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.

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

Posted in Bailouts, Dependency, Economic Issues, Entrepreneurs, Free Society, Free-Market, government incompetence, Government Regulations, Government Spending, Government Stimulus, Job loss, Keynesian Economics, Liberty, Organizational structure, Philosophy, Policy Issues, Uncategorized, Unemployment

Focus on People During Economic Crises, Not Macro-Statistics – Foundation for Economic Education

By Mark Hornshaw

“Economics studies human choice under scarcity. Humans must act in the present to provide for the future. Informed choice relies on market data in the form of prices—specific prices for specific things, as we assess various different means to satisfy our ends—that is what economics is about.

Macro-statistics such as GDP and CPI, whether they are rising or falling in the aggregate, do not help much with this vital task. These statistics are compilations of vast amounts of data to come up with averages across entire countries and time-periods. It’s a dilution of the data, not an enhancement.

“What a country wants to make it richer, is never consumption, but production. Where there is the latter, we may be sure that there is no want of the former,” said John Stuart Mill, citing Say’s law.

In a tune of rapid change and disruption, we need prices to do their job more than ever so the entrepreneurial process can work. High prices show which industries to move more resources into, and low prices show which ones to move resources out of to free them up for more urgent uses. From the point of view of consumers, high prices show us what we should cut back on, and low prices show where we can pick up bargains.

This process takes time. Interfering with this process just locks in shortages and surpluses.
So-called “stimulus,” just thrown at “the economy” to increase “aggregate demand” in the abstract, cannot work, when there are supply constraints in some industries and prohibitions in others.

Government policy should be on mending holes in the social safety net, compensating those it has forced out of business and jobs, and reducing the tax and regulatory burden it places on businesses, workers and consumers as they try to adjust.

These are all microeconomic responses to relieve suffering and remove impediments.”

https://fee.org/articles/focus-on-people-during-economic-crises-not-macro-statistics/

Posted in Bailouts, Currency Manipulation, Dependency, Economic Issues, Federal Reserve, Government Regulations, Government Spending, Interest on the Debt, Keynesian Economics, Policy Issues, Tax Policy, Uncategorized

Economic Lessons from Coronavirus: Government-Subsidized Private Debt Creates Macro Vulnerability | International Liberty

Little more than a decade after consumers binged on inexpensive mortgages that helped bring on a global financial crisis, a new debt surge — this time by major corporations — threatens to unleash fresh turmoil.

The root cause of the debt boom is the decision by the Federal Reserve and other key central banks to cut interest rates to zero in the wake of the financial crisis and to hold them at historic lows for years.

https://danieljmitchell.wordpress.com/2020/03/20/economic-lessons-from-coronavirus-government-subsidized-private-debt-creates-macro-vulnerability/

Posted in Access to healthcare, Canadian Health System, Economic Issues, Government Regulations, Healthcare financing, Medical Costs, Organizational structure, Policy Issues, Uncategorized

Alberta ends master agreement with doctors, new rules to be in place April 1 | CBC News

HEALTHCARE ECONOMIC REALITY CHECK:

  • Supply is limited (it is a service & commodity that is rendered by others)
  • Demand is inexhaustible (innumerable definitions of healthcare needs and wants)
  • Fixing prices exacerbates shortages (resources flow to where they are valued)

This article instantiates the snares and trappings of gov’t financed systems where gov’t functions as a buyer, payer and regulator!  

In the case of this Alberta Canