Next Things First


Reform: Finally, Some Discussion of the Real Issues by Rob Coppedge

In light of all the distraction recently generated by discussions of health care IT (and even, cue the smoke machines, Health 2.0), I was very pleased to find Senator Tom Coburn, MD, and Regina Herzlinger’s piece in the Huffington Post.

In a week that for many of us has been dominated by reading the “wouldn’t-it-be-cool-ifs” of messenger bag-carrying technology evangelists, it was refreshing to see a call for a much needed national debate around the *real issues* facing the health care system.

With little fanfare, Congressional leaders may be near to agreeing on the most sweeping expansion of government in a generation – the de-facto takeover of the health insurance market by the government. Congressional Democrats are already icing the champagne. When the President’s “Medicare for all” plan is coupled with the budget, which contains a “down payment” of $634 billion over the next decade for health care, government-run health care may be inevitable.

All sides in this debate acknowledge that the U.S. has long needed easier access to health insurance. This need has gained urgency for the many Americans who are fearful of losing their employer-sponsored insurance in the midst of a recession. Unfortunately, the President’s plan will not only endanger the U.S. economy, but millions of patients as well.

They make clear that the issue here is cost containment. Or, perhaps better, that solving the “access” issue without controlling costs may be politically expedient but is a recipe for disaster.

The fundamental problem is that the President and congressional leaders lack realistic plans to control the health care costs that are already crippling U.S. global competitiveness. As a percentage of GDP, our businesses spend roughly 70 percent more on health care than competitors in other developed nations, yet we hardly receive 70 percent more in real value.

We talk a lot about cost containment – and in the world of health care venture capital, some of the most exciting investment opportunities address just this set of issues. But translating these decidedly market-focused ideas into terms that are politically palatable is difficult. Denying reimbursement for treatments, no matter their relative value or efficacy, has interest groups rushing to mount the barricades. However, as Coburn and Herzlinger point out, there is a risk of even greater hazard if we don’t engage the cost containment challenge now:

In the end, the Democrats’ health care reform will require drastic rationing… Consider Canadian patients, who may wait a year or longer to get radiation therapy. Or ask one of the nearly 1.8 million Britons who are waiting to get into a hospital or have an outpatient procedure. Or talk to the German breast cancer patients who are 52 percent more likely to die from the disease than Americans.

Concerns about rationing and patient outcomes are not demagoguery. How else can a government control costs in the real world? Many experts, including the Congressional Budget Office, dismiss as wishful thinking the Democrats’ claims of achieving efficiencies through bureaucrats’ dazzling implementation of information technology and other technocratic tools.

And this is where the real world collides with the health care technology bandwagon. It goes without saying that health care lags behind in the implementation of back office and administrative information technology. And certainly this is due in some part to all the factors that are debated regularly in the blogosphere. However, it is also due to the basic fact that there has been little ROI for physicians implementing these technologies.

I worry that we are just further confusing the issue. As my colleague Alan Buffington points out:

Isn’t it interesting that no matter how many times they are corrected, politicians and media folk refuse to distinguish between health care and health insurance.  Failing to make this distinction is what causes the problems discussed in the article.

If you watch the blogs, Twitter or CNN, you will have proof that the problem Alan points out is deep and widespread. The problem with health care is that it is “hard” – complex, path dependent, interlocking, huge, with substantial ethical and moral considerations. For most people (especially politicians),  this is way too much.

Posted by RobC

Share

Advertisements

3 Comments so far
Leave a comment

you have such a nic eblog thank for sharing

Comment by sam

Thank you Friends … To find it, I am very happy to be able to visit your blog, a lot of good information
interesting, I hope we can share information…

By.indri

Comment by indri

Finding the right sports books and bookmakers to use for your arbitrage sports betting can be a daunting task with the internet now they are everywhere. The list of crooked bookmaking sites that have helped part people with their money and robbed them of their winnings grows longer every day. Being enlightened about this all sports bettors should do their due diligence before signing up with any bookmaker and be sure of their reputation as well as their guarantees on return of winnings. Almost all sports betting sites will have reviews so read them before making your decision on which one you go with.

Still, there are tons of bettors looking through rose colored glasses for the holy grail of betting systems that will let them make money without risking any. Well, there is a way to do that and it is called work! Gambling is called gambling for a reason, it’s risky. Let’s take a look at some sports betting systems.
[url=http://www.pulsebet.com]football betting line[/url]
For quite some time the United States House of Representatives has been trying to pass a bill that will make it much more difficult for people to get away with breaking the online gambling laws. Not to mention stricter penalties for those who are caught.

So, having established that using a good Selection System is an absolute must if you want to make money from sports betting, how does the average Bettor actually go about making his/her betting selections? My research shows me that, in the main (ignoring the extremes), there are generally two approaches taken:

– The more conservative group looks at the “Short Odds” calls, and plays safe by selecting only those matches where they themselves feel very confident about the outcome.

– The more adventurous group analyses the matches and odds on offer, and then makes selections based on their own gut feeling about how the matches will turn out, making sure that the odds match their concept of a “value” bet.

Comment by FrancescaRivierra




Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s



%d bloggers like this: