Washington launches online tool that lets patients compare prices for medical procedures

Interested in knowing a bit about how to much you might pay for a procedure?  Check out the emergency room prices both from Jefferson Healthcare and surrounding areas. Finally we are seeing the curtain being pulled back on our hospital pricing, which many of us have known is overpriced for many standard procedures.  Our elected hospital commissioners, have claimed  that this kind of comparison was not possible to do. The Governor has had it done.

https://www.wahealthcarecompare.com/procedure/emergency-room-visit?zipcode=98368

If you or a loved one needed knee replacement surgery, would you want to know which surgeon in your community has the highest rating for quality of care? Would you like to know how much a knee replacement costs, on average, at all of the medical offices close to your home?

Those are the types of information easily accessed through Washington state’s new HealthCareCompare website, an online tool that launched today. The user-friendly website is part of the state’s larger effort to make health care costs more transparent, and gives the public access to health care price and quality information from the Washington All-Payer Claims Database. The database is the result of legislation proposed by the governor.

https://www.governor.wa.gov/news-media/washington-launches-online-tool-lets-patients-compare-prices-medical-procedures

 

Insulin prices skyrocketing -Washington Post

The Washington Post has an interesting article on the issues of skyrocketing insulin prices. If you are a Jefferson or Clallam County resident and having a hard time affording your insulin, I would like to know. Would like to look at the scope of the problem here in on the Peninsula.  Contact me at Al_inPT@outlook.com

www.washingtonpost.com/news/magazine/wp/2019/01/07/feature/insulin-is-a-lifesaving-drug-but-it-has-become-intolerably-expensive-and-the-consequences-can-be-tragic/

In states, Democrats start delivering on health care pledges – Chicago Sun Times

The outcome of the Blue Wave of November is starting to be felt. The article, while from Chicago, opens with Washington State and California as examples. In case you haven’t been following, newly elected Governor Gavin Newsome is off to an incredible start. He ran on healthcare as a major issue, and is already starting to deliver.

https://chicago.suntimes.com/news/democrats-midterm-election-campaign-promise-health-care-affordable-healthcare/

2019 WA State of Reform Conference Speaker Presentations now available

On Thursday the 2019 Washington State of Reform Health Policy Conference was held, with what was billed as the most diverse convenings of health care executives and health policy leaders in the state.  If you have a special interest in some area of healthcare, you’ll likely find it listed here.

Here are some of the presentation materials from the speakers at the event.

https://stateofreform.com/news/states/washington/2019/01/speaker-presentations-now-available-from-2019-washington-state-of-reform-conference/

 

V.A. Seeks to Redirect Billions of Dollars Into Private Care – NY Times

Whatever could go wrong with this proposal? Everything. A long time goal of the Koch Brothers and the Libertarian right wing,  the Trump administration seems bent on carrying out this ill advised plan. If you are a vet, and value the notion of being supported for your health costs in the future, you better come out against this now. The proposal shifts money from a low cost federal government model to a high cost, low value private world of care where you will be milked for your savings. This is a recipe for disaster. What might be done to fix the situation? Shift money from military spending to the V.A. It would cost far less. One less fighter would add billions to the V.A. now. No new taxes needed. But I’m not a vet. Ultimately, it’s not my battle. It’s yours. I’ll remind you of a quote from a Republican operative, Grover Nordquist”,”

“Our goal is to shrink government to the size where we can drown it in a bathtub. “

 

The Deteriorating Administrative Efficiency Of The U.S. Health Care System – PNHP

As we start 2019, I thought I would bring in some fundamental issues that we have been facing and continue to face, both in Jefferson County and nationwide. In reading through a variety of articles recently, I came across a couple of articles that pretty clearly identify the state of healthcare in the US.

The first is an old study, but one that has been updated and used frequently in presentations. Lest start with the original study first.

The Physician’s for a National Health Program published a 1991 study from the Harvard School of Medicine that validates what many of us, the critics of modern hospital management, have been instinctively feeling all along. The situation, updated in a more recent slide deck, here, gives the current situation.

The problems of hospital administration are endemic. You can hear it every time there is a hospital commissioner meeting each month. Only good news is presented. Bad news is couched in doublespeak if it’s ever raised at all.  No mention of the medical bankruptcy rates in Jefferson County (they are on the rise). Never raise issues that are problems or concerns or face being ostracized by your peers. From executive suites of hospital management making vastly more money than the surrounding towns they serve, to the rubber stamps of hospital commissioners that simply are uninformed and  like staying that way, or aren’t willing to challenge anything of a controversial nature, to medical professionals who cosy up to the administration to make themselves feel better about their positions of authority and stop any change agents ending up as hospital commissioners. It all feeds the continuation of a system that is fundamentally out of control on costs. It’s not just JHC it’s the whole broken system.

