Poll Shows Eroding Support for Health Reform

By Karen Pallarito
HealthDay Reporter

THURSDAY, Feb. 11 (HealthDay News) -- While half of Americans want some kind of health reform in the next two years, nearly 40% say it would be a good thing if the legislation proposed by the Democrats and President Barack Obama never materializes. And one-quarter aren't sure if health reform would be good or bad for the country, a new Harris Interactive/HealthDay poll finds.

"Essentially what they're saying is we want reform but we don't trust or like what we're seeing now," said Humphrey Taylor, chairman of The Harris Poll, a service of Harris Interactive.

While reforming health care is still important for many Americans, the most pressing issue is fixing the troubled economy, the poll found.

When asked to pick two top priorities for the President and Congress, about 8 out of 10 of respondents, regardless of their political persuasion, picked reducing unemployment and creating new jobs as a top priority over the next few months. Among Democrats, health reform came next (59%), while among Republicans preventing a terrorist attack in the United States (64%) took second place.

The Harris Interactive/HealthDay poll, conducted online Feb. 3-5, included a national cross-section of 2,075 adults 18 and older. Respondents represented all three major political affiliations: Democrats (35%), Republicans (27%) and Independents (28%).

John C. Goodman, president of the National Center for Policy Analysis in Dallas, which supports free-market health-care solutions, said the poll findings suggest that Americans have lost confidence in Congress and the White House.

When half of the public thinks no major reform is not a bad thing, "that's because they've been soured on this," said Goodman, asserting that much of the focus on health-care reform has been on its more painful aspects, such as how to pay for it, whose taxes to raise and what benefits to cut, rather than what people would gain from it.

"Eighty percent or more of people who have health insurance like the plan they're in, and when they read about the government dithering with their plan, they get apprehensive," he said.

Voters still want health reform, "but they don't trust this legislation," added Mark C. Blum, executive director of America's Agenda: Health Care for All, a coalition of business, labor union and government leaders. The process wasn't transparent enough, it was fraught with deals with special interests and, ultimately, consumers had very little understanding of the details of the reform proposals, he said.

"That's a big hurdle to climb when time is slipping away very quickly to pass legislation this year," Blum said.

According to the poll, only 13% of Republicans believe the President should keep trying now to pass health reform, while 68% say he should wait another year. Among Democrats, the opposite is true: 66% say he should keep pushing now and 18% prefer holding off for a year.

"The public is clearly split, with Republicans on one side and Democrats on the other, as to how hard the president should push for health-care reform," Taylor observed. "The president's stated intention to push ahead is likely to be popular with most Democrats, but will probably remain so only if he and Congress can deliver significant legislation. Failure to do so could be very damaging."

Independents are somewhat more inclined to wait for reform (45%) than forge ahead (39%).

While Independents helped elect Obama to the White House in 2008, the political winds are shifting, Taylor said. "That support has been eroding and eroded, so that actually on many issues the Independents look a bit more like Republicans than they do like Democrats," he observed.

Some other key findings from the poll:

Forty-two percent of all adults -- and roughly equal proportions of Republicans, Democrats and Independents -- say it's important to control out-of-pocket health-care costs and health insurance expenses paid for by the public and patients.

Sixty-one percent of Republicans say they don't want to see an increase in taxes to pay for health reform, compared to 21% of Democrats and 36% of Independents.

Fifty-two percent of Democrats say their top priority is ensuring that many more people have health insurance, compared to 30% of Independents and 16% of Republicans.

"Eighteen months ago, coverage tended to be as high or a higher priority than controlling costs, and now the two top items are both about controlling costs," Taylor noted.

Blum applauded Obama for trying to "reset" the health-care debate in recent weeks. The president has called for a bipartisan summit on health care that would be televised nationally on Feb. 25. But, Blum added, Republicans and Democrats are also positioning for the November elections, making true bipartisanship unlikely.

The best solution, Blum said, maybe for an independent bipartisan group to merge their ideas and challenge Congress to react. "Then we could get real constructive debate moving into the November mid-terms," he said.

Copyright © 2010 HealthDay. All rights reserved.












Poll Shows Eroding Support for Health Reform: Poll Shows Eroding Support for Health Reform

Predictions for 2020: Big tech's here to stay, digital health moves through Gartner hype cycle and more |

Our second edition on Digital Health Prospects for 2020

How HIPAA, investor funding, digital health commercialization, and other focus areas will be changing over the course of the new year.

Big tech isn’t going away — and its healthcare moves will only get bolder

This has become a perennial prediction, but it’s still an important one. Few people believe at this point that Amazon’s Amazon Care program will stay an employee experiment for long. We’re convinced it’s headed for a wider rollout that will see Amazon offering, or at least facilitating, telemedicine services, disrupting the supply chain for care the same way it has with so many other things. Exactly what form that will take remains to be seen, but healthcare is a market ripe for disruption and Amazon is well-positioned to get more involved in disrupting it, as indeed they already have with mail-order prescription delivery. We’ve heard surprisingly little out of Haven, Amazon’s joint venture with JP Morgan Chase and Berkshire Hathaway, but we suspect Haven and Amazon Care are pieces of the same puzzle. Some idea how Amazon intends to grow and dominate the market is the fact they have purchased the domain  (.care).  A visit to the Amazon Care Program Website reveals the comprehensive plan which is enabled by digital health apps.

Apple and Google may not be taking as direct a role, but we expect to see them slowly expanding their role as well. Apple continues to invest in a whole ecosystem of hardware and software around both health monitoring and mobile-enabled health research. Recent signals by Google that it may want to compete — including a new 510(k) clearance for the Verily Study Watch and the company’s acquisition of Fitbit — should only heat up Apple’s efforts.

As for Google, we had the opportunity to hear Google Health VP David Feinberg speak last week at the Startup Health Festival. After sharing several interesting AI projects the company is involved in around mammography and eye health, this is how he described the company’s vision:

“Fundamentally in 10 years, I feel like we'll be successful if we have helped the health care system in communities redesign health care. So it's actually centered around patients and families. I think we fundamentally have built the wrong system. And I think these tools can help us achieve that. How that looks, I'm not sure. But it will be more affordable. It will be much easier. The quality will be better. There'll be joy in being a caregiver. And health will be something that you don't have to worry about, because when bad stuff happens or if we can predict bad stuff, we can get you in the right direction.

Data privacy will remain in the spotlight, and HIPAA won’t cut it

The limits of HIPAA are a double-edged sword for big tech, something Google learned the hard way this year when news broke of its Ascensia partnership in a less-than-flattering way. The company was operating within the letter of the decades-old law, but that was cold comfort to patients alarmed that (A) Google had access to their data and (B) they weren’t notified.

At events like the HIMSS Security Forum in December, a growing chorus of voices saying that we need a new law — some kind of fusion of HIPAA and GDPR that protects patient data even if it didn’t originate in the health system (for instance, if it came from a direct-to-consumer wearable).

These concerns aren’t new, but that chorus is getting louder. We need something that gives patients more transparency into the hundreds of business associates agreements that permit hospital partners to use that data in increasingly novel and varied ways. We need a law that acknowledges the limits of de-identification.

For new entities entering the health care market, it will do well to have their legal counsel study the HIPAA rules regarding business associate agreements.  The health IT culture is very different from ordinary offerings in the way of apps

“Everyone’s concerned about what’s happening to their data,” Salesforce CMO Ash Zenooz told MobiHealthNews in an interview on the sidelines of JP Morgan. “And this is a global thing. GDPR tried to address that. But our healthcare data for our interactions with our providers and insurance companies lives in a place, but there’s a ton of other data about us that’s living outside that’s not protected by HIPAA. … Most of our data is sitting outside and that’s the data that a good part of that is going to predict what’s happening to a person’s health, and I think people are appropriately concerned about where that’s being utilized.”







MobiHealthNews' predictions for 2020: Big tech's here to stay, digital health moves through Gartner hype cycle and more | MobiHealthNews:

There is now a number, that you can't see, that follows you wherever you go.

Your Poorly Secured Medical Credit Score Could Deny You Care

Private hospitals are now consulting a secret medical credit score from Experian before you even see a doctor. As a patient you do not have access to this score, nor can you see how it is generated. All you know is that you may be denied care, or receive different care, because of it.  

In our backward health care system, neither the hospitals nor Experian see any potential issue with this. It helps a hospital's bottom line and that's what counts. They're actually pretty excited about it:

I spoke with Ashley Reede, information systems and privacy consultant, who worked with a private hospital in California as they were onboarding Experian's 'Financial Clearance' system. What she saw was quite upsetting and she wants people to know what's happening with their data.

