Archive for the Economics of Health Care Category

The Pause That Refreshes

Posted in Economics of Health Care, Health Care Policy with tags , , , on November 3, 2009 by drbobbs

HaveACokeThe American Academy of Family Physicians (AAFP) continues to be the target of criticism in both the blogosphere and conventional media outlets for its partnership with the Coca-Cola company.

From The Kansas City Star:

[T]he American Academy of Family Physicians…represents about 94,000 doctors who struggle to get their patients to shed excess pounds.

From across the room, Coca-Cola bats its eyelashes. The queen of carbonated drinks is fending off attacks that its sugar-sweetened products promote obesity and should be taxed.

The two organizations last month sealed a deal that had Coca-Cola giving the academy a grant in the mid six figures to come up with health messages for the public about beverages and sweeteners.

The academy and Coca-Cola said the information would be based on objective science.

But doctors, nutrition experts and consumer advocates charge that Coca-Cola is proffering the money just to improve its reputation and possibly to buy the academy’s silence.

In various toasts to our health, bedfellows of the strangest kind are everywhere and go back decades. The study of alcoholism owes much to the distilled-spirits industry, which teamed with Cornell University and the National Institute of Health on research as early as the 1940s.

Now an increasingly skeptical and health-conscious public, with so much information at its fingertips, isn’t sure whose advice to trust, said Shelly Rodgers, a University of Missouri researcher of strategic communications: “Consumers instantly see the conflict and go, ‘What? What?’ ”

From American Medical News:

The academy squandered its credibility by “taking tainted Coke cash,” said a statement from the Center for Science in the Public Interest, an advocacy group strongly critical of the food industry. In a letter to Dr. Henley, the group called on the academy to reject the deal.

Henry Blackburn, MD, who was one of 22 public health experts to sign the CSPI letter, said the deal is “just crazy.” Dr. Blackburn, professor emeritus in the division of epidemiology and community health at the University of Minnesota School of Public Health, said “no professional society should accept funding from such companies.”

And from the blogosphere:

coke and doctors, sitting in a tree . . .

Looking for health advice? Dr. Coca-Cola will see you now

Doctor’s Group Under Fire for Coke Partnership

A little bit of a bad thing (is still a bad thing)

An Embarrassing Conflict of Interests

Family Doctor Group Squanders Credibility by Taking Tainted Coke Cash

Perfect Harmony: AAFP and Coca-Cola Get Cozy

The problem here is not that the AAFP will necessarily become a mouthpiece for Coca-Cola.  AAFP members are not going to start telling their patients to have a Coke and a smile three times a day.  The problem is one of perception and credibility.  And you can’t buy back your credibility.  Not for six figures.  Not for any price.


Obamacare dead for 2009?

Posted in Economics of Health Care, Health Care Policy, Medicolegal with tags , , on November 3, 2009 by drbobbs

Is Obamacare, for the present at least, dead on arrival?  According to ABC News, it is:

Senior Congressional Democrats told ABC News today it is highly unlikely that a health care reform bill will be completed this year, just a week after President Barack Obama declared he was “absolutely confident” he’ll be able to sign one by then.

“Getting this done by the by the end of the year is a no-go,” a senior Democratic leadership aide told ABC News. Two other key Congressional Democrats also told ABC News the same thing.

This administration seems to have been totally unprepared for the resistance to their proposed health care reforms.  The town halls of this past summer will go down in American political history as the model of how not to sell an idea to the American people.  And the series of health care reform bills, culminating most recently in a 1,990 page behemoth that “runs more pages than War and Peace [and] has nearly five times as many words as the Torah,” are bloated and bureaucratic.  The $1.2 trillion price tag does little to inspire confidence that health care costs will in any way be lowered by it.

Of course, we don’t really seem to inclined to lower health care costs in the United States anyway.  Are fast food restaurants going out of business due to a lack of customers?  Is there a public outcry for loser pays medical malpractice reform?  Is there bipartisan support to allow individuals and groups to purchase health insurance across states lines to create a truly national health insurance market with competition and lower prices?  Are there any substantive steps to increase the number of primary care physicians in the country?

So far, the answer across the board appears to be “No.”

But I thought their healthcare was so much better than ours, Part 10

Posted in Economics of Health Care with tags , on October 22, 2009 by drbobbs

BardotA Russian coal miner with a lung disease is trying to sell his autographed photo of Brigitte Bardot to pay for his treatment.  The picture is said to be valued at about $45.

Administration NOT throwing in the towel?

Posted in Economics of Health Care, Health Care Policy with tags , , on September 8, 2009 by drbobbs

Last month it looked like the Obama administration was giving up on a public health option.  But according to this, the Obama team may not have given up on the public option after all.  Incidentally, this plan also calls for, well, read it for yourself:

The plan includes some of the stiffest penalties Congress has proposed for Americans who don’t carry health insurance coverage.

