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Dave,
thanks for your input on unreasonable premium increases but take it from someone who has to explain why their clients premiums have for the last 3 years increased year 1 -18%, year 2-30% year 3-30% for a total 78% in three years, the client does not want hear that the insurance company isn’t making enough profit or your premiums have increased because XYZ Inc. had to lay people off… What ever hapened to the “Law of Large Numbers” ???
I want to express my appreciation to MVP and Dave for doing these pieces. They are really well done and thought provoking. In the most recent piece Dave touched on the a huge issue for all of us especially given the state of the economy and our exploding deficit spending. The Medicare reimbursement cuts are what the CBO used to project “savings” from the health care reform legislation. These cuts represented hundreds of billions of dollars over the modeled time frame. Congress has already pushed off the cuts modeled for 2011. We really should pressure the CBO to model the cost of this legislation with and without the proposed Medicare cuts. I believe the answer and consequences of that modeling are very significant. Another major assumption is that the so called “ACO”s” will significantly reduce costs. Some recent publications are suggesting the ACO’s might improve quality which is important but may have very little impact on reducing costs. The last point is that a recent CMS report indicated that preventable medical errors in our hospitals are causing 200,000 deaths a year or 500 per day (not to mention the number of disabilities) which is costing Medicare $324 million per month/$4 billion per year. This is something that with or without reform we should all demand is an unacceptable outcome for our health system. The implementation of CPOE systems….surgical check lists…..focus of hospital acquired infections could significantly reduce preventable errors…save lives….and hundreds of billions of dollars a year in wasted health resources.
Mr. Oliker,
I read your comments on the overuse of technology as a shield against physician lawsuits and agree that doctors need to be educated that few lawsuits actually stem from lack of testing. This type of defensive medicine is driving up insurance cost to an unaffordable level for many and a little information to the doctors and their insurers might go a long way to solve the problem.
I also agree that patients see hi-tech medical testing as an entitlement rather that as a tool. If a doctor does not order an MRI for a stomach ache the patient feels they are being discriminated against or denied a basic right. Expensive medical testing is not a basic right, but we have a basic distrust between doctors and their patients which must be addressed.
Your blog is brilliant and I hope you keep it going. As a lawyer, bioethicist and utilitarian I believe MVP is on the right road. I have also recently become a hospice volunteer and hope you also utilize their support network of kind, committed volunteers. Good luck to you.
Tristan McCann, JD, MA
(We actually met a few times at Northeast Jewelers. Hope all is well with your family.)
Dave :
I found your latest thoughts on health care and the swiss system very interesting. My thoughts exactly as to educating our society on a better way to be healthy and wise. American’s have to be among the most obese in the world. It would be a wonderful thing to be recognized among the healthiest nations instead !!