WSJ is Wrong: Healthcare Needs IT
Warning! I am a practicing doctor who sees real patients using an Electronic Medical Record (EMR). My sole agenda is to provide the best patient care. I have no financial stake in Information Technology (IT).
However, unlike the editorial board at the Wall Street Journal (WSJ), Mr. Stephen Soumerai of Harvard or Mr. Ross Koppel of the University of Pennsylvania, I have actually used digital patient records for over a decade, and I have news for them: EMRs work.
In a reactionary opinion in the Wall Street Journal entitled “A Major Glitch for Digitized Health-Care Records,” the authors expanded to the point of silliness the conclusions of a review of healthcare IT by McMaster University.
The McMaster analysis abstracts data from 36,000 studies over five decades of healthcare IT and concludes that computerization has yet to save dollars nor improve health care. WSJ editorialists proposed that the concept of a common medical database has “already failed” as is “common knowledge.” While they portend to “fully share the hope” in the success of a computerized healthcare system they express doubt as to “why are we pushing ahead to digitalize.”
The question is so ridiculous as to barely require an answer. We are pushing ahead to digitalize because the healthcare industry, which is 18% of our GDP, is the last major industry to go electronic. Despite how critical medicine is to our citizen and nation’s vitality, health care is most often documented with paper and ink.
Can you imagine any other industry where this would be acceptable? Would you go to a bank where they use a hand-written ledger? Travel on an airplane without GPS, fly by wire technology or a minimum of three computers? Do you yearn for rotary phones? Credit cards left paper money behind decades ago and will soon move on to the next phase, pay by smart-phone.
The world is digital and one of the core problems with medical care is its failure to follow. The average doctor writes his notes on parchment and scribbles orders on contact paper. He wastes time writing prescriptions by hand that cannot be read and will produce unneeded drug interactions and side effects.
The data on billions of health care events cannot be mined, monitored, analyzed or improved, because they are not digital. Millions of hours are wasted, billions of dollars vanish and tens of thousands die because of preventable medical complications, the result of massive variation in quality and safety. We are doomed because we cannot access or evaluate most medical care data; “If you can not measure it, you can not manage it.”
Taking health digital is key to fixing and affording care. Standard, unified medical records will significantly decrease the risk of providing unneeded or dangerous medical care. Massive efficiencies will result by reducing duplication, speeding communication and reduction in waste (and fraud). Critical improvements will follow the use of guidelines to study clinical databases and drive quality. This means that whether one lives in Manhattan, in the mountains of Tennessee or potentially deep in Africa, the finest care will be possible.
How do I know this to be true? Our practice of seven doctors and three nurse practitioners was an early EMR adapter. We put in our first basic system in 2000, upgraded three times and have been fully electronic for four years.
This has resulted in marked efficiencies and obvious quality improvement. Encrypted electronic records cannot be lost, are unlikely to be stolen and are always available from anywhere. Ordering tests is instantaneous, as is reviewing results, organizing treatments, scheduling appointments or communication with outside health providers.
On the cost side we reduced non-clinical staff by more than 50%, and in an accounts receivable analysis, our billing cycle dropped more than 60% and bad debt fell into the low single-digits.
Today in the office, I saw four new patients. Without the assistance of clerical staff and without leaving my desk, I reviewed their entire surgical, laboratory, pathological, and radiologic records. By the time, I entered the room to meet each of them, a significant part of their medical history was entered into our EMR based on outside records so that the care and observations of previous doctors was not forgotten.
Halfway through each visit documentation of their history and physical exam was complete, leaving more time to talk with each patient. Tests were ordered, treatments scheduled, disability letters printed, medications e-scripted, instructions created and follow-up appointments set up. Patients were given codes to electronically access their records from home. Letters were sent online to referring doctors, as well as any clinicians we were consulting in that patient's care. Billing was complete before each patient got to the parking lot.
Such is the power, efficiency and quality of electronic medical records.
This is just the beginning. Although EMRs now provide assistance with basic medical care, such as scheduling flu shots, identifying drug interactions, and health screening reminders, future systems will use academic information to assist the doctor in making diagnoses and planning treatments.
Seamless with the EMR will be computer augmentation to create differential diagnoses and recommend treatment alternatives. In oncology alone there are almost 50,000 articles published each year; artificial intelligence integration with the clinical EMR will help every doctor penetrate that massive database on a continuous basis as it applies to individual patients.
So, why does the McMaster study not show this obvious benefit? It comes to four factors.
The first is the “five decades” of study reviewed by the Canadian authors. Since most doctors did not start adapting EMRs until three years ago, that leaves 57 months of irrelevant data.
Second, we have not reached the critical mass to achieve broad system efficiencies, as hospitals and doctors are still figuring out how to incorporate the technology into their daily practice, and less than 50% of health care providers have converted to EMRs.
Third, we do not yet have a universal common database for medical records. This is a complex technological step, which has been achieved in major industries such as banking, but still must be assembled in medicine.
Finally, as was correctly stated in the WSJ Op-Ed piece, present EMRs are cumbersome, immature, and several generations short of perfection. However, these are expected problems when implementing disruptive evolving technology in the complex changing health market. Challenge is a weak argument for giving up and bringing back the fountain pen.
I am not certain what the goal of Sommeri and Koppel was in writing this piece. They offer nothing but “hope.” The Journal has been a strong supporter of business technology leading the drive towards quality, and has long recognized the positive contribution of IT to industry.
Those of us in the trenches, putting EMRs in place, ironing out the kinks, know that Electronic Medical Records are now and they are the future. With IT at the core of the healthcare renaissance we can make medicine cost-efficient, producing quality that is second-to-none.
