Once again, I will repeat myself. Take the profit out of ALL healthcare. There should be no healthcare companies owned by any Wall Street investors.
Make pharmaceutical companies pay for their own research costs. If they take research grants from the government, then they cannot profit off those grants.
I agree. We need single-payer universal healthcare, period. Everything else is gamed for profit by predators who make money in their sleep. Medicare Advantage Plans have grown, not because they deliver better low cost healthcare, but because Medicare has a 20% copay and doesn't cover the eye glasses, hearing aides, or dental care. Then you have an army of salespeople working on commission to sell MA Plans that promise benefits that are arbitrarily denied or that you must fight for.
I really enjoy your balanced writing, which is very hard to find and the fact that the USA grift is stacked. Meaning it’s not one variable of how we got here, no one is clean, it’s 100 variables or more : and our public is very asleep and likes it that way.
Balanced writing highlights there are no winners or heroes. There isn’t anyone or any group who’s been morally right or clean or doesn’t self appropriate. There is no Easter Bunny. We are going to have to admit ( egoic maturity here please ) that we’re messy , reimagine how we treat each other, and all lines of business flow from this concept. Self appropriation eats itself. And we are here.
Healthcare reform entails not only local control but ridding the system of insurers, corporate healthcare and PBMs do not suck inordinate amounts of money from delivery of healthcare. Universal, free healthcare is the answer with a single EMR. Consider joining PNHP, Physicians for a National Healthcare Program PNHP.com. We welcome not only physicians but all healthcare providers and advocates.
Very disturbing to read this in Uncpovered....As long as profit extraction and insurance corporations are involved in our Healthcare we will continue to see the degradation of our actual health... And, no MA is not necessarily here to stay... PlusChoice tried the same incremental squeeze and was made to get out of Healthcare by government catching on and stop just piling money into it. That was "only" a little over 20 years ago... Government, we the people, becoming informed and removing the outrageous subsidies-- quit collaborating with the scam/steal-- will drive these thiefs out of our healthcare
ABSOLUTELY NOT. Please PLEASE do some research about the insanely CORRUPT "rural electric co-ops"! Medicare Advantage (and actually all Medicare programs) pale in comparison when it comes to rural electrification masquerading as co-operatives but ACTING LIKE THE WORST KINDS OF PREDATORS. False flags everywhere! First of all they usually acquire power under contract with such big power providers as BPA which is so far out of control as to be laughable if so many people getting the trickle-down bills weren't suffering so much! Second these "co-ops" illegally roll into their electric bills all kinds of executive and management compensation - salaries, bonuses, company cars, percs - and paying lobbyists to keep the corruption in place. Especially where there are "smart meters" the computer programs and wink-wink "profit" algorithms allow these co-ops to allege it's the consumer over-using wattage or "it's the weather" wink-wink-wink. Worse yet, states' utility boards rubber stamp even the most egregious increases in consumer billings. Medicare Advantage could take lessons in corruption from electric co-ops!
If anyone wants to help fight for single-payer universal expanded Medicare for All, please sign up for email with Physicians for a National Health Plan PNHP.org, onepayerstates.org, and berniesanders.com/issues.
Since it's politically impractical to get to a single-payer system in the near term, a good step would be to require full transparency with all-payer rates, meaning providers can charge what they want, but must charge all payers (Medicare, Medicaid, insurance companies, and individuals paying out of pocket) the same rates for any particular service. This would improve competition, since patients would see what all prices are and, depending on a plan's cost-sharing incentives, would select the provider offering the best rates coupled with good quality scores. Where there is no competition, especially for hospitals, then communities should treat them as regulated utilities with global budgets (see Maryland). This approach would eliminate networks and all their complexities and patient risks. It might force providers to compete not only on rates but also on rate bundling approaches (e.g., capitation, episode of care). It would make insurance carriers compete on administrative efficiency, member satisfaction, and plan design, instead of on who has the clout to get the biggest discounts (which just cost-shifts to other payers). Finally, it would facilitate more standardization and efficiencies in claim processing and data aggregation.
Interesting that we have today, established in the 1960's FQHCs/Community Health Centers, that are "plug and play" for the re-engineering of Medicare Advantage and disintermediating #BUCHA and "for profit" sickcare. The largest and the most advanced 3rd generation PCMH, they provide care for over 31 million Americans, regardless of their ability to pay. Check out the #NACHC website to learn more.
