When Obama and neo-liberals say middle-class they mean about $250,000 and climbing. The other 95% will get this Medicaid-level preventative care with third world clinic care. That is what expanded Medicaid is all about!
I stated last time that a health care system with the likes of Carlyle Group, General Electric, and Lockheed Martin is likely not about giving quality care for all. We thank Colin Powell for coming out for Expanded and Improved Medicare for All. Let's look how corporate Obama has gone and how to reverse this ridiculous policy.
Obama has privatized most Federal agencies more than Bush and now he is getting rid of the Federal programs....Medicare and Medicaid. While acting as though he is compromising and shoring up these programs he is creating the structure of privatized systems throughout this Federal health agencies. We see it on steroids in Maryland as Johns Hopkins makes Maryland health care all about global corporations ready to suck all the money left from the entitlement trusts----health fraud skyrocketing to subprime mortgage fame!
As we see in Maryland the problem first and foremost is that Medicare expansion was the easiest and justice approach to this health care reform. Vermont did it and we will watch to see if they carry through with public interest or marginalize the public. The second problem was the fact that none of the neo-liberals elected and/or appointed to do the job have any talent....they simply graduated from an Ivy League school for the most part and got the job through the 'who you know' naked capitalism. NO TALENT, just the willingness to LIE, CHEAT, AND STEAL and the willingness to embrace the 3 monkey syndrome of SEE NO EVIL, HEAR NO EVIL, SPEAK NO EVIL.......
THIS IS THE RECIPE FOR DISASTER! Everything that is public policy in Maryland is a disaster....education, environment, health care, transportation......
This is what ACA is creating.....US health insurance corporations are tying to health care abroad and US health systems are building their global health corporations to tap this market. So, Johns Hopkins has a health business in India that markets health tourism and does business without any US government accountability. Meanwhile, the huge medical campus built when billions of dollars in taxpayer money will be a global corporate headquarters managing this system with affluent foreigners coming in to access care while you and I head to an ever devolving MedStar or clinic health. Note that the health insurer is paying to fly US citizens to India for procedures....see where all the money is going. Who is getting these health insurance policies? The 5% of people in the US who will be able to afford the kind of health care we all had before BUSH/OBAMA.
Medical Tourism - Medical Travel Abroad - USA - Health Tour India - Overseas Surgery - Surgical
Tour...www.healthbase.com
Bad management plagues Obamacare: Ex-Obama advisor
Published: Friday, 25 Oct 2013 | 10:46 AM ET By: Matthew J. Belvedere | Producer, CNBC's "Squawk Box"
Obamacare 'CEO' needed, says ex-Obama health adviser Friday, 25 Oct 2013 | 8:12 AM ET
Dr. Ezekiel Emanuel told CNBC the goal when fixing the tech problems on the federal Obamacare website should be to create an "Amazon-like shopping experience." The technology problems with the federal Obamacare website were a function of poor management and implementation, said Dr. Ezekiel Emanuel, former special advisor on health policy to President Barack Obama.
"The people who were in charge did not…assemble a good team and assemble the team that has competency in the exact area you need," Emanuel told CNBC's "Squawk Box" on Friday. The bioethicist was part of the president's health care reform team for two years until January 2011 and is the brother of former Obama Chief of Staff Rahm Emanuel.
The goal has to be an "Amazon-like shopping experience," he stressed, as the process moves forward to fix the glitches with Healthcare.gov—the federally operated health insurance online store, serving the 36 states that are not operating their own.
Is Obamacare in need of triage? Scott Gottlieb, American Enterprise Institute, and Ezekiel Emanuel, University of Pennsylvania, debate whether the Affordable Care Act will produce more problems than solutions for the health care community. "It's a flawed law. What you're seeing now, the IT problems, are just small compared to what we're going to see going forward," said Dr. Scott Gottlieb of the American Enterprise Institute.
"What's going to be most painful in the near-term is the subsidy calculations are wrong," he added. "So people [are] getting the wrong amount of money to offset the costs of these plans, and that's going to be clawed-back from them."
Jeff Zients, a problem-solver who served Obama in the past, has been brought in to oversee the so-called "tech surge."
"[He's] someone I have worked with at OMB. He's a very good manager. He's an excellent people-person," said Emanuel, referring to the Office of Management and Budget. "He's been a consultant in the health care industry. So I think he has the requisite knowledge."
Zients is scheduled to start in January as head of the National Economics Council. "For two months in the crisis he's a very good choice," said Emanuel, vice provost at the University of Pennsylvania. "I think they have to hire a permanent person who's really the CEO of this and go along for the long-haul over the next couple of, or three, years until everything is up."
Meanwhile, House Oversight Committee Chairman Darrell Issa has asked Google, Microsoft, and three other U.S. companies to provide details on their possible involvement in the White House "tech surge."
Getty Images A message is seen on the computer indicating that there are too many visitors on the Affordable Care Act site to continue. What went wrong was at the center of the first congressional hearing Thursday into the botched rollout, with contractors on the project blaming the Centers for Medicare & Medicaid Services (CMS)—a division of the Department of Health and Human Services. CMS was in charge of pulling together the work of many contractors for the Oct 1. launch.
"Assigning this to CMS, which doesn't have experience integrating these complex IT systems, doesn't have experience in e-commerce website development, was not a wise choice. I didn't make that choice," said Emanuel.
A CMS spokeswoman acknowledged the issues raised by the contractors—saying "due to a compressed time frame the system wasn't tested enough," but that's changing now.
Gottlieb, who served as an adviser to CMS during the George W. Bush administration, said: "The reality is they will get these IT issues sorted out. I think the risk is that the entire market in 2015 gets repriced off the experience in 2014."
Emanuel responded: "That's something that Scott and I agree on. If it's a very difficult market within the next five week … it could rebound in 2015."
"These are technical problems that are blocking and tackling, and that will be solved," he said. "Over the next year, it's going to be a much better shopping experience. Then we're all going to look back and say, 'Wow, this was a great restructuring of the health care system."
Gottlieb disagreed: "I think people are going to be surprised by the very limited choice they have. And the difficulty is once you go outside your network in these plans you're going to be faced with very high co-insurance."
Emanuel said the insurance companies learned from the managed-care backlash of the 1990s and they're going to put measures in place to protect against that. He said he has advocated that people who get serious illnesses such as cancer be allowed to get a second opinion out of network for in network costs.
________________________________________________
Keep in mind that neo-liberals do not see the US as a first world country------they are building the conditions of third world Asia here in America to recreate the business environment they had when outsourcing to China. So, this will extend to health care as the ever deepening poverty through massive corporate fraud, ending of social safety nets, and deliberately high unemployment create these same social conditions.
Baltimore is clearly seeing this social construct.
This article fails to address the costs of US health care vs performance.......massive health industry fraud steals 1/2 of health spending while citizens fail to get the health care that stats tell us they are......STEALING THE HEALTH CARE MONEY AND SKEWING THE DATA SAYING US CITIZENS ARE GETTING THE CARE SAID.......this is the problem. The solution here is simply take all the modern advances away from US citizens and tell them preventative care is all they need! Raise your hand if you think this push to see the poor in America get quality food and social services will really occur_____NO ONE! Raise your hand if you know that these preventative care plans are only about keeping 95% of Americans from accessing real health care!!!!!! EVERYONE!
YOUR NEO-LIBERAL REALLY WORKS FOR FAMILIES DON'T THEY!!!!! SO CUTE AND FUZZY!
Below you see what Medicaid for All.......the state health systems created by ACA for most people.....will look like!
Doctor and Patient July 26, 2012, 12:01 am 40 Comments
What We Can Learn From Third-World Health
Care By PAULINE W. CHEN, M.D. Béatrice de Géa for The New York Times
The young doctor had just returned from a month working in a country in Africa, familiar to the rest of us only through pictures of its impoverished population and news reports of recurring natural disasters and political upheavals. “You must feel exhausted but great,” a senior colleague commented. “You went in there and you really helped those people.”
Doctor and Patient Dr. Pauline Chen on medical care.
But my younger colleague felt neither exhausted nor relieved to be back home, she confided when the older doctor had left the room. She had cared for dozens of patients with abscesses and broken bones, tumors and arrow wounds, relying on nothing more than a single rickety X-ray machine, a handful of battered surgical instruments and the aid of one well-connected local nurse.
“We could get so much done with so little over there,” she said. “It’s like we’re not doing something right over here.”
Put another way, the American health care system has become the great international paradox, spending more but getting less.
With all the most advanced technology and equipment, spending far more on health care than any other nation — a whopping $2.6 trillion annually, or over 17 percent of our gross domestic product — the United States consistently underperforms on some of the most important health indicators. Our infant mortality rates, for example, are worse than those in countries like Hungary, Cuba and Slovenia. Our life expectancy rates are not much better; in global rankings, we sit within spitting distance of Cuba, Chile and Libya.
This quality conundrum dogs us, even as our best and brightest have tried to imagine a more cost-efficient system. Some have pursued the carrot-and-stick route, linking quality measures to reimbursement. Others have attempted to reduce quality to its most basic parts, creating checklists and to-do lists. And still others have rearranged networks of hospitals, clinics, physician practices and payments, conjuring up a breathtaking array of combinations, permutations and bundles of care in order to create more cost-efficient systems.
