Posted in Access to healthcare, Affordable Care Act (ObamaCare), American Presidents, big government, Consumer-Driven Health Care, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Free-Market, Government Regulations, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medical Costs, Medical Practice Models, News From Washington, Patient Choice, Patient-centered Care, Policy Issues, Price Tansparency, primary care, Subsidies, Uncategorized

Fund the Money Pit or Move to Sustainable Patient-Centered Care: Rethinking Health Care Policy | RealClearHealth

Despite proposals from Biden to double-down on the current dysfunction, the Republicans have not coalesced around one plan, though many market-friendly reforms have been floated. Given the obvious fatal flaws of the Affordable Care Act and lack of political will to confront the real cost-drivers, many have lost faith in a government solution for a problem that government largely caused.

Fortunately, the private sector has brought forward new ideas for health care reforms, and these promise access to affordable and innovative care on our terms. Alternative market-driven options exist that improve access, reduce costs, and move patients into closer relationships with their doctors instead of with government bureaucracies.

https://www.realclearhealth.com/articles/2020/11/30/fund_the_money_pit_or_move_to_sustainable_patient-centered_care_rethinking_health_care_policy_111144.html

Posted in big government, CDC, Dependency, Education, Government Regulations, Liberty, Organizational structure, Patient Choice, Patient Safety, Philosophy, Policy Issues, Prevention, Protocols, Rule of Law, Uncategorized

The CDC Perspective on COVID Shielding Approaches and Green Zones: A Humanitarian Oxymoron?

Manitoba Metis Federation minister of energy and infrastructure minister Jack Park hosts a video tour of a 96-room camp the federation is setting up for people who may need to isolate or quarantine if the coronavirus hits a high number of people. (Screenshot)

 

The comments below are in response to a CDC article entitled, Operational Considerations for Humanitarian Settings. As citizens with sovereign rights, we need to be aware of the “operational considerations” being discussed by policymakers & influencers, because there is not ONE reference to, or acknowledgement of, the individual right of self-determination or rights of families to make decisions for themselves.

Leave it to the public health theorists, who truly believe it’s their job to war-game these scenarios (and then make our decisions for us) to miss the obvious.

Like, for instance, the fact that things rarely turn out optimally.  Their planning should not only acknowledge that reality, but the ACTUAL final plan should assume bad stuff happens and reflect that reality in its design.

But alas, that’s not what we get with Green Zone Shielding Approach to those at high risk for COVID19.

As a person with common sense and a hopeful future, you would not store kindling in same box as flammable accelerants. Nor, would you stow all weapons & ammunition in same cache; or invest all funds in the same asset class.  No, you wouldn’t protect your precious resources that way; you would minimize your risk by using strategies designed to diversify, shield, obscure your cargo from theft, devaluation or damage.

To be fair, the CDC acknowledges…“Inadvertent introduction of the virus into a green zone may result in rapid transmission among the most vulnerable populations the approach is trying to protect.”  They seem confident that careful central planning can mitigate that risk.

So here’s an excerpt from a CDC article about humanitarian issues pertaining to shielding approaches for those at high-risk for COVID. The article’s stated purpose was to give the CDC’s perspective on and challenges to…“implementing the shielding approach in humanitarian settings as outlined in guidance documents focused on camps, displaced populations and low-resource settings.”1,2 

It goes on to state, “High-risk individuals would be temporarily relocated to safe or “green zones” established at the household, neighborhood, camp/sector or community level…”

  • “Neighbors “swap” households to accommodate high-risk individuals.”
  • “A group of shelters such as schools, community buildings within a camp/sector (max 50 high-risk individuals per single green zone) where high-risk individuals are physically isolated together.”
  • “No movement into or outside the green zone.”

Other considerations:

  • “Plan for an extended duration of implementation time, at least 6 months.”
  • “Ensure safe and protective environments for all individuals, including minors and individuals who require additional care whether they are in the green zone or remain in a household after the primary caregiver or income provider has moved to the green zone.”

Note the focus on “camps, displaced populations and low resource settings.” No one should be comfortable with the historical images conjured up by that quote. Need I say more?

In the summary section, the CDC authors admit the shielding approach is “ambitious” but offer no proof of concept. 

Specifically they state, “The shielding approach is an ambitious undertaking, which may prove effective in preventing COVID-19 infection among high-risk populations if well managed. While the premise is based on mitigation strategies used in the United Kingdom,24,25 there is no empirical evidence whether this approach will increase, decrease or have no effect on morbidity and mortality during the COVID-19 epidemic in various humanitarian settings.”

What could possibly go wrong?

