Friday, December 19, 2014

Top 25 Healthcare Blogs | Cision

Top 25 Healthcare Blogs | Cision

Covered California II

Enrollment for Covered California began one month ago, and will end on January 15, 2014. The online internet enrollment worked more smoothly and was easy to access. It functions fairly well and most of the time it proceeds without a hitch.

One problem I encountered was an inability to progress from {adding members}  to where the web page for adding new members. This attempt repeated itself a number of times when 'next' was selected. After several attempts the next page did appear, and the process proceeded without further difficulty.

The people who receive the 'best benefits/premium cost' are clearly in the Medi-Cal category if their income is at or below the poverty level. The web site performed fairly well with numerous pop-ups and drop down menu selection. Because of the relatively large number of selections and fields it was difficult to scan through deductibles, and/or co pays. The site allowed users to select and compare plans by checking the plans one wanted to compare.

The plans all have deductibles and co pays. The lower the premium the higher the copay and and deductible.  In many cases the insurance appears to be 'catastrophic coverage'  Common sense would make one wonder how many people could afford a deductible of $2500 to $10,000.

The financial algorithm was  designed by people who know little about health care or it's real expenses.  It seems the design was to fit health care into the budget process.

Jonathan Gruber, the principal economic adviser and designer is an expert in health economics at the macro level, and is no authority on patient care.  He has no medical experience or clinical credentials and is ignorant of patient-provider health process.  He had received numerous awards in healthcare economics.
Gruber has published more than 140 research articles (the majority of which were for NBER) and has edited six research volumes.[11] He is a co-editor of the Journal of Public Economics, an associate editor of the Journal of Health Economics, and the author of Public Finance and Public Policy.[12] In 2011, he wrote Health Care Reform: What It Is, Why It's Necessary, How It Works, a graphic novel delineating the Affordable Care Act, illustrated by Nathan Schreiber.[2]
An allegation and video content of Gruber testifying in several resulted in an eruption of public outrage and discontent.
In January 2010, after news emerged that Gruber was under a $297,000 contract with the Department of Health and Human Services, while at the same time promoting the Obama administration's health care reform policies, some conservative commentators suggested a conflict of interest.[18][19][20] Paul Krugman in The New York Times[21] argued that, although Gruber didn't always disclose his HHS connections, the times when he didn't were no big deal. 
In November 2014, a series of videos emerged of Gruber speaking about the ACA at different events, from 2010 to 2013, in ways that proved to be controversial. Many of the videos show him talking about ways in which he felt the ACA was misleadingly crafted and/or marketed in order to get the bill passed, while in some of the videos he specifically refers to American voters as ill-informed or "stupid." In the first, most widely-publicized video taken at a panel discussion about the ACA at the University of Pennsylvania in October 2013, Gruber said the bill was deliberately written "in a tortured way" to disguise the fact that it creates a system by which "healthy people pay in and sick people get money." He said this obfuscation was needed due to "the stupidity of the American voter" in ensuring the bill's passage.
Writings:
Gruber's published works include:
Covered California web site illuminates the copay/deductible inverse relationship and premium subsidy.  The working of Obamacare  obfuscates the ACA bill which was passed by the Democratic party.  Very troubling is  it did not include Republcan legislators in the design process. 



Contrary to Obama's proclamations many patients did not keep their physician,or hospital. Nancy Pelosi's uncannily accurate comment 'we won't know what is in it until we pass it'. Jonathan Gruber's "stupid" must also mean 'congress' was too stupid as well.


Portions of this article are attributable to 
New York Times, Covered California (online enrollment)






Monday, December 15, 2014

Mobile Health, Telemedicine and Walgreens

Walgreens app makes virtual doctor visits a reality


The service is immediately available to residents of California and Michigan and will be rolled out in other states in the next few years. Illinois residents should be able to use the app by the end of 2015.  Appointments cost $49, most of which goes to physicians. That fee is also not much more than a copay for an in-person doctor's visit through some insurance plans. “Some insurance companies cover telemedicine”, Leider said.

Walgreens is launching a virtual doctor visit feature on its mobile app, the company announced Monday. The nation's largest drugstore chain is teaming up with MDLive, a provider of virtual health services, to connect Walgreens customers with certified doctors via video chat on a smartphone, tablet or computer. 

"Consumers are demanding to do everything through mobile," Parker said. "Everything else they can do through mobile, and now they can do this too."

MDLive stands to gain 2 million people a day through Walgreens' mobile app and website. CEO Randy Parker said the company has 2,000 doctors available.
Last year Walgreens launched a Pharmacy Chat feature on its app to allow users to instant message with pharmacy staff. The company said it averages 9,000 chats a week.
"I think this will become a normal part of health care in three to five years," Leider said. "We have got some real forces that are going to make this very compelling."
He said a shortage of primary care physicians coupled with more people becoming insured through the Affordable Care Act means the market is growing for people who might find telemedicine useful.
Dr. Leider made the bold statement, “"I think this will become a normal part of health care in three to five years," Leider said. "We have got some real forces that are going to make this very compelling."
In October, Deerfield-based Walgreen announced a similar telehealth initiative partnership with health information website WebMD to encourage customers to increase exercise to earn discounts at Walgreens stores. The company said it now awards points on its Balance Rewards loyalty card for logging activities on the WebMD Healthy Target app.