"The revenue department came to me and said they were going to start sharing data with Experian," she says. "They wanted approval to send data from reception/patient admittance to Experian to check a medical credit score that's generated and assigned by Experian. Then Experian would send that score back to the hospital."

The Financial Clearance system combines medical records along with the financial records Experian already has on you to calculate the score. Since they have a network of hospitals reporting this kind of data, separate visits to different hospitals by a patient are no longer siloed. There is now a number, that you can't see, that follows you wherever you go.

"The central issue is that we don't have any actual transparency on what's in the record," says Reede. "I can't see what this is being evaluated on."

And have you ever found anything inaccurate on your credit report? The process to get it expunged is so onerous that many people just leave the false item on the report. But at least in that case you can see what other people see. With this new, arguably more important score, it's secret.

"What if you paid a medical bill and now it's reported that you didn't?" says Reede. "You'd be totally unaware that you have medical delinquency on your report. You have no recourse and you don't know what you don't know."

The Worst of a Bad Situation

Let's all keep in mind under what circumstances one would be approaching reception at a hospital. There is something wrong with your health, or the health of someone you love, and you're seeking medical care. Under these heightened circumstances, you now have to wait to see if a company thinks you're a good customer for them.

While Reede says this is likely not an issue for larger hospitals that have less financial pressure (although Kaiser Permanente uses this system), it's definitely appealing for smaller hospitals that will notice a hit to their finances if a patient defaults. She also points out that this is for private hospitals, not public.

But without any public pushback, it could conceivably be used for public hospitals as well. In a time where we seem to be burning down any regulation we can find and trying to privatize everything, this is a window into a possible future.

At Least It's Secure, Right?

There are security certifications that most big vendors of Experian's size have. Google, Salesforce, and AWS all have it, and they have dedicated teams that works year-round to get them. As part of her consulting with the hospital in California, Reede had to discuss this certification with Experian.

"Experian had issues with getting their certifications," says Reede. "There were discrepancies. They were having difficulty administering and patching servers within their environment. While that is a common occurrence in IT Security, it does create vulnerabilities and can create opportunities for data loss."

Experian's infrastructure that handles regular credit scores does have these certifications, but the medical score system did not.

We expect our personal data to stay at the hospital. We don't anticipate that it might be shipped to a less secure third-party.

Google reveals ‘Project Nightingale’ after being accused of secretly gathering personal health records

Google secretly gathered millions of patient records across 21 states on behalf of a health care provider, in an effort dubbed “Project Nightingale,” reports The Wall Street Journal. Neither the provider’s doctors nor patients were made aware of the effort, according to the report.

The Wall Street Journal’s Rob Copeland wrote that the data amassed in the program include “lab results, doctor diagnoses and hospitalization records, among other categories, and amounts to a complete health history, complete with patient names and dates of birth,” and that as many as 150 Google employees may have had access to the data.

The New York Times corroborated much of the report later in the day, writing that “dozens of Google employees” may have access to sensitive patient data, and that there are concerns that some Google employees may have downloaded some of that data

Standard Industry Practices, according to But Google tells The Verge that despite the surprise, it’s standard industry practice for a health care provider to share highly sensitive health records with tech workers under an agreement like the kind it signed — one that narrowly allows Google to build tools for that health care provider by using the private medical data of its patients, and one that doesn’t require patients to be notified, the company claims.

Many of health care entities attempt to partner with Google in order to use tools such as search, artificial intelligence as an API to harness tools not present in their EHR. This may well be all good in other industries however it is akin to opening Pandora's Box which contains your medical records.

It is doubtful that all the details have been carefully examined by HHS and HIPAA.

There is no more security than a file locked in a steel cabinet. The more complex a system is the more likely it won't work. To get at a file in the office the intruder breaks the door, jimmies the file cabinet and your records are exposed Once your data is digitized, sent to the cloud and many other entities the risks escalate enormously.

You do own your private data, BUT so do many other entities and hackers

Your Poorly Secured Medical Credit Score Could Deny You Care:

Healthcare - USAFacts

Our nation, in numbers:

Government data from over 70 sources organized to show how the money flows, the impact, and who "the people" are.

From health insurance to prescription drug prices, the cost of healthcare has been a political issue for decades. There’s a good reason for that: In 2018, $3.7 trillion was spent on healthcare-related goods and services, 18% of the nation’s gross domestic product. The issue encompasses several government programs, with Medicare (which primarily serves the 65+ population) and Medicaid (for low-income people) being the best known. Beyond government healthcare programs, private insurance is also an important aspect of this issue.

