A whole industry is devoted to measuring, tracking and even incentivizing the quality of American hospital care. Unfortunately, that industry is horribly inefficient, costing us billions of dollars.
Quality measurement is inefficient in large part because there is no single source that hospitals (and provider systems, more generally) can use to track the quality of their care.
The Medicare Diabetes Prevention Program is a lifesaver. Consisting of of at least 16 class sessions that provide practical training about healthy eating, physical activity, and other strategies for weight control, the Program reduces the chance that people at high risk for diabetes actually develop that life-threatening condition.
However, the Program is floundering, with distressingly few people having access to or enrolling in the program. Could it be because Medicare administrators haven’t watched enough episodes of Shark Tank?
Latuda is a drug to treat schizophrenia. It costs about $4,000 per month in the U.S. In Canada, the price is closer to $500.
Ibrance, a breast cancer drug, costs $10,000 more per month in the U.S. than in Canada.
Why these enormous price differences?
Many people die in ways, and even in locations, that go against their preferences. They don’t want to be put on ventilators and, yet, spend their last days in intensive care units tethered to breathing machines. They don’t want cardiopulmonary resuscitation (CPR), and, yet, receive full-on “codes” when their hearts stop.
Much of this unwanted care could be avoided if patients (aka: “people”) discussed their treatment preferences with their clinicians.
How is a physician supposed to know which medicine is most affordable under which insurance plan?
Fortunately, there are tools coming into use designed to help clinicians figure out patient-specific costs of any medication they prescribe. The tools (jargon alert!) are called RTBTs, for real-time benefit tools.
After learning that her favorite prophylactic is going off the market, Seinfeld’s Elaine Benes had to decide which potential partners were “sponge-worthy,” even putting her new boyfriend through what resembled a job interview to see if he was up to her new sexual standards.
While the worst of the Covid-19 pandemic is hopefully behind us, new variants continue to spread, with news sources reporting this week that Jill Biden and Whoopi Goldberg have come down with the virus. Given the ongoing threat of Covid-19 and other infectious diseases, we all face a new kind of worthiness judgement, a decision about who is “contagion-worthy”: who should we hug, kiss and socialize with given the risk that they harbor a dangerous microorganism?
You wake up in the post-operative recovery area, still groggy, the full effects of the procedure obscured by an anesthetic haze. You begin to ponder several questions: Was the surgery a success? Did the surgeon find anything unexpected? How quickly will the procedure make you feel better?
There’s another question you might ask yourself. A few weeks from now, is anyone involved in your care going to send you a surprise bill?
It would have been a difficult ending under the best of circumstances. Composing what would be his last opera, Giacomo Puccini was struggling to humanize Turandot, daughter of the Emperor and a woman of mesmerizing beauty. Early in the opera, she had cruelly disposed of a series of want-to-be suitors, beheading some and torturing others,…
Will a fiercely independent person like me become less generous if I practice mindfulness? Will all that focus on self and present drawing me away from other people’s concerns?
Doctors who join up with hospitals or large healthcare organizations in anticipation that this will increase their incomes are misguided or ill informed.