BUCA has to go. We at Sentia have automated the entire health insurance process. We provide the EMR to practices, price the procedures 10% ABOVE medical consumer price index, and pay for work performed in real time. This eliminates medical coding. It eliminates everything the health insurance companies do that isn't 'write a check for the patient's health care.' For this service we charge $10 per month plus the actual cost of the risk. That alone should cut over 40% of the cost. Add to that telemedicine, a DICOM (XRay, etc) viewer, the ability to draw on the XRay to highlight structures, secure 'email', and health and wellness. Further, we offer patient education based on the the results of their lab tests. This happens automatically. When they read it, they get a small discount. When they follow it and get healthier, they get a large discount. This is science based measurement and based on bloodwork. This gives the system 'teeth' by incentivizing healthy living. Then we start getting back some of the 84% of monies spent on behavior based chronic disease. Getting us down to the OECD average will save $1.27 trillion, or an additional 25%. This would save us 60+%.
In general, Coops are inherently successful due to their “ownership” feature. When those making the decisions are impacted by and own those decisions, successful outcomes follow.
The underlying framework for the ACA contributed to the demise of coops with their fundamental approach of using government risk corridors and short-sighted reinsurance plans.
When you have skin in the game, prudent decisions are made.
I, too, am a big critic of the most common type of Medicare Advantage...but that is because of how it's owned/governed. The reality is 50% of new Medicare recipients are choosing Medicare Advantage. The question is how best to deal with that reality as there's no evidence it will go away. Remember the post-ACA blowback when some plans were taken away. It's a lot more people with Medicare Advantage than that and they are at an even more critical point in their lives.
This powerful story in the Saturday Evening Post on "How Doctors Die" describes the misery inflicted on individuals in traditional Medicare that don't have someone to care for them from a medical standpoint (like my father's great primary care team that mercifully was able to avoid the kind of misery described below for the entirety of his Parkinsons while getting great care at home and in the primary care clinic)
"Almost all medical professionals have seen too much of what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo."
Once again, I will repeat myself. Take the profit out of ALL healthcare. There should be no healthcare companies owned by any Wall Street investors.
Make pharmaceutical companies pay for their own research costs. If they take research grants from the government, then they cannot profit off those grants.
I agree. We need single-payer universal healthcare, period. Everything else is gamed for profit by predators who make money in their sleep. Medicare Advantage Plans have grown, not because they deliver better low cost healthcare, but because Medicare has a 20% copay and doesn't cover the eye glasses, hearing aides, or dental care. Then you have an army of salespeople working on commission to sell MA Plans that promise benefits that are arbitrarily denied or that you must fight for.
I really enjoy your balanced writing, which is very hard to find and the fact that the USA grift is stacked. Meaning it’s not one variable of how we got here, no one is clean, it’s 100 variables or more : and our public is very asleep and likes it that way.
Balanced writing highlights there are no winners or heroes. There isn’t anyone or any group who’s been morally right or clean or doesn’t self appropriate. There is no Easter Bunny. We are going to have to admit ( egoic maturity here please ) that we’re messy , reimagine how we treat each other, and all lines of business flow from this concept. Self appropriation eats itself. And we are here.
Healthcare reform entails not only local control but ridding the system of insurers, corporate healthcare and PBMs do not suck inordinate amounts of money from delivery of healthcare. Universal, free healthcare is the answer with a single EMR. Consider joining PNHP, Physicians for a National Healthcare Program PNHP.com. We welcome not only physicians but all healthcare providers and advocates.
Bravo! I really hope this approach can gain traction. The need is urgent.
Very disturbing to read this in Uncpovered....As long as profit extraction and insurance corporations are involved in our Healthcare we will continue to see the degradation of our actual health... And, no MA is not necessarily here to stay... PlusChoice tried the same incremental squeeze and was made to get out of Healthcare by government catching on and stop just piling money into it. That was "only" a little over 20 years ago... Government, we the people, becoming informed and removing the outrageous subsidies-- quit collaborating with the scam/steal-- will drive these thiefs out of our healthcare
ABSOLUTELY NOT. Please PLEASE do some research about the insanely CORRUPT "rural electric co-ops"! Medicare Advantage (and actually all Medicare programs) pale in comparison when it comes to rural electrification masquerading as co-operatives but ACTING LIKE THE WORST KINDS OF PREDATORS. False flags everywhere! First of all they usually acquire power under contract with such big power providers as BPA which is so far out of control as to be laughable if so many people getting the trickle-down bills weren't suffering so much! Second these "co-ops" illegally roll into their electric bills all kinds of executive and management compensation - salaries, bonuses, company cars, percs - and paying lobbyists to keep the corruption in place. Especially where there are "smart meters" the computer programs and wink-wink "profit" algorithms allow these co-ops to allege it's the consumer over-using wattage or "it's the weather" wink-wink-wink. Worse yet, states' utility boards rubber stamp even the most egregious increases in consumer billings. Medicare Advantage could take lessons in corruption from electric co-ops!
