December 29, 2016
Medicare ‘value based pricing’ of health care is a perfect companion to a patient-centric model of safety to combat rising costs caused by error and quality fraud. http://www.nejm.org/doi/full/10.1056/NEJMp1616278?query=TOC
Quality Fraud Drives Medical Costs
Daraprim was first made available in 1952. It treats toxoplasmosis and cystoisosporiasis, diseases caused by eating undercooked food and other digestive problems – often with no detectable symptoms. Turing Pharma, operated by Martin Shkreli, bought this old drug in August of 2015, immediately jacking up the price of Daraprim from about $13 a pill to […]
Quality Fraud Drives Medical and Insurance Costs Up
In 1999, HHS announced 371 criminal indictments for health care billing fraud, up 61% from the previous year[1]. DOJ convicted 396 Defendants for health care fraud, filed 2,278 civil matters relating to health care fraud and excluded 2,976 providers from billing Federal programs like Medicare and Medicaid as a result of fraud[2]. These cases included […]
Some Child Left Behind
Five-year-old Abby Muszynski was born with a brain malformation that causes seizures and respiratory failure. http://www.cnn.com/2016/11/28/health/health-care-refugees-part-1/ Abby’s family is leaving Florida to get her proper health care. The Muszynskis’ older high school aged children will be left behind. Why are they doing this? Because Florida’s Medicaid program will not pay for Abby’s treatment. This dates […]
Medicare’s Repeal and Other Consumer Penalties
Instead of learning the obvious lessons from the HMO/PPO example (http://thethompsonlawfirm.net/access-to-healthcare/), industry leaders and their lobbyists in the nineties prevailed on the Florida legislature for a different solution – one that took more skin out of the hide of consumers. Industry leaders used an organized public relations campaign to pass “tort reform” and laws limiting […]
Medicare’s Repeal
When the Congress convenes in 2017, the first items on the agenda appear to be repeal of health insurance for 75 million Americans. http://nymag.com/daily/intelligencer/2016/11/paul-ryan-says-medicare-privatization-is-on.html If Medicare and the Affordable Care Act are repealed, pre-existing conditions would presumably be the law of the land at the same time that tens of millions lose their insurance. Those […]
Access To Healthcare
Without understanding the market in which you live and access healthcare, it is impossible to appreciate the value of the services being provided. This is why many people are worried when they become sick abroad or in a strange place. Our own healthcare market can seem like one of those strange places to many. In […]