Here’s the underlying data sets of one aspect of our current, deeply broken system.

The 1991 study found that “the spending on hospital administration is 117% higher than Canada and accounts for about half the total difference in healthcare spending between the two nations…If healthcare in the United States had been as efficient as Canada’s between $69 to $83 Billion dollars would have been saved. ” It has only gotten much worse since then.

Enough to pay for healthcare for all Americans without cutting the beloved military budget that so many Americans feel is beyond questioning, even as it consumes more than half of all governmental expenditures.

It goes on to state: “Recent health policies with the avowed goal of improving the efficiency of care have imposed substantial new bureaucratic costs and burdens.”

There are other issues at work beyond this, such as pharmaceutical costs, etc, but this goes to the core of this leg of the stool. Perhaps the stool should have three legs, For Profit Insurance Companies, Pharmaceutical companies, and hospital administration. But read it yourself and draw your own conclusions.

“CONCLUSIONS: The administration structure of the United States healthcare system is increasingly inefficient as compared to that of Canada’s national healthcare program. Recent health policies with the avowed goal of improving efficiency of care have imposed significant new bureaucratic costs and burdens.”

http://www.pnhp.org/publications/NEJM5_2_91.htm

The data has been updated through 2014 with data from the Department of Labor Statistics. It only got vastly worse since 1991. What happened between then and now? Well, computer use exploded. Is that the problem? During this time we also had both Democratic and Republican Presidents and Congress. And we had an explosion of medical insurance growth.

growth of physicians and admin

This recent study covers updated information related to hospital administration costs.

Medical Spending Differences in the United States and Canada: The Role of Prices,

Procedures, and Administrative Expenses

Abstract

The United States far outspends Canada on health care, but the sources of additional spending are unclear. We evaluated the importance of incomes, administration, and medical interventions in this difference. Pooling various sources, we calculated medical personnel incomes, administrative expenses, and procedure volume and intensity for the United States and Canada. We found that Canada spent $1,589 per capita less on physicians and hospitals in 2002. Administration accounted for the largest share of this difference (39%), followed by incomes (31%), and more intensive provision of medical services (14%). Whether this additional spending is wasteful or warranted is unknown.

The United States spends nearly twice as much per capita on health care as Canada: $7,290 per person in the United States in 2007 compared with $3,895 per person in Canada (aOrganisation for Economic Co-operation and Development [OECD] 2009a).

Despite this higher spending, however, U.S. health indicators continue to lag behind those of Canada. In 2006, infant mortality was 6.7 per 1,000 live births in the United States, compared to 5.0 per 1,000 in Canada. In the same year, life expectancy at birth was 78.1 years in the United States and 80.7 years in Canada (OECD 2009a)

…Some studies stress administrative expenses; estimates suggest that U.S. administrative costs are 46% to 71% higher than Canada’s (Aaron 2003; Woolhandler, Campbell, and Himmelstein 2003). Other studies propose that higher prices paid for services are the primary driver of greater spending (Anderson et al. 2003). Pharmaceutical costs are higher for branded drugs (Danzon 1992; Graham and Robson 2000), and physicians earn more in the United States as well (Newhouse 1992). Still other studies have examined the volume and intensity of health care services received.

another study, from Princeton

http://www.princeton.edu/~ota/disk1/1994/9417/941705.PDF

Hopefully, if you have interest in this issue, you can look through these studies and come to your own conclusions. Some critics state that we won’t get better healthcare by having single payer or some other blanket coverage. I’m unclear, given the current system and it’s documented bad outcomes compared to other countries, how this is possible.

But it seems increasingly like only those who can afford healthcare get it and an increasingly large share of Americans can’t afford coverage, or get coverage and become impoverished by being taken to court to pay for services that they never could afford in the first place. By the way, both here in Jefferson County and nationwide, medical bankruptcies are on the rise. They are unheard of in all other industrialized countries.

If you are worried about this state of affairs and want to do something about it, there will be an election for Matt Ready’s seat this year.

The surprising reason drug prices are on the rise – VOX

Background: Many people in Jefferson County have been discussing the rising price of drugs, including retired physicians, pharmacists and patients. While the President has made bold statements that have never materialized into actions, (and only seem to provide a buying opportunity to purchase drug stocks at a discount during the 24 hours after the tweet), the industry has chosen to continue to raise it’s prices. Many horrific stories are starting to appear on NPR and the mainstream media.

Here’s an overview of some ideas on why this is happening.

https://www.vox.com/policy-and-politics/2019/1/7/18172678/how-much-drug-prices-rise-voxcare