Imagine for a moment that you are an oncologist caring for a 53-year-old man with metastatic cancer, a person whose tumor has spread to lung and liver. With standard chemotherapy, this man can expect to live around 12 months. That standard treatment isn’t all that expensive in today’s terms, only $25,000 and his insurance company will pick up the entire tab since he is already maxed out on his yearly deductible and co-pays.
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Healthcare systems are big and complex beasts, that are very hard to transform overnight. In the United States, for example, we have long had a system of care dominated by fee-for-service payment. In this kind of system, the more tests and procedures and office visits that a physician orders, the more that physician gets paid….
Pretty soon, people will be able to start shopping for health insurance on the infamous Obamacare exchanges. In North Carolina, one of the states asking the feds to take the lead in this effort, only one insurer is offering insurance coverage in every county of the state. That is Blue Cross Blue Shield, and they…
Here is an excellent picture from the New England Journal of Medicine, illustrating which states have chosen to run their own exchanges, which are relying on the federal government, and which are following some kind of hybrid approach. Unsurprisingly, the distribution of states pretty closely mirrors the outcome of the most recent presidential election. (Click…
In the New York Times on Friday, Roni Caryn Rabin writes a great article about the crazy price hikes that hospitals and medical clinics impose upon patients who come to them from “out of the network.” Examples include a more than $6,000 doctor visit, one for which Medicare would have paid less than $200. Examples…
The urologist broke the news: “Out of 12 cores, three were positive for cancer, so you have a small amount of cancer.” He would soon explain the treatment choices—surgery, radiation, or active surveillance (watching the cancer closely with blood tests and biopsies). He described each option in elaborate detail, because he knew that the “right…
