This rings home when seeking articles concerning our current health care system in the U.S. I took excerpts from an article written by Dr. Schroeder, published in the New England Journal of Medicine. What do you think???
The United States spends more on health care than any other nation in the world, yet it ranks poorly on nearly every measure of health status. How can this be? What explains this apparent paradox?
The two-part answer is deceptively simple — first, the pathways to better health do not generally depend on better health care, and second, even in those instances in which health care is important, too many Americans do not receive it, receive it too late, or receive poor-quality care.
Among the 30 developed nations that make up the Organization for Economic Cooperation and Development (OECD), the United States ranks near the bottom on most standard measures of health status (One measure on which the United States does better is life expectancy from the age of 65 years, possibly reflecting the comprehensive health insurance provided for this segment of the population.) Among the 192 nations for which 2004 data are available, the United States ranks 46th in average life expectancy from birth and 42nd in infant mortality. It is remarkable how complacent the public and the medical profession are in their acceptance of these unfavorable comparisons, especially in light of how carefully we track health-systems measures, such as the size of the budget for the National Institutes of Health, trends in national spending on health, and the number of Americans who lack health insurance. One reason for the complacency may be the rationalization that the United States is more ethnically heterogeneous than the nations at the top of the rankings, such as Japan, Switzerland, and Iceland. It is true that within the United States there are large disparities in health status — by geographic area, race and ethnic group, and class. But even when comparisons are limited to white Americans, our performance is dismal. And even if the health status of white Americans matched that in the leading nations, it would still be incumbent on us to improve the health of the entire nation.
Although inadequate health care accounts for only 10% of premature deaths, health care receives by far the greatest share of resources and attention. In the case of heart disease, it is estimated that health care has accounted for half of the 40% decline in mortality over the past two decades.
Improving population health would be more than a statistical accomplishment. It could enhance the productivity of the workforce and boost the national economy, reduce health care expenditures, and most important, improve people's lives. But in the absence of a strong political voice from the less fortunate themselves, it is incumbent on health care professionals, especially physicians, to become champions for population health.
Americans take great pride in asserting that we are number one in terms of wealth, number of Nobel Prizes, and military strength. Why don't we try to become number one in health? -Steven A.Schroeder, MD
Wednesday, September 26, 2007
Monday, September 24, 2007
SICKO Healthcare System
I found this blurb at http://www.bestamericanhospital.blogspot.com
It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore's indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 — most of them insured — say they are "somewhat" or "completely" unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year — perhaps as many as half — are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing — yes, "dating back to the 1980s" — and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.
The question is why we let these problems fester and what we can do to address them.
How do you Medical Billers feel about this?
It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore's indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 — most of them insured — say they are "somewhat" or "completely" unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year — perhaps as many as half — are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing — yes, "dating back to the 1980s" — and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.
The question is why we let these problems fester and what we can do to address them.
How do you Medical Billers feel about this?
Thursday, August 23, 2007
SICKO - A Review
I found this review at http://www.stylusmagazine.com/articles/movie_review/sicko.htm by Yannick LeJacq.
The review is quite long, so visit the above site to read more...
When I went to see Sicko, I sat next to a group of middle-aged, mild-mannered women who were talking softly before the movie started. Then a large picture of George W. Bush appeared on screen, and the women next to me, along with most of the theater, began jeering and laughing so loudly I couldn't hear what the President was actually saying. This continued throughout the movie. The audience enunciated each punch line not with a laugh, but with a resounding “ohhhhh!” as if this were an episode of “Yo Momma.”
You could say this is all circumstantial. But, really, I think this is what Sicko is supposed to be. Almost all the overviews and reviews I've heard of the movie begin with a phrase like, “Michael Moore: first, he took on GM. Then, he took on the NRA. Next up was the Bush administration. Now, he's setting his sights on health care.” The movie poster shows Moore putting on a doctor’s glove with a mischievous and aggressive look on his face under the tagline, “This might hurt a little.” Moore is picking a fight with someone.
Many critics have noted that Sicko is Moore's most mature work, and they praise the new observational, tragic tone he carries alongside his trademark cynicism. I agree that the opening interviews of the movie are some of the best work Moore has ever done. The first half of Sicko consists largely of individual stories of people affected by America's health care system. Moore shows people cheated out of proper financial assistance for obscure reasons, and pairs them with startling confessions by people who used to work for HMOs, describing how they received praise for denying as much financial assistance as possible. But he's only interviewing people that fundamentally corroborate his view on health care. Looking back through his films, you can see that Moore reserves the most eloquent outrage for those with whom he sympathizes.
