Thursday, March 14, 2013

1) The high price of health care; 2) Obamacare priorities

this blog covers

1) The high price of health care and possible solutions

2) Obamacare priorities

I.   The high price of health care and possible solutions
A complex ecosystem of costs in health care

this article was in the washington post on 3/14/13

points out the incredible variations within a region on health care prices for MRIs, doctor visits, and many other aspects of the health care system.  The article is based on the work of Gio Colella, CEO, Castlight Health

This paper fits in very well with a program sponsored by the Center for American Progress (CAP) entitled


The High Price of Health Care

A Conversation with Steven Brill

This program builds on Brill's special issue in Time Magazine

 Bitter Pill: Why Medical Bills Are Killing Us

The program included Brill, Colella, and Ezekiel Emanuel who contributed key parts of the Affordable Care Act. 

Brill papers discusses both the wide variations in prices, and also the large profits and salaries for executives and practitioners in the medical care field.  Further these prices are increasing in health care while other prices remain constant. 

The speakers proposed the following key solutions to reducing these inequities:

  • Expand competitve bidding based on price and quality

  • Increase transparency as to price and quality.  The above articles drive this point very well re prices.   

  • The health exchanges will put pressure on the providers to control prices.  

  • An all payor system

    Other ideas that were discussed

  • Malpractice reforms

  • Limit self-referrals

  • Improved care for chronically ill

  • More prevention through public health systems

  • More consumer education

    Here are my thoughts

  • Test and evaluate accountable care organizations

  •  Test and evaluate integration of services such as post acute services

  • Examine options for alternatives to the high costs to the last year of life and end of life care. 

  • Expanded use of electronic health records and greater integration of the different systems.

  • Integration of payments and services for dual eligibles

    Here is an earlier blog that I wrote on this topic. Particularly see the CAP paper. 

    Medicare and Deficit Reduction, Health Reform Strategic Plan 

    II. Obamacare priorities 

     I would be very interested in thoughts from each of you as to the next key steps to implementing Obamacare.  My guess would be how well the Health exchanges get off the ground is one key. Obviously there will be successes and failures in terms of getting the information out, enrollment, and the quality of the plans.   What other keys are there that the administration and the health care field need to focus on.  

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