Covered by public or private health insurance

(%)National spending on healthcare goods and services

Healthcare Expenditures as % of GDP

Share of uninsured Americans increases for the first time since ACA went into effect, Census data shows

The number of uninsured Americans increased by 1.8 million between 2017 to 2018, increasing the percentage of Americans without health insurance by 0.6 percentage points.

The uptick represents the first increase in the percentage of uninsured Americans since 2014, when the bulk of the provisions of the Affordable Care Act went into effect.

The data was released by the Census Bureau Tuesday in its annual Health Insurance Coverage in the United States report.

How Americans get insurance

The individual mandate, a provision of the Affordable Care Act, was still in effect in 2018 requiring health insurance in lieu of paying a tax penalty. For 2019, the tax penalty was lowered to $0, effectively ending the individual mandate.

At the state level, 25 states had a higher share of uninsured in 2018 compared with 2017, with Hawaii and Idaho experiencing increases by more than 1 percentage point.

The share of those uninsured increased across age groups, excluding slight decreases for those 26 to 34 years old and those 65 and older.

The share of those uninsured, by age

Age group	% uninsured in 2016	% uninsured in 2017
Under 65	9.2%	10.0%
Under 19	5.0%	5.5%
19 to 64	11.0%	11.7%
19 to 25	13.7%	14.3%
26 to 34	14.0%	13.9%
35 to 44	11.4%	12.5%
45 to 64	8.3%	9.3%
65 and over	1.0%	0.9%

How does the census compile health insurance data

The US Census Bureau releases data on health insurance rates using two different measures. Its Current Population Survey Annual Social and Economic Supplement (CPS ASEC) is conducted between every February and April, asking respondents if they had health insurance at any point during the previous calendar year. Data used in this report from prior to 2016 had a different data processing approach to the post-2017 statistics.

The agency also asks about health insurance coverage in its American Community Survey. Unlike the CPS ASEC, that survey asks respondents if they are covered at the time of questioning. This data is used to provide estimates at the state and local levels.




Healthcare - USAFacts:

How to Choose Your Primary Care Physician

How-does-one-select-the right-physician-as-patient ?

This is not an easy thing to do..However, there is a plan which can help you decide.  If you are well established in the community you may or may not have your own physician and you can ask a friend or a fellow employee who their physician is and if they like them?  If it is for a general physical examination when you are well some experts feel the annual physical examination is almost useless.  There are recommendations for screening tests, such as mammograms, EKG, stress testing. Your family history also is important for diseases that can now be suspected with genetic testing. Breast cancer is one where a gene BCRA can be found. History is very important. Heart disease has no specific genetic markers, but testing for lipid disorders helps and can reveal increased risk factors. Other diseases are recommended for colon cancer (colonoscopy).

Here are 10 tips on how to choose the right primary care doctor for you.

1. Ask around.

The first step to finding a great doctor: Talk to your family and friends about their great doctors. A recommendation from someone you trust is a great way to identify a highly-skilled, helpful physician. But remember: Every person is different. Just because a doctor was perfect for your neighbor or your best friend doesn’t mean that he or she is right for you.

2. Map it out.

Since you’ll be visiting your primary care doctor for everyday health needs, it’s important that he or she be located somewhere convenient to you. You won’t want to travel very far when you’re not feeling good. And if your doctor’s office is conveniently located, you’ll be more inclined to keep appointments for physicals and other preventive care when you’re healthy. If you’re enrolled in a Medicare Advantage plan, check if it offers transportation benefits, which can come in handy if you need help getting to and from your doctor appointments.

3. Make sure you’ve got coverage.

Once you’ve identified some possible candidates, check whether they work with your health plan. If you have traditional Medicare, call the doctor’s office and ask if he or she accepts Medicare patients. If you have a Medicare Advantage plan, call your insurance provider or check your plan’s website to see if the doctor is in your plan’s network. Most plans charge more if you see a doctor outside the network, and some won’t cover out-of-network care at all, so it’s important to take this step before scheduling an appointment.

4. Do a quality check.

Chances are you wouldn’t hire someone to make repairs in your home without doing a little research into the quality of their work. So why would you choose a doctor without doing the same?