I think this is because Michael Moore, as the ideologue that he enjoys being, has no real appreciation for journalistic research. He prefers to take a polemic than analytical approach to an issue. It's easy to see why he does this. It gives him his gruff, un-intellectual charm that's made him compelling from the beginning of his career. People didn't go to see Fahrenheit 9/11, just as I'm sure they didn't go to see Sicko, to learn anything new (you can find out very easily that socialized health care means you get treated at the hospital for free); they went because, by supporting Michael Moore, they're inherently becoming part of his rant. Through him, they're shouting at the powerful, incompetent elite they're also sick of.
The review is quite long, so visit the above site to read more...
When I went to see Sicko, I sat next to a group of middle-aged, mild-mannered women who were talking softly before the movie started. Then a large picture of George W. Bush appeared on screen, and the women next to me, along with most of the theater, began jeering and laughing so loudly I couldn't hear what the President was actually saying. This continued throughout the movie. The audience enunciated each punch line not with a laugh, but with a resounding “ohhhhh!” as if this were an episode of “Yo Momma.”
You could say this is all circumstantial. But, really, I think this is what Sicko is supposed to be. Almost all the overviews and reviews I've heard of the movie begin with a phrase like, “Michael Moore: first, he took on GM. Then, he took on the NRA. Next up was the Bush administration. Now, he's setting his sights on health care.” The movie poster shows Moore putting on a doctor’s glove with a mischievous and aggressive look on his face under the tagline, “This might hurt a little.” Moore is picking a fight with someone.
Many critics have noted that Sicko is Moore's most mature work, and they praise the new observational, tragic tone he carries alongside his trademark cynicism. I agree that the opening interviews of the movie are some of the best work Moore has ever done. The first half of Sicko consists largely of individual stories of people affected by America's health care system. Moore shows people cheated out of proper financial assistance for obscure reasons, and pairs them with startling confessions by people who used to work for HMOs, describing how they received praise for denying as much financial assistance as possible. But he's only interviewing people that fundamentally corroborate his view on health care. Looking back through his films, you can see that Moore reserves the most eloquent outrage for those with whom he sympathizes.
I think this is because Michael Moore, as the ideologue that he enjoys being, has no real appreciation for journalistic research. He prefers to take a polemic than analytical approach to an issue. It's easy to see why he does this. It gives him his gruff, un-intellectual charm that's made him compelling from the beginning of his career. People didn't go to see Fahrenheit 9/11, just as I'm sure they didn't go to see Sicko, to learn anything new (you can find out very easily that socialized health care means you get treated at the hospital for free); they went because, by supporting Michael Moore, they're inherently becoming part of his rant. Through him, they're shouting at the powerful, incompetent elite they're also sick of.
Tuesday, August 14, 2007
SICKO Billing - Words Directly From Michael Moore
How about some words DIRECTLY from Michael Moore!
I found this excerpt from an article in LA times.
For more on this, visit http://www.latimes.com/entertainment/news/la-et-moore21may21
"When people say there is no confrontation in this movie, to me there is a big confrontation in this movie," Moore said in an interview here. "Because I am confronting the American audience with a question: 'Who are we, and what has happened to our soul?' To me, that's maybe more confrontation than going after the CEO of Aetna or the CEO of Pfizer." The reason Moore feels compelled to ask this "Sicko" question is because, he feels, the country unthinkingly settles for substandard and ruinously expensive medical treatment, especially when compared with countries with universal healthcare.
"I don't have to convince the American public that there is something wrong with our health care system. I think most American people already feel that way," said Moore, who enjoys great coverage himself through the Directors Guild of America. "That's why I don't spend a lot of time in the film on the healthcare horror stories. I wanted to propose that there's a different way we can go with this. I'm hoping that the American people, when they see this film, will say, 'You know, there is a better way, and maybe we should look at what they are doing in some of these other countries..."
Medical Billers need to stay up with all news in health care, whether sparked from their own individual client's level OR from a documentary which brings our health care crisis to light.
I found this excerpt from an article in LA times.