As published in Sunrise Rounds.
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Bob Griffiths
11:51 am on Saturday, September 22, 2012
It is my opinion that EMRs are a threat to patient privacy. Medical records begin as a recorded dictation by the doctor and include some very private information, such as home address, occupation, employer, social security number, health history and treatments and other personal and family information about the patient. Today, in most cases the doctor’s dictation is recorded in a format that allows it be sent anywhere in the world via the internet. This recorded medical report must now be transcribed meaning downloaded to a PC and then typed into a permanent record. Most of your private medical records are set via the internet to India to be downloaded to a PC and typed by a foreign transcriptionist. Very few medical records are transcribed in-house by hospitals. Very often, your private medical records are already in India before you return home from the hospital.
Much has been made of HIPAA privacy regulations but HIPAA is a paper tiger when it comes to actual protection of patient privacy. HIPAA regulation apply directly to covered entities here in the U.S. but if your medical records are sent to India they are now no longer directly covered by U.S. regulations. The hospital only needs a third party “business agreement” with the medical transcription company in India and from that point it is a matter of self-regulation and self-reporting of any breech that occurs in India.
KC
1:37 am on Friday, September 28, 2012
Wow Bob G, I didn't know this. I seriously didn't. I can agree with the doctor's well drafted arguements for technology, but also see your point. I plain and simply do not think social security numbers belong on a medical records.
This may be a very good reason to end the unreasonable amount of outsourcing that is happening especially while so many of our own Americans go jobless or underemployed - something the medical people know little of being a service even the one percent are in need of. This is a true dilemma.
Bob Griffiths
8:11 am on Friday, September 28, 2012
It is my opinion, that there is a “big lie” being perpetrated upon the American people when it comes to our “expectation” of privacy regarding our health and medical records.
In addition, although much is made of HIPAA privacy regulations they mean little if HIPAA allows our private medical records to be transmitted outside the U.S to be downloaded to a PC in Mumbai, India so it can be transcribed by a foreign transcriptionist. I think it is ridiculous and disengenuous for a hospital or health care provider here in the U.S. to have a patient sign a pile of HIPAA privacy forms but then turn around and transmit that same private information to Mumbai, India, or Pakistan, or Indonesia.
Now I am fully aware that Hospitals and health providers will become very defensive if you bring up the outsourcing of our medial records; the health care provider will assure us that the proper HIPAA “business agreement” forms are on file and everything is being done to protect a patients privacy, but that is like assuring us that you are doing everything to prevent forest fires but at the same time you are walking around with a torch in yor hand, your actions are generating the threat.
Barney
8:21 am on Friday, September 28, 2012
Interesting theories Bob. I bet you you were side by side with Al Gore when LIBS still believed and tried convincing other sheep the earth was flat and global warming was something was created by conservatives. Al Gore made lots of money from teaching sheep those classes.
You lost all credibility with your recent 7th grade level write up.
Chris Welch
1:44 pm on Saturday, September 22, 2012
Are paper documents being passed from person to person throughout a medical facility any safer from information being stolen ?
How do you encrypt a paper document ?
Any information can be stolen if the criminal wants it bad enough.
Not the point of the article.
Medical records start the moment you enter the medical facility. Long before you see a doctor.
And doctors don't always dictate orders to later be transcribed. In most hospitals today (including the one I work at) doctors enter orders and notes right in the patients room. Computers are on a rolling cart that they bring with them into the room.
Bob Griffiths
2:20 pm on Saturday, September 22, 2012
In addition, are you referring to VR software at your facility?
KC
1:44 am on Friday, September 28, 2012
Maybe also a little off point but I have a story here. I once went to a local dermatologist. My insurance co-pay was thirty dollars for a specialist. I gave the assistant at the desk thirty dollars and she told me, "We do not accept cash". When I asked how they could not accept cash as I did not have my check book she told me it was because someone in the office was stealing the cash and proceeded to ask for a credit card. I asked her - "you don't trust your employees with cash, but I am supposed to trust them with my credit card number? No dice - take the cash now - or I will mail you the co-pay." I might add I have gone to this practice over a twenty five year time period!
Bob Griffiths
2:15 pm on Saturday, September 22, 2012
I am not sure what dictation platform you are using at the facility where you work, but you cannot argue that doctor dictated medical reports are not at this moment being sent offshore, to places such as India to be transcribed. Patient expectation of privacy when it comes to their health records is a critical part of ANY discussion regarding EMRs.
Chris Welch
7:25 pm on Saturday, September 22, 2012
Actually I can. Do you have proof that its happening ?
According to this article ( again from the WSJ) American hospitals are reluctant to do it.
http://online.wsj.com/article/SB10001424052748704865104575588252907738276.html
bsdtktr
4:05 pm on Saturday, September 22, 2012
Well put, Mr. Griffiths.
James Salwitz
5:13 pm on Saturday, September 22, 2012
Thanks for the input. A full EMR does not use dictation unless it is local to the particular computer via direct data entry using a program such as Dragon. Data is entered directly by the physician into drop menus which fill in common medical events by moving through a decision tree (ie. Pain - shoulder - left - achy - three weeks ...etc). The old model of dictations being outsourced (which is what is still done in non-EMR environments by many doctors) is eliminated in an EMR. Instead they use a closed, encrypted system which is far harder to penetrate than paper charts and files laying around a medical office for thousands of individual patients. And while it is true that HIPAA fines are rarely levied, those fines are massive ($10,000 per single patient event) and therefore physicians and soft ware designers take the security threat very seriously.
jcs
Bob Griffiths
8:38 pm on Saturday, September 22, 2012
Thanks for the clarification. One question, I am familiar with drop menus as I am also familiar with VR, there are obvious limitations to both, for example, an op report or discharge summary. There are some less detailed or repetitive reports where it is effective utilizing your EMR model, but like I said there are practical limitations. Your thoughts?