Sen. Baucus emerged from a meeting with the six-member bipartisan group saying he had given his colleagues until 10 a.m. Wednesday to provide feedback on his draft. The group will meet again Wednesday afternoon in an attempt to come up with an agreement before Mr. Obama’s address.

Under the plan, people who earn between 100% and 300% of the poverty level (or between about $22,000 a year and $66,000 a year for a family of four) would face fees ranging from $750 to $1,500 a year.

For taxpayers with incomes above 300% of poverty, the penalty starts at $950 a year and reaches as high as $3,800 for families. Nearly 12 million people fit in this category, according to the National Institute for Health Care Management.

The idea behind the penalty is that those who can afford insurance but don’t buy it are imposing costs on the entire health system. Under the proposal, nearly 12 million people who currently have no insurance could be subject to such fines, according to figures compiled by the National Institute for Health Care Management.

Starting next year, the plan also calls for annual fees of $6 billion on health-insurance providers, $4 billion for medical-device makers, $2.3 billion on drug makers and $750 million on clinical laboratories. The fees would be levied on individual companies based on market share. Insurers also face an excise tax of 35% for any health plan worth more than $8,000 a year for individuals and $21,000 a year for families.

Karen Ignagni, chief executive of America’s Health Insurance Plans, an industry lobbying group, said the new fees would make it more difficult for health insurers to contain rising costs. “Our members are talking about that being at odds with the goal of cost containment,” she said.

Either the administration has compromising photos of hundreds of Congressmen and Senators in a desk drawer somewhere, or they are seriously misreading the political tea leaves.  This sounds like the kind of thing that would give all those irate town hall meeting people from this past summer hemorrhagic strokes.

A roosting chicken prepares for landing

Posted in Economics of Health Care, Health Care Policy with tags , , , , on September 1, 2009 by drbobbs

I posted the following this past April in response to absurd prior authorization requests and denials by private health insurers:

[P]atients have private insurance that they and/or their employers pay for so it will be there when they need it.

[I]f I were in charge of a private insurance company I would be doing my damnest to demonstrate how well the private sector works.

Now there’s this:

Fifty-two health and accident insurance companies have until Friday to turn over salary details on employees who make more than $500,000 a year.

Last month, Rep. Henry Waxman, D-Calif., head of the House Energy and Commerce Committee, asked for the figures as part of a broader look at how health insurers operate.

And last week, Sen. John D. Rockefeller IV, D-W.Va., who runs the Senate Commerce panel, also asked the biggest health insurers to cough up particulars of premium dollars spent on patient care.

Some policy watchers believe the congressional push has the potential to shake things up. In fact, a controversy over CEO pay could renew debate over a public option, a government-run health insurance plan that would compete with private insurers.

Public option advocates hope outrage over big-time salaries prompts a new rally for their case.

“I think they will get some information that will surprise policyholders, because there’s not a great deal of awareness of how much these executives do make,” said Wendell Potter, a former Cigna vice president who now works for a left-leaning media group. “A lot of money they’re paying in premiums is going to make executives richer and richer every year.”


In the early 1990s, health insurers spent more than 90 cents of every dollar collected on patient care, but that has been declining. In 2007, national publicly-traded health companies spent about 81 cents of every dollar on patient care, according to a PriceWaterhouseCoopers report.

Advocates who want executive pay included in the reform debate want to reverse that trend and force insurers to spend more on patient care.

Just because the American people appear to be rejecting government-run healthcare, that doesn’t mean that they are in love with the terms of their private health insurance.  Health insurance carriers have been cutting benefits and raising premiums.  Don’t forget that grassroots populism can target big business just as easily as big government.

Telling it like it is

Posted in Economics of Health Care, Health Care Policy with tags , , on August 20, 2009 by drbobbs

I don’t think I can add anything to this great editorial by Dr. Marshall Ackerman.  Read the whole thing:

Devaluing Doctors — and Care

But I thought their healthcare was so much better than ours, Part 8

Posted in Economics of Health Care, Health Care Policy with tags , on August 16, 2009 by drbobbs

The Canadian healthcare system that we Americans are allegedly too stupid to adopt is in a state of disrepair according to the incoming president of the Canadian Medical Association.

“We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,” [Dr. Anne Doig] said in an interview with The Canadian Press.

“We know that there must be change,” she said. “We’re all running flat out, we’re all just trying to stay ahead of the immediate day-to-day demands.”

It gets better:

Dr. Robert Ouellet, the current president of the CMA…has been saying…that “a health-care revolution has passed us by,” that it’s possible to make wait lists disappear while maintaining universal coverage and “that competition should be welcomed, not feared.”

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

So why should we try to make our healthcare system more like Canada’s when it sounds like Canada’s healthcare system is becoming more like ours?