By Evan Falchuk
Last week, the Senate Finance committee finally released the initial description of Senator Baucus’ long-awaited “America’s Healthy Future Act.”
There is a lot to digest in the 223 pages of text, and others have given good summaries of the high points.
Here are my “quick six” reactions to it.
By Evan Falchuk
Want to know why big health reform plans are going badly?
Not enough attention is being paid to people doing real, meaningful things to improve the cost and quality of health care.
In my series “Real People Real Reform,” I share some of these stories.
This time, I speak with Rick George, Director of Benefits for J.B. Hunt Transport Services, Inc. If you live in North America, you’ve almost certainly seen their yellow logo on a truck on a highway near you.
But J.B. Hunt is more than just trucks. They are a recognized leader in transportation logistics. And they’re bringing that same level of insight and attention to their health care programs.
By Evan Falchuk
Newsweek tries refute the “Five Biggest Lies In the Health Care Debate.”
But I’ve heard much bigger lies than the ones in this article.
I mean, are people really showing up angry at town hall meetings over fears that “the government will set doctor’s wages”?
Misinformation – or just plain old confusion – about our health care system is common. To try to help fix this, I offer five of the biggest, most commonly repeated misconceptions I hear regularly about the U.S. health care system.
By Evan Falchuk
AllBusiness’ Nancy Germond writes about health care quality in her Risk Management for the 21st Century column. Best Doctors gets prominent billing:
Employers are buying Best Doctors services as an employee benefit to ensure their employees receive a higher quality of medical care, according to Falchuk. “If you feel unsure about your diagnosis or treatment, you are entitled to feel confident.”
Also, at Wired magazine, Curtis Silver interviewed me for his blog, Geek Dad. We talked about using social media in business and how important it can be for your family, too.
Everyone struggles with work-life balance. We care deeply about our business and our families. And the realization is this: you have as much of a moral obligation to build a successful business as you do to build a successful family life. Technology and social media help make this possible. I wish more people saw it that way.
In both cases, read the whole thing.
UPDATE: The Wall Street Journal reviews my brother’s new TV show, Glee. They like it.
The Boston Globe, too, with a mention of Best Doctors and the work we did to help my brother with his health crisis last year.
By Evan Falchuk
Bad news in the paper today: health care costs are expected to rise another 10.5% next year. It’s a serious problem that affects businesses and families across the country.
But the headlines miss something important: the rate of increase has been steadily slowing.
Are we already bending the health care cost curve?
By Evan Falchuk
In our survey of major U.S. employers, we found very little interest in medical tourism.
But there is a great deal of interest in it among the major media – the Wall Street Journal, the New York Times, and today, Forbes (via the Associated Press) have done major stories on it.
But here’s something curious.
All three stories have featured the exact same medical tourist – Ben Schreiner of Camden, South Carolina.
Back in March, I wrote about how curious this was. I guess it’s curiouser now.
Are there this few patient stories? Based on our survey, maybe.
Whether medical tourism becomes a trend in America remains to be seen. But since he’s appeared three times, one thing is certainly a trend – Ben Schreiner’s role as the go-to guy for stories on it.
WELCOME Instapundit readers.
This blog is about health care. It is from the perspective of someone actually in the health care business. It is a perspective informed by the health care system as it actually works.
And what it is really about is this: Health care has become focused on the unit cost of care – treating it like something that can be produced on an assembly line.
But it’s not.
It is about thinking, judging, and deciding what is wrong with a patient.
The trouble is, our system systematically undervalues this process. When your doctor can only spend 15 minutes with you, why are we surprised when things go wrong?
Proposed reforms continue to see health care in this light, hoping that through ever-more clever ways to pay for care, we can fix a problem created in that very same way.
If you read this blog, you will see not just the reality of how this works, but also the good news – the stories of patients, doctors, employers and others who are doing real and meaningful things to put right what is wrong. You won’t hear much about it in the media – well, sometimes you will – but there are people out there changing the face of health care even faster than the politicians can. And perhaps you will see what politicians might learn about how to actually make change.
Please visit again, join the discussion, and add your voice to this most important debate.
By Evan Falchuk
Health care cooperatives: It’s suddenly the hot topic in reform. But what do Congressional and Administration leaders mean when they use that word?
We don’t really know – there is no legislation describing it. But based on news reports, it sounds like a kind of mutual insurance company.
So, what is a mutual insurance company?
In general, a mutual insurer is a non-profit company in which each insured is also a part-owner. So you buy not just an insurance policy but also an ownership interest in the insurer. With a co-op, you probably wouldn’t have to actually buy an ownership interest – it would just come with your policy (in a traditional mutual insurer, you would have to pay an extra fee for this). From the strands of discussion about the government providing start-up money for these co-ops, it seems like that will the the source of capital.
The policyholders have major influence on how the business is run, even though there is a professional management team. Normally, if a mutual insurer makes a profit, all of the money is either kept as part of its reserves, or given back to the owners as a dividend. By linking ownership with insurance, you create incentives for lower costs and lower premiums and create a mechanism for making sure that the plan provides good benefits.
It’s hardly revolutionary – this type of insurance has its origins in the ancient world. And the rural cooperatives from which the idea of the health care cooperative springs came into being largely around the time of the New Deal.
But old ideas can be good. There are existing health care cooperatives that are doing good and interesting things. For example, Seattle’s Group Health Cooperative (founded in 1947) runs an entire health system around its membership, and is highly thought of for its innovative approaches to providing coordinated, high quality medical care. Still, while I don’t doubt that Group Health’s financial structure helps it do the very good things it does, I suspect their success has as much to do with the culture of their organization as it does with the way in which care is financed.
Stepping back to the bigger picture, then, it seems like the idea is to create new mutual insurers that could compete with existing players in the market. It might add some new competition to under-served markets for individual and small group coverage.
I’m sure we will be hearing much more on this new avenue for reform in the coming weeks.
By Evan Falchuk
As I’ve blogged about before (here, here, here and here), a big reason reform is going so badly is this: Reformers don’t understand how people react when you try to make changes to their health benefits.
Companies across America have been making changes to health benefits for years.
Reformers seem to have ignored the lessons of their experience.
By Evan Falchuk
President Obama held a town hall meeting today, which seems to have gone well.
Except he decided to use an analogy to dispute the idea that a government-run health insurer would drive private insurers out of business:
“As long as they have a good product and the government plan has to sustain itself through premiums and other non-tax revenue, private insurers should be able to compete with the government plan,” Obama said. “They do it all the time,” he said. “UPS and Fedex are doing just fine. . . . it’s the Post Office that’s always having problems.”
This is probably not the best analogy.
The US Postal Service has a monopoly on first-class mail, and is staffed pretty much completely by government workers. As good as these workers are, the idea of the Post Office evokes images of waiting on line, and the rising cost of stamps.
And as for the villainous health insurers, are they now UPS and Fedex?
It is all very hard to follow. It’s no wonder even people paying close attention to this issue are left wondering what these plans are all about.
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?