Blogette
6:22 pm on Saturday, September 22, 2012
IT people in healthcare are a necessity. This article concerns me.
Monk
5:49 am on Sunday, September 23, 2012
Medicare Bills Rise as Records Turn Electronic ... This from the NYT, of all sources. A September 21, 2012 article.
Eleanor
6:22 am on Sunday, September 23, 2012
The NYT article was interesting but one thing it did was imply that drs and hospitals were overbilling when in fact they were 'upbilling' which is a flaw in the insurance billing code model that is necessary for electronic recording. Instead of writing down exactly what the patient has and says, a dr will have to see if what the patients condition is fits a computerized code. So if a patient is somewhere between a 50319 and a 50320 and there is no 50319.5 which is closest to what describes the patients condition, the dr or hospital may go to the higher one, sometimes to bill higher, sometimes because it is the better of two bad options.
The other problem is that there is no single ER system - like any other software, they are a bunch of software products and services - the one that works best for one dr may not work for another, or for the hospital so you may have them working with incompatible records.
There is also an increased cost - because if you have to buy an expensive product to do what you had done as a written filing system you now have to maintain and upgrade and repair the product, deal with problems when the system is down. Its like buying a Kindle to read a book. Some people love it but it is not something you buy instead of the book, it is something you buy and then still have to buy the book, and if the Kindle breaks down, you cant access your library.
Simple Simon
11:37 am on Sunday, September 23, 2012
The NYT article strongly "suggests" without citing hardly any evidence that Medicare billings/reimbursements are increased by EMRs because of "cloning", i.e., using templates to document services NOT actually delivered.
I believe EMRs improve charge capture, not fraud, thus increased costs to Medicare. We have in the past underbilled. That day is over.
KC
1:53 am on Friday, September 28, 2012
It is absolutely a necessity to have IT's where you have computers. Networked systems are altogether different than stand alone PCs. What if you are in a tough situation and the computer crashes. Will the doc know what to do w.o the drop down menus.? There is just so much information - too much information that we all need anymore. The recent security breach of the major banks stands as a warning I think. If evil doers can freeze people's bank accounts couldn't they concievably alter or delete imperative information on a medical record? It is scary to think of the potential for abuse. Still the technology is a wonderful tool for connecting people to good doctors and treatments and as organizational tools.
firedup49
3:07 pm on Sunday, September 23, 2012
New York Times...that I have known for a long time
Medicare Bills Rise as Records Turn Electronic
Published: September 21, 2012
When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.
But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.
“What’s happening is just the problem we feared,” he said.
http://www.nytimes.com/2012/09/22/business/medicare-billing-rises-at-hospitals-with-electronic-records.html
firedup49
3:12 pm on Sunday, September 23, 2012
I know of 3 private practicing physicians that do not want to invest in this, to hire someone to do more work and problems then it's worth, with the new Obama healthcare program
Chris Welch
7:34 pm on Sunday, September 23, 2012
Or maybe hospitals and physicians are finally getting paid the correct amount (vs being under reimbursed) for services provided. As pathetic as that amount is when it comes to Medicare reimbursements.
You all just assume that hospitals and doctors are cheating the government.
Did it ever occur to you that the government has been cheating the providers for years ?
firedup49
10:20 pm on Sunday, September 23, 2012
Chris Welch
Your are correct and I agree, the government has been cheating (stiffing) doctors for years. With the new Health care law they will get screwed even more this is also why some maybe most doctor will not take new Medicare and especially Medicaid patients.
Did you know that medicare turns down more then regular health care companies.
James Salwitz
7:10 pm on Sunday, September 23, 2012
Thanks again for the great comments. Some quick thoughts - as pointed out by Bob G. drop downs are not ideal and can be slow. In general effcient data entry, while improving, is still an problem with present EMRs and requires development. However, it does beat dication or hand writing. Most hospitals have or are implementing EMRs ... for example all three of the area hospitals at which I attend are partial or fully electronic. I have no doubt that a few "bad eggs" do manipulate electronic billing to "up code", but in general EMRs encourage more accurate billing by more closely tying clinical activities to charges. There are a number of physicians that have resisted implementation as it is a major transition and despite the large amount of money available from the federal government is a significant investment in time. I am reminded of the woodsman who manually pushed and pulled his silent chain saw to cut down a tree because he did not want to take the time to get gas.
jcs
Uncle Moe
6:24 pm on Monday, September 24, 2012
Obamacare will mandate the implant of RFID chips in our skin to track us, this EMR mumbo jumbo is just to provide the pretext! Dont go down this slippery slope
KC
2:00 am on Friday, September 28, 2012
Geez Moe if it will get rid of some of this identity theft and voluminous paper work I think some of us would volunteer for the chip.
Jeremiah Wright
7:04 pm on Monday, September 24, 2012
Hey doc - Are the infection rates at British hospitals lower or higher than American hospitals? Wait times for procedures? And what about the Brits and their lovely teeth. Yeah, govt run health care is a smashing success. What a laugh.
Joe R
7:40 pm on Monday, September 24, 2012
What about Israel, New Zealand, Japan, Taiwan, Canada, Denmark, Holland, Austria, Norway, Sweden, Finland, France, Germany, etc., all counries with universal health care and no one goes bankrupt from medical expenses? What about all the Americans who go bankrupt from medical costs, even the folks with insurance, what about all the Americans who can't afford dental care, the 50 million uninsured (US Census)? The Brits do not want our cruel mish mash of a health care non system.