The service is immediately available to residents of California and Michigan and will be rolled out in other states in the next few years. Illinois residents should be able to use the app by the end of 2015, said Dr. Harry Leider, chief medical officer  for Walgreens.  Appointments cost $49, most of which goes to physicians. That fee is also not much more than a copay for an in-person doctor's visit through some insurance plans. “Some insurance companies cover telemedicine”, Leider said.

"Consumers are demanding to do everything through mobile," Parker said. "Everything else they can do through mobile, and now they can do this too."

Chicago Tribune


Saturday, December 13, 2014

CellScope’s iPhone-enabled otoscope, remote consultation service launches for CA parents

Parents in California who have children who get chronic ear infections will soon have a more convenient way to get their kids care.


San Francisco-based CellScope, a Khosla Ventures-backed Rock Health alum, has begun taking preorders for its FDA registered smartphone-enabled otoscope,called Oto Home. The director-to-consumer device is priced at $79 and will ship in four to six weeks. A feature-rich, $299 version of the system, called Oto Pro, is also available for preorder now to physicians located anywhere in the US.

There are caveats in using this device and parents should be trained how to insert the scope. The Otohome will come with an FDA approved label for  users, the same as any FDA approved device or medication.

Friday, December 12, 2014

Buffaloed ?

Thanks to Martin Samuel M.D. I now know why the Canadian Health System works as well as it does.



According to him:

"Some years ago, I was acting as a visiting professor in Canada. I was discussing a patient with a disorder that I thought required a rapid, though not urgent, intervention. I was discussing the optimal timing of the intervention, when a chuckle arose in the audience. I inquired about why people seemed so amused and they told me that considerations of that type did not apply to this particular patient because he was going to be “Buffaloed.”
What could that mean, I inquired?
It means that this patient had private insurance and would go to Buffalo for the procedure rather than wait in the queue in the regular Canadian health care system. The reason the Canadian health care system works as well as it does (and that is not by any means optimal) is because 90% of the population is within driving distance of the United States where the privately insured can be Seattled, Minneapolised, Mayoed, Detroited, Chicagoed, Clevelanded and Buffaloed, thus relieving the pressure by the rich and influential to change a system which works well enough for the other people but not for them, especially when they are worried or in pain."
In the United States, there is no analogous safety valve so the influential simply demand a different level of care and receive it. This includes all the authors of the major books, articles and policies that have been written to repair our allegedly hopelessly expensive and error prone system. The array of suggestions is practically incomprehensible partly because there is a secret hypocrisy. Will the pundit actually use their proposed system themselves?
Whenever anyone writes about the rehabilitation of our health care system, they should be required to publish their own health care history, so the public can see where these experts obtain their own medical care. To protect their privacy, specific diseases need not be declared; just the method by which the pundit handled his or her own medical problems. This would be analogous to requiring that politicians reveal their income tax records or that academic doctors report any real or perceived conflict of interest when publishing a paper. Articles, proposals and laws written by anyone who is unwilling to publish his or her own health care history would simply not be considered or published. If just the leading newspapers and opinion magazines would agree to this system the degree of credibility of proposals for changes in our health care system would be dramatically improved.
Where will you Buffalo ?
My thoughts exactly, and Dr. Samuel expresses it so well
reprinted from The Health Care Blog
Martin Samuels is a practicing neurologist and founder of two Harvard-affiliated neurology departments. He holds a membership in the American Neurological Association, a fellowship in the American Academy of Neurology and a mastership in the American College of Physicians.

Wednesday, December 10, 2014

Did Jonathan Gruber mean Congress is Stupid

Congress just completed it's hearing on the economic planning prior to  the passage of the Affordable Care Act.  The keynone witness was Jonathan Gruber, PhD, whose credentials include MIT.

This is a continuation of our last post here.


Gruber, who most know was the  financial economic planner for Obamacare.  Any clinician and hospital administrator knew that Obamacare is the 'Kool Aid' for liberals wishing  for change and hope. Since Obamacare became law insurance deductibles tripled.

Darrell Issa, chairman of the committee quizzed Gruber and pointedly, asking him if he  was "stupid'. Gruber, who is obviously smart enough  to be at MIT. Gruber responsed, no he was not, but smart people make stupid comments or decisions.  Jonathan Gruber, PhD is a  theoretical economist, observing and making decisions from orbit, with no clnical expereince based upon reality.

Wikipedia's article on Gruber includes the following,

"An American professor of economics at theMassachusetts Institute of Technology, where he has taught since 1992. He is also the director of the Health Care Program at the National Bureau of Economic Research, where he is a research associate. An associate editor of both the Journal of Public Economics and the Journal of Health Economics, Gruber has been heavily involved in crafting public health policy. He is an academic professor of economics at MIT


He was a key architect of both the 2006 Massachusetts health care reform, sometimes referred to as "Romneycare", and the 2010 Patient Protection and Affordable Care Act, sometimes referred to as the "ACA" and "Obamacare".[1]He became the focus of a media and political firestorm in late 2014 when videos surfaced in which he made controversial statements about the legislative process, marketing strategies, and public perception surrounding the passage of the ACA.

Most of the Affordable Care Act is based upon Gruber and President Obama's face-to-face meetings. It failed the self-proclaimed promise of openness and transparency promise of President Obama"