Uwe Reinhardt at Economix sums up health care policy proposals over the last decades(hat tip save the rustbelt) To describe the unifying theme running through these past variants, it is helpful to enumerate the major economic functions any health system must perform: Producing health-care goods and services. Financing health care, which involves extracting money from […]

Health Care thoughts: PPACA Employer Mandate Part 1 So I am trying to put together a template for evaluating the employer health insurance mandate under PPACA…. Some preliminary thoughts: 50 employees does not mean 50 employees, there as a Full Time Equivalent (FTE) calculation that is certain to confuse employers because it is different than […]

Health Care Thoughts: Accountable Care Part II Accountable care organizations (ACOs) are the keystone of PPACA  (Obamacare) as far as restraining costs and improving quality. Early this year there was great excitement about ACOs in the provider community, but the publication of the (first phase) Medicare ACO rules threw cold water on everything. The rules […]

by Tom aka Rusty Rustbelt Health Care Thoughts: Institute of Medicine recommendations The Institute of Medicine (IOM) an influential organization long known for criticizing health care providers and advocating reform, has issued process recommendations for deciding the “essentials” of health insurance plans. An essentials list is required by DHHS by 2014 for all health plans […]

Health Care Thoughts: No CLASS Act The Community Living Assistance Services and Supports, aka CLASS, was to be an integral part of PPACA (Obamacare), providing a funding source for some part of long-term care costs. When DHHS Secretary Sebelius declared she would have to fix the program because the poor design was not financially viable, […]

Health Care Thoughts: Please do everything you can…. …. to keep mom/dad alive. Physicians and nurses often dread these conversations. Any of us who have been on the family side of this know how agonizing it can be. And I know even mentioning this can cause a firestorm. However, there are some unsettling issues raised […]

As Rusty presents his short ‘thoughts’ on the administrative end of the national healthcare reform process, I noticed some readers have taken the problems he notes as indicative that the whole process is flawed and destructive. I do believe that is a wrong tack to take and will not serve to learn more of what […]

Health Care Thoughts: Draft Exchange Rules Published The Obama administration has published draft rules for the formation and operation of Affordable Insurance Exchanges, a key element in the PPACA (Obamacare) plan to increase insurance coverage. There is a 75 day comment and then more time to digest the comments before final rules are issued. Implementation […]

Health Care Thoughts: Non-Compliant Patients Ask physicians and nurses about their biggest clinical problems and non-compliant patients will likely be near the top of the list. And why should we care? Because non-compliant patients are huge cost drivers. Ezekiel Emanuel (MD, PhD, NIH) estimates that one-third of U.S. health care costs are driven by diabetes, […]

by Tom aka Rusty Rustbelt Health Care Thoughts: Accountable Care “Smackdown” Part II While the feds were developing regulations for Medicare ACOs, both the feds and the American Hospital Association were developing cost numbers for ACO start-ups. Today the AHA published its preliminary numbers, listing 23 major competencies to form and operate a hospital-based ACO […]