If you have a Medicare Advantage plan, check with your insurance company to see if they have any information about the quality ratings of specific primary care doctors in your network. You can also use the Physician Compare tool on Medicare.gov to see if your doctor has participated in any activities that indicate he or she provides high-quality care.

Finally, check to see whether your doctor is board-certified through the Certification Matters site, which the American Board of Medical Specialties maintains. Board-certified primary care doctors have not only met the licensing requirements of their states, but also passed comprehensive exams in internal medicine. Doctors also have to keep up with the latest developments in their fields to maintain their certification, so you can be sure they’re giving you up-to-date advice.

5. Place a cold call.

Castillo advises that patients call a potential doctor’s office for a first impression of the practice.

“You can tell a lot by the phone etiquette of the office staff,” Castillo said. “Ask if they’re taking new patients and see how they answer. If they say, ‘The next appointment is in 90 days, have a great day,’ that’s a lot different than saying, ‘He’s really busy, and we always make time for existing patients, so it might take us some time to fit a new patient in.’”

6. Ask about logistics…and consider scheduling an in-person meeting.

Castillo recommends asking questions during that initial call that provide a sense of how the office runs. How does the office handle prescription refills? How do they let you know about test results? Can you email your doctor or schedule appointments online? Will the office call to remind you if you’re overdue for an annual screening or a flu shot?

When Castillo was in practice, some patients would ask for quick in-person conversations before making an appointment. Not all doctors will be able to accommodate such requests, but it doesn’t hurt to ask.

7. Keep your needs in mind.

Every person has unique health needs, and those needs change as people age. Castillo suggests asking your doctor about his or her specialties or areas of interest.

“Some primary care doctors are really good at sports medicine, but if you’re not a serious athlete in your senior years, that may not be helpful to you,” Castillo said. “Some doctors, on the other hand, may have a special interest in diabetes care or have a large population of diabetics in their practice. Those are things to ask when you call.”

And if you have multiple complex medical issues, you may benefit from seeing a geriatrician, Castillo said. Geriatricians specialize in the care of older patients.

8. Look at the bigger picture.

At the first visit, it’s important to make sure your doctor’s philosophy of care lines up with your own. Consider asking these questions: Why did the doctor decide to go into primary care? What is his or her favorite thing about being a doctor? What does he or she wish more patients would do after they leave his or her office? If your doctor’s outlook on patient care meshes nicely with your preferences, you’ll be more likely to follow his or her recommendations in between appointments. So take this information into consideration when deciding whether to stick with a doctor following your first appointment.

9. Avoid culture shock.

Every culture has its own customs, ideas, and taboos about medical care, so find a doctor who not only speaks your language but is sensitive to your cultural and religious convictions.

“In some cultures, it’s very easy to joke around, and in other cultures, that is just not the way you do things,” Castillo said. “It’s important that your doctor is culturally aware.”

10. Trust your gut.

Your primary care doctor is going to be a problem-solver and an important advocate for your health. It’s critical that you trust him or her and feel comfortable asking questions.

The American Academy of Family Physicians recommends that after your first appointment, you ask yourself the following questions:

• Do you feel at ease with this doctor?

• Did you have enough time to ask questions?

• Did he or she answer all your questions?

• Did he or she explain things in a way you understood?

If something seems off, trust your instincts and look for a new doctor, Castillo advised.

“You should be comfortable with your primary care doctor,” Castillo said. “It’s really about what you expect and need. It’s OK to say, ‘This person is not the right fit for me.’”

Plans are insured through UnitedHealthcare Insurance Company or one of

There are four categories to evaluate in a primary care physician (Family doc, or GP)

Accessibility
Affability
Affordability
Advocacy

What to do

You can also ask the doctor what journals he reads and how often. If he questions why you want to know...tell him it is important to you to know he continues his medical education. Medicine is a profession that requires continuing medical education. Trust your gut reaction.  How do you react emotionally to a doctor?  Does he listen more than he talks? Or does he have a fast answer?  Good doctors pause and ask more questions.
If you are fortunate enough to live near a School of Medicine, check with them. Physicians in a university setting are well-vetted and work closely with specialists. The U.S. News publishes a list of best hospitals for specific diseases. The hospitals do not pay to be on this list.

What not to do

Avoid 'Best Doctors in America"
Avoid doctors who advertise on TV, Radio, Newspapers and even the Internet.
Avoid 'health screening' fairs". 

Listen to the Podcast from Peter Attia M.D.  If you like it subscribe to it.




























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