Our biggest problem in healthcare is efficiency (quality of care per dollar spent) and Obamacare doesn't solve it. Our spending is off the charts by any measure (growth over time, % of GDP, per capita) Consumerism as a force of change in Healthcare is just getting started, but there are many barriers in place that serve to protect existing stakeholders in the industry. Knocking down these barriers to competition is what the GOP should be focusing on, but it's not. "Repeal and replace" seems to be a slogan, not a plan. Do Republican lawmakers have the will to make changes that might upset entrenched players?
Transparency has become even more important in the past year as we begin the health care reform discussion. There is not a signature event in Nashville to bring quality, marketing, transparency, and technology together. The Naked Hospital event will take the user experience from high level strategy through national and state legislative issues through practical hands on tools to walk away with. The event will focus on how and why health systems and hospitals should focus on quality reporting as well as financial reporting. At the end of the day, all of this puts additional strains on the information systems and resources deployed by most health systems and hospitals. How will they cope? What is the next step?
WealthTrust-Arizona - Five Fallacies for Improving Healthcare WealthTrust-Arizona
Educational workshop presented by WealthTrust-Arizona and world-renowned guest Robert K. Smoldt, Chief Administrative Officer Emeritus at Mayo Clinic and Associate Director of Healthcare Delivery & Policy Programs at Arizona State University. Mr. Smoldt has been involved in health care administration for more than 30 years and is currently pursuing U.S. health reform in close partnership with Mayo Clinic’s Emeritus President and CEO.
At this workshop Robert examines a number of general statements that are, in his view, fallacious.
This document discusses policy making in the era of health reform. It notes that while Americans are living longer due to medical advances, health care spending as a percentage of GDP has risen dramatically. This rising cost has significant impacts on other national priorities for both the government and private sector. The document then examines how the US health system developed and the issues with the current fee-for-service model. It argues the health reform bill appears to increase access and coverage while reducing payments from certain groups to help control costs.
This presentation discusses the impact of health reform. It begins by defining the problem, then provides an overview of legislation and the impact on business. It provides a contrarian view of the subject and explains why health reform is really insurance reform. It also introduces the concept of consumer sovereignty,
The document summarizes key issues facing the U.S. healthcare system including rising costs, an increasing number of uninsured and underinsured Americans, and poor health outcomes compared to other developed nations. It attributes these problems partially to the for-profit insurance model which incentivizes denying claims to maximize profits. This leads to high administrative waste as hospitals must employ large staffs to deal with insurance bureaucracies. The majority of healthcare spending is shouldered by the government through programs like Medicare and Medicaid, yet the U.S. still spends over twice as much per capita as other countries without achieving better population health.
The document summarizes the current landscape for health care reform in the United States. It discusses the prospects for reform given Democratic control of Congress and the White House as well as the economic crisis. However, it also notes challenges like a split public and the need to control costs long term. The document advocates for a blended policy approach that combines expanding access through mechanisms like subsidies, exchanges and Medicaid expansion, while also implementing reforms to curb cost growth and improve quality, such as payment reform, health IT and establishing best practices.
Politics and Health Reform:Lessons From a Year in Washington, D.C.UWGlobalHealth
This document summarizes the history of health reform efforts in the United States from the late 19th century to 2009. It discusses how a national health insurance system has been proposed since the 1880s but consistently opposed by groups like the AMA and insurance industry. The US now spends over twice as much per capita on healthcare as other OECD countries but has lower life expectancy and more administrative waste. Creating a universal, publicly financed system could reduce costs while improving access and outcomes.
The document discusses the healthcare crisis in the United States, which it describes as having both a cost crisis and a quality crisis. It notes that healthcare costs make up 18% of GDP and over half of healthcare is financed through taxpayers. Additionally, 30% of healthcare spending goes to private insurance administration rather than direct medical services. The document argues the current system is flawed and promotes alternatives like a universal healthcare system.
Transparency has become even more important in the past year as we begin the health care reform discussion. There is not a signature event in Nashville to bring quality, marketing, transparency, and technology together. The Naked Hospital event will take the user experience from high level strategy through national and state legislative issues through practical hands on tools to walk away with. The event will focus on how and why health systems and hospitals should focus on quality reporting as well as financial reporting. At the end of the day, all of this puts additional strains on the information systems and resources deployed by most health systems and hospitals. How will they cope? What is the next step?
WealthTrust-Arizona - Five Fallacies for Improving Healthcare WealthTrust-Arizona
Educational workshop presented by WealthTrust-Arizona and world-renowned guest Robert K. Smoldt, Chief Administrative Officer Emeritus at Mayo Clinic and Associate Director of Healthcare Delivery & Policy Programs at Arizona State University. Mr. Smoldt has been involved in health care administration for more than 30 years and is currently pursuing U.S. health reform in close partnership with Mayo Clinic’s Emeritus President and CEO.
At this workshop Robert examines a number of general statements that are, in his view, fallacious.
This document discusses policy making in the era of health reform. It notes that while Americans are living longer due to medical advances, health care spending as a percentage of GDP has risen dramatically. This rising cost has significant impacts on other national priorities for both the government and private sector. The document then examines how the US health system developed and the issues with the current fee-for-service model. It argues the health reform bill appears to increase access and coverage while reducing payments from certain groups to help control costs.
