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Wednesday, January 20, 2010

Closing the divide in the Health Care Debate

Congress has begun the pain staking process of interfacing the Senate's health care proposal with it's counterpart written by the House of Representatives. It seems as though those involved in the development of the bill truly do believe that it cannot fail.

California's 15th District Representative - Mike Honda recently posted on the
Huffington Post explaining and commending the Health Care bill currently under review - below you can read what he had to say or you can:

Skip to the good stuff - what's this bill about? |   Skip to the author's comments CMARWSQMDTHF

"This month, as Congress begins to reconcile two very different health care reform bills in the Senate and House, it is worth taking perspective on the significance of this moment. It is an understatement to say that the road to health reform has been long and difficult. The most recent attempt, in 1994, failed through a combination of scare tactics by opponents and intense opposition from entrenched and wealthy interests. Since then, the health insurance industry has staved off the threat of real reform by pledging to control costs and make health insurance affordable. They have failed to deliver, however, and do not deserve another chance to play with the lives and pocketbooks of the American people.

Meaningful health reform must deliver accessible, affordable, high quality health care. Passage of reform is critical to the economic health of our nation and for millions of chronically ill and low income Americans. It is the goal of the thousands of chronically ill Americans who come to Capitol Hill every year, and the millions unable to make the trip, who share their stories of struggling with insurance company bureaucracy, medically related personal bankruptcies, deaths, and financial ruin that result from our broken health care system. It is the goal of county and local health officials who struggle to deliver the services their communities need as the public health system across our nation struggles under the weight of the uninsured and underinsured. These voices are not the fringe of America; they are from the heart of our nation and represent the reality of our broken health care system.

Businesses small and large, their employees, the self-employed, and the self-insured all find themselves increasingly unable to bear the cost of premiums that climb 8, 10, 15, or as much as 25% per year, every year. Our bill in the House -- America's Affordable Health Choices Act, H.R. 3962 -- was specifically designed to address the needs of small businesses, middle and low-income workers, and families to expand access and quality, while creating transparency and accountability in the health care industry.

The bill allows small businesses to access, for the first time, large group provider rates through the mechanism of the health insurance exchange. It provides substantial tax credits for small businesses to provide health care for their workers. Subsidies are made available to American families from 150% up to 400% of the federal poverty line so they can afford to purchase the health insurance plan of their choice. For the very poorest families in our communities, HR-3962 expands Medicaid to 150% of the federal poverty line, and it does so without substantially burdening the states. In fact, for the first three years, the expansion is fully funded by the Federal government and thereafter, states shoulder only 10% of the expansion.

Our bill in the House ends the insurance industry practice of capping annual and lifetime payments for health care. In two years, pre-existing conditions will no longer be able to be used as the basis for coverage denials. Insurance companies will have to report and justify their rate increases and spend at least 85% of the premium dollars they collect directly on patient care rather than administrative costs. We invest heavily in preventative services because we know that chronic health conditions either prevented or caught early cost less to the system and less to the patient than only responding to acute health needs.

HR-3962 institutes basic consumer protections and requires plans to provide information and outreach in plain language, increasing consumer knowledge and power. Finally, because so much of our focus is on strengthening prevention and coordination of patient care (more efficient, cost effective, and results in better health outcomes), the House bill contains a much stronger investment in primary care physician training and education than the current Senate bill. In fact, I recently joined several of my colleagues in sending a letter to the President and Congressional leaders supporting the House language over the Senate language because of this concern.