If anyone wants to help fight for single-payer universal expanded Medicare for All, please sign up for email with Physicians for a National Health Plan PNHP.org, onepayerstates.org, and berniesanders.com/issues.
Since it's politically impractical to get to a single-payer system in the near term, a good step would be to require full transparency with all-payer rates, meaning providers can charge what they want, but must charge all payers (Medicare, Medicaid, insurance companies, and individuals paying out of pocket) the same rates for any particular service. This would improve competition, since patients would see what all prices are and, depending on a plan's cost-sharing incentives, would select the provider offering the best rates coupled with good quality scores. Where there is no competition, especially for hospitals, then communities should treat them as regulated utilities with global budgets (see Maryland). This approach would eliminate networks and all their complexities and patient risks. It might force providers to compete not only on rates but also on rate bundling approaches (e.g., capitation, episode of care). It would make insurance carriers compete on administrative efficiency, member satisfaction, and plan design, instead of on who has the clout to get the biggest discounts (which just cost-shifts to other payers). Finally, it would facilitate more standardization and efficiencies in claim processing and data aggregation.
Interesting that we have today, established in the 1960's FQHCs/Community Health Centers, that are "plug and play" for the re-engineering of Medicare Advantage and disintermediating #BUCHA and "for profit" sickcare. The largest and the most advanced 3rd generation PCMH, they provide care for over 31 million Americans, regardless of their ability to pay. Check out the #NACHC website to learn more.
BUCA has to go. We at Sentia have automated the entire health insurance process. We provide the EMR to practices, price the procedures 10% ABOVE medical consumer price index, and pay for work performed in real time. This eliminates medical coding. It eliminates everything the health insurance companies do that isn't 'write a check for the patient's health care.' For this service we charge $10 per month plus the actual cost of the risk. That alone should cut over 40% of the cost. Add to that telemedicine, a DICOM (XRay, etc) viewer, the ability to draw on the XRay to highlight structures, secure 'email', and health and wellness. Further, we offer patient education based on the the results of their lab tests. This happens automatically. When they read it, they get a small discount. When they follow it and get healthier, they get a large discount. This is science based measurement and based on bloodwork. This gives the system 'teeth' by incentivizing healthy living. Then we start getting back some of the 84% of monies spent on behavior based chronic disease. Getting us down to the OECD average will save $1.27 trillion, or an additional 25%. This would save us 60+%.
We have this system in prototype.
I believe you will find this interesting.
In general, Coops are inherently successful due to their “ownership” feature. When those making the decisions are impacted by and own those decisions, successful outcomes follow.
The underlying framework for the ACA contributed to the demise of coops with their fundamental approach of using government risk corridors and short-sighted reinsurance plans.
When you have skin in the game, prudent decisions are made.
I, too, am a big critic of the most common type of Medicare Advantage...but that is because of how it's owned/governed. The reality is 50% of new Medicare recipients are choosing Medicare Advantage. The question is how best to deal with that reality as there's no evidence it will go away. Remember the post-ACA blowback when some plans were taken away. It's a lot more people with Medicare Advantage than that and they are at an even more critical point in their lives.
This powerful story in the Saturday Evening Post on "How Doctors Die" describes the misery inflicted on individuals in traditional Medicare that don't have someone to care for them from a medical standpoint (like my father's great primary care team that mercifully was able to avoid the kind of misery described below for the entirety of his Parkinsons while getting great care at home and in the primary care clinic)
https://www.saturdayeveningpost.com/2013/03/how-doctors-die/
"Almost all medical professionals have seen too much of what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo."
Doctors need to be talking with their patients about hospice well before the end of life. Too many docs are afraid of the subject.