This presentation discusses the impact of health reform. It begins by defining the problem, then provides an overview of legislation and the impact on business. It provides a contrarian view of the subject and explains why health reform is really insurance reform. It also introduces the concept of consumer sovereignty,
The document summarizes key issues facing the U.S. healthcare system including rising costs, an increasing number of uninsured and underinsured Americans, and poor health outcomes compared to other developed nations. It attributes these problems partially to the for-profit insurance model which incentivizes denying claims to maximize profits. This leads to high administrative waste as hospitals must employ large staffs to deal with insurance bureaucracies. The majority of healthcare spending is shouldered by the government through programs like Medicare and Medicaid, yet the U.S. still spends over twice as much per capita as other countries without achieving better population health.
The document summarizes the current landscape for health care reform in the United States. It discusses the prospects for reform given Democratic control of Congress and the White House as well as the economic crisis. However, it also notes challenges like a split public and the need to control costs long term. The document advocates for a blended policy approach that combines expanding access through mechanisms like subsidies, exchanges and Medicaid expansion, while also implementing reforms to curb cost growth and improve quality, such as payment reform, health IT and establishing best practices.
Politics and Health Reform:Lessons From a Year in Washington, D.C.UWGlobalHealth
This document summarizes the history of health reform efforts in the United States from the late 19th century to 2009. It discusses how a national health insurance system has been proposed since the 1880s but consistently opposed by groups like the AMA and insurance industry. The US now spends over twice as much per capita on healthcare as other OECD countries but has lower life expectancy and more administrative waste. Creating a universal, publicly financed system could reduce costs while improving access and outcomes.
The document discusses the healthcare crisis in the United States, which it describes as having both a cost crisis and a quality crisis. It notes that healthcare costs make up 18% of GDP and over half of healthcare is financed through taxpayers. Additionally, 30% of healthcare spending goes to private insurance administration rather than direct medical services. The document argues the current system is flawed and promotes alternatives like a universal healthcare system.
This document advocates for a single-payer health care system in Pennsylvania called the Pennsylvania Health Care Plan (PHCP). It argues that a single-payer system would reduce administrative waste, lower healthcare costs for individuals and businesses, create jobs, and provide universal healthcare coverage for all state residents. The analysis estimates that the PHCP would save over $32 billion annually compared to the current system due to reductions in insurance company overhead, drug prices, and healthcare utilization increases from reduced cost-sharing. The savings would finance expanded coverage and lower the growing burden of healthcare costs on the state economy.
Reasons Why You Need An Experienced Account Managergingin4
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
The document discusses employer forum discussions on healthcare reform in 2009. It covers topics like changing the supply and demand curve for healthcare, the various players involved, why reform is happening now versus the 1990s, potential models for reform, and impacts on employers and employees. It also provides information on controlling costs, current bills being considered, and actions employers can take to manage healthcare costs.
The Cost & Impact of Massive Complexity in the US Health Insurance MarketRuss Kuhn
This document discusses the complexity of the US health insurance system and the potential impacts of an upcoming Supreme Court ruling on the Affordable Care Act. It notes that the US system is already very complex and expensive, with high costs preventing many from getting needed care. The ACA increased access to insurance but also added complexity. A Supreme Court case this month could end ACA subsidies for 8 million people, significantly increasing their costs overnight. Regardless of the ruling, the system will remain difficult for most consumers to navigate, with many making poor insurance choices without adequate understanding of options.
Zweig powerpoint on Palliative Care in Nursing Homes for Theme Session co-spo...MedicineAndHealthUSA
This document provides information on reducing prescription drug costs for patients, including learning drug prices, using generic medications, slicing pills, selecting alternative medications, and assistance programs. It discusses specific cost-saving strategies like comparing prices online, using $4 generic programs, Medicare Part D, and pharmaceutical company assistance. The summary focuses on high-level strategies to help a sample patient who cannot afford his medications due to lack of prescription coverage.
The document discusses how the US healthcare system is currently pre-industrial and will undergo disruption through industrialization. It argues that healthcare costs are unsustainably high and increasing faster than wages or inflation. As consumers face higher deductibles and premiums, consumerism will drive changes in the system. The document also notes several problems including the instability of Medicare and Medicaid funding, an aging population increasing demand, and significant issues with patient safety. It believes elements of value-based care and payment reform show signs of an emerging industrialized, more efficient healthcare model in the US.
The document discusses the dual cost and quality crises facing the American healthcare system. It argues that the root causes are a dysfunctional medical decision-making process and a financing system that relies too heavily on for-profit private insurance. The author proposes transitioning to a universal healthcare system financed by taxpayers and administered through non-profit third parties to reduce costs by an estimated $1 trillion annually. New electronic health records and medical AI tools could help improve decision-making quality if designed properly. Overall, the crises require understanding decision flaws and adopting evidence-based reforms rather than blaming any single group.
Intensive Care for Medicaid McQ Quarterly 2005Craig Tanio
This document summarizes a McKinsey report analyzing the unsustainable growth of Medicaid costs in the United States. It finds that by 2009, Medicaid will consume more than 75% of new state revenue in some states and 25-50% in many others. While opportunities exist to capture savings, actually doing so will require difficult decisions and creative leadership given political and structural challenges. Reform is needed to put Medicaid on a more stable long-term footing while still serving those in need.
The document discusses how the Affordable Care Act aims to address problems in the US healthcare system like the large number of uninsured, rising costs, and quality and access issues. It will expand coverage to 32 million uninsured through Medicaid expansion and health insurance exchanges. Reforms to payment and delivery systems are also expected to help slow premium growth and reduce costs over time. Implementation will occur gradually through 2019, with many provisions taking effect in 2014 such as the individual mandate, Medicaid expansion, and state-based insurance exchanges.
