Thanks to the Affordable Care Act, a.k.a. Obamacare, millions of people receive generous subsidies to cover the cost of health insurance. Some people, in fact, receive coverage for free, their monthly premiums paid in full by the federal government. Unfortunately, even a small change in price can cause people to lose their coverage. That’s important…
Anyone who has raised kids knows what happens when you give them a monthly allowance without requiring any work in return: they plop in front of their new videogame consoles while their dirty dishes collect in the sink. That’s the logic behind Republican plans to establish work requirements for people who receive safety net benefits—if…
Your father’s rheumatoid arthritis medicine was working well, fighting off that otherwise debilitating illness. Then he found out that Medicare would no longer pay for the drug. Your aunt’s multiple sclerosis was flaring and her neurologist recommended a promising new treatment. But she learned that she would have to try, and “fail,” on two other…
The patient arrived in my clinic, their right big toe the color of a spring strawberry. The lightest touch caused exquisite pain. Fortunately, I was able to prescribe a pill (an ancient medicine, actually) and the patient was better by the next day.
Too bad that simple treatment is becoming unaffordable, through a maddening combination of greed and regulatory failure.
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?
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.
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?
Many wealthy nonprofit hospitals provide surprisingly little charitable care.