Necessity is the mother of invention. Desperate times call for desperate measures. Pick your favorite idiom, but the point remains the same: Sometimes the only way to get out of a bad situation is to innovate. This theme is at the heart of the brilliant documentary on the health care system, Escape Fire.
The goal of our health care system is to keep us all healthy. So it’s not outrageous to think that doctors and hospitals would be paid for meeting this goal, right?
Until recently, hospitals have had no financial incentive to keep patients from returning. In fact, hospitals have historically made money every time a patient is admitted. If it sounds wacky, that’s because it is: Hospitals actually profited from keeping patients sick!
As health care consumers, we can all agree that health care costs are too high. What we may not realize is that the “just in case” X-ray or CT scan that we request or that our doctor prescribes may be a major driver of these costs. But how do we know when “just in case” isn’t necessary or is potentially harmful?
A recent New York Times editorial explored the exciting potential of allowing alternative health providers give patients routine care. This step could help meet the growing demand for primary care services as we face a shortage of primary care physicians in many areas. And, it could save both consumers and the health system money.
This piece by Ezekiel J. Emanuel was originally posted in The New York Times Opininoater section.
It is conventional wisdom that end-of-life care is an increasingly huge proportion of health care spending. I’ve often heard it said that people spend more on health care in the year before they die than they do in the entire rest of their lives. If we don’t address these costs, the story goes, we can never control health care inflation.
When Avandia entered the market, it was touted as one of the best medicines available to help people with type 2 diabetes. The great potential of this new diabetes wonder drug was proclaimed in an article in the prestigious New England Journal of Medicine, and Avandia was quickly adopted as the standard of care. Sadly, an important piece of information came out much later. Avandia has an unfortunate and dangerous side effect: It increases the risk of heart attack. A lot.
When student volunteers at the Baltimore Rescue Mission—a free clinic in East Baltimore that serves low-income and homeless individuals—recognized that the clinic was providing a lot of duplicated, unnecessary, and costly services to its patients, they took action. Part of the problem, they recognized, was that it was challenging to keep up-to-date records on such a transient population and that there was little to no record sharing between clinics similar to the Mission.
Have you ever gone to the doctor and had to repeat a test because they didn't have the results on hand? Do you ever feel that your doctors don't talk to each other? Or that no one doctor knows all of the medications you're taking and why? These kinds of things happen frequently. And they not only lead to higher costs: They can also be dangerous.
Find out how to get involved in developing Medicaid health homes, one of the ways states can get funding from the Affordable Care Act to provide coordinated, patient-centered care.
Is newer always better? Not in the case of a pricey new cancer drug, according to clinical trial data and experts around the nation. The drug, Zaltrap, is getting lots of media attention not because it is novel for a new drug to be twice as expensive as its competitor and no more effective (the FDA doesn't require new medicines to be either more effective or less costly than existing drugs), but because Memorial Sloan-Kettering Cancer Center—one of the nation's premier cancer treatment centers—has decided that it won't offer Zaltrap to its patients.