The High Performing FQHC of Tomorrow: Expanding the Mission Through MarginSage Growth Partners
This document summarizes a presentation given at the NACHC Conference FOM/IT on October 28, 2015 about the high-performing Federally Qualified Health Center (FQHC) of the future. It discusses major trends like rising healthcare costs, the shift to value-based care, and Medicaid reform that are drawing FQHCs into the changing healthcare economy. It provides examples of FQHCs partnering with Accountable Care Organizations and payers. The presentation argues that FQHCs should embrace transparency, pursue value-based payment opportunities, and actively manage patient populations to succeed in this new environment while continuing their mission.
The document summarizes the Affordable Care Act and identifies some of its flaws and deficiencies. It discusses two main goals of the ACA - to increase the number of insured individuals while reducing overall healthcare costs. However, it notes the ACA has yet to achieve these goals. One deficiency is that individuals who remain uninsured face a penalty fee, which does not actually encourage accessing healthcare. Another issue is the "coverage gap" where many remain uninsured. The document proposes solutions like a state-run program to cover those in the gap and bundled payments to replace fee-for-service. It argues more reform is still needed to control rising costs while expanding access.
This document provides an overview of the Affordable Care Act (ACA) including key provisions, implementation challenges, and political aspects. It discusses major reforms such as prohibiting denial of coverage for pre-existing conditions, essential health benefits, subsidies for low-income individuals, health insurance exchanges, and penalties for large employers not providing coverage. Implementation has resulted in over 16 million more Americans with health insurance but ongoing issues include rising costs, inadequate provider networks, and legal challenges to the ACA.
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
This document discusses the potential for national health reform in 2009 based on lessons from previous state reform efforts and the current political environment. It analyzes four potential scenarios based on the party of the President and Congress. It also outlines Community Catalyst's assumptions and goals for influencing the national reform process to promote quality, affordable coverage for all while protecting state policies and vulnerable groups.
The document summarizes a project to refurbish scrapers in two primary settlement tanks at a wastewater treatment plant. The old scrapers were performing poorly and needed replacement. The project contractor designed new scrapers with an improved scum skimming arrangement to address issues with the old design. The scrapers were then manufactured and installed, with the project contractor overseeing all stages from design to commissioning.
Columbia University's 2014 Healthcare Management Case CompetitionJessica Ken
Our team won 1st place in presenting analysis and recommendations for the future of the LEGACY Foundation, a major nonprofit that aims to reduce cigarette smoking.
This document advocates for a single-payer health care system in Pennsylvania called the Pennsylvania Health Care Plan (PHCP). It argues that a single-payer system would reduce administrative waste, lower healthcare costs for individuals and businesses, create jobs, and provide universal healthcare coverage for all state residents. The analysis estimates that the PHCP would save over $32 billion annually compared to the current system due to reductions in insurance company overhead, drug prices, and healthcare utilization increases from reduced cost-sharing. The savings would finance expanded coverage and lower the growing burden of healthcare costs on the state economy.
Reasons Why You Need An Experienced Account Managergingin4
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
The document discusses employer forum discussions on healthcare reform in 2009. It covers topics like changing the supply and demand curve for healthcare, the various players involved, why reform is happening now versus the 1990s, potential models for reform, and impacts on employers and employees. It also provides information on controlling costs, current bills being considered, and actions employers can take to manage healthcare costs.
The Cost & Impact of Massive Complexity in the US Health Insurance MarketRuss Kuhn
This document discusses the complexity of the US health insurance system and the potential impacts of an upcoming Supreme Court ruling on the Affordable Care Act. It notes that the US system is already very complex and expensive, with high costs preventing many from getting needed care. The ACA increased access to insurance but also added complexity. A Supreme Court case this month could end ACA subsidies for 8 million people, significantly increasing their costs overnight. Regardless of the ruling, the system will remain difficult for most consumers to navigate, with many making poor insurance choices without adequate understanding of options.
Zweig powerpoint on Palliative Care in Nursing Homes for Theme Session co-spo...MedicineAndHealthUSA
This document provides information on reducing prescription drug costs for patients, including learning drug prices, using generic medications, slicing pills, selecting alternative medications, and assistance programs. It discusses specific cost-saving strategies like comparing prices online, using $4 generic programs, Medicare Part D, and pharmaceutical company assistance. The summary focuses on high-level strategies to help a sample patient who cannot afford his medications due to lack of prescription coverage.
The document discusses how the US healthcare system is currently pre-industrial and will undergo disruption through industrialization. It argues that healthcare costs are unsustainably high and increasing faster than wages or inflation. As consumers face higher deductibles and premiums, consumerism will drive changes in the system. The document also notes several problems including the instability of Medicare and Medicaid funding, an aging population increasing demand, and significant issues with patient safety. It believes elements of value-based care and payment reform show signs of an emerging industrialized, more efficient healthcare model in the US.
The document discusses the dual cost and quality crises facing the American healthcare system. It argues that the root causes are a dysfunctional medical decision-making process and a financing system that relies too heavily on for-profit private insurance. The author proposes transitioning to a universal healthcare system financed by taxpayers and administered through non-profit third parties to reduce costs by an estimated $1 trillion annually. New electronic health records and medical AI tools could help improve decision-making quality if designed properly. Overall, the crises require understanding decision flaws and adopting evidence-based reforms rather than blaming any single group.
Intensive Care for Medicaid McQ Quarterly 2005Craig Tanio
This document summarizes a McKinsey report analyzing the unsustainable growth of Medicaid costs in the United States. It finds that by 2009, Medicaid will consume more than 75% of new state revenue in some states and 25-50% in many others. While opportunities exist to capture savings, actually doing so will require difficult decisions and creative leadership given political and structural challenges. Reform is needed to put Medicaid on a more stable long-term footing while still serving those in need.