Chris Welch
8:47 pm on Monday, September 24, 2012
Joe R
Do you actually know anything about the cost and quality of healthcare in those countries ?
The myth of people going bankrupt from "medical expenses" is only slightly smaller then the myth of 50 million Americans without insurance.
But nice job on covering the democrat talking points.
Bill
8:37 am on Tuesday, September 25, 2012
This is an economic issue. Government regulations have made it so expensive to invest in EMR many practices simply take a pass. Practices are often run by physicians, or even worse, the spouse of one of the partners. There are no business people on the staff. Decisions are made based on the short term goals of the partners, not the long term good of the business.
Joe R
10:22 am on Tuesday, September 25, 2012
@Chris Welch: OK, the new figures are out, it's down to 48.6 million UNINSURED. Obamacare helped to lower the number uninsured. The U.S. Census Bureau reported Wednesday that 48.6 million people were uninsured in 2011 -- down from 50 million the year before.
http://money.cnn.com/2012/09/12/news/economy/census-bureau-health-insurance/index.html
New census data shows that for the first time since 2007, the number of Americans without health insurance declined. However, high rates of poverty persisted.
The Washington Post: Number Of Uninsured Americans Drops By 1.3 Million, Census Report Shows
One spot of good news in the census data released Wednesday was on the health-care front: For the first time in three years, the share of Americans without health insurance declined, with the number of uninsured dropping by 1.3 million people from 2010 to 2011. A major factor was an influx of newly insured young adults, many of whom benefitted from a provision in the 2010 health-care law requiring insurers to let parents keep adult children on their plans up to age 26 (Aizenman, 9/12).
http://www.kaiserhealthnews.org/Daily-Reports/2012/September/13/census-numbers.aspx
Donna Griffin
10:35 pm on Tuesday, September 25, 2012
Joe R - Maybe the number of uninsured went down because they entered the Medicaid rolls because their unemployment benefits ran out? It would certainly make sense to me.
Joe R
10:23 am on Tuesday, September 25, 2012
48.6 million people uninsured in 2011, that's from the US CENSUS!
Bob Griffiths
10:32 am on Tuesday, September 25, 2012
Romney has a solution, all 48.6 million uninsured can go to the ER if they get sick, yea that will work!
Chris Welch
11:17 am on Tuesday, September 25, 2012
I'm not going to waste time with people that chose to read garbage put out but BS organizations like Money and Kaiser..
Here's the report from the CBO. Why don't you go read it.
http://cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf
Joe R
10:29 am on Tuesday, September 25, 2012
From CNN, 6-9-2011:
This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills.
Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine. [snip]
"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that's the major finding in our study."
http://www.kaiserhealthnews.org/Daily-Reports/2012/September/13/census-numbers.aspx
Chris Welch
11:24 am on Tuesday, September 25, 2012
Medical Bankruptcy at 50% or more. Another lie told often enough that people like you believe it.
http://content.healthaffairs.org/content/25/2/w74.long
"David Himmelstein and colleagues recently contended that medical problems contribute to 54.5 percent of personal bankruptcies and threaten the solvency of solidly middle-class Americans. They propose comprehensive national health insurance as a solution. A reexamination of their data suggests that medical bills are a contributing factor in just 17 percent of personal bankruptcies and that those affected tend to have incomes closer to poverty level than to middle class."
KC
2:05 am on Friday, September 28, 2012
I just spent the entire night combing through a medical insurance comparison chart for my daughter - a young professional who switched jobs. You need a Philadlphia lawyer to pick an insurance plan! She at least has coverage I think - but am not sure with all of the loopholes and whatifs. Still not sure what plan offers what after spending considerable time.
Joe R
10:32 am on Tuesday, September 25, 2012
Whoops, the hyperlink for medical bankruptcies is http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH. Medical bills prompt more than 60 percent of U.S. bankruptcies.
KC
2:09 am on Friday, September 28, 2012
Joe, Chis I have a sister who was not long ago diagnosed with light chain myeloma. It is a form of cancer. Can you believe her husband's insurance ( Parks Department City of New York employee for twenty five years) his insurance said " Chemotherapy - Noncoverable Expense." This is happening to people and it is very real. You may think you have insurance until you need it and then you find out. You may only think you have insurance. I swear to you this is the gospel truth.
Joe R
10:48 am on Tuesday, September 25, 2012
You do realize that just one visit to the ER can cost thousands of dollars and the hospital will go after you for payments. If you don't have insurance or if your insurer refuses to pay or only pays a pittance, you could lose your shirt (bankruptcy).
Chris Welch
11:28 am on Tuesday, September 25, 2012
Considering I work at a hospital I'm pretty familiar with the costs involved with treating patients.
I know it's terrible that a hospital expects to be paid for services, but we don't come here and work for free.
Do you get paid for your work ? If someone walked into your place of business and asked for services but then told you they can't pay, what would you say ?
marylou
2:40 pm on Tuesday, September 25, 2012
Joe R,hospitals will only go aftger you for money if you tell them the truth.I know of people who own a nice home,cars,electronics,jewelry,etc.They go to the ER don't pay anything that their insurance doesn't cover.They apply for charity care and get it.
I also have a friend who had outpatient surgery recently.His insurance company declined to cover the anesthsia.There was no option to have the surgery without anesthesia,so he has to pay for that himself.So,yeah,I can see how people could become bankrupt from medical bills.