But, according to an essay published this summer in The Stanford Social Innovation Review, we might have saved ourselves the huge effort, the expenses and the disappointments of only marginally successful initiatives, if we had first looked to countries traditionally viewed as needing our aid and learned from their successes in facing challenges similar to our own.
In the essay, Rebecca D. Onie, a founder and the chief executive of Health Leads, a domestic health care organization; Dr. Paul Farmer, a founder of Partners in Health, a Boston-based medical nonprofit group; and Dr. Heidi Behforouz, medical and executive director of the Prevention and Access to Care and Treatment project, a community-based health care initiative in the United States that is part of Partners in Health, argue eloquently for “reverse innovation.” They contend that for decades, several nongovernmental and nonprofit medical organizations have delivered high-quality care in some of the most challenging circumstances possible. Applying the solutions these medical organizations have already discovered could allow us to bypass or at least foreshorten what has become an interminable trial-and-error search for the answers to our country’s health care woes.
Their own organizations offer several models of success. For nearly three decades, Partners in Health, for example, has delivered consistently high-quality care to more than 2.5 million people in a dozen countries like Haiti, Rwanda and Peru, places with widespread poverty, scarce numbers of providers and no health care infrastructure. But they have managed to achieve, among other successes, the highest rate of cure of multidrug-resistant tuberculosis in the world and better rates of adherence to treatment regimens and follow-up than in much of the United States.
The key to their success is an unabashed disregard for some of our most cherished assumptions about what constitutes good care. Instead of providing antibiotics, CT scans and high-tech interventions, Partners in Health considers basic necessities like food and housing as critical components of the group’s medical work. Instead of asking patients to travel miles to the only clinic and see only the doctor or nurse, they train cadres of community health workers who can monitor, administer and advise in the heart of local villages and in people’s homes.
Applied to organizations in the United States, this approach has proved startlingly effective, as the Prevention and Access to Care and Treatment, or PACT, program has demonstrated. PACT targets some of the poorest and sickest patients with H.I.V. and other chronic illnesses in the greater Boston area. Just like Partners in Health, PACT relies extensively on community health workers who are trained in tasks like helping patients take their medications and make it to clinic appointments as well as reviewing their pantries and teaching them to prepare healthy meals. Applying these broad definitions of care, PACT has significantly decreased the number of emergency room visits and life-threatening opportunistic infections, cut hospitalization rates by 60 percent and yielded a 16 percent savings for Medicaid.
Health Leads has stretched these definitions even further, giving the terms “provider” and “care” a millennial twist. Each year, Health Leads trains a selected group of technology-savvy and tenacious college students to staff “resource desks” in primary care and prenatal clinics in cities like New York, Baltimore, Boston and Chicago. With these Health Leads volunteers in place, doctors can, for example, “prescribe” housing assistance for a family whose child’s severe asthma has been exacerbated by a cockroach infestation, healthy foods and nutrition resources for a man suffering from obesity, or transportation to a drugstore for an elderly woman who needs diabetes medications. At the resource desk, a Health Leads volunteer then “fills” these prescriptions by finding the best solutions for the problems at hand, whether that means tracking down the appropriate agency, navigating complicated online application processes or providing support as the patient makes the calls. In clinics where a single social worker may be responsible for as many as 25,000 patients, Health Leads volunteers have more than doubled the services provided.
The successes of PACT and Health Leads are no secret. But what does remain mysterious as our health care system threatens to implode is why more of us haven’t done the same and rushed to apply the lessons learned and proved elsewhere.
“We keep trying to reinvent the wheel,” Ms. Onie observed. “The humbling reality is that we are trying to recreate innovations that have been robustly developed in the developing world.”
In other words, we have yet to deploy what could prove to be the most powerful weapon in the fight to contain costs and improve the quality of health care: our own humility.
_______________________________________________
Below you see what corporate health is becoming.....preventative policy that will take all the internet data collected on each person and use it to determine if you are meeting corporate standards. Think you can lie about how much you drink or smoke? Well, cash register data is now being collected and centralized that show when you use your GROCER VALUE CARD that you purchased so much alcohol and so many packs of cigarettes. It will show if you attend wellness programs to lose weight or control cholesterol and this will determine if that corporation will employ you or have to insure you....
THIS IS WHAT WILL BE ALL THAT IS LEFT OF CORPORATE HEALTH COVERAGE.....ACCESS TO REAL HEALTH PROCEDURES WILL NOT BE INCLUDED!