The document discusses how the Affordable Care Act aims to address problems in the US healthcare system like the large number of uninsured, rising costs, and quality and access issues. It will expand coverage to 32 million uninsured through Medicaid expansion and health insurance exchanges. Reforms to payment and delivery systems are also expected to help slow premium growth and reduce costs over time. Implementation will occur gradually through 2019, with many provisions taking effect in 2014 such as the individual mandate, Medicaid expansion, and state-based insurance exchanges.
The High Performing FQHC of Tomorrow: Expanding the Mission Through MarginSage Growth Partners
This document summarizes a presentation given at the NACHC Conference FOM/IT on October 28, 2015 about the high-performing Federally Qualified Health Center (FQHC) of the future. It discusses major trends like rising healthcare costs, the shift to value-based care, and Medicaid reform that are drawing FQHCs into the changing healthcare economy. It provides examples of FQHCs partnering with Accountable Care Organizations and payers. The presentation argues that FQHCs should embrace transparency, pursue value-based payment opportunities, and actively manage patient populations to succeed in this new environment while continuing their mission.
The document summarizes the Affordable Care Act and identifies some of its flaws and deficiencies. It discusses two main goals of the ACA - to increase the number of insured individuals while reducing overall healthcare costs. However, it notes the ACA has yet to achieve these goals. One deficiency is that individuals who remain uninsured face a penalty fee, which does not actually encourage accessing healthcare. Another issue is the "coverage gap" where many remain uninsured. The document proposes solutions like a state-run program to cover those in the gap and bundled payments to replace fee-for-service. It argues more reform is still needed to control rising costs while expanding access.
This document provides an overview of the Affordable Care Act (ACA) including key provisions, implementation challenges, and political aspects. It discusses major reforms such as prohibiting denial of coverage for pre-existing conditions, essential health benefits, subsidies for low-income individuals, health insurance exchanges, and penalties for large employers not providing coverage. Implementation has resulted in over 16 million more Americans with health insurance but ongoing issues include rising costs, inadequate provider networks, and legal challenges to the ACA.
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
This document discusses the potential for national health reform in 2009 based on lessons from previous state reform efforts and the current political environment. It analyzes four potential scenarios based on the party of the President and Congress. It also outlines Community Catalyst's assumptions and goals for influencing the national reform process to promote quality, affordable coverage for all while protecting state policies and vulnerable groups.
The document summarizes a project to refurbish scrapers in two primary settlement tanks at a wastewater treatment plant. The old scrapers were performing poorly and needed replacement. The project contractor designed new scrapers with an improved scum skimming arrangement to address issues with the old design. The scrapers were then manufactured and installed, with the project contractor overseeing all stages from design to commissioning.
Columbia University's 2014 Healthcare Management Case CompetitionJessica Ken
Our team won 1st place in presenting analysis and recommendations for the future of the LEGACY Foundation, a major nonprofit that aims to reduce cigarette smoking.
This document summarizes the current state of healthcare quality in Minnesota and discusses how federal and state healthcare reform efforts may affect quality and patient safety. It provides an overview of various quality reporting initiatives in Minnesota, such as nursing home and hospital quality report cards. It also discusses converging forces in healthcare quality and politics that could create opportunities for meaningful healthcare reform. Key components of federal and Minnesota state healthcare reform bills related to quality include accountable care organizations, medical homes, payment reform to incentivize quality, and reducing disparities.
Shorten trial startup. Lower your costs. Recruit more patients, faster. All i...Julio G. Martinez-Clark
Colombia offers unparalleled benefits to pharma, medtech & biotech startups looking for a place to conduct their clinical trials with fast regulatory approval, ample access to patients, and very competitive costs.
The rising costs of health care are unsustainable and threaten Americans' access to affordable care. While the Affordable Care Act improved access to insurance, it did little to address the underlying cost drivers. Blue Cross lost over $400 million on its ACA business in the past two years due to sicker-than-expected customers with high medical claims. Reforms are needed like stronger enforcement of the individual mandate to broaden the risk pool and reduce costs.
This document discusses Medicare spending and how it has grown significantly since its inception in 1965. It analyzes physician billing data from CMS using the framework of a "three-legged stool" of incentives, decision rights, and performance measurement. It finds disparities in billing amounts across specialties and locations that suggest physicians may respond to financial incentives, with some specialties showing much higher billing in high-cost versus low-cost areas of living. This could be due to unclear medical decisions or anchor institutions setting norms around revenue maximization in those specialties.
This document discusses rising healthcare costs in the United States and strategies for controlling costs. It notes that the US will spend $2.80 trillion on healthcare in 2012, more than any other country per capita. While some point to defensive medicine, insurance profits, or demanding patients as the cause, the data shows these are a small part of overall costs. True savings may come from addressing the uneven distribution of costs among patients and choosing medical interventions wisely based on whether they improve outcomes or reduce side effects and costs. The document advocates for physicians to practice efficiently and consider costs responsibly when making treatment decisions.
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
The document discusses key components and goals of the Affordable Care Act (ACA) and healthcare reform initiatives, and their potential impact on continuing medical education (CME) and medical communication businesses. It describes major provisions of the ACA that aim to increase access to healthcare coverage, improve quality of care, and contain healthcare costs. These include the individual mandate, health insurance exchanges, Medicaid expansion, essential health benefits, and various programs to promote higher-quality, more coordinated, and cost-effective care through value-based purchasing and alternative payment models.
Clearly identifies the root cause of skyrocketing health cost and what companies and employees can do to reduce cost of health care.
You will learn proven strategies used successfully to reduce company health cost for over 20 years.
