This story from PBS Newshour clearly shows how important it is to ask questions, and shop around, when it comes to prescription drug prices. Think a generic drug guarantees a lower price? Not so much. Watch this story, and learn how the same generic drug can cost anywhere from $11 to $455. The best way to get the lowest price? The same way you shop for shoes, or appliances: research online, ask local retailers, and make an informed decision.
I attended the 2nd edition of the bill conference in Richmond VA today (for the record, that’s Saturday, April 6, 2013), and wound up kicking off the talks with what’s become my core topic: #howmuchisthat, healthcare edition. That link goes to the hashtag’s home on Symplur, the healthcare hashtag registry that’s also a veritable time-sink of terrific healthcare thought leadership. Including healthcare data visualization. You’re welcome. Why is this a topic I care so much, and know so much, about? I believe that in all the hot air that’s been expended in the discussion about healthcare and healthcare reform in the US – and boy, howdy, is that some hot air! – very little shrift is given to how consumers (commonly called “patients”) can effect grassroots change themselves. The firehose below takes a wander through the history of US healthcare, particularly from the cost angle, and resources that the average human can use to start figuring out, ahead of time, how to assess the value (medical and fiscal) of their healthcare options. Here’s the firehose. Steve Brill’s epic TIME piece, Bitter Pill pack a lunch, it’s the longest article TIME has ever published My take on where Brill missed the mark on his “fix this mess” recommendations A Feb. 12 post that raises Brill’s issue in what I think of as a great-minds-thinking-alike synergy My health econ guru Uwe Reinhardt’s Chaos Behind a Veil of Secrecy article in January 2006 edition of Health Affairs A post that includes intel on the RUC and the LA Times piece – both of which I mentioned in my verbal firehose A NY Times story on the unintentionally hilarious 2013 report in JAMA (Journal of the American Medical Assn.) on the wide disparity in pricing for hip replacements in the US – the RUC is an AMA committee! Society…
Hang on to your hats – this one might wade into controversy. As I write this (3:30pm EST on January 1, 2013), I’m listening to a conversation on NPR about the Emancipation Proclamation, which was signed into law by Abraham Lincoln 150 years ago today. I’m also reflecting on a couple of movies I’ve seen in the last 45 days: Lincoln (over Thanksgiving weekend) and Django Unchained (on Christmas Day). Is it time for an emancipation proclamation for patients? Or should we just saddle up and have a shootout at the plantation … um, hospital instead? Too many healthcare transactions are still conducted over the patient’s supine form. Doctors, hospitals, and other entities in the “provider” column horse-trade with health insurers, including Medicare, in the “payer” column. That means that the patient winds up shackled. No say in how much something costs, no real voice (yet) in what happens next, little interest on the part of the two trading entities in clueing us in to what’s happening. Some of my connections in the participatory medicine/e-patients movement use a driver-rider metaphor for transforming healthcare, with the patient moving from passenger to driver in healthcare. It’s a less controversial/confrontational metaphor than referring to patients as chattel on the medical plantation. However, I’m sticking with that plantation metaphor for the moment, because too many in the provider and payer camps are still viewing patients as meat puppets, not as full participants. Does healthcare need an emancipation proclamation? Yes. Here’s where the metaphor shifts: let’s not wait for someone to proclaim us (patients) emancipated. Let’s break our own chains, and be our own liberators. Let’s demand that the providers and the payers give us an equal seat at the table, and then let’s … LEARN EVERYTHING WE CAN TO BE PRODUCTIVE CONTRIBUTORS TO THE HEALTHCARE SYSTEM. That last statement is…
Accountable care. That’s one of the central pillars of healthcare reform/Obamacare/the Affordable Care Act. Given that Obamacare is built on transforming Medicare, the payment system from which all Holy Billing Codes and the pricing attached thereto flow, Accountable Care Organizations (ACOs) would seem, given their name, to be about accountability for care, right? Not so fast. The “accountable” in ACOs has more to do with accounting than accountability. An ACO is defined as a network of doctors and hospitals that shares responsibility for providing care to patients. In essence, that network agrees to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years. The ACO is indeed accountable for providing care, yet that 5,000-Medicare-beneficiaries-for-three-years is as much about accounting as it is about patient care. Real accountability in healthcare is an elusive thing. I’ve said many times that there are no guarantees in medicine, other than that there are no guarantees in medicine. That does not mean, though, that we should expect mistakes. Medicine is a human effort, with human failings embedded within it. We should help ourselves, and the medical-industrial complex, though, by taking advantage of the information available to us – patients, providers, all of us – to determine where to get the best and safest care. jeopardy clue tileAccountability, in the accountable-actions definition, was codified in a California law that went into effect on January 1, 2007. That law gives the California Dept. of Public Health the power to fine hospitals up to $100,000 per event for what they call “immediate jeopardy”, which is defined thus: An immediate jeopardy is a situation in which the hospital’s noncompliance with one or more requirements of licensure has caused, or is likely to cause, serious injury or death to the patient….
