Health Care for a Changing Work Force
By DAVID BORNSTEINFixes looks at solutions to social problems and why they work.
Tags:
Carolyn SilveiraSara Horowitz, the founder of the Freelancers Union, addressed union members at a 2009 forum on the issues affecting independent workers.
Big institutions are often slow to awaken to major social transformations. Microsoft was famously late to grasp the importance of the Internet. American auto manufacturers were slow to identify the demand for fuel-efficient cars. And today, the United States government is making a similar mistake: it still doesn’t seem to recognize that Americans no longer work the way they used to.
Costs of Health Care Administration in the United States and Canada
Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D.
Rethinking Health Care
To the Editor:
I agree with Dr. Ezekiel J. Emanuel about the need to abandon the fee-for-service model with its bizarre incentive system that rewards maximal use of services often to the detriment of patient care (“Saving by the Bundle,” Sunday Review, Nov. 20).
He is also right that the current system of billing results in too much time, energy and, of course, money spent in collecting fees (“Billions Wasted on Billing,” Sunday Review, Nov. 13).
Health Official Takes Parting Shot at ‘Waste’
By ROBERT PEAR
WASHINGTON — The official in charge of Medicare and Medicaid for the last 17 months says that 20 percent to 30 percent of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.
The official, Dr. Donald M. Berwick, listed five reasons for what he described as the “extremely high level of waste.” They are overtreatment of patients, the failure to coordinate care, the administrative complexity of the health care system, burdensome rules and fraud.
“Much is done that does not help patients at all,” Dr. Berwick said, “and many physicians know it.”
What About Premium Support?
As the election campaign progresses voters can expect to hear a lot of hype — and if we are very lucky some good ideas — about how best to “reform” Medicare. It will take stamina and well-honed skepticism to sort it all out.
Republican politicians are touting the virtues of market competition and calling for a “premium support” plan that would give beneficiaries a set amount of money to shop among private plans for their own insurance. What they do not say is that private plans have long been more costly than traditional Medicare and have shown far less ability to slow spending. Nor do they admit that the most extreme versions of premium support — like the one championed by Representative Paul Ryan — would save the government money mainly by shifting costs to the beneficiaries, who would have to decide whether to forgo treatments or pay more for coverage.
No comments:
Post a Comment