The document discusses various topics related to health care economics and financing in the United States, including the legislative process for health reform, current issues, health care financing models, sources of health insurance coverage, national health expenditures, payment reform efforts, and principles of health economics.
Health Care and Medicare Corporate Culture and the Three-Legged StoolLillian Rosenthal
This document discusses the history and current state of Medicare spending in the United States. It notes that while Medicare was originally intended to provide healthcare access for seniors, costs have risen significantly due to an aging population living longer and advancing medical technology. The document analyzes newly released data on payments made to individual physicians by the Centers for Medicare and Medicaid Services to determine if and how healthcare providers may respond to financial incentives.
The document discusses Medicare spending in the United States. It reports that Medicare spending was reduced to 0.2% in 2013 compared to 1.8% between 2009-2012. This decrease may have resulted from the recession limiting spending, delivery system reforms to improve quality while reducing local costs, or a focus on patient-centered care. Statistical data from Medicare budget reports is cited to support the claims around reduced spending.
Martin Trussell presented on upcoming healthcare reform and how it may affect different groups. He discussed that reform is now a priority due to the economic crisis, unsustainable growth of Medicare and Medicaid, and consensus among stakeholders. The proposed reforms include expanding coverage to all Americans, eliminating pre-existing condition restrictions, implementing an individual mandate, emphasizing prevention, and finding $2 trillion in savings over 10 years. The reforms would impact employers, carriers, brokers, individuals, providers, and other healthcare industry roles in various ways. The speaker noted many specifics are still unknown as legislation is still being drafted.
Healthcare Quality Improvement: A Foundational Business StrategyHealth Catalyst
Waste is a $3 trillion problem in the U.S. Fortunately, quality improvement theory (per W. Edwards Deming) intrinsically links high-quality care with financial performance and waste reduction. According to Deming, better outcomes eliminate waste, thereby reducing costs.
To improve quality and process and ultimately financial performance, an industry must first determine where it falls short of its theoretic potential. Healthcare fails in five critical areas:
Massive variation in clinical practices.
High rates of inappropriate care.
Unacceptable rates of preventable care-associated patient injury and death.
A striking inability to “do what we know works.”
Huge amounts of waste.
The document discusses problems with the US healthcare system and proposals for reforming it. It outlines issues like rising costs, lack of cost control, inefficiency of private insurers compared to Medicare, and the shortcomings of both the current system and the Affordable Care Act. It then proposes a single-payer system for Pennsylvania called the Pennsylvania Healthcare Plan that would provide comprehensive coverage for all state residents through a publicly financed but privately delivered system. Analysis found the plan would save the state government billions annually and have economic benefits for businesses from reduced healthcare costs. While opponents argue single-payer discourages cost control, proponents counter that Medicare has lower overhead than private insurers. The document evaluates the various options and advocates the Pennsylvania Healthcare Plan
Acs0008 Health Care Economics The Broader Contextmedbookonline
1) US healthcare spending is very high at over $2 trillion annually, yet health outcomes are mixed compared to other developed nations.
2) There is debate around whether rising healthcare costs represent an economic risk, with some arguing costs crowd out other spending while others say spending is acceptable if the value of health is high.
3) A key factor driving higher US costs with no clear improvement in outcomes is the market-based healthcare system, which differs from other countries. Features of healthcare markets like supplier-induced demand and moral hazard may contribute to rising costs.
The healthcare reform debate is very heated and this presentation is our effort to cut through some of the misunderstandings and misinformation. We hope you find it helpful!
This gives a good base knowledge of where the current insurance industry is, a timeline of when certain mandates go into effect and a simplified description of the mandats being launched on Sept 23, 2010.
The United States spends more on healthcare than any other country but has poor health outcomes. Money influences the healthcare system in several ways. The system is fragmented with different providers and payers not sharing information, leading to duplicate tests and costs. A fee-for-service payment model incentivizes providers to see more patients and perform more procedures to increase payments. Lobbying by the pharmaceutical and insurance industries shapes healthcare policies and regulations in ways that prioritize profits over public health. Transforming how care is delivered, such as emphasizing prevention and plant-based diets, could reduce costs and improve health.
1) The US healthcare system is costly and inefficient compared to other developed nations, with many Americans uninsured or underinsured and poorer health outcomes.
2) A single-payer healthcare system could reduce administrative waste and ensure universal access to healthcare, as seen in other countries, while preserving choice of doctors.
3) Common arguments against single-payer reform such as costs, quality of care, and impact on businesses are unfounded and contradicted by evidence from successful systems in other nations.
This document summarizes information about prescription drug costs and development. It discusses how medicines have transformed treatment for diseases like hepatitis C and cancer. Developing new treatments takes over 10 years and $2.6 billion on average, with only 12% of drug candidates being approved. Medicines help avoid expensive medical services and provide major savings to the healthcare system. While drug costs have risen, they account for a stable share of overall healthcare spending and are projected to grow in line with other healthcare costs. Many factors influence drug prices, including discounts, rebates, and competition from generics.
The best of both worlds: Uniting universal coverage and personal choice in he...AEI
The document proposes a new health care reform plan called "Best of Both Worlds" that aims to balance universal coverage with personal choice. It would create a national health insurance exchange with standardized basic plans and income-based premium supports. It also calls for removing the tax exemption for employer-provided health insurance and implementing a safety-net tax to finance minimum emergency care for all Americans. The plan is estimated to reduce spending compared to the Affordable Care Act while expanding access and protecting low-income and sick individuals.
#WenguiGuo#WashingtonFarm Guo Wengui Wolf son ambition exposed to open a far...rittaajmal71
Since fleeing to the United States in 2014, Guo Wengui has founded a number of projects in the United States, such as GTV Media Group, GTV private equity, farm loan project, G Club Operations Co., LTD., and Himalaya Exchange.
