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Saturday, January 21, 2017

20 January, 2017 | Bill and his guests – Keith Olbermann, Heather McGhee, Tom Perez, and Jon Meacham – answer viewer questions after the show. read more


Obamacare, at least in its original incarnation, is on its way out... attacks have focused mostly on sections of the Affordable Care Act that expanded access to health insurance.

At least as important, however, are the lesser-known parts of the law that have let Medicare use its financial clout to push for better, safer, and less expensive medical care.

Value-based care initiatives in the ACA include reducing payments for preventable hospitalizations, establishing mandatory reporting of physician quality, and payment arrangements that emphasize care coordination. Those kinds of initiatives have garnered widespread bipartisan support, albeit more vocally outside Washington.

Value-based purchasing saves lives and money... Most physician organizations now back value-based purchasing, understanding that accountability for quality and safety is the right path to controlling spending -- both morally and clinically. read more


Tuesday, January 17, 2017

An international group of leading doctors and academics say up to one-third of many medical procedures are now being done unnecessarily, causing physical, psychological and financial harm that could threaten the viability of healthcare systems.

A landmark report in The Lancet medical journal said more needed to be done to address inappropriate medicine, which includes deliberate over-servicing by doctors for their own financial gain.

Over-use of medicine, which paradoxically exists alongside under-use of evidence-based medicine, is driven by defensiveness among health professionals who fear being sued; gaps in knowledge; erroneous beliefs; and lack of meaningful consultation with patients to understand their individual aims and preferences, the researchers said...

The Lancet report said a fee-for-service payment system was likely fueling the over-use of medicine in some countries. read more


Monday, January 16, 2017

U.S. political journalist Matt Taibbi is very clear about the fact that he doesn't like Donald Trump.

Still, the Rolling Stone columnist says the president-elect got more than a few things right during an election campaign that brought to the forefront America's struggles with racism, class divide and economic stagnation.

One of Trump's gambles that really paid off, according to Taibbi, was painting a target on the back of the U.S. political media.

"The media and politicians had spent so much time with each other that they lost touch with regular people, and Trump capitalized on that. He made us in the media villains, representative of this out of touch, ivory tower political culture," he said.

"I think there's some fairness to it, as much as I dislike Donald Trump, he hit a note, several notes, in this campaign that were true, and that was one of them." read more


Sunday, January 15, 2017

In a few short years, two things seem likely to happen. The country will look back fondly at the Obama years. And many of the people who voted for Trump will deny they ever did.

Wondering what the next year will look like? Look no further than eight years ago, when Republicans openly promised to block anything the incoming president tried to do. Now reverse the roles of the two parties.

Ironically, Trump's biggest problems over the next few years may not be with Democrats as much as with traditional Republican fiscal and military hawks, who have spent decades fighting two things that Trump seems indifferent to: budget-busting programs and the Russian bear.

Health care is shaping up as the first major migraine for Republicans. Trump has promised to "repeal and replace" Obamacare. Republicans are slathering over the repeal part but lack any collective sense of what to replace it with. read more


Comments

The author of the above link, Michael L. Millenson, also points out the following ...

At least as important, however, are the lesser-known parts of the law that have let Medicare use its financial clout to push for better, safer, and less expensive medical care. In Trump's terminology, it's been a "terrific deal" for anyone who's seen a doctor or gone into the hospital, saving a staggering 125,000 lives and $28 billion in just four years, according to the Department of Health and Human Services.

Unfortunately, Trump's pick as HHS secretary, orthopedic surgeon and Georgia Republican Representative Tom Price, appears at best a lukewarm supporter of this approach. Will Trump protect Americans' great health care deal?

A few years ago, Price and I were keynote speakers at a conference sponsored by a conservative Florida business group. He was applauded for denouncing the ACA; I was applauded for praising it. Price spoke about government-sponsored health insurance, while I laid out the law's impact on the cost and quality of care.

Business leaders appreciate that HHS, the largest health care purchaser in the world, exerts leverage the private sector alone can only dream about. Or as Trump put it in his book, "Leverage: don't make deals without it."

Value-based purchasing saves lives and money. According to the Institute of Medicine, almost one-third of all health care expenditures are unnecessary.

In the private sector, which is seeking to move in the same direction as the ACA, that magnitude of savings on health costs can keep employers from moving jobs to cheaper venues overseas.


QFT

My doctor gets it right every time, Loaf.

#306 | POSTED BY JEFFJ

No they don't ...

Health Care Myth Busters: Is There a High Degree of Scientific Certainty in Modern Medicine?

www.scientificamerican.com

Medical decision-making itself is fraught with inherent subjectivity, some of it necessary and beneficial to patients, and some of it flawed and potentially dangerous.

For these reasons, millions of Americans receive medications and treatments that have no proven clinical benefit, and millions fail to get care that is proven to be effective. Quality and safety suffer, and waste flourishes.


Drop your shorts and bend over ... youtu.be

World's Top Doctors: Too Many Patients Get Too Much Medicine
www.drudge.com

"If you like your doctor you can keep them"

#279 | POSTED BY SAWDUST

Your doctor only gets their clinical decisions right just barely over half of the time, 55%. Doctors base their clinical on science ONLY about 20% of the time.