Apollo Life
Corporate Wellness
Most organizations look at corporate wellness from the point of view of the workplace only. But, there is much more that affects an employees work performance and attitude. it is impossible for a person to come for work and completely switch off his / her personal problems, complication, limitations etc.
No matter which area of a person's life a problem or a stress arises from, it will eventually reflect in all areas that the individual functions. it is important to address both work related and non work related issues of employees if a company is to be "Well".
Keeping this in mind Wellness Rx has designed a two pronged approach that is made up of the following two major plans that run parallel :
A. Corporate Wellness Plan that takes care of work related issues
B. Employee Assistance Program that takes care of all other issues
EMPLOYEE ASSISTANCE PROGRAM
Objectives
To help employers identify and address productivity concerns in employees whose work is affected by personal problems and to provide support and practical help for employees and their families experiencing problems.
To help reduce absenteeism, conflict in the workplace, sickness and unwelcome staff turnover.
To promote mental, emotional and physical health, to aid improved performance and reduce incidence of disciplinary processes.
To contribute to the provision of a work environment which yields greater commitment and loyalty to the employers, leading to improved morale and motivation.
To enable employees to take responsibility for addressing problems either caused by or affecting their work. To make a positive contribution to human resources and help employees cope with change.
Components
Individual employee and Family Wellness counseling
Elements of EAP may be available in stand alone form or in other combinations
Face to Face Counseling
24 telephone hour assistance
Marital and relationship difficulties
Alcohol and drug misuse
Loss of confidence
Stress & psychosoma
Bereavement & loss
Workplace stress
Domestic problems
Personal injury
Weight loss
Retirement planning
_____________________________________________
If you think PHARMA is expensive in the US wait until you see what Obama and TPP intend to do. Obama is working for US PHARMA in making drugs more expensive all around the world. The US has always been the one to charge its citizens the most. Well, now we will see costs soar as generic medication and patent-extensions make cost-effective drug manufacturing impossible.
We keep hearing that people with Medicare and Medicaid will only be allowed to have generic drugs subsidized but you do not hear that generics are under attack and may not be available in many cases. Think about Medicare D and the donut-whole Obama keeps saying he is filling-----we will see what seniors care access if generics are the only choice and generics become hard to find.
The Trans-Pacific Partnership and Public Health
The TPP would provide large pharmaceutical firms with new rights and powers to increase medicine prices and limit consumers' access to cheaper generic drugs. This would include extensions of monopoly drug patents that would allow drug companies to raise prices for more medicines and even allow monopoly rights over surgical procedures. For people in the developing countries involved in TPP, these rules could be deadly - denying consumers access to HIV-AIDS, tuberculosis and cancer drugs.
The TPP would establish new rules that could undermine government programs in developed countries. The TPP would control the cost of medicines by employing drug formularies. These are lists of proven medicines that the government selects for use by government health care systems. Lower prices are negotiated for bulk purchase of such drugs and new medicines that are under monopoly patents are not approved if less expensive generic drugs are equally effective. Drug firms would be empowered to challenge these decisions and pricing standards. In the United States, these rules threaten provisions included in Medicare, Medicaid and veterans' health programs to make medicines more affordable for seniors, military families and the poor.
TPP would empower foreign pharmaceutical corporations to directly attack our domestic patent and drug-pricing laws in foreign tribunals. Already under NAFTA, which does not contain the new rules proposed for TPP, drug firm Eli Lilly has launched such a case against Canada, demanding $100 million for the government's enforcement of its own patent standards.
The TPP would also empower foreign corporations to directly challenge domestic toxics, zoning, cigarette and alcohol and other public health and environmental policies to demand taxpayer compensation for any such policies that undermine their expected future profits. Often initiatives to improve such laws are chilled by the mere filing of such an "investor-state" case. In other instances, countries eliminate the attacked policies. For instance Canada lifted a ban on a gasoline additive already banned in the U.S. as a suspected carcinogen after an investor attack by Ethyl Corporation under NAFTA. It also paid the firm $13 million and published a formal statement that the chemical was not hazardous.
Cases now underway include:
I stated last time that a health care system with the likes of Carlyle Group, General Electric, and Lockheed Martin is likely not about giving quality care for all. We thank Colin Powell for coming out for Expanded and Improved Medicare for All. Let's look how corporate Obama has gone and how to reverse this ridiculous policy.
Obama has privatized most Federal agencies more than Bush and now he is getting rid of the Federal programs....Medicare and Medicaid. While acting as though he is compromising and shoring up these programs he is creating the structure of privatized systems throughout this Federal health agencies. We see it on steroids in Maryland as Johns Hopkins makes Maryland health care all about global corporations ready to suck all the money left from the entitlement trusts----health fraud skyrocketing to subprime mortgage fame!
As we see in Maryland the problem first and foremost is that Medicare expansion was the easiest and justice approach to this health care reform. Vermont did it and we will watch to see if they carry through with public interest or marginalize the public. The second problem was the fact that none of the neo-liberals elected and/or appointed to do the job have any talent....they simply graduated from an Ivy League school for the most part and got the job through the 'who you know' naked capitalism. NO TALENT, just the willingness to LIE, CHEAT, AND STEAL and the willingness to embrace the 3 monkey syndrome of SEE NO EVIL, HEAR NO EVIL, SPEAK NO EVIL.......
THIS IS THE RECIPE FOR DISASTER! Everything that is public policy in Maryland is a disaster....education, environment, health care, transportation......
This is what ACA is creating.....US health insurance corporations are tying to health care abroad and US health systems are building their global health corporations to tap this market. So, Johns Hopkins has a health business in India that markets health tourism and does business without any US government accountability. Meanwhile, the huge medical campus built when billions of dollars in taxpayer money will be a global corporate headquarters managing this system with affluent foreigners coming in to access care while you and I head to an ever devolving MedStar or clinic health. Note that the health insurer is paying to fly US citizens to India for procedures....see where all the money is going. Who is getting these health insurance policies? The 5% of people in the US who will be able to afford the kind of health care we all had before BUSH/OBAMA.
Medical Tourism - Medical Travel Abroad - USA - Health Tour India - Overseas Surgery - Surgical
Tour...www.healthbase.com
Bad management plagues Obamacare: Ex-Obama advisor
Published: Friday, 25 Oct 2013 | 10:46 AM ET By: Matthew J. Belvedere | Producer, CNBC's "Squawk Box"
Obamacare 'CEO' needed, says ex-Obama health adviser Friday, 25 Oct 2013 | 8:12 AM ET
Dr. Ezekiel Emanuel told CNBC the goal when fixing the tech problems on the federal Obamacare website should be to create an "Amazon-like shopping experience." The technology problems with the federal Obamacare website were a function of poor management and implementation, said Dr. Ezekiel Emanuel, former special advisor on health policy to President Barack Obama.
"The people who were in charge did not…assemble a good team and assemble the team that has competency in the exact area you need," Emanuel told CNBC's "Squawk Box" on Friday. The bioethicist was part of the president's health care reform team for two years until January 2011 and is the brother of former Obama Chief of Staff Rahm Emanuel.
The goal has to be an "Amazon-like shopping experience," he stressed, as the process moves forward to fix the glitches with Healthcare.gov—the federally operated health insurance online store, serving the 36 states that are not operating their own.
Is Obamacare in need of triage? Scott Gottlieb, American Enterprise Institute, and Ezekiel Emanuel, University of Pennsylvania, debate whether the Affordable Care Act will produce more problems than solutions for the health care community. "It's a flawed law. What you're seeing now, the IT problems, are just small compared to what we're going to see going forward," said Dr. Scott Gottlieb of the American Enterprise Institute.
"What's going to be most painful in the near-term is the subsidy calculations are wrong," he added. "So people [are] getting the wrong amount of money to offset the costs of these plans, and that's going to be clawed-back from them."
Jeff Zients, a problem-solver who served Obama in the past, has been brought in to oversee the so-called "tech surge."
"[He's] someone I have worked with at OMB. He's a very good manager. He's an excellent people-person," said Emanuel, referring to the Office of Management and Budget. "He's been a consultant in the health care industry. So I think he has the requisite knowledge."
Zients is scheduled to start in January as head of the National Economics Council. "For two months in the crisis he's a very good choice," said Emanuel, vice provost at the University of Pennsylvania. "I think they have to hire a permanent person who's really the CEO of this and go along for the long-haul over the next couple of, or three, years until everything is up."
Meanwhile, House Oversight Committee Chairman Darrell Issa has asked Google, Microsoft, and three other U.S. companies to provide details on their possible involvement in the White House "tech surge."
Getty Images A message is seen on the computer indicating that there are too many visitors on the Affordable Care Act site to continue. What went wrong was at the center of the first congressional hearing Thursday into the botched rollout, with contractors on the project blaming the Centers for Medicare & Medicaid Services (CMS)—a division of the Department of Health and Human Services. CMS was in charge of pulling together the work of many contractors for the Oct 1. launch.
"Assigning this to CMS, which doesn't have experience integrating these complex IT systems, doesn't have experience in e-commerce website development, was not a wise choice. I didn't make that choice," said Emanuel.
A CMS spokeswoman acknowledged the issues raised by the contractors—saying "due to a compressed time frame the system wasn't tested enough," but that's changing now.
