Archive for the ‘Health Care Media’ Category

To Serve Man

Friday, August 14th, 2009

By Evan Falchuk

Fresh off labeling opponents of reform “political terrorists,” the Washington Post’s Steven Pearlstein says that, well, actually, “it is possible to disagree about health reform without being disagreeable.”

ToServeMan3

That’s nice.

I don’t think he means to, but Pearlstein shows one of the reasons why reform has been so contentious:  It’s because people are suspicious that they aren’t getting a clear, direct, honest story from their leaders.

They fear that buried in the thousands of pages of unread legislation is much more than just harmless changes to the health insurance market, or ways to help doctors do a better job, or to control expenses while improving the quality of care. They are skeptical, and the President’s assurances that if they like their coverage they can keep it – that they can somehow “opt out” of reform – aren’t working.

I think it’s because they keep hearing things that make them think otherwise.  The foolishness around “death panels” had such bite because it seemed like just the sort of thing you might try to sneak in as a way to fix “the most important fiscal issue we face as a country.”

I’ve knocked Pearlstein before, but he’s doing a better job of saying what reformers really want than the President and Congressional leaders.  He says reform should be a “bold national experiment aimed at redefining the doctor-patient relationship and dramatically altering the way health care is delivered.”  That’s fine, but if this is what we’re doing, we should be honest about it, and have the kind of thoughtful discussion that kind of endeavor deserves.

Absent that, people get nervous, and they have every right to be.

hen we talk about health care reform, we are really talking about dozens of different issues. Is health care reform about covering the uninsured, or about cutting costs for employers? It is about having a publicly-funded health plan, or changing reimbursements to doctors? Is it about longer life expectancies or creating insurance cooperatives? Is it about caps on medical malpractice awards, or comparative effectiveness? Is it about healthier lifestyles, or cutting the cost of prescription drugs? Is it about cutting administrative waste, or incentives for more people to go to medical school? Is it about implementing new health care IT, or preventing insurers from making excessive profits?

Ed Koch: Don’t Mess With My Employee Benefits

Tuesday, August 11th, 2009

By Evan Falchuk

I’ve been making the point that health reform’s troubles are due to a fundamental failure of reformers to understand that health care is all about employee benefits.

At Real Clear Politics, former New York City Mayor Ed Koch shows you what I mean.  He recently had bypass surgery:

I speak from personal experience. I have been told that the cost of my hospital care, including the services of 20 doctors and 72 nurses and medical technicians over a six-week period may ultimately cost a million dollars. My private insurance policy is paid for by my law firm, Bryan Cave LLP, and because I still work full-time, that insurance policy is my primary one, not Medicare, even though I am 84 years old. Will that continue to be the case under any law signed by President Obama or will I be denied the right to spend my own money and my law firm’s for such unlimited coverage?

Koch says he think the answer is probably “yes,” but he’s very unsure.  In fact, he points to quotes from Administration officials along these lines that he says are “alarming.”

So, is the problem with health care reform politics?  Of course there is politics, but I don’t think Ed Koch is motivated by that.

No, Koch’s article illustrates something else.

If someone as sophisticated as Ed Koch is left wondering about the answer to fundamental questions about reform, how can you expect others, paying much less attention, to feel otherwise?

What in the World is Steven Pearlstein Talking About, Ctd.

Sunday, August 9th, 2009

By Evan Falchuk

Steven Pearlstein wants to know:

Are you with him, or are you with the terrorists?

He’s serious.  And it’s part of the continuing, thoughtful debate on health care.

(more…)

Oh, Good, a Thoughtful Debate on Health Care

Wednesday, August 5th, 2009

By Evan Falchuk

If you were hoping for a thoughtful discussion on the reform of our health care system, I have bad, bad news.

It turns out that health insurers are “villians.”  Public anger over the massive, mostly unread, reform bills is “manufactured,” and anxiety created by the expectation of unknown changes to people’s most valued benefits is the result of disinformation and “fishy” stories.

It’s like an employee benefits roll-out gone horribly awry.

The protests and disastrous town halls look to me just like the kinds of angry protests that happen all the time when employers make important changes to a benefit plan and the employees either don’t understand them or don’t agree.

Blaming the people who don’t follow what you’re doing and why is a big mistake.  Sure, there is politics.  But health care is a serious, emotional issue, and it should be no surprise that people react badly when they think something to do with it may be taken away.

Dreaming up ideas of how health care ought to work is relatively easy.  But figuring out how to implement it is hard, and there are no short cuts.  The people who actually run benefits plans – employers, benefits consultants, HR professionals – can tell you:  there is no replacement for communication, engagement and respect for opposing views.

The strategy of demonizing those who aren’t on board is a mistake, and is as likely to set back the cause of reform as it is to further inflame an already volatile audience.

Why is Health Insurance So Expensive?

Friday, July 24th, 2009

By Evan Falchuk

Gary Schwitzer links to a Business Week article that says health insurance is a very uncompetitive market.  Schwitzer notes this hasn’t gotten much attention, and wonders if it is a reason why health insurance premiums keep going up.

It is – and it isn’t.  As with most things in health care, there’s more to it than it seems.

(more…)

Roundup: Reactions to Putting Patients First

Monday, July 20th, 2009

by Evan Falchuk

Friday, I went to the National Press Club in DC for the Putting Patients First event.  It was organized by Dr. Val Jones of the Better Health blog, and was meant to raise the profile of patient issues in our discussion of health care reform.

Val deserves congratulations, as the issue has gotten wide attention in the medical blogosphere and beyond.

Here’s a round-up of reactions.

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Ezra Loses It

Thursday, June 25th, 2009

By Evan Falchuk

Ezra Klein is back with another post showing what happens when you form strong opinions without knowing very much about your subject matter.

Today, he’s here to tell us the “truth” about the insurance industry.   He succeeds – but only in making himself look very silly.

(more…)

Gawande Speaks

Wednesday, June 24th, 2009

By Evan Falchuk

Ezra Klein recently wrote that doctors were at the root of our health care problems, citing Atul Gawande’s discussion of McAllen as his inspiration, as well as Steve Pearlstein’s work.  I’ve already noted how both Klein and Pearlstein misunderstand Gawande’s work.

Now, Klein has scored an interview with Gawande.

(more…)

Reform Has to Mean Change, Not Just Coverage

Tuesday, June 23rd, 2009

By Evan Falchuk

The New York Times has been running a series on its Economix blog about health care reform.

Today, they post answers to following the questson from three health care experts:  “What should our priorities for health care reform be?”

You should read them all, but you should think about two things.

(more…)

The McAllenization of Health Care Reform

Monday, June 22nd, 2009

By Evan Falchuk

Everything is McAllen, Texas.

It’s all part of our “uniquely American” approach to many issues: oversimplify the problem, so we can solve it. Ideally, on an artificially short time line.

In the case of health care reform, let’s say we get ‘er done by August 1.

(more…)

  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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