's a great idea, and most people are insured. The problem is they did not estimate the costs properly, and it is drastically impacting on the state budget.
9. Who will be monitoring health care waste? Can the studies be put on line in a user friendly way? Can we teach high school students to learn to analyze data in their math classes? One estimate from a project at Dartmouth College is that as much as one-third of every health care dollar is wasted.
10. Follow the money: According the Washington Post, 30 key lawmakers have holdings in the health industry.
An Associated Press investigation showed PhRMA spent $7 million lobbying the first quarter of 2009 followed by Pfizer at $6.1 million.
However, I want to offer a guide to what to look for in the bill and the debates. Here are 10 items to watch for in health care legislation:
1. Does the health care bill offer a chance for the consumer to compare costs? Because of my age and family history, my internist prescribed a breast MRI. Having great insurance
I scheduled the test at huge radiology practice and was charged a whopping $7500, which my insurance company refused to pay. Accompanying someone to a biopsy I found out that a famous radiologist in private practice in the same city charges $2,400 for a breast MRI. It was the same procedure with a better physician at less than a third the cost.
2. How does the bill intend to even out costs around the country? From the available Medicare data we know that costs vary widely and have little to do with living in Manhattan or other large expensive cities. Some rural areas have astounding costs.
3. Does the health care bill deal with the medical equivalent of NIMB (not in my backyard) that stops so many local building projects? Does the bill have a way of addressing the blocking of other professionals from the doctor's guilds? Does the bill have a way of making sure state licensing boards accept competent foreign medical school graduates (many of them older Americans)? How about nurse practitioners and physicians assistants?
4. How are the costs for end of life care addressed? One of the biggest costs is end of life care: Care that is provided when it is clear that there can be no real benefit to extra tests and treatment. Are there provisions to extending and paying for quality hospice care?
5. Will heath care records be accessible to the patient? The advantage of a computerized record is that patients can shop around and get a second opinion via the Internet. They can even do their own medical research online.
6. Where are the incentives to health care providers to promote wellness and reduce drug usage? Having spent 15 years in the mental health area, I saw a huge overuse of drugs at great costs and an increase in addiction. Simple meditation and breath work reduces the need for drugs for anxiety and depression. Hospitals and physicians have no reward built in to work with patients to reduce costs and numbers of visits.
7. Does the bill promote comparative research in other countries? Why is our infant mortality rate so high compared to other westernized countries? Why is mortality from strokes so high?
8. Are we being sold a bill of goods by the cost estimates? Massachusetts has a health insurance requirement for every resident. It's a great idea, and most people are insured. The problem is they did not estimate the costs properly, and it is drastically impacting on the state budget.
9. Who will be monitoring health care waste? Can the studies be put on line in a user friendly way? Can we teach high school students to learn to analyze data in their math classes? One estimate from a project at Dartmouth College is that as much as one-third of every health care dollar is wasted.
10. Follow the money: According the Washington Post, 30 key lawmakers have holdings in the health industry.
An Associated Press investigation showed PhRMA spent $7 million lobbying the first quarter of 2009 followed by Pfizer at $6.1 million.
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