Donna Griffin
3:07 pm on Tuesday, September 25, 2012
marylou - If you are aware of charity application fraud, you have an obligation to report it. Hospitals will absolutely attach assets (homes, bank accounts, etc.) for unpaid bills. Hospitals do not operate on rainbows and sunshine.
Chris Welch
3:27 pm on Tuesday, September 25, 2012
@Donna - rainbow skittles are my favorite form of payment. I wonder if the muffler shop will accept them too. My truck needs some work. ;)
I'd guarantee you that 75% or more of Americans don't have the slightest clue how expensive medical care is.
Donna Griffin
3:45 pm on Tuesday, September 25, 2012
I'm with you on that, Chris. People only know the term "overhead" when it applies to storing bags on an airline.
marylou
3:55 pm on Tuesday, September 25, 2012
Donna,you don't know how much I'd love to have these people caught.I checked into it with a woman who works in the billing dept.of hospital in another state.She said that it's been her experience that the hosptals more or less take the word of the person applying for charity care.She also said that anyone reporting someone has to know their personal information,SS#,how much their mortgage payment(s) is,other loans they may have, etc.,which I don't know.I;m not even sure which hospitals they went to.
Donna Griffin
5:25 pm on Tuesday, September 25, 2012
marylou - You can e-mail anonymously your concerns regarding the alleged charity care fraud you have experienced. Here is the address: Charity.Care-Fraud@doh.state.nj.us. They do not require the detail you indicated but do ask for as much information as you have available. Alternately, you may phone them at 866-588-5696. They will investigate the matter. Remember that by so doing you are preventing system abuse and saving taxpayer dollars. Good luck.
Donna Griffin
5:29 pm on Tuesday, September 25, 2012
marylou - One more thing with respect to your friend's anesthesiologist. The same thing happened to me with surgery as the anesthesiologist was out of network. When I spoke with my insurer, however, they did make an exception as the hospital and surgeon were both in-network and I was not provided with an option of another anesthesiologist at the time of my procedure. Hard to believe, but insurance companies can be reasonable at times.
Bob Griffiths
10:55 am on Tuesday, September 25, 2012
For Romney to even suggest the ER for the uninsured is evidence of his disconnection from a real understanding of the issue.
Chris Welch
11:43 am on Tuesday, September 25, 2012
Not what he suggested.
But why let a sound bite taken out of context go to waste.
And I don't support the guy.
Joe R
12:32 pm on Tuesday, September 25, 2012
Let's try this again: one visit to the ER could easily force a working class family, living paycheck to paycheck, into bankruptcy. When the right wing yahoos claim that everyone is covered because everyone can go to the ER, they leave out the part that the ER is not free and that they will go after you for payments. You cannot go to the ER for follow up care, regular check ups or palliative care.
Joe R
12:50 pm on Tuesday, September 25, 2012
July 30, 2011|By Kate Santich, Orlando Sentinel
Ellie's birth on Aug. 30, 2007, began a 25-day, $74,000 stay in one of the most expensive places in any hospital. More daunting, it would launch a four-year journey of fear, hope, devotion and grief — a journey made all the more difficult by financial devastation.
Ultimately, it led two middle-class parents with good jobs, two major health-insurance policies and a house in suburbia into foreclosure and bankruptcy.
"To this day," Simon said, "we still have creditors calling us, wanting to talk to Ellie. They'll say things like, 'We want to discuss how she's going to take care of this overdue bill.' I just lose it."
Ellie Sutherland died June 26. She was two months shy of her fourth birthday.
Though financial failures often have been blamed on careless consumer borrowing or the widespread layoffs of the recession, the Sutherlands' financial storyline is strikingly common.
Joe R
12:51 pm on Tuesday, September 25, 2012
Orlando Sentinel article continued:
Two years ago, researchers at Harvard and Ohio universities reported that 62 percent of all bankruptcies were related to medical debt. An American family, they said, filed for bankruptcy in the aftermath of illness every 90 seconds — and three-quarters of those families had health insurance.
Although the data used for the study is now 4 years old, most experts interviewed said the problem is likely only to have worsened, at least until this year, as out-of-pocket medical costs have continued to spiral.
In addition, widespread layoffs have contributed to the rapid rise in uninsured Americans, who now number more than 59 million. For most of them, any major medical expense threatens to overwhelm their resources, leading to further bankruptcies and driving up costs for those who can pay. According to Families USA — a nonprofit, nonpartisan consumer-advocacy group — the shifting of uncompensated care onto insured patients results in a "hidden health tax."
Chris Welch
10:27 pm on Tuesday, September 25, 2012
@JoeR - Question for you.
Why did you chose to leave this section of the story about Ellie out ?
" Marsha tried to sign Ellie up for Social Security disability, and when that failed, for Medicaid. Even after the family was down to a single income, though, the couple made too much to qualify.
I was very overwhelmed at first," Marsha said. "Now I know that the game is that they automatically deny you at least three times — any parent in our world knows that."
Good old government healthcare turning people away. Imagine that.
Maryanne
3:31 pm on Tuesday, September 25, 2012
Hmmmmm......the number keeps growing and growing.......if healthcare costs for those who already pay keep climbing and is already unaffordable, how on earth can the system absord and pay for 47 million more people? I suppose the answer Joe R has in mind is the Federal Government borrowing the money from China and adding to our $16 trillion national debt. All in the name of avoiding bankruptcy right?
Maryanne
3:33 pm on Tuesday, September 25, 2012
OMG!!!! Another lie by Obama!! Told by ABC of all places.
"During Obama’s term, between 2009 to 2012, premiums have climbed $2,370 for the average family with an employer-provided plan – a rate faster than the during the previous four years under President George W. Bush, according to Kaiser."
http://abcnews.go.com/blogs/politics/2012/09/rising-health-costs-undermine-obama-pledge-to-curb-trend/
Maryanne
3:42 pm on Tuesday, September 25, 2012
Another dent in the economy coming as healthcare costs consume more and more of our paychecks. Oh wait, wasn't Obamascare going to reduce them? Did I miss out already? With $4 gas and rising insurance costs, I sure hope I can put food on the table. Thanks Obama. You are a great President NOT!
http://www.reuters.com/article/2011/08/18/us-healthcare-costs-idUSTRE77H62B20110818
Maryanne
3:49 pm on Tuesday, September 25, 2012
@ChrisWelch most think insurance and other stuff is free today so why would they ever care how much something really costs. Someone else will always pay. Isn't that why the government borrows $1 trillion a year it doesn't already take in? Gotta fill those election year promises. Who cares if there is no money or the debt is $16 trillion and irresponsible.
Maryanne
4:08 pm on Tuesday, September 25, 2012
More incovenient truths about Obamascare
I really like how Obama has EXEMPTED so many from the plan he is so proud of. Guess it's not good enough for some.
New regulations Obamacare puts on insurers have been so unworkable that the Obama team has had to dole out 1,231 waivers. These exemptions are granted when the Obamacare rules are projected to raise healthcare premiums more than 10 percent, or create a "significant decrease in access to healthcare benefits." These waivers haven't been doled out consistently. Entities winning the preferences are over-represented by plans offered by unionized businesses and other administration allies.
http://www.realclearmarkets.com/articles/2012/09/19/the_emerging_obamacare_truth_is_disarray_99890.html
John Jay
4:09 pm on Tuesday, September 25, 2012
Obamacare is more than a scam: it's an invasive intrusion on our privacy, income, and personal choices regarding how we, as FREE AMERICANS choose how to live.
RE: "Joshua Huddy 3:47 pm on Tuesday, September 25, 2012 We do not need Obamacare, which is just a scam to get the Insurance Industry's hand in the pocket of more Americans."
Spooner
6:09 pm on Tuesday, September 25, 2012
...another time your using Freedom again. . .yet your opposed to freedom of choice for woman when it comes to abortion. . .Oh that's only if they weren't playing around!
Spooner
6:12 pm on Tuesday, September 25, 2012
and Josh: if your opposed to insurance companies getting their hands in medical coverage. . .then there was the "single payer option". . .no insurance middle man there!
Joe R
4:38 pm on Tuesday, September 25, 2012
Just wondering if all you right wingers are against Medicare, Medicaid and the VA? The VA is actual socialized medicine. Ronny Raygun was paid big bucks in the early 1960s to propagandize against Medicare saying that it would lead to socialism, communism and a loss of freedom. Without Medicare, we would have another 45 to 50 million uninsured added to the already 48.6 million uninsured (US CENSUS).
Donna Griffin
6:15 pm on Tuesday, September 25, 2012
Honestly, Joshua....our Veterans deserve far better than the VA system of healthcare. The voluminous red tape, the illogical service points requiring pick ups from all around the state to get the veteran to his doctor, the wait times at the facilities...it is an absolute shame. This problem can be laid at the feet of both parties. This is one reason why I fear Obamacare as well. The cost overruns in the VA and Medicare systems show me that the federal government hasn't a clue on how to function as the primary insurer of healthcare in our nation. Heaven help us all.
wheres murrow?
6:57 pm on Tuesday, September 25, 2012
Majority of vets lean conservative. No one can deny however the va improvements realized under the President. Funding, access, facility improvements. PTSD and brain trauma initiatives. I'm interested to know what the vets think of last weeks republican senate block of more veteran specific improvements. How does any senator vote against that?
wheres murrow?
7:14 pm on Tuesday, September 25, 2012
@ chris, thanks for your service. not pushing anything but the facts. I don't blame you for not trusting the stuff you see on politically charged blogs, but here it is from the vfw you're vote is your own and i respect everyone's right to that. But the facts can be found at trusted sources like the vfw
http://www.vfw.org/News-and-Events/Articles/2012-Articles/Fact-Sheet--President-Obama%e2%80%99s-Work-to-Honor-our-Military-Families-and-Veterans/
wheres murrow?
8:23 pm on Tuesday, September 25, 2012
The Veterans Job Corps Act of 2012, sought to lower unemployment among military veterans, giving grants to federal, state, and local agencies, which in turn would hire veterans -- giving priority to those who served on or after 9/11 -- to work as first-responders and in conservation jobs at national parks - Senate Republicans killed this last week. Where is the outrage ?
Donna Griffin
9:32 pm on Tuesday, September 25, 2012
where's murrow - The most effective way of lowering unemployment across the board is for the federal government to get out of the way of business and take a legitimate step toward improving our educational system by allowing parents the option of school choice. Between regulations and tax burdens alone and an educational system ranked 31st internationally, it is no small wonder we are in the financial hole we are in. The World Economic Forum dropped the US economy ranking from first in 2008 to fourth place this week. For goodness sake, Finland's economy is stronger than our nation's. Spending more money on job creation is NOT the job of the federal government even if the noble cause is veterans. Veterans, in a healthy economy, have always been highly sought-after employees. Unless we fix our business environment in the US, the feds cannot spend their way (with borrowed money) out of this unemployment mess. Everyone, including our Veterans, will continue to suffer.
wheres murrow?
9:55 pm on Tuesday, September 25, 2012
Donna, I think history tells us that Friedman economics don't work. That aside, this bill was deficit neutral in 5 yrs. The Iraq and Afghanistan Veterans of America made a last minute plea but it fell on the deaf ears of the obstructionist republican senate. (Most of them anyway, several gop did the right thing and voted yes, alas it was not enough). I'm sure Mitt the draft dodger will take care of our vets if he wins.
Donna Griffin
10:25 pm on Tuesday, September 25, 2012
where's murrow - I guess that private sector business philosophies would not have worked in those oh so successful soviet economies. It's interesting too that this "draft dodger" is polling nearly 20 points higher among veterans than President Obama. I guess they have yet to drink the Kool Aid. Lastly, please tell me how 20,000 temporary jobs at a cost of $1 billion to the tax payer would provide a long-term fix for 700,000 unemployed veterans? The political timing seemed to be driving the Democrats on this one.
Maryanne
4:47 pm on Tuesday, September 25, 2012
WOW Joe R. Everyone who has an opinion and can do basic math is automatically a "right winger" I guess if being accurate makes me "right" then YEP I AM! It's easy for people like you to spend money we need to borrow from China to make yourself feel good. We get it. Our problem is the debt and the irresponsible and unpatriotic borrowing from CHINA that your pal Obama complained about. Is borrowing money suddenly OK when it does what you want it to do? What's next free cell phones for anyone who doesn't already have one? Wait.....they have that too. It's paid for by borrowing from CHINA
Bob Griffiths
8:07 am on Wednesday, September 26, 2012
Ah, knock it off; whether you like it or not, Electronic Medical Records are a reality and will become the standard. You can politicize it all you want, none the less it will happen, and politics has nothing to do with it. Too many people only have a memory that goes back to 2008 and the election of a new President, get over it. I would compare all this hoopla about EMR's to the uproar that occurred back in the 1960's when IBM was selling mainframe computer systems to business and industries. These systems took over billing and inventory and there where many that cried, just like some of you, that it was too expensive to change over and maintain. You had to hire Programmers and Key Punchers, blah, blah, blah. Well, the crying didn’t change a damn thing, it happened, you can’t stop progress, not even a Conservative Republican can do that.
Maryanne
9:03 am on Wednesday, September 26, 2012
Thanks for the lecture Bob. I agree technology when deployed properly can be effective. Problem is with EMR it is NOT the case. Doctors I know are spending more time on their devices than with patients. That's bad!!
I'm more interested in knowing why I was promised EMR would save money, healthcare costs would go down and I would get a raise. You know you just can't trust Obama to tell the truth.
John Jay
9:13 am on Wednesday, September 26, 2012
The use of EMR will be used asa weapon against the people to comply withh Obamcare. Your records will become part of the illegal big government scam Obama and his supporters within the insurance annd banking industry.
Bob Griffiths
9:51 am on Wednesday, September 26, 2012
Where have you people been for the last 10 years? The law that set the standard for EMR’s was signed in 2002, it’s called HIPAA. Now let me give you a history “lecture”, Obama wasn’t President, you can guess who was, the compliance dates were in 2003 and 2004 for EMR’s. Did you just hear about it now? There was no “Obamacare” then, or didn’t you know that either? Health care reform at the time was only a twinkle in the eye of Senator Kennedy and Bill and Hillary Clinton.
Maryanne
9:56 am on Wednesday, September 26, 2012
Bob who cares?? EMR is driving up COSTS!! That is not the answer to rising healthcare costs. We were promised lower costs and raises by Obama!!! Where are they?
Bob Griffiths
10:12 am on Wednesday, September 26, 2012
Maryanne, with all due respect, you should care, if you are going to address a topic and act like you know what you are talking about.
Maryanne
10:15 am on Wednesday, September 26, 2012
Bob nice try at deflection. I said I don't care who started the idea. The idea has value but obviously like all government activities, it hasn't worked. By working I mean LOWERING COSTS! Do you disagree? Where's your data? I am sick and tired of being lied to by Obama. I will cut the debt. The debt is unpatriotic. I won't raise taxes. You can keep your doctor. I won't give out exemptions to my union pals for Obamascare. I will create jobs. Healthcare costs will go down and we will get raises
Chris Welch
10:54 am on Wednesday, September 26, 2012
@ Maryann - I've worked in healthcare for 17 years. No president, (including Obama) has anything to say about us getting raises. Never have, never will.
Sure decisions they make can have an impact on the operating costs, but that's it.
If he truely said that, add it to the "stupid crap Presidents say" video and leave it at that.
Maryanne
11:00 am on Wednesday, September 26, 2012
That is the exactly the point I was trying to make. Obama says "stupid crap" on a daily basis to stay in power while the real world watches costs go up and jobs get lost. Obama did in fact say healthcare costs would go down and we could have raises. Thanks for helping deliver the message!!
Bob Griffiths
11:29 am on Wednesday, September 26, 2012
Maryanne, I assume from your comments you work in health care, if you are an RN, I can fully understand your frustration. Over the past 10 or 15 years Nursing salaries have been going down, with more nurses on per diem, with no job security and no benefits, the rate can be OK but not dependable. Many feel that Nursing has taken the brunt of the impact as hospitals pass on the loss from indigent care and unpaid bills from the uninsured. As the Affordable Care Act is phased in it will delete those claims for the uninsured and ensures payment for services for every patient making health care more profitable for everyone.
Chris Welch
12:01 pm on Wednesday, September 26, 2012
@ Bob, "As the Affordable Care Act is phased in it will delete those claims for the uninsured and ensures payment for services for every patient making health care more profitable for everyone."
How do you figure this ? Where is the money coming from to cover services provided to the uninsured ?
Maryanne
3:08 pm on Wednesday, September 26, 2012
Bob how does the government ensure payments? You mean like borrowing from China to pay them? Yes, I do work in healthcare. Nursing salaries like everyone else in a legitimate business that needs to make money has taken a hit. You know what the number one impact to salaries is???? Increased costs for healthcare. #2 pension expenses. Sounds kinda like the same issues facing governments who until recently could just raise and raise our taxes.
John Jay
11:32 am on Wednesday, September 26, 2012
I have a right to be left alone. It doesn't matter if I am a billionaire, working-class, or not a dime to my name.
American citizens should not be forced to submit medical information about themselves against thier will. This is government coercion at its worst because it forces people to submit their most private information of all: personal medical information.
We are going to need to have massive resistance to Obamacare -- and vote out any politician Rep. or Dem. who supports this tax on working Americans.
John Jay
11:59 am on Wednesday, September 26, 2012
Wait until the IRS starts using heavily-armed SWAT-like teams to raid the homes of citizens who do not comply (knowingly or unknowingly) with the Obamacare law.
It will be sad, but it will not suprise me when federal agents kill citizens over their Obamacare "taxes" during the course of a raid.
How will the IRS know all about you? The federal government will have access to your EMRs! They will be Nazi Gestapo on sterioids, folks. Check out some of the many abuses "militarized" federal agents have recently committed.
The craziest was the man whose home was raided by a SWAT team because his estranged wife did not pay her student loans. http://www.huffingtonpost.com/john-w-whitehead/swat-team-mania-the-war-a_b_875967.html
Bob Griffiths
12:18 pm on Wednesday, September 26, 2012
The objective is to provide affordable health care coverage to individuals and small businesses by utilizing health insurance exchanges and a public option. Competition drives down price.
Maryanne
3:04 pm on Wednesday, September 26, 2012
Huh? Competition like free markets drives down prices? Oh my, did you just say that? Why didn't the insurance companies just open up across state lines? I'm still trying to understand how adding 10million of the 40million uninsured drives down costs? All data shows costs are the problem and EMR and Obamascare will not drive costs down. It's a great goal to insure everyone just like it was a great idea to allow everyone to buy a house whether they could afford it or not.
Spooner
3:40 pm on Wednesday, September 26, 2012
Maryanne- what insurance/state rights world do you live. . .open up across state lines. . .hey you'd better go read the fine print before you give anymore of those one liners...States and the insurance businesses that operate there would than have competition. . .This was the same argument when they proposed unemployment insurance in Wisconsin way back during the depression. . .where people would gravitate to Wisconsin for the insurance, while the employers would be at a competitive disadvantage having to pay for it.
Chris Welch
12:25 pm on Wednesday, September 26, 2012
You didn't answer my question.
How does it address the 30 million American citizens (according to CBO estimates) that still will not have health coverage by 2022 ?
And I wrote "American citizens" because you can add another 12-15 million illegals onto that number.
That comes straight from the CBO report on the AMA.
http://cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf
Uncle Moe
10:30 pm on Wednesday, September 26, 2012
Repeal Obamacare. Nobody should be forced to purchase ANY insurance. I for one am proudly uninsured and practice natural and herbal remedies, which dont cause cancer like chemotherapy
marylou
9:00 am on Friday, September 28, 2012
Good for youBut,what happens if hyou have an accident and they rush you to the ER unconcious?Who pays for that?I have no problem with you being uninsured as long as you pay for your own care,and do apply for charity care.Just bear in mind even the heathiest people break bones,have cateracts and contract disases.
marylou
1:36 pm on Friday, September 28, 2012
'do NOT" apply for charity care...
KC
2:27 am on Friday, September 28, 2012
Who mucked the entire thing up was not the docs or the insurance companies, or Obama it was the creep lawyers. As soon as you got the creep lawyers involved in things it all went haywire. I remember paying fifteen dollars to see a doctor and five dollars to get prescribed meds. I ususally had ten bucks left for some chicken soup and went home to sleep. Now forget about it. The system is broken and the litigeous ones are to blame.
John Jay
5:01 am on Friday, September 28, 2012
I have to disagree with KC regarding who "mucked" healthcare -- it was the moment the government, under LBJ, stuck his dirty fingers into it. All of the promises of "lower cost" and that it was for "the children"...blah, blah, blah.
The government has been feeding on us like a swarm of blood-sucking tics. The scary thing is that there are millions of people out there who surrendered their liberty in exchange for sub-standard "government" care.
Ben Dover
8:49 am on Friday, September 28, 2012
So far the data shows that EMR costs have driven up the cost of healthcare. Obamacare has driven up the costs of healthcare. adding millions more to the system are driving up the costs for healthcare.
What happened to trying to solve the problem of rising costs? All the government is doing is placating more people and forcing the rest to pay more.
Did you hear Sears is going to stop paying for healthcare and instead give employees an amout that they can they spend. This is the only way they can cap their exposure and remain in business.
More and more companies have also capped their contribution. Why is that???
Maybe Bob can enlighten us all on how much our local school systems will see their healthcare costs rise this year and since we know we pay for that via property taxes how much that is going to cost us on top of paying for our own increases.
John Jay
9:41 am on Friday, September 28, 2012
Remove the 30 million illegal immigrants that are breaking the financial backs of hospitals will allow poor American citizens to receive better care. This is not a statement to be mean, this is a statement of fact.
I choose to use the 30 million number because I distrust the Obama administration's "estimate" of about 11 million. They don't want to admit the real numbers that are causing undue burdens to hospitals and other groups that must provide "services" for illegals.
Would any other nation tolerate the situation the United States faces today? Be honest with yourselves and demand that whoever "runs" Washington to correct this situation.