12062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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projet de traité négocié à Istanbul (anglais).pdfEdouardHusson
Ceci est le projet de traité qui avait été négocié entre Russes et Ukrainiens à Istanbul en mars 2022, avant que les Etats-Unis et la Grande-Bretagne ne détournent Kiev de signer.
Slide deck with charts from our Digital News Report 2024, the most comprehensive exploration of news consumption habits around the world, based on survey data from more than 95,000 respondents across 47 countries.
13062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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#First_India_NewsPaper
16062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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18062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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15062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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Christian persecution in Islamic countries has intensified, with alarming incidents of violence, discrimination, and intolerance. This article highlights recent attacks in Nigeria, Pakistan, Egypt, Iran, and Iraq, exposing the multifaceted challenges faced by Christian communities. Despite the severity of these atrocities, the Western world's response remains muted due to political, economic, and social considerations. The urgent need for international intervention is underscored, emphasizing that without substantial support, the future of Christianity in these regions is at grave risk.
https://ecspe.org/the-rise-of-christian-persecution-in-islamic-countries/
The Rise of Christian Persecution In Islamic Countries
Market-based Healthcare Reforms
1. Market-based
Healthcare Reform
14 ways to increase competition,
improve quality and reduce cost
January 2014
A billion dollars here, a billion
dollars there, and pretty soon
you're talking real money.
-Everett Dirksen
U.S. Senator 1951-69
2. Introduction
Healthcare was a mess long before Obamacare came along. It’s a complicated problem,
but reform really is possible. It’s just hard politically.
The next steps in reform need to clearly separate the two objectives of driving access to
care and driving efficiency of care (quality of healthcare per dollar spent). Both are noble
objectives, but they are not the same. The Patient Protection and Affordable Care Act
(aka Obamacare) focused almost entirely on expanding access to care, but it was sold
as equal parts access and efficiency improvement.
The GOP will never be able to toss out all of PPACA, nor should it try. Rightly or wrongly,
some of the access improvements (e.g. elimination of pre-existing conditions exclusions)
are far too popular to toss. The huge opportunity is in reforms to drive efficiency.
The most efficient industries are the ones with the most competition for customers – cars,
electronics, transportation, energy. Healthcare is inefficient because it lacks true
competition for our business. Lack of supplier and customer incentives are largely to
blame. These incentives have begun to change, but the change has only just begun.
Increasing incentives and eliminating the many barriers to true competition in healthcare
are the secrets to improving efficiency. What follows are some new and old ideas for
accelerating the changes that will bring better health outcomes per dollar.
4. Ugly Facts
Comparisons2
Norway #2-- $5,400/person, 9.6% of GDP (Norway is wealthier per capita than the U.S.)
Germany #7-- $4,200/person, 11.6% of GDP
OECD Median-- $3,200/person, 9.5% of GDP
• Annual U.S. healthcare spending is $2.9 trillion, $9,216/person
• This is about 18% (over a sixth) of our economy6
• No other nation comes close to these levels, even adjusting for
wealth differences1
5. American “Exceptionalism”
U.S. healthcare spending vs. OECD countries2
OECD is the Organization for Economic Co-operation and Development, consisting of 30 countries
considered high-income, and developed. It was established in 1948.
6. We pay a big premium for our healthcare
Are we getting our money’s worth?
• Life Expectancy
– U.S. ranked 23rd out of 30 within the 30 OECD nations1
• Cancer survival (5-year survival rate vs. OECD Median2)
– Breast - 5% better
– Cervical - 2% worse
– Colorectal - 3% better
• Ischemic stroke survival2 – Better
• Hemorrhagic Stroke survival2 – Worse
• Acute Myocardial Infarction survival2 – Better
• Asthma mortality (Ages 5-39)2 – Worse
• Diabetes, Lower extremity amputations2 – Worse
7. The Myth of Employer Health Plans
“My company provides my health benefits, so the
increases don’t affect me.”
Reality
Rising Benefit costs put downward pressure on Salaries
– Cost of an Employee = Salary + Benefits
Ballooning healthcare costs disadvantage U.S. companies
– GM’s healthcare costs add $1.5-$2.0K to the cost of each vehicle3
– GM’s global competitors do not have this problem
8. Healthcare Costs vs. Wages
Cumulative active employee health care cost increases vs. wage
increases
Source: Towers Watson Health Care Cost Survey 2010 (active employee data) and Bureau of Labor Statistics,
seasonally adjusted data from the Current Employment Statistics Survey August to August, 2000 – 2009
9. Where does the money go?9
2013 Total $2.9 Trillion
$899 Billion
$580 Billion
$290 Billion
$203 Billion
$203 Billion
$174 Billion
$551 Billion
Hospital Services
Other
Physician Services
Prescription Drugs
Dental, Other
Professional
Admin
Long term
Care
14. Excessive Costs for Diagnostic Imaging
Higher utilization and higher pricing of CT & MRI exams2
15. The Self-Referral Problem
When referring Physicians own an MRI machine their patients get
more MRI exams. 12
Press Release, November 30, 2011
CHICAGO – Physicians who have a financial interest in imaging equipment are more
likely to refer their patients for potentially unnecessary imaging exams, according to a
study presented today at the annual meeting of the Radiological Society of North
America (RSNA)…
During [2000-2006 study period], private office imaging utilization rates by non-
radiologists who control patient referral grew by 71 percent…
There were 86 percent more negative scans in the FI* group than the NFI** group,
indicating a significantly higher number of potentially unnecessary exams…
* FI Group – patients whose physicians had a financial interest in the MRI
**NFI Group – patients whose physicians did not have a financial interest in the MRI
16. How bad will it get?
Projections for family of four with employer-sponsored healthcare
8
17. • Growth of 3.9% since 2009 (Inflation = 1%, GDP growth = 2%)
• If ACA works as advertised, it won’t solve the cost problem.
• Healthcare spending growth is expected to accelerate as baby
boomers retire and ACA is implemented
But the cost curve is bending… isn’t it?
• Growth slowed since 2009 (fewer people employed, higher deductibles)
It’s getting worse less quickly, but the
“good news” won’t last.
18. We are in hot water!
If you put a frog into a pot of boiling water, it
will leap out right away to escape the danger.
But, if you put a frog in a kettle of cool water
and gradually heat the kettle until it starts
boiling, the frog will not become aware of the
threat until it is too late.
The frog's survival instincts are geared
toward detecting sudden changes.
Excessive healthcare cost growth has been the norm
for decades. The water is getting hot. Let’s not be frogs!
20. Healthcare Lacks Competition
In other markets
• We shop around; we get competitive bids; we go to Costco.
• We compare prices and customer ratings
• We love getting a great deal and we’re good at it.
In the healthcare market
• We make $10,000 purchase decisions without pricing or quality data
• We often pay no more when the price is higher.
– The “payer” does!
• We lack the incentive and the info to shop around, so we don’t.
Buyer incentives and provider transparency are the keys
21. Could greater competition reduce healthcare
costs and improve quality?
Is healthcare “special”, not governed by normal market
forces? NO!
• What would allow market forces to work in healthcare?
– Customer Incentives
• Everyone needs a reason to care about the true cost of their care
• Catastrophic care coverage with high deductibles
– Transparency
• Quality - Reliable data on outcomes, complication rates, patient
satisfaction
• Price - Up front information on the total price of care
– Fewer Barriers
• Eliminate unnecessary rules that restrict new competitors
22. The Payoff
Of a $1 trillion reduction in health spending….
•Puts more money in consumers’ pockets
•Improves competitiveness of U.S. companies
– Levels the playing field vs. global competitors
•Reduces deficits and debt
•Enables investments
– Healthcare for the poor
– Upgrading the energy grid
– Building roads and bridges
But how?
24. If U.S. healthcare spending per person
was equal to Germany’s, we would save
over $1 trillion/year*
* Difference between the U.S. and Germany’s health spending per capita(2) X U.S. population (311 million)
Reform does not mean sacrificing.
It means cutting waste.
If we matched the OECD Median, savings would be $1.5 trillion/year.
25. YES, EASILY!
Can we afford to reduce healthcare
spending by $1 trillion/year?
•$1 trillion reduction is $3,200/person
•Spending would go to $6,000/person
– This is the 2002 level (inflation adjusted)
27. Change Incentives to Unleash the Consumer
• When people have no reason to save resources, they waste them.
• Reward patients for cost effective health choices
– People who make financially irresponsible choices in managing their health
should pay more than people who don’t.
• e.g. Medication non-compliance, smoking, a sedentary lifestyle
1. Reduce the role of third party payers by reducing regulations
– Reduce the individual mandate to catastrophic events only
– Less mandated coverage means more consumerism, more competition
– Take the third party payer out of routine, predicable healthcare spending
2. Eliminate the tax distortion of employer health coverage
– It hides the true costs from employees
– Shift the money to employees & let them decide what insurance to buy
28. Reform the Third Party Payment System
3. Allow Insurance companies to compete across state lines
– Consumer choices are unnecessarily limited
– Current regulations prevent this, benefiting no one except large insurers
4. Increase Medicare copayments for those who can afford it.
– Medicare Part B average copayment rate has fallen by nearly half
during the past 35 years.
5. Provide beneficiaries with a defined level of support and
allow them to purchase insurance. Beneficiaries may
choose health plans with lower premiums but higher
deductibles and/or coinsurance than those in traditional
Medicare.
– Similar model to the Medicare prescription drug coverage
– Similar to proposal by Rep. Paul Ryan (R., Wis.) and Sen. Ron Wyden
(D., Ore.)
29. Increase Transparency of Information on
Healthcare Value
6. Prices of healthcare services must be communicated to
patients and/or family
– Require providers to give patients a “Good Faith Estimate” of all charges
to enable comparison shopping
– Life-threatening emergencies must be an exception
7. Quality and Outcomes data must be standardized, reported,
and made accessible to patients via web
– Imperfect data is better than no data
– Data integrity and granularity will improve over time
30. • AMA controls the supply of U.S. physician labor4,5
– Beyond defining education standards, AMA controls med school enrollment
– AMA has a financial interest in keeping physician supply low
• Shortages reduce competition, raising the cost of medical education,
driving up physician salaries
– If U.S. physician pay aligned with the UK, it would save $118 billion/yr
– If pay aligned with Germany, it would save $239 billion/yr
8. AMA should draft education standards, but should not be allowed to influence
the number of students enrolled or the # of medical schools
9. We must ease restrictions that make it difficult for internationally trained
physicians to practice medicine in the U.S.
The powerful American Medical Association restricts the supply of physicians
which bids up their compensation.