WEGO Health is an online network of people from across the globe who use the internet and social media to connect around health and share health information. WEGO calls us Health Activists, and they’ve created a special awards program to recognize those Health Activists who are making a real difference in the online health community: click here to find out all about it. Health Activists are doctors, patients, caregivers, family members, any and all folks who care about their own health and the health of their families and communities. I’ve signed up to be an Awards Ambassador – that means that I’m doing what I can to share the WEGO Health Activist Awards with my audience to make sure that all Health Activists are recognized for the efforts they make every day. Take a spin over to the nominations page and recognize your favorite health leaders. There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend. WEGO Health has 12 different categories so everyone should fit somewhere! Is there someone who inspires you to get and stay healthy? Is there someone whose online presence helps you manage a chronic condition? Is there a healthcare professional in your life who has guided you, your family, or your community toward better health with their work on the web? Nominate ’em! There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend. WEGO Health has 12 different categories, so there’s a slot fo any kind of online Health Activist! So go on – NOMINATE!
The American College of Medical Informatimusicology (ACMiMiMi) has launched a hit!
I was born in one of the Chinese zodiac’s Years of the Dragon. I am a fire sign – Leo – in western astrology. I’m fierce, and I roar frequently. I have often been accused of being a fire-breathing dragon. Those who said that aimed at criticism. I took it as praise. #HAWMC Day 24 – today – I am asked to create a mascot for myself and my health activism. I’m a dragon. Of course I’m a dragon. I embrace my dragon, and my ferocity.
I have taken both of my #post #fail days for #HAWMC, so I gotta really slave to the grind thru the next 10 days. That said, today’s prompt involved going to Madlibs Poem generator, filling in the blanks (be prepared, there are many!), and hitting “go!”. I went. This was the result. I surrender I spread you up inside my party. funny cancer’s funny cancer I swim my wings and all the walls prays books; I shake my gardens and all is fight again. (I surrender I spread you up inside my party.) The wines go releasing out in crazy and fierce, And foggy beer opens in: I jump my fear and all the humor flys tree. I runed that you leaned me into flower And bend me scary, walked me quite free. (I surrender I spread you up inside my party.) sun leaps from the moon, surfboard’s mountains soar: dive ocean and sailboat’s train: I jump my fear and all the humor flys tree. I surfed you’d bounce the way you look, But I see beautiful and I hear your jet. (I surrender I spread you up inside my party.) I should have speaked a submarine instead; At least when parachute roars they scream back again. I jump my fear and all the humor flys tree. (I surrender I spread you up inside my party.) – Mighty Casey & Sylvia Plath
There are five people for whom I would walk over broken glass, if on the other side of said glass was a dinner table set for six, with them waiting for me. Here they are, in no particular order: Marie Curie My mother was a stone-cold science geek. One of her inspirations was Madame Curie, who literally gave her life to her scientific research. I’d love to ask Mme. Curie what it was like to be a brilliant scientist and a woman at a time when women were supposed to be mere decorative objects or domestic drudges. I’m sure her self-told story would be incredible to hear. Oscar Wilde What can I say? I’m just Wilde about Oscar, always have been. His sharp wit, his inability to truck with idiots, his life-long search for beauty and intellectual stimulation, along with a good laugh, tell me that he and I would be instant BFFs. I would love to hear his take on social media. And the Kardashians. Tenzin Gyatzo Who’s that, you say? The Dalai Lama, kids. Actually, I kinda did have dinner with him once, in a sushi bar on Rt. 7 in Arlington, VA. I was in there on a busy Saturday night with my sister, and we were negotiating seats at the sushi bar – the place was packed – when suddenly there was a noticeable shift of all eyes to the big group waiting in line behind us. In the middle of that group was a bright-eyed guy in saffron robes. Yep, the Dalai Lama. We got our seats at the sushi bar, and he was seated immediately at the owner’s table. Boudica You don’t know who she is? She faced down the Roman Empire in what is now Wales back in AD 60 or so, and…
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