Gottlieb, who served as an adviser to CMS during the George W. Bush administration, said: "The reality is they will get these IT issues sorted out. I think the risk is that the entire market in 2015 gets repriced off the experience in 2014."
Emanuel responded: "That's something that Scott and I agree on. If it's a very difficult market within the next five week … it could rebound in 2015."
"These are technical problems that are blocking and tackling, and that will be solved," he said. "Over the next year, it's going to be a much better shopping experience. Then we're all going to look back and say, 'Wow, this was a great restructuring of the health care system."
Gottlieb disagreed: "I think people are going to be surprised by the very limited choice they have. And the difficulty is once you go outside your network in these plans you're going to be faced with very high co-insurance."
Emanuel said the insurance companies learned from the managed-care backlash of the 1990s and they're going to put measures in place to protect against that. He said he has advocated that people who get serious illnesses such as cancer be allowed to get a second opinion out of network for in network costs.
________________________________________________
Keep in mind that neo-liberals do not see the US as a first world country------they are building the conditions of third world Asia here in America to recreate the business environment they had when outsourcing to China. So, this will extend to health care as the ever deepening poverty through massive corporate fraud, ending of social safety nets, and deliberately high unemployment create these same social conditions.
Baltimore is clearly seeing this social construct.
This article fails to address the costs of US health care vs performance.......massive health industry fraud steals 1/2 of health spending while citizens fail to get the health care that stats tell us they are......STEALING THE HEALTH CARE MONEY AND SKEWING THE DATA SAYING US CITIZENS ARE GETTING THE CARE SAID.......this is the problem. The solution here is simply take all the modern advances away from US citizens and tell them preventative care is all they need! Raise your hand if you think this push to see the poor in America get quality food and social services will really occur_____NO ONE! Raise your hand if you know that these preventative care plans are only about keeping 95% of Americans from accessing real health care!!!!!! EVERYONE!
YOUR NEO-LIBERAL REALLY WORKS FOR FAMILIES DON'T THEY!!!!! SO CUTE AND FUZZY!
Below you see what Medicaid for All.......the state health systems created by ACA for most people.....will look like!
Doctor and Patient July 26, 2012, 12:01 am 40 Comments
What We Can Learn From Third-World Health
Care By PAULINE W. CHEN, M.D. Béatrice de Géa for The New York Times
The young doctor had just returned from a month working in a country in Africa, familiar to the rest of us only through pictures of its impoverished population and news reports of recurring natural disasters and political upheavals. “You must feel exhausted but great,” a senior colleague commented. “You went in there and you really helped those people.”
Doctor and Patient Dr. Pauline Chen on medical care.
But my younger colleague felt neither exhausted nor relieved to be back home, she confided when the older doctor had left the room. She had cared for dozens of patients with abscesses and broken bones, tumors and arrow wounds, relying on nothing more than a single rickety X-ray machine, a handful of battered surgical instruments and the aid of one well-connected local nurse.
“We could get so much done with so little over there,” she said. “It’s like we’re not doing something right over here.”
Put another way, the American health care system has become the great international paradox, spending more but getting less.
With all the most advanced technology and equipment, spending far more on health care than any other nation — a whopping $2.6 trillion annually, or over 17 percent of our gross domestic product — the United States consistently underperforms on some of the most important health indicators. Our infant mortality rates, for example, are worse than those in countries like Hungary, Cuba and Slovenia. Our life expectancy rates are not much better; in global rankings, we sit within spitting distance of Cuba, Chile and Libya.
This quality conundrum dogs us, even as our best and brightest have tried to imagine a more cost-efficient system. Some have pursued the carrot-and-stick route, linking quality measures to reimbursement. Others have attempted to reduce quality to its most basic parts, creating checklists and to-do lists. And still others have rearranged networks of hospitals, clinics, physician practices and payments, conjuring up a breathtaking array of combinations, permutations and bundles of care in order to create more cost-efficient systems.
But, according to an essay published this summer in The Stanford Social Innovation Review, we might have saved ourselves the huge effort, the expenses and the disappointments of only marginally successful initiatives, if we had first looked to countries traditionally viewed as needing our aid and learned from their successes in facing challenges similar to our own.
In the essay, Rebecca D. Onie, a founder and the chief executive of Health Leads, a domestic health care organization; Dr. Paul Farmer, a founder of Partners in Health, a Boston-based medical nonprofit group; and Dr. Heidi Behforouz, medical and executive director of the Prevention and Access to Care and Treatment project, a community-based health care initiative in the United States that is part of Partners in Health, argue eloquently for “reverse innovation.” They contend that for decades, several nongovernmental and nonprofit medical organizations have delivered high-quality care in some of the most challenging circumstances possible. Applying the solutions these medical organizations have already discovered could allow us to bypass or at least foreshorten what has become an interminable trial-and-error search for the answers to our country’s health care woes.