As Congress calls upon its constituents to weigh in on health care reform during this final phase, I encourage all who are interested in health reform to visit my website and the websites of the Speaker of the House of Representatives and the Committee on Energy and Commerce to read the bill yourself, access summaries and fact sheets about the bill and its effects on different groups, and educate yourself about the substance of the bill."
- Rep. Mike Honda represents California's 15th district and serves on the House Appropriations Subcommittee on Labor & Health and Human Services

It strikes me as ironic that Medicare, Medicaid and every HMO out there has been trying to make the health care system more efficient and emphasize the importance of preventative medicine for a few decades now. Usually they claim to aim for the exact same standards outlined in Mr. Honda's speech - however consider this:

[caption id="attachment_163" align="alignright" width="300" caption="Number (in Millions) of Civilian/Noninstitutionalized Persons with Diagnosed Diabetes, United States, 1980–2006"]Number (in Millions) of Civilian/Noninstitutionalized Persons with Diagnosed Diabetes, United States, 1980–2006[/caption]

Diabetes is one of the biggest problems in America and possibly even the world, 7.8% of the U.S. population is diagnosed with diabetes. Of those - 5-10%  have

Type I or 'juvenille' diabetes - for which a cause has not yet been discovered. The other 90% have type II diabetes - which is directly linked to obesity and

inactivity and can controlled with diet, frequent light exercise and preventative medicine. The battle to fight diabetes with preventative medicine has been going on since it became a concern around the 1970's and 80's - and yet if you look at the data collected by places like the CDC's - Division of Diabetes HERE or HERE it becomes crystal clear that preventative medicine - hasn't done anything at all to slow the trend - so what makes anyone think that if government tries to do the same thing, it'll actually work?!

Saturday, January 9, 2010

Thirteen percent of poison exposure calls related to painkillers

U.S. poison centers answered more than 4.3 million calls in 2008, including nearly 2.5 million calls about human exposures to poison, according to the American Association of Poison Control Centers -- up from 4.2 million calls in 2007. About 13 percent of all poison exposure calls poison centers received in 2008 were related to analgesics, or painkillers.

The National Poison Data System also documented 1,756 deaths reported to poison centers in 2008. Most of these fatalities involved exposure to drugs including sedatives, antipsychotics, antidepressants and cardiovascular drugs. And most poison-related fatalities occurred among adults between the ages of 20 and 59.

Friday, January 8, 2010

2009 Hospital Report

According to Press Ganey Associates’ 2009 Hospital Pulse Report, the Physician Perspectives on American Hospitals found physicians’ overall satisfaction with fully functioning electronic medical records (EMRs) is on a downhill slope. Many physicians actually consider the increasingly common technology to be very time-consuming. Some fear that it may compromise patient safety and the security of their information. 

The report also finds that, for the third year in a row, physicians’ number one complaint is a gap in the physician-administration relationship. Physicians continue to stress a need for a much better line of communication between administrators and medical staff.

The 2009 Physician Pulse Report surveyed the experiences of 27,328 physicians practicing at nearly 300 hospitals and facilities across the country. Some other significant findings detailed in the report include:
  • Physicians who work in government-owned hospitals are reporting a lower satisfaction with their hospitals than peers in community-owned and teaching hospitals. The difference in the score is 6.3 points – a significant variance.
  • Physicians practicing in psychiatry, pediatrics and emergency medicine are those most highly satisfied within their practice when grouped by specialty. Those least satisfied include physicians dealing with cardiovascular disease, anesthesiologists, and general and orthopedic surgeons.
  • Physicians who have been practicing for less than five years, and those who have been practicing for over 20 years are the most satisfied.
  • Although many physicians would like to see improvements in EMRs, most are satisfied with their facilities’ ability to provide up-to-date medical equipment.
  • One of the top concerns of physicians is their confidence in hospital administration to carry out its duties and responsibilities.

“Open communication between administrators and physicians is vital not only to their relationship, but also to the bottom-line of the hospital,”
said Deirdre Mylod, PhD, vice president of hospital services, Press Ganey.
“So much of a hospital’s business is based on physician referrals, and competition among hospitals and surgical facilities continues to heat up. If administrators and physicians can improve communication, the effects will trickle down and lead to more satisfied patients and a better bottom-line.”
Findings of the survey show that physicians satisfaction level improves when hospitals put targeted programs in place, such as a monthly newsletter from the CEO, a 1-800 number for physicians to call with concerns (and a 48 hour return call guarantee), and a commitment to take simple steps like keeping physicians in updated on important issues such as hospital finances.

You can download a full copy of the report here.

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