For more on this, visit http://www.latimes.com/entertainment/news/la-et-moore21may21
"When people say there is no confrontation in this movie, to me there is a big confrontation in this movie," Moore said in an interview here. "Because I am confronting the American audience with a question: 'Who are we, and what has happened to our soul?' To me, that's maybe more confrontation than going after the CEO of Aetna or the CEO of Pfizer." The reason Moore feels compelled to ask this "Sicko" question is because, he feels, the country unthinkingly settles for substandard and ruinously expensive medical treatment, especially when compared with countries with universal healthcare.
"I don't have to convince the American public that there is something wrong with our health care system. I think most American people already feel that way," said Moore, who enjoys great coverage himself through the Directors Guild of America. "That's why I don't spend a lot of time in the film on the healthcare horror stories. I wanted to propose that there's a different way we can go with this. I'm hoping that the American people, when they see this film, will say, 'You know, there is a better way, and maybe we should look at what they are doing in some of these other countries..."
Medical Billers need to stay up with all news in health care, whether sparked from their own individual client's level OR from a documentary which brings our health care crisis to light.
Thursday, August 9, 2007
Medical Billing - "Transparent" Charges; Is This Possible?
As I have mentioned, previously, a DRASTIC change to our health care system, LIKE Socialized Medicine, makes me nervous as a Medical Biller. I feel that this type of change would put my job in jeopardy.
I did, however, see a news segment recently that spoke about "Transparency" in insurance billing and payouts, according to specialty and whether the services received by the patient were done so at a hospital, clinic or private practice.
This seems like an interesting idea and I'll explain why.
The current system varies to extremes.
I have TWO Physical Therapy clients. Each submits an identical code. One of my clients receives a reimbursement of $69.27, while the other - for the exact same code - receives $16.38! What is with these numbers?? There is no rhyme or reason and getting a valid explanation from a payer is next to near impossible.
It's almost as if the representatives employed at these carriers are unable to explain such vast differences in payouts also.
In a revised "Transparent" health care system, all providers within a specialty would be reimbursed at the exact same rate, regardless of history or longevity, or which size the moon was at the time while credentialing with the carrier.
There would be SOME variation depending upon the location of the services; hospital, clinic or private practice. But, Medicare would need to impose such a regulation in order for all carriers to follow suit.
Asking Medicare for a change to this magnitude is like asking the sun to quiet its rays for a while; impossible!
However, the only organization that could force Medicare to oblige would be the government, somewhat, unfortunately...
SICKO and Michael Moore are, of course, considered fiercely liberal.
What this movie has done though, is forced a dialogue to occur regardless of one's position in the political spectrum. A republican from Iowa - Charles Grassley -is the individual that coined "Transparency".
Many advocates for change in our health care system see this point of view as the closest to the best outcome for all to date.
What do you think??
I did, however, see a news segment recently that spoke about "Transparency" in insurance billing and payouts, according to specialty and whether the services received by the patient were done so at a hospital, clinic or private practice.
This seems like an interesting idea and I'll explain why.
The current system varies to extremes.
I have TWO Physical Therapy clients. Each submits an identical code. One of my clients receives a reimbursement of $69.27, while the other - for the exact same code - receives $16.38! What is with these numbers?? There is no rhyme or reason and getting a valid explanation from a payer is next to near impossible.
It's almost as if the representatives employed at these carriers are unable to explain such vast differences in payouts also.
In a revised "Transparent" health care system, all providers within a specialty would be reimbursed at the exact same rate, regardless of history or longevity, or which size the moon was at the time while credentialing with the carrier.
There would be SOME variation depending upon the location of the services; hospital, clinic or private practice. But, Medicare would need to impose such a regulation in order for all carriers to follow suit.
Asking Medicare for a change to this magnitude is like asking the sun to quiet its rays for a while; impossible!
However, the only organization that could force Medicare to oblige would be the government, somewhat, unfortunately...
SICKO and Michael Moore are, of course, considered fiercely liberal.
What this movie has done though, is forced a dialogue to occur regardless of one's position in the political spectrum. A republican from Iowa - Charles Grassley -is the individual that coined "Transparency".
Many advocates for change in our health care system see this point of view as the closest to the best outcome for all to date.
What do you think??
Tuesday, August 7, 2007
SICKO Billing - Single Payor System Would NOT Impact Quality of Care?
As a Professional Mdical Biller, I continuously seek information on the possible impact of a change in our health care system.
The reason that I do this, is because I survive on the process as it exists today.
Private practice owners generally do not have the resources or the money to support the overhead in keeping medical billing in-house. They seek an outsourced solution, like ME to process electronic medical claims on their behalf.
I am convinced that a single payor system would NOT improve anything BUT the paperwork currently required. That is it. It would not impact the quality of care at all.
So, with that said, perhaps health care system in the US shouldn't change all that much?
What I would like to see change are the numbers of people that lack health coverage go away entirely.
Every person deserves health insurance and all should have it for proper medical care.
I found this quote at http://whynow.dumka.us/2007/07/02/more-on-the-sicko-issue/
"Paperwork is a major cost of the American health care system that would be radically cut by a single payer system, and would have no impact at all on the quality of care. This is something that the insurance companies could have done decades ago, but chose not to, and just made it worse. Confusing billing procedures delays payouts, and that is one of the reasons they do it, no matter what they tell you."
And, I agree.
The reason that I do this, is because I survive on the process as it exists today.
Private practice owners generally do not have the resources or the money to support the overhead in keeping medical billing in-house. They seek an outsourced solution, like ME to process electronic medical claims on their behalf.
I am convinced that a single payor system would NOT improve anything BUT the paperwork currently required. That is it. It would not impact the quality of care at all.
So, with that said, perhaps health care system in the US shouldn't change all that much?
What I would like to see change are the numbers of people that lack health coverage go away entirely.
Every person deserves health insurance and all should have it for proper medical care.
I found this quote at http://whynow.dumka.us/2007/07/02/more-on-the-sicko-issue/
"Paperwork is a major cost of the American health care system that would be radically cut by a single payer system, and would have no impact at all on the quality of care. This is something that the insurance companies could have done decades ago, but chose not to, and just made it worse. Confusing billing procedures delays payouts, and that is one of the reasons they do it, no matter what they tell you."
And, I agree.
Tuesday, July 31, 2007
Michael Moore - "I've been saved"
This article can be found at http://www.comcast.net in their news section.
Moore: I've Been Served
Sun Jul 29, 8:05 PM
Maybe Michael Moore isn't paranoid, because it sure seems like the government really is out to get him.
The firebrand filmmaker says he has been served with a subpoena by the federal government for a trip to Cuba for his hit health-care documentary, Sicko. The Treasury Department confirmed two months ago that it was probing Moore's visit to Cuba, during which he was accompanied by some ailing 9/11 rescue workers.
Appearing Thursday on NBC's Tonight Show with Jay Leno, the Oscar winner said he had just learned backstage that he had been served with an order compelling him to testify about his sojourn to the communist nation.
"I haven't even told my own family this yet," Moore said. "I was just informed when I was back there with Jay that the Bush administration has now issued a subpoena for me, going after me for helping these 9/11 rescue workers."
Michael Moore's No Paris Hilton
Bootleg Sicko Copies Quarantined
Moore to Bush: Stop Pestering Me
E! Online
"No, no, for going to Cuba, not for helping them," chimed in Leno.
In March, the Fahrenheit 9/11 helmer and a trio of first responders who had fallen ill after working around ground zero traveled to the U.S. Naval Base at Guantanamo Bay to demand the same quality health care that administration officials publicly promised was being given to suspected Al Qaeda terrorists held there.
After getting no response from U.S. authorities, Moore and his traveling companions subsequently received free medical treatment from Cuban doctors, which the 53-year-old helmer depicted in Sicko, ostensibly to point out the failings of America's health-care system.
"I didn't go there like Cameron Diaz, to get a tan," quipped Moore. "I was there to help them, and now I'm going to face this further harassment from the Bush people. Aren't they busy with something else?"
In May, the Treasury's Office of Foreign Assets Control, or OFAC, sent a letter to Moore requesting information about the trip, which it claimed was not approved. (Under the U.S. government's comprehensive trade embargo, American citizens are forbidden to work in Cuba unless granted an exception.)
Moore shot back with an open letter to U.S. Treasury Secretary Henry Paulson, calling for an end to the investigation and accusing the White House of playing politics by using a government agency to try to silence him.
He also stated he informed the OFAC in October about the Cuba trip, asserting that as a journalist, he qualified for an exemption to the travel ban, a point he reiterated with Leno last week.
"A journalist can go, and this is a work of journalism," said Moore. "And frankly, the larger point is being missed here. The point is that first of all, can we all agree we should take care of our 9/11 rescue workers?"
The statement elicited cheers from the studio audience.
Moore's attorney, David Boies, could not be reached for comment.
According to Reuters, Boies was contacted by a representative of the U.S. Department of Commerce, who requested the name of a person to accept the subpoena on Moore's behalf.
Aside from his burgeoning offscreen problems, Moore dropped another bombshell to Leno, saying that Harvey Weinstein—whose Weinstein company is distributing Sicko and who's also one of Hilary Clinton's biggest Hollywood supporters—asked Moore to cut scenes criticizing the Democratic presidential candidate.
The reason? Because Moore called out Clinton for purportedly accepting the most campaign donations of any senator from lobbyists representing the same private insurers and drug companies she's railed against in the past.
Moore refused, and Weinstein eventually backed down. The director also announced on The Tonight Show that the Weinstein Company has agreed to donate 11 percent of Sicko's box office to help ailing 9/11 workers who have been ignored by the Bush administration
Moore: I've Been Served
Sun Jul 29, 8:05 PM
Maybe Michael Moore isn't paranoid, because it sure seems like the government really is out to get him.
The firebrand filmmaker says he has been served with a subpoena by the federal government for a trip to Cuba for his hit health-care documentary, Sicko. The Treasury Department confirmed two months ago that it was probing Moore's visit to Cuba, during which he was accompanied by some ailing 9/11 rescue workers.
Appearing Thursday on NBC's Tonight Show with Jay Leno, the Oscar winner said he had just learned backstage that he had been served with an order compelling him to testify about his sojourn to the communist nation.
"I haven't even told my own family this yet," Moore said. "I was just informed when I was back there with Jay that the Bush administration has now issued a subpoena for me, going after me for helping these 9/11 rescue workers."
Michael Moore's No Paris Hilton
Bootleg Sicko Copies Quarantined
Moore to Bush: Stop Pestering Me
E! Online
"No, no, for going to Cuba, not for helping them," chimed in Leno.
In March, the Fahrenheit 9/11 helmer and a trio of first responders who had fallen ill after working around ground zero traveled to the U.S. Naval Base at Guantanamo Bay to demand the same quality health care that administration officials publicly promised was being given to suspected Al Qaeda terrorists held there.
After getting no response from U.S. authorities, Moore and his traveling companions subsequently received free medical treatment from Cuban doctors, which the 53-year-old helmer depicted in Sicko, ostensibly to point out the failings of America's health-care system.
"I didn't go there like Cameron Diaz, to get a tan," quipped Moore. "I was there to help them, and now I'm going to face this further harassment from the Bush people. Aren't they busy with something else?"
In May, the Treasury's Office of Foreign Assets Control, or OFAC, sent a letter to Moore requesting information about the trip, which it claimed was not approved. (Under the U.S. government's comprehensive trade embargo, American citizens are forbidden to work in Cuba unless granted an exception.)
Moore shot back with an open letter to U.S. Treasury Secretary Henry Paulson, calling for an end to the investigation and accusing the White House of playing politics by using a government agency to try to silence him.
He also stated he informed the OFAC in October about the Cuba trip, asserting that as a journalist, he qualified for an exemption to the travel ban, a point he reiterated with Leno last week.
"A journalist can go, and this is a work of journalism," said Moore. "And frankly, the larger point is being missed here. The point is that first of all, can we all agree we should take care of our 9/11 rescue workers?"
The statement elicited cheers from the studio audience.
Moore's attorney, David Boies, could not be reached for comment.
According to Reuters, Boies was contacted by a representative of the U.S. Department of Commerce, who requested the name of a person to accept the subpoena on Moore's behalf.
Aside from his burgeoning offscreen problems, Moore dropped another bombshell to Leno, saying that Harvey Weinstein—whose Weinstein company is distributing Sicko and who's also one of Hilary Clinton's biggest Hollywood supporters—asked Moore to cut scenes criticizing the Democratic presidential candidate.
The reason? Because Moore called out Clinton for purportedly accepting the most campaign donations of any senator from lobbyists representing the same private insurers and drug companies she's railed against in the past.
Moore refused, and Weinstein eventually backed down. The director also announced on The Tonight Show that the Weinstein Company has agreed to donate 11 percent of Sicko's box office to help ailing 9/11 workers who have been ignored by the Bush administration
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