Their own organizations offer several models of success. For nearly three decades, Partners in Health, for example, has delivered consistently high-quality care to more than 2.5 million people in a dozen countries like Haiti, Rwanda and Peru, places with widespread poverty, scarce numbers of providers and no health care infrastructure. But they have managed to achieve, among other successes, the highest rate of cure of multidrug-resistant tuberculosis in the world and better rates of adherence to treatment regimens and follow-up than in much of the United States.
The key to their success is an unabashed disregard for some of our most cherished assumptions about what constitutes good care. Instead of providing antibiotics, CT scans and high-tech interventions, Partners in Health considers basic necessities like food and housing as critical components of the group’s medical work. Instead of asking patients to travel miles to the only clinic and see only the doctor or nurse, they train cadres of community health workers who can monitor, administer and advise in the heart of local villages and in people’s homes.
Applied to organizations in the United States, this approach has proved startlingly effective, as the Prevention and Access to Care and Treatment, or PACT, program has demonstrated. PACT targets some of the poorest and sickest patients with H.I.V. and other chronic illnesses in the greater Boston area. Just like Partners in Health, PACT relies extensively on community health workers who are trained in tasks like helping patients take their medications and make it to clinic appointments as well as reviewing their pantries and teaching them to prepare healthy meals. Applying these broad definitions of care, PACT has significantly decreased the number of emergency room visits and life-threatening opportunistic infections, cut hospitalization rates by 60 percent and yielded a 16 percent savings for Medicaid.
Health Leads has stretched these definitions even further, giving the terms “provider” and “care” a millennial twist. Each year, Health Leads trains a selected group of technology-savvy and tenacious college students to staff “resource desks” in primary care and prenatal clinics in cities like New York, Baltimore, Boston and Chicago. With these Health Leads volunteers in place, doctors can, for example, “prescribe” housing assistance for a family whose child’s severe asthma has been exacerbated by a cockroach infestation, healthy foods and nutrition resources for a man suffering from obesity, or transportation to a drugstore for an elderly woman who needs diabetes medications. At the resource desk, a Health Leads volunteer then “fills” these prescriptions by finding the best solutions for the problems at hand, whether that means tracking down the appropriate agency, navigating complicated online application processes or providing support as the patient makes the calls. In clinics where a single social worker may be responsible for as many as 25,000 patients, Health Leads volunteers have more than doubled the services provided.
The successes of PACT and Health Leads are no secret. But what does remain mysterious as our health care system threatens to implode is why more of us haven’t done the same and rushed to apply the lessons learned and proved elsewhere.
“We keep trying to reinvent the wheel,” Ms. Onie observed. “The humbling reality is that we are trying to recreate innovations that have been robustly developed in the developing world.”
In other words, we have yet to deploy what could prove to be the most powerful weapon in the fight to contain costs and improve the quality of health care: our own humility.
_______________________________________________
Below you see what corporate health is becoming.....preventative policy that will take all the internet data collected on each person and use it to determine if you are meeting corporate standards. Think you can lie about how much you drink or smoke? Well, cash register data is now being collected and centralized that show when you use your GROCER VALUE CARD that you purchased so much alcohol and so many packs of cigarettes. It will show if you attend wellness programs to lose weight or control cholesterol and this will determine if that corporation will employ you or have to insure you....
THIS IS WHAT WILL BE ALL THAT IS LEFT OF CORPORATE HEALTH COVERAGE.....ACCESS TO REAL HEALTH PROCEDURES WILL NOT BE INCLUDED!
Apollo Life
Corporate Wellness
Most organizations look at corporate wellness from the point of view of the workplace only. But, there is much more that affects an employees work performance and attitude. it is impossible for a person to come for work and completely switch off his / her personal problems, complication, limitations etc.
No matter which area of a person's life a problem or a stress arises from, it will eventually reflect in all areas that the individual functions. it is important to address both work related and non work related issues of employees if a company is to be "Well".
Keeping this in mind Wellness Rx has designed a two pronged approach that is made up of the following two major plans that run parallel :
A. Corporate Wellness Plan that takes care of work related issues
B. Employee Assistance Program that takes care of all other issues
EMPLOYEE ASSISTANCE PROGRAM
Objectives
To help employers identify and address productivity concerns in employees whose work is affected by personal problems and to provide support and practical help for employees and their families experiencing problems.