Interim Operational Considerations for Implementing the Shielding Approach to Prevent COVID-19 Infections in Humanitarian Settings | CDC

Posted in Access to healthcare, advance-pricing, Economic Issues, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, Medical Practice Models, out-of-pocket costs, Patient Choice, Price Tansparency, primary care, Uncategorized

Wealth Extracting “Insurance” Bureaucracy vs Real Value-based Care: #DPC

From Dr. Lee Gross, Epiphany Health:

“New patient in the office today had a CT scan ordered by his urologist for presumed symptomatic kidney stones, which was denied by his insurance for 2 months. I ordered the study stat, cash pay. Done 30 minutes later, $220 cost paid by the patient. Stone identified, results given same day. Treatment and care plan initiated. Now that we have a diagnosis, the urologist has the insurance logjam relieved to proceed with a care plan if our conservative therapy is ineffective. Insurance is frequently an obstacle to health care.” #DPC

https://www.facebook.com/groups/DPCdocs/permalink/3473547759342175/

Posted in Canadian Health System, Disease Prevention, emotional intelligence, outcomes measurement, Patient Choice, Patient Safety, Policy Issues, Prevention, Protocols, Uncategorized, Unsettled Science

The surgical mask is a bad fit for risk reduction|Shane Neilson, MD | CMAJ.JAMC

1880606f1

As represented by our cinema and other media, Western society expects too much of masks. In the public’s mind, the still-legitimate use of masks for source control has gone off-label; masks are thought to prevent infection. From here, another problem arises: because surgical masks are thought to protect against infection in the community setting, people wearing masks for legitimate purposes (those who have a cough in a hospital, say) form part of the larger misperception and act to reinforce it. Even this proper use of surgical masks is incorporated into a larger improper use in the era of pandemic fear, especially in Asia, where such fear is high. The widespread misconception about the use of surgical masks — that wearing a mask protects against the transmission of virus — is a problem of the kind theorized by German sociologist Ulrich Beck.

The surgical mask communicates risk. For most, risk is perceived as the potential loss of something of value, but there is another side to risk, memorably formulated by Beck in his Risk Society. Beck states that risk society is “a systematic way of dealing with hazards and insecurities induced and introduced by modernisation itself.” For Beck, risk occurs not only in the form of threat and possible loss, but also in society’s organized management and response to these risks, which create a forwarding of present risk into the future. Furthermore, Beck writes of the “symptoms and symbols of risks” that combine in populations to create a “cosmetics of risk.” He suggests that people living in the present moment conceive of risk in terms of the physical tools used to mitigate risk while still “maintaining the source of the filth.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868614/#:~:text=Wearing%20a%20mask%20reinforces%20fear,%2C%20but%20somehow%20threatening%2C%20future.

 

Posted in Evidence-based Medicine, News From Washington, outcomes measurement, Patient Choice, Patient Safety, Policy Issues, Prevention, Protocols, Uncategorized

The data is in — stop the panic and end the total isolation | TheHill

Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.

Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding.

Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures.

https://thehill.com/opinion/healthcare/494034-the-data-are-in-stop-the-panic-and-end-the-total-isolation

Posted in Access to healthcare, American Exceptionalism, Consumer-Driven Health Care, Dependency, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Free Society, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, Medical Practice Models, News From Washington, DC & Related Shenanigans, Organizational structure, Patient Choice, Patient Safety, Patient-centered Care, Policy Issues, primary care, Quality, Technology, Telemedicine Trends, Third-Party Free Practices, Uncategorized

Shelter In-Place Care: Another “Box Checked” for the Value of Direct Primary Care

HEADLINE:

FCC Unveils COVID-19 Telehealth Program, Updates Connected Care Pilot

The Federal Communications Commission is using $200 million in funding from the CARES Act to launch a new program to help providers access the broadband resources they need to support telehealth programs.

Wow, the government has discovered remote digital technology medical care!  Although, maybe a little late. What would we do without those innovative minds in D.C. ?!?

But there’s a better solution that’s been up and running for more than a decade; private citizens being free to act and chose what services they value.  It is a solution which occurred organically when an innovative supply side acted to solve other people’s problems within a cooperative marketplace driven by mutual benefit.  It is called Direct Primary Care (DPC). And it is only possible because we still have some semblance of healthcare freedom within our society.  No thanks to Washington, D.C.

But step aside, the FCC with money to burn is coming to the rescue after COVID is already in full crisis mode.

The DPC Consumer Guide -- Now Available for office/clinic use and and an educational/marketing resource for your patients.Never mind that Direct Primary Care physicians have routinely integrated remote care technology platforms into their practices for a more than a decade.  And set aside the fact that revenue in a DPC business model doesn’t rely on office visits (the opposite of social distancing) to trigger a billable encounter, the claim against which is paid out of a grossly over-priced pre-paid 3rd party fund that we call health insurance.  Instead, the Direct Primary Care physician is paid to be available to solve problems, answer questions, triage illness/injury, provide treatment and advice via the most appropriate venue for each patient.