30% of everything done in US Healthcare is waste with no benefit to patients -- $750 billion in waste every year.

There's little to no accountability in all healthcare settings, by all healthcare professionals...

youtu.be

Hundreds of thousands of Americans die every year from preventable medical errors.

Obamacare was all about making doctors and hospitals more accountable, making them meet clinical and safety standards. And those doctors failing to meet those standards were dropped.

Given these facts, why would you want to keep your doctor?

not after being lied to repeatedly and profusely and PROVEN to be
lies that the LIAR knew were LIES when he told the LIES.....

#21 | POSTED BY AFKABL2

Since Obama saying people could keep their doctor when that wasn't always the case REALLY bothers you, I have a straight forward question to ask you.

Click on the link below and peruse the three short videos and the headlines ...

www.drudge.com

My question -

Knowing what you know now, that doctors prescribe treatments, tests, and drugs that are more often than not the wrong patient care that is also harmful to patients ... why would you want to keep your doctor, wouldn't want a another doctor that wasn't so wrong in their treatments and diagnoses?

Isnt there already a body that oversee's doctors and their standards in training and their profession?

#18 | POSTED BY BOAZ

Nope. The AMA is all lobby, no accountability.

Dr. Lucian Leape drives home the lack of healthcare accountability in America in less than a minute and a half ...

Dr. Leape on the 4 facts of patient safety
youtu.be
[1:24]

1. Medical injury happens in all healthcare settings.

2. Accountability in healthcare is weak to non-existent ar all levels.

3. Our healthcare structure and the we finance it does not only provide incentives for patient safety, it provides serious disincentives for patient safety.

4. Doctors, who should be providing leadership, have been mostly been passive when it comes to patient safety.

Who's Dr. Leape? Here's his bio ... en.m.wikipedia.org

Dr. Leape is also considered the father of patient safety ...

How Many Die From Medical Mistakes in U.S. Hospitals?

www.propublica.org

In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher -- between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

Dr. Lucian Leape, a Harvard pediatrician who is referred to the "father of patient safety," was on the committee that wrote the "To Err Is Human" report.

He told ProPublica that he has confidence in the four studies and the estimate by James.

Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said.

"It was based on a rather crude method compared to what we do now," Leape said. Plus, medicine has become much more complex in recent decades, which leads to more mistakes, he said.


QFT

America's Epidemic of Unnecessary Medical Care

www.newyorker.com

Virtually every family in the country, the research indicates, has been subject to overtesting and overtreatment in one form or another. The costs appear to take thousands of dollars out of the paychecks of every household each year.

Researchers have come to refer to financial as well as physical "toxicities" of inappropriate care -- including reduced spending on food, clothing, education, and shelter. Millions of people are receiving drugs that aren't helping them, operations that aren't going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.

Why does this fact barely seem to register publicly?

QFT

Half of cardiac stent procedures overused, unnecessary

www.fiercehealthcare.com

Half of elective surgeries to implant cardiac stents may be unnecessary and inadvertently causing patient deaths, according to an in-depth investigative report by Bloomberg.

Seven million Americans have undergone the popular practice--implanting stents to open blocked arteries--at a cost of more than $110 billion in the past decade, Bloomberg reports. When used to restore blood flow in heart attack patients, the procedure proves beneficial. These acute cases account for half of the 700,000 stent procedures in the United States each year, according to the article.

The problem stems in the country's payment system that rewards doctors based on volume of procedures rather than quality of care, according to the article. Cardiologists get paid less to talk about the risk of the procedure and alternative treatments than they do for implanting the device.


QFT

One Third of Knee Replacements for Arthritis May Be Unnecessary

www.healthline.com

A new study calls for better and more modern ways to evaluate patients before total knee replacement surgery. Under current guidelines, many patients may be receiving the procedure when it could be avoided.

The study authors hope to see better patient selection criteria in the future to make sure that those going under the knife really need the procedure.

According to the Agency for Healthcare Research and Quality, Americans undergo about 600,000 knee replacements each year. Between 1991 and 2010, Medicare-covered knee replacements skyrocketed by about 162 percent per year.


QFT

How the U.S. Health-Care System Wastes $750 Billion Annually

www.theatlantic.com

Every year, the United States spends eight times as much money on unnecessary health-care costs as the Pentagon spent for each year of its operations in Iraq.

The massive annual waste is the takeaway from a new report by the Institute of Medicine (IOM), which estimates that the country loses some $750 billion annually to medical fraud, inefficiencies, and other siphons in the health-care system. In comparison, the Defense Department budgeted $757.8 billion for the war in Iraq over the eight years it was there.

By far the biggest black hole when it comes to waste has to do with how we practice medicine -- over half of it is accounted for by unnecessary services, inefficient care, or the failure to prevent problems that require expensive intervention.

The report underscores how much we could save just by encouraging doctors to order fewer procedures and, on the patient side, by taking a more active interest in lifestyle monitoring. The IOM offers a few specific examples:

- Patients don't need to get more than one colonoscopy every 10 years.
- If you had a fainting spell but it didn't come with a seizure, you can safely forego a $2,000 MRI.
- Avoiding expensive imaging studies for early complaints of back pain.


QFT

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