Eliminate Competitive Barriers due to Special
Interests: Physician Supply
31. Eliminate Competitive Barriers due to Special
Interests: Pricing
Create Transparency in Setting Medicare Prices13
• AMA’s Relative Value Update Committee (RUC) controls the Medicare price
list (Physician Fee Schedule)
• RUC holds secret, closed door meetings three times a year to adjust prices
paid by Medicare and followed by many private payers
• Meetings are invitation only, among AMA members
• Once prices are set, there is no transactional price competition for Medicare’s
business
10. The price-setting process should be externally audited with results
published
11. RUC Meetings should be open to the public with attendee lists and
meeting minutes published
32. Reducing U.S. Prescription Drug Prices
• Unlike oil, prescription drugs do not have global market-driven prices
• U.S. prices are almost double international prices2
– (Median of countries from following slide)
– Many countries (e.g. Canada) cap prescription drug prices
– High R&D spending by pharma companies is funded by higher U.S. drug
prices
• “Re-importing” U.S.-made drugs from low price countries is illegal
12. There are three reform options, each with risks
A. Medicare as price leader, negotiates prices that align with OECD markets
B. Legalize re-importation of U.S. drugs from low cost markets back to the U.S.
C. Shorten the duration of drug patents to speed availability of low cost
generics
33. Medical Malpractice and Defensive Medicine
“Overall annual medical liability system costs, including
defensive medicine, are estimated to be $55.6 billion* in
2008 dollars, or 2.4 percent of total health care spending.” 7
* Estimated total cost, not incremental vs. other nations
13. Cap jury awards to reduce the direct and indirect costs
of malpractice litigation.
34. Diagnostic Imaging
More frequent tests and higher pricing costs up to $67 billion/year
• U.S. doctors order CT & MRI scans at double the rate of
physicians in other nations2
• U.S. Prices for CT and MRI exams are nearly double
international prices2
• Stark Law was created to eliminate the self-referral problem
– Stark has huge exceptions11 that make it ineffective
– Eliminating self-referral would save tens of billions of dollars
14. “Self-Referral” and its overutilization of resources must be
reduced by adding teeth to the Stark Law
– More specificity in its application, greater penalties for violations
35. Waking up the Lions
Tackling a trillion dollars of entrenched spending will be a tough fight.
• These changes would threaten powerful special
interests
– American Medical Association (AMA)
– Pharmaceutical Research and Manufacturers of
America (PhRMA)
– Many, many others
• Reforms would be spun as “Healthcare Armageddon”
– Special interests will turn both parties against market-
based reforms– Remember “Death Panels”?
• There are risks and challenges in each of these
changes
– These are implementation issues, not justifications for
inaction!
– None are as big as the risk of not changing
36. American consumers are lions too!
If we want cost reform, we should start now.
• Runaway healthcare costs must become a
big voter issue
– Where’s the GOP Plan and sense of urgency?
• Demand a plan
– Obamacare adds to the cost problem
– Which type of cost reform do you want?
• Value-enhancing competition
• Single payer government system
– The current path is the worst possible option
• Start asking for prices before you make decisions
– Huge differences in prices exist
• e.g. MRI’s can vary by 400%
– It’s OK to shop around!
– We can can save money right now
37. Imagine…
Consumers with the information and the incentive to choose
healthcare services based on price, quality, outcomes, and patient
satisfaction data.
Doctors and hospitals competing with each other to earn our
business.
Those providing excellent care at reasonable prices thrive and
prosper. Others improve or go out of business.
A trillion dollars of hard dollar cost savings to fund expanded patient
access, invest and reduce debt.
An innovative, efficient healthcare market costing 12% of GDP.
This is not radical change! Many markets work this way
and 12% of GDP is plenty (almost $2 trillion).
38. Sources
1. McKinsey Global Institute publication, “Accounting for the Cost of U.S. Healthcare: A New Look at Why
Americans Spend More”, December 2008
2. Commonwealth Fund publication, “Issues in International Health Policy”, May 2012
3. “Healthcare Costs and U.S. Competitiveness”, Council on Foreign Relations, March 26, 2012
4. Forbes Magazine, “The Evil-Mongering Of The American Medical Association” August 26, 2009, Shikha Dalmia
5. “The Medical Cartel: Why are MD Salaries So High?”, Mark J. Perry
6. Assoc. Press, July 28, 2011. “U.S. health care spending to reach $13,710 per person by 2020, government
says”
7. “National Costs Of The Medical Liability System”, 2010, Health Affairs.
http://content.healthaffairs.org/content/29/9/1569.abstract
8. Center for American Progress, September 15, 2009.
http://www.americanprogress.org/issues/2009/09/family_health_spending.html
9. Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, 2009
10. “Diagnostic Imaging Regulations’ Possible Benefit to Hospitals”, Hospitals & Health Networks, Scott Clay and
Gregory Milton, February 9, 2009.
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/02FEB2009/0
90203HHN_Online_Clay&domain=HHNMAG
11. Exceptions to the Stark Act. http://starklaws.uslegal.com/exceptions-to-the-stark-act/
12. Press Release: “Self-referral leads to more negative exams for patients” November 30, 2011. Matthew
Lungren, M.D., Sin-Ho Jung, Ph.D., and Peter Kranz, M.D. http://www.eurekalert.org/pub_releases/2011-
11/rson-slt111711.php
13. “The Secret World of Healthcare Pricing”, Marketplace, NPR, June 11, 2012.
http://www.marketplace.org/topics/life/health-care/secret-world-health-care-pricing
14. “The Wrong Remedy for Healthcare”, June 28, 2012. John F. Cogan, R. Glenn Hubbard, Daniel P. Kessler
15. Reuters, “No matter who wins, there’s still a healthcare cost crisis”, Reihan Salam, October 1, 2012
39. Market-based
Healthcare Reform
14 ways to increase competition,
improve quality and reduce cost
January 2014
A billion dollars here, a billion
dollars there, and pretty soon
you're talking real money.
-Everett Dirksen
U.S. Senator 1951-69