I intended for this post to be about the challenges of health reform; notably how government structure, culture and social differences, human and administrative resource capacity, corruption and other bureaucratic obstacles muddy the reform waters. Theory and empirical evidence simply isn’t enough to get a health system effectively, efficiently and equitably implemented. I planned to talk about the work of William Hsiao and other reformers with decades of real world experience dealing with such issues. Turns out I’ll get to that next week. A family friend who has been running a successful business for over 30 years wrote to me after the last post and asked sincere, critical questions about why health care markets fail and what differentiates these problems from all other industries. Because it’s a major economic topic, critical to understand and perhaps the most controversial, I’d like to devote one more post to it and other myths.
The first question is “What’s so different about information gaps between health care and all other goods, like cars?” To begin, health care deals heavily with life and death, unlike most other industries — so people aren’t necessarily rational, economic actors when they or family members are extremely sick. They’ll often do and spend whatever it takes to get cured, even when prices rise. The concept was discussed in the 2nd post and indicated that many (but certainly not all) health care procedures incite inelastic patient demand. The economic evidence for this is overwhelming. Now here’s where it gets important. Third party payers, or insurance companies, are there to help us pay for services that we can’t afford. When they foot the bill, patients don’t feel the full price tag and are more willing to buy additional services and spend more money that isn’t theirs. Coupled with inadequate information, they’re even more likely to consume extra health services when the doctor tells them it’s necessary. These two factors cause the price of health care to rise in a vicious cycle.
The second question is, “So why not have the insurance company pay a set fee to the doctor (ie capitation) and let the patients pay the rest? Doctors should charge what they want, and patients can pay out of pocket based on quality.” The answer: That’s a wonderful idea. The Mayo clinic does this successfully, provides top quality care and only takes privately insured patients. But throughout entire health care systems the quality and prices set by doctors and hospitals are very difficult to measure without transparent and sound information – which is why billions of U.S. dollars are actually being spent on this kind of research.
Posted February 26, 2010 by Ali Al-Rajhi under Guest Bloggers
(source: Johns Hopkins Bloomberg School of Public Health)
Tom Kirsch, MD, MPH, an emergency physician at Johns Hopkins Hospital and co-director of the Bloomberg School’s Center for Refugee and Disaster Responseis leading the first of twoJohns Hopkins Disaster Teams to Haiti. He has served in a number of other disasters, including the September 11 destruction of the World Trade Center towers in 2001 and Hurricane Katrina.
The team will be stationed at University Hospital in Port-au-Prince, where they will provide health care for those affected by the earthquake.
Dr. Kirsch will send updates from Haiti, which you can follow here or on the CRDR Facebook page.
Shopping the perimeter of your local grocery store and avoiding the aisles will give you a head start on fighting the battle of the bulge. “In most grocery stores, the aisles are filled with canned goods, frozen and boxed dinners that are loaded with fat and extra unnecessary calories,” said Gaye Lynn Hicks, RD, LD, with The Methodist Weight Management Center in Houston. “The perimeter features fruits, vegetables, lean meats and other healthy fair.”
Q. I have a coworker who has diabetes and possibly a very rare syndrome that could shorten her life significantly. She is very concerned about it and is trying to take good care of herself by exercising. However, every day at lunch she brings a plain sandwich of cheese and white bread and nothing else. I don’t feel it’s my place to say anything, but is there a polite and indirect way to suggest whole wheat bread and vegetables?
Sharing powerful stories from his anti-obesity project in Huntington, W. Va., TED Prize winner Jamie Oliver makes the case for an all-out assault on our ignorance of food.
About Jamie Oliver
(source: TED)
Jamie Oliver has been drawn to the kitchen since he was a child working in his father’s pub-restaurant. He showed not only a precocious culinary talent but also a passion for creating (and talking about) fresh, honest, delicious food. In the past decade, the shaggy-haired “Naked Chef” of late-’90s BBC2 has built a worldwide media conglomerate of TV shows, books, cookware and magazines, all based on a formula of simple, unpretentious food that invites everyone to get busy in the kitchen. And as much as his cooking is generous, so is his business model — his Fifteen Foundation, for instance, trains young chefs from challenged backgrounds to run four of his restaurants.
Now, Oliver is using his fame and charm to bring attention to the changes that Brits and Americans need to make in their lifestyles and diet. Campaigns such as Jamie’s School Dinner, Ministry of Food and Food Revolution USA combine Oliver’s culinary tools, cookbooks and television, with serious activism and community organizing — to create change on both the individual and governmental level.
Posted February 23, 2010 by Ali Al-Rajhi under Video Articles
Governments are increasingly turning to private insurance in order to widen access to health care and make it more efficient. Are they expecting too much?
OTTO VON BISMARCK believed that the ordinary worker “is unsure if he will always be healthy and he can predict that he will reach old age and be unable to work. If he falls into poverty, and be that only through prolonged illness, he will find himself totally helpless.” So in 1883 Germany’s Iron Chancellor introduced a health-insurance law that required both companies and workers to contribute to the costs of care.
Ali Al-Rajhi writes with the purpose of informing individuals in the Public Health field about pressing issues in environmental health, public health policy, epidemiology, and behavioral health. Learn more here.