To help reduce absenteeism, conflict in the workplace, sickness and unwelcome staff turnover.
To promote mental, emotional and physical health, to aid improved performance and reduce incidence of disciplinary processes.
To contribute to the provision of a work environment which yields greater commitment and loyalty to the employers, leading to improved morale and motivation.
To enable employees to take responsibility for addressing problems either caused by or affecting their work. To make a positive contribution to human resources and help employees cope with change.
Components
Individual employee and Family Wellness counseling
Elements of EAP may be available in stand alone form or in other combinations
Face to Face Counseling
24 telephone hour assistance
Marital and relationship difficulties
Alcohol and drug misuse
Loss of confidence
Stress & psychosoma
Bereavement & loss
Workplace stress
Domestic problems
Personal injury
Weight loss
Retirement planning
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If you think PHARMA is expensive in the US wait until you see what Obama and TPP intend to do. Obama is working for US PHARMA in making drugs more expensive all around the world. The US has always been the one to charge its citizens the most. Well, now we will see costs soar as generic medication and patent-extensions make cost-effective drug manufacturing impossible.
We keep hearing that people with Medicare and Medicaid will only be allowed to have generic drugs subsidized but you do not hear that generics are under attack and may not be available in many cases. Think about Medicare D and the donut-whole Obama keeps saying he is filling-----we will see what seniors care access if generics are the only choice and generics become hard to find.
The Trans-Pacific Partnership and Public Health
The TPP would provide large pharmaceutical firms with new rights and powers to increase medicine prices and limit consumers' access to cheaper generic drugs. This would include extensions of monopoly drug patents that would allow drug companies to raise prices for more medicines and even allow monopoly rights over surgical procedures. For people in the developing countries involved in TPP, these rules could be deadly - denying consumers access to HIV-AIDS, tuberculosis and cancer drugs.
The TPP would establish new rules that could undermine government programs in developed countries. The TPP would control the cost of medicines by employing drug formularies. These are lists of proven medicines that the government selects for use by government health care systems. Lower prices are negotiated for bulk purchase of such drugs and new medicines that are under monopoly patents are not approved if less expensive generic drugs are equally effective. Drug firms would be empowered to challenge these decisions and pricing standards. In the United States, these rules threaten provisions included in Medicare, Medicaid and veterans' health programs to make medicines more affordable for seniors, military families and the poor.
TPP would empower foreign pharmaceutical corporations to directly attack our domestic patent and drug-pricing laws in foreign tribunals. Already under NAFTA, which does not contain the new rules proposed for TPP, drug firm Eli Lilly has launched such a case against Canada, demanding $100 million for the government's enforcement of its own patent standards.
The TPP would also empower foreign corporations to directly challenge domestic toxics, zoning, cigarette and alcohol and other public health and environmental policies to demand taxpayer compensation for any such policies that undermine their expected future profits. Often initiatives to improve such laws are chilled by the mere filing of such an "investor-state" case. In other instances, countries eliminate the attacked policies. For instance Canada lifted a ban on a gasoline additive already banned in the U.S. as a suspected carcinogen after an investor attack by Ethyl Corporation under NAFTA. It also paid the firm $13 million and published a formal statement that the chemical was not hazardous.
Cases now underway include:
- In 2008, Uruguay began implementing its obligations under the World Health Organization's Framework Convention on Tobacco Control, including enhanced tobacco warning labels and requiring plain packaging for cigarettes. In 2010, Australia followed suit. Philip Morris responded by launching "investor-state" challenges against both countries' tobacco control policies, asking extrajudicial tribunals to order the governments to suspend plain packaging and compensate the corporate tobacco giant for "losses." Even though Australia's High Court upheld the country's plain packaging laws in 2012, Philip Morris continues to use a foreign investor-state tribunal to try to roll back this important public health policy.
- For years, Renco Group Inc., a company owned by one of the richest men in America, operated a metal smelter in La Oroya, Peru, which became notorious when the site was designated as one of the top 10 most polluted places in the world. Sulfur dioxide concentrations in La Oroya, which greatly exceed international standards and pose severe respiratory risks, doubled in the years after Renco's acquisition of the complex. Renco's Peruvian subsidiary promised to install sulfur plants by 2007 as part of a government-mandated environmental remediation program, but it sought (and Peru granted) two extraordinary extensions to complete the project. In December 2010, Renco notified Peru that it would use the U.S.-Peru FTA investor-state system to demand $800 million from the Peruvian government for not granting the corporation a third extension on its unfulfilled environmental commitments. Since the launch of the investor-state attack, the Peruvian government has allowed operations to begin again at the La Oroya smelter, resulting in reports of new pollution.
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