Doctors are Not Terrorists, But…….

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Changing behavior is very complex.  Many management books, philosophical tomes, and academic psychology articles have been written on this subject, so I’m going to simply and quickly get to the connections among doctors, terrorists, and health reform.

1. Changing people’s behavior requires appealing to basic motivating factors. Different individuals have different motivators, but everyone has them.

2. Physicians are a key part of the healthcare system.  Improving quality and controlling healthcare spending will require physicians to do some things differently – particularly how they work with other clinicians (i.e., in teams), prescribe treatments, order tests, make referrals, and interact with patients and their families. …

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Congressional Accomplishments for 2009

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Why the Democrats are increasingly becoming politically vulnerable is a topic that pundits are dissecting in great detail.  A general consensus is that the root cause of the public’s growing discontent is a lack of progress on the economy and jobs.

While the economy and the job market have stabilized somewhat – even if they haven’t rapidly rebounded – the President and Congress haven’t gotten much credit for not letting the ship sink.  In addition, most of the President’s and Congress’ major accomplishments occurred in the first part of 2009, while towards the end of the year the focus shifted to the very slow moving health care bill – which also included many real and concocted controversies.…

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Historical Perspectives on Health Policy: Part 3

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I just found my copy of the book “Improving Health Policy and Management” edited by Stephen Shortell and Uwe Reinhardt.  The book’s eleven chapters address many of the hot-button issues in today’s health reform debate:

  1. Creating and Executing Health Policy
  2. Minimum Health Insurance Benefits
  3. Caring for the Disabled Elderly
  4. An Overview of Rural Health Care
  5. Effectiveness Research and the Impact of Financial Incentives and Outcomes
  6. Changing Provider Behavior: Applying Research on Outcomes and Effectiveness in Health Care
  7. Health Care Cost Containment
  8. Redesign of Delivery Systems to Enhance Productivity
  9. Medical Malpractice
  10. Prolongation of Life: The Issues and the Questions
  11. Challenges for Health Services Research

The observant ready will notice one critical issue from today’s debate missing from this list… Information technology. …

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Thanksgiving Conversations About Health – Engage With Grace Blog Rally

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For many years I’ve used the Thanksgiving dinner table conversation as a model for discussions about healthcare – but usually I’ve put it in the context of people who work for healthcare companies, (e.g. pharmaceutical or managed care), trying to address, rebuff and rebut the criticisms they might get from family members, (e.g. Aunt Lilly), about the problems with the US healthcare system and the actions or positions of various companies or industries.  However, last year – and again this year – several bloggers have been cooperating to promote Thanksgiving weekend discussions about end of life care issues.  This effort has been called the Engage with Grace, and last year it was a great success, with over 100 bloggers participating.…

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Making Health Reform Work

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With momentum for health reform continuing to build, events have overtaken the scope of the book I’ve been writing – which has had the working title “Fixing the US Healthcare System.”  Therefore, I’m reconstituting the draft text and outline to increase the focus on how to effectively implement changes in the healthcare system – while still discussing the substance of reform.  To highlight the need and importance of effective implementation, the new working title is “Making Health Reform Work.” (A one page summary of the book can be found here.)

“Making Health Reform Work” will be different from other health reform books by going beyond just describing the health system’s problems and recommending solutions, to also exploring processes for effectively implementing positive changes and reforms.…

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Humana on Health Reform

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Humana has added another “educational” to its YouTube series – this one is about “why do we need health reform.”

It’s a good question, and since I’ve been somewhat critical of other Human videos, I feel obligated to say that this one is OK – mostly because it doesn’t contain too much substance, i.e. it’s a mile wide and an inch deep.  And I do want to give the writers credit because the video starts by answering the question about what is health reform and why do we need it by stating, “The simple answer is…. Well there is no simple answer.”…

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Communicating Health Quality Measures

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Educating patients, (a.k.a. “consumers”), to make the “best” health care choices has been a fundamental principle in some health reforms schools, including those advocating for more high-deductible health plans.  While this concept makes sense in economic theories, it also requires belief that patients can and will make good use of the information available to them – particularly when they are ill.

Another fundamental necessity for making such consumer-directed healthcare work to improve quality and lower costs is that the information provided to people is meaningful and accurate.  A study published in the November/December 2008 issue of Health Affairs illustrates the complexity of providing accurate information.…

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Darwinian Politics of Health Reform in the U.S.

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Tomorrow is Charles Darwin’s 200th birthday, and the Economist had a very interesting article about how his original theories have evolved over the past 200 years – and how a greater understanding of human evolution have revealed insights into human society and economics.

One of the most interesting observations in the Economist article is the differing levels of belief in evolution among countries.  The article explains these differences as possibly arising from the country’s safety nets for vulnerable people, i.e., individuals who have less concern about being able to obtain food or housing may be less likely to believe in God and be more likely to believe in evolution. …

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Napping to Increase Productivity

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The New York Times had a great short report about a scientific study comparing a short nap to caffeine for improving a person’s memory.  The study found what many people have suspected for years – a nap is better than caffeine.

The benefits of napping are something that proponents of “power napping” have known for years. (Disclaimer: I’ve used the 20 minute power nap for years to re-energize and turn an afternoon impaired by a severe case of “the weakies” into several very productive hours.)

The study specifically found that naps were better for improving recall of a word list after both 20 minutes and 7 hours. …

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Humana Does Drugs

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Humana has put another couple of videos on YouTube in their ongoing series to explain – from their perspective – how the healthcare system works.

The first new video is “Insurance Companies and Prescription Drugs.” Like their other videos, this one paints the insurance industry’s as rosy and altruistic, while stating that “Prescription drug manufacturers are allowed to set their own prices, and they often build large profit margins into name brand drugs to recoup the costs of researching, marketing and advertising.”

This statement strikes me as very curious.  First, how do companies “build large profit margins into name brand drugs?”…

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Another Humorous? Humana Video

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Last week I wrote about Humana’s YouTube videos designed to “explain” parts of the healthcare system.  Well they just put another one titled, “Some Doctors Cost More. Why?”

Two interesting points about this video: First, at the beginning they describe  insurance companies (like Humana) as “Providers.” (The narration uses the term “health coverage providers,” but the graphic shows “PROVIDER.”)

While physicians and other clinicians really dislike being called providers, I think they wouldn’t want to see that term used for insurance companies either, since it implies that the insurance company is actually providing healthcare.  (I usually reserve the term provider to describe broad groupings of clinical entities, such as, “providers of oncology care in the Chicago area,” – which would include physicians, nurses, hospitals, etc…)

And second, the title and content of the video doesn’t focus on the total costs of care or services provided by individual physicians, but mostly only patients’ co-pays – which are lower when they use the physicians that are in-network for their insurance plan.…

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Managed Care/Health Insurance Direct-to-Consumer Advertising or YouTube Educational-Propaganda Videos?

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I saw a very interesting couple of videos today put on YouTube by Humana – the managed care insurance company.  Apparently they are the first in a series that they are calling “Stay Smart Stay Healthy.”  According to an email I got today promoting the second video, “Stay Smart Stay Healthy is a Humana new-media venture designed to deliver guidance, and to support awareness and understanding of the healthcare industry. Our goal is simple: to educate consumers on the healthcare system by removing the usual complexities and replacing them with an informative and engaging series of videos.”

While that sounds like good corporate citizenship, the actual content of the videos doesn’t seem quite so innocent.…

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