And last, no disrespect meant to the media outlet below for featuring this story.  They are just reporting the healthcare news, as is their mission.

logos

https://mhealthintelligence.com/news/fcc-unveils-covid-19-telehealth-program-updates-connected-care-pilot

Posted in Access to healthcare, CDC, Disease Prevention, Education, Evidence-based Medicine, FDA, News From Washington, outcomes, outcomes measurement, Patient Choice, Patient Safety, Uncategorized, Unsettled Science

FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

The drug is currently approved for malaria and also for rheumatoid arthritis and systemic lupus erythematosus, which is its main use in the U.S. It’s therefore available to be prescribed off-label, and some clinicians have already said they’re using it on COVID-19 patients. But neither Hahn nor other task force members addressed whether enough hydroxychloroquine is on hand to treat large numbers of coronavirus cases. Convalescent plasma is another treatment the FDA is considering for COVID-19, said FDA Commissioner Stephen Hahn, MD.

Convalescent plasma and the immune globulin that it contains is another possible treatment the agency is considering, Hahn added. “FDA’s been working for some time on this,” he said. “If you’ve been exposed to coronavirus and you’re better — you don’t have the virus in your blood — we could collect the blood, concentrate that and have the ability, once it’s pathogen-free, to give that to other patients, and the immune response could potentially provide a benefit to patients. That’s another thing we’re looking at; over the next couple of weeks, we’ll have information and we’re really pushing hard to try to accelerate that.” Such treatments have been effective in Ebola, for example.

Source: FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

Posted in Access to healthcare, advance-pricing, Economic Issues, Health Insurance, Healthcare financing, Medicaid, Medical Costs, medical inflation, Medical Practice Models, Medicare, out-of-pocket costs, Patient Choice, Price Tansparency, Quality, Uncategorized

G. Keith Smith, M.D. — Health “Coverage” as a Distraction


I think it is good to be alert to any discussions that are “downstream of a flawed premise.” Let me explain.

When I hear, for instance, that the “flat tax” is preferable to the current income tax, I think to myself that this is a discussion of the knife versus the axe, a conversation far downstream of one addressing government spending or the very legitimacy of denying someone their earnings. After all, victims don’t generally care what the mugger does with their money. They just resent being mugged and no discussion about whether the mugger used a knife or a gun will likely provide any solace.

Similarly, I would argue that arguing for everyone to have health “coverage” is far downstream of the more original problem: the cost of healthcare. To provide “coverage” for everyone in the current climate of gross overcharging primarily serves the interests of those who employ the “what can I get away with” method of medical pricing.

The fierce push back against true price transparency by the cronies in the medical industry makes more sense in this context, as price honesty denies them access to everyone’s blank checkbook as the health cronies are well aware.

Supporters of government-guaranteed “coverage” object with the following arguments.

First, coverage is equated with healthcare. While millions of Canadians streaming across the border to secure their health needs could be used to refute the idea that coverage is synonymous with care, this disconnect has become more apparent in this country. Each passing day reveals Medicaid and Medicare “coverage” to be a “black mark,” an actual obstacle to obtaining care, as these government programs and their associated rationing through price controls and hassles are creating the lines the central planners intended. Physicians are either dropping out of these programs altogether or they are limiting their exposure to patients with this “coverage.”

Another objection points to the relief from financial devastation that having “coverage” represents. Keep in mind that not only are well over half of the bankruptcies in this country medically related, but almost three quarters of those filing for medical bankruptcy have insurance. This points powerfully to cost as the root cause of medical economic ills.

Acknowledging this is a slippery slope for the objector, however, for no economic system better provides for resource allocation than the market and the cronies and their government pals know this as well as anyone.

The market is the only source of price deflation with simultaneous improvement in quality. This powerful competitive mechanism has brought affordability to countless products and services in all industries and has begun to bring rationality to health care pricing as more physicians and facilities honestly post their prices for all to see.

Rather than focus on “coverage,” which allows the cronies to continue their financial feeding frenzy, we should remain unalterably focused on cost. The competition unleashed will result in a medical price deflation the likes of which will cause even the most skeptical objector to re-evaluate the role of “coverage” in the provision of payment for health care.

This is no prediction. This is exactly what is happening here in Oklahoma where so many health professionals have embraced the same market discipline every other industry must endure. The reasonable prices and high quality of care, have had such a wide appeal that Oklahoma City has evolved into a medical tourist destination for many patients far from here, while simultaneously bringing savings in the millions of dollars to those who actually pay for healthcare, locally.

This is my answer to another objection from those who claim the inapplicability of market competition to health care.  Whether the focus on “coverage” is a deliberate distraction by the crony propaganda machine or a well-meaning but misguided attempt to provide better access to care, we must keep our eyes on the “price transparency ball.” The Oklahoma market is already harshly judging those attempting to avoid this gaze and I believe this trend will continue as long as we identify, challenge and reject conclusions downstream of their flawed premises.