Wednesday, July 30, 2008

Millennial Challenge: Health Care Speculators and Cost Crisis !

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Monday, July 28, 2008
Faces Of The Health-care Crisis
By Chris Frates
Jul 28, 2008

The National Federation of Independent Business is on the Hill today, distributing a new booklet to congressional offices titled, “The Faces of the Healthcare Crisis: Small Business in America.”

The compendium details the difficulties small business owners face in getting health care. The effort is designed to send a message to Congress and the next president that “small businesses are demanding solutions to rising health care costs and they expect reform that works for them.”

One fairly typical vignette, Rich Gallo, owner of Office Outlet in Indiana, Pa., said he cannot afford to offer his employees health-care coverage.

And while he was searching for individual coverage, Gallo had a heart attack and put off going to the hospital because he didn’t have insurance – a delay that could have killed him. The $200,000 trip, he said, “makes me realize how we really need reform to make sure that small business people can get the coverage they need at the price they can afford.”

The push is part of NFIB’s Solutions Start Here campaign to pass health care reform that benefits small businesses.

Legislator wants legal review of GVSU's live-in partner health insurance benefit
Posted by Nardy Baeza Bickel | The Grand Rapids Press July 28, 2008 21:34PM
Categories: Breaking News

ALLENDALE -- A West Olive legislator has requested the state Attorney General's opinion on the live-in partner health insurance benefit Grand Valley State University approved for its employees earlier this month.

The benefit applies to gay couples, as well as any other live-in partner or friend who has lived with a staff or faculty member for 18 months or more. It does not cover relatives or tenants.

Republican state Rep. Arlan Meekhof sent the request last week, said his legal assistant, Bob DeVries.

It has been received by Attorney General Mike Cox, and it will be reviewed, said his spokesman Matt Frendewey, who declined to give a timeline on the issue. Cox has not been asked to review any similar policies that other universities have implemented, he said.

Other universities offering the partner benefits include the University of Michigan, Michigan State University, Central Michigan University and Michigan Tech.

GVSU trustees have said the change was necessary for the university to remain competitive in attracting talent. School officials also have said it is not same-sex benefits repackaged under another name. Same-sex plans are banned under state law.

DeVries said they are taking up the issue now that it has been enacted in West Michigan.

"Grand Valley is in (Meekhof's) district and is a more immediate interest by us.

"It's our opinion ... that these benefits are against the law, especially at a time when Grand Valley increased tuition by 13 percent. There's no reason they need to institute a new program that's going to cost them $180,000 a year."

As they have with other criticism of the change, GVSU officials remained polite but firm in their stance.

"Last Monday, Representative Meekhof advised the university of his plan to request an opinion from the Attorney General, a right that is available to all members of the Legislature. Grand Valley's trustees believe that the program they adopted complies with Michigan law," vice president Matt McLogan said.

Meekhof's request came at the same time fellow state Rep. Dave Agema, R-Grandville, said he would push for universities to lose 5 percent of their state funding if they spend taxpayer dollars to provide unmarried partner benefits.
at 10:59 PM 0 comments

Thursday, July 24, 2008

Scrap Medicare Fee-For-Service System, Doctor Says Posted by Jacob Goldstein
They way Medicare pays doctors encourages excessive testing and discourages spending time with patients, a doctor argues today on the New York Times op-ed page.

The fee-for-service system reimburses doctors not only for their time, but also for overhead — which includes the costs of expensive machines used to run tests such as CT scans.

This is why doctors who own their own imaging equipment order far more scans than doctors who refer patients elsewhere for scans, argues the author, Peter B. Bach of Memorial Sloan-Kettering Cancer Center. He writes:

Any first-year business school student can see the profit opportunity here. The cost of a CT scanner is fixed, but a doctor earns fees each time it is used. This means that a scanner becomes highly profitable as soon as it’s paid for.

Patient visits, on the other hand, don’t incur the overhead of fancy machinery and so aren’t big moneymakers in the current system.

Getting rid of this payment system would trim excessive use of expensive tests and encourage docs to spend more time with patients instead, argues Bach, who is a former adviser to Medicare’s top brass.

He suggests paying doctors a fixed amount for each patient, with higher payments for more complex patients to discourage cherry picking. Payment for overhead should be based on the typical costs of tests and treatments for a patient’s condition — similar to how Medicare pays hospitals.

Implementing such a program would be pretty complicated — you could run the risk of giving doctors incentive to under-treat patients, and you’d have to do a good job of setting fees to avoid cherry picking.

Still, it’s worth considering alternatives to the current system. The recent debate in Washington over Medicare payments to doctors is sure to be back next year. And the health-policy gurus we’ve been talking to say financial pressures mean some kind of radical restructuring of the payment system is coming sooner or later.

Photo by Associated Press

at 12:55 PM 0 comments Southlake doctor pleads guilty to possession of child pornography

12:42 PM CDT on Thursday, July 24, 2008
By WENDY HUNDLEY / The Dallas Morning News
A Southlake doctor pleaded guilty this morning to one count of possession of child pornography.

Dr. James Shin, 46, faces up to 10 years in prison and a $250,000 fine, and will be required to register as a sex offender.

Dr. Shin, also known as Young Jin Shin and James Young-Jin Shin, resigned in May from the staff of John Peter Smith Hospital in Fort Worth, where he had been the chairman of the internal medicine department in 2004, according to his attorney, Bob Webster.

The U.S. Attorney’s Office said that when Dr. Shin allowed Immigration and Customs Enforcement agents to search his home computer in September 2007, he acknowledged that he used the Internet to download images and videos of minor children engaged in sexually explicit conduct.

“Some of the images of child pornography contained images of real children that have been identified through other law enforcement investigations throughout the nation,” according to a press release from the U.S. Attorney’s Office.

at 12:54 PM 0 comments
Wednesday, July 23, 2008

Medical tourism needs 5k-10k professionals in 5 years

NEW DELHI: With medical tourism in India expected to grow 30% annually till 2012, the demand for talent is going up at a brisk pace even as it opens up a whole gamut of job opportunities in the sector. Little wonder then that a full-time course in medical tourism launched by the Indian Clinical Research Institute (ICRI) has generated a great deal of interest in the medical fraternity.

India’s medical tourism is expected to be a $2.2-billion industry by 2012, up from the current $1.2 billion. Encouraged by the growth momentum, the government has launched medical visas to be given on a priority basis.

Estimates suggest that there would be a demand for 5,000-10,000 professionals specifically catering to this industry segment in the next five years. These would include international marketing professionals, patients relation managers, backoffice employees.

However, analysts believe there’s an acute need for infrastructure to train people in these functions. And there are no institutions offering such niche courses. “There is a great demand for such modules as the manpower requirement goes up and the need for specialised roles arises,” says ICRI HEALTH director, health service, major general (Dr) M Srivastava.

The course from ICRI would offer training in hospital services, financial management, marketing, OR techniques, costing and budgeting. Pricing techniques, hospitality & patient relation & conflict resolution, healthcare laws & regulations, health insurance & regulations, business ethics & corporate governance are also part of the course.

A major requirement, say experts, would also be for patient relation managers who can understand the needs of people from other geographies, their food habits, language and their comfort level.

Soft skills would be in great demand. Currently, individuals with a background in medicine deliver such services. As the need increases and the doctors become more engaged with the medical procedures, a different pool of people would be required to man those positions.

“Till now no institute offered such courses and the hospitals survived only on in-house resources and training,” says Apollo Healthcare and Lifestyle CEO Ratan Jalan.

at 11:35 AM 0 comments
Monday, October 1, 2007

Healthcare Issues in the World Today Despite incredible improvements in health since 1950, there are still a number of challenges, which should have been easy to solve. Consider the following:

One billion people lack access to health care systems.
Around 11 million children under the age of 5 die from malnutrition and mostly preventable diseases, each year.

In 2002, almost 11 million people died of infectious diseases alone, far more than the number killed in the natural or man-made catastrophes that make headlines. (These are the latest figures presented by the World Health Organization.)
AIDS/HIV has spread rapidly.

UNAIDS estimates for 2005 that there are roughly:
40 million living with HIV (most in Africa, 25.8 million)
4.9 million new HIV infections in 2005 (mostly in Africa, 3.2 million)
3.1 million AIDS deaths in 2005, (mostly in Africa, 2.4 million)
There are 8.8 million new cases of Tuberculosis (TB) and 1.75 million deaths from TB, each year.

Malaria causes more than 300 million acute illnesses and at least 1 million deaths, annually. More than half a million people, mostly children, died from measles in 2003 even though effective immunization costs just 0.30 US dollars per person, and has been available for over 40 years.
Source: WHO

at 2:35 PM 0 comments
US healthcare burden

In America, coping with sickness is all about making someone else cough up. To a degree, General Motors’ deal to shift retiree healthcare obligations into a trust managed by the United Auto Workers is a victory for both sides. GM has to fund a voluntary employees’ beneficiary association upfront, but at a discount.

The UAW takes on responsibility for its retired members’ healthcare costs, but this protects them from the risk that those very costs destroy the company that was funding them. This circularity boosts the Veba’s appeal: its creation raises future cash flow expectations, boosting the shares of the company concerned, in theory making it easier to fund the structure.

Does that portend a rash of new Vebas? Goldman Sachs estimates that even as the S&P 500’s collective pension deficit has, on one measure, disappeared, unfunded retiree healthcare obligations are about $289bn. That is, however, just 2 per cent of the index’s market value and exposure is very uneven: GM and Ford account for a quarter of the total amount. Certain other sectors, such as telecoms, also have big deficits. But they do not necessarily share Detroit’s other problems: a greying, unionised workforce and fear of bankruptcy.

America’s public sector, where unfunded healthcare obligations might top $1,000bn, also looks unlikely to embrace Vebas wholesale. Try convincing a civil servant that the government might go bust. And in the absence of listed stock, the Veba’s circular attraction disappears.

Fund managers hoping for a sudden windfall of new assets to be put to work, therefore, may be disappointed. Still, those Vebas that are created will need star performers: healthcare cost inflation is running in double figures. Might that prompt a big weighting towards riskier asset classes such as private equity? If so, it raises the intriguing possibility of retirees one day acquiring their former employers.

at 12:40 PM 0 comments
Tuesday, July 31, 2007

Why Medical Tourism? A growing 10 Billion Dollar Industry

Medical tourism is the practice of traveling to another country to obtain health care. The provider and patient use informal channels of communication-connection-contract, with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed. Services typically include elective procedures as well as complex specialized surgeries such as hip and knee joint replacement, cardiac surgery, dental surgery, and cosmetic surgeries.

Due to the high costs of medical treatment and surgery in the United States, the waiting lists in the United Kingdom, Australia and Canada and the lack of high tech medical procedures in many third world countries, medical tourism is expected to blossom into a ten billion dollar business world-wide. Recognizing this trend governments, large corporations, hospitals, and doctors are flooding the medical tourism market with choices, and prices are dropping in many countries world-wide.

The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism.

Medical tourists can come from anywhere in the world, including Europe, the UK, the Middle East, Japan, and the U.S. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care.

Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery.

Colombia provides a knee replacement for about $5,000 USD, including all associated fees such as FDA approved prosthetics and hospital stay over expenses. However, many clinics quote prices that are not all inclusive and include only the surgeon fees associated with the procedure

As the number of uninsured Americans grows, medical patients are now becoming consumers of medical care in record numbers. Many of these medical consumers are taking part in medical tourism i.e., people who leave the country primarily for medical treatment.

When a medical consumer searches for a provider, they tend to focus on the credentials of the doctor and forget about other important factors. Possibly the most important other factor is the country where the doctor and hospital are located. The country determines many things about the quality of care you will receive.

A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936

Factors that have led to the recent increase in popularity of medical travel include the high cost of health care or wait times for procedures in industrialized nations, the ease and affordability of international travel, and improvements in technology and standards of care in many countries of the world.

To understand the phenomenon of medical travel, we can compare the average costs of cosmetic surgeries between the industrialized nations and Latin America countries where medical tourism and cosmetic surgery tourism are becoming popular, such Argentina, Bolivia, Brazil, Costa Rica, Colombia, Philippines, Mexico. Prices quoted in the table below are from offices affiliated with the ministries of health in the U.S., Europe (France, Spain, Switzerland), Argentina, Bolivia, Brazil, Costa Rica, India, and Mexico.

Medical tourism carries some risks that local medical procedures do not. Should complications arise, patients might not be covered by insurance or able to seek compensation via malpractice lawsuits, though it should be noted that malpractice insurance is a considerable portion of the cost in the Western countries such as the US that allow doctors to be sued.

The most outspoken critics of medical tourism are U.S. malpractice lawyers who see this emerging trend as a threat to their livelihood. Some countries currently sought after as medical tourism destinations provide some form of legal remedies for medical malpractice. However, this legal avenue is unappealing to the medical tourist. Advocates of medical tourism advise prospective tourists to evaluate the unlikely legal challenges against the benefits of such a trip before undergoing any surgery abroad.

Those involved in medical tourism should seek a hospital in country where government inspections of the hospital are mandated and the standards are high. But just this mandate is not enough. After all the results of the inspections may be known to only a few. Government should also mandate that the results be made public. Such a practice is now law in Germany for German hospitals and other countries in Europe. Wouldn't the medical tourism consumer want to know the results? After all, hospital infection rates vary widely and give the consumer a good idea about how well the hospital is managed.

at 12:25 PM 0 comments
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Articles▼ 2008 (4)
▼ July (4)
Faces Of The Health-care Crisis
Scrap Medicare Fee-For-Service System, Doctor Says...
Southlake doctor pleads guilty to possession of ch...
Medical tourism needs 5k-10k professionals in 5 ye...
► 2007 (4)
► October (2)
Healthcare Issues in the World Today
US healthcare burden
► July (2)
Why Medical Tourism? A growing 10 Billion Dollar I...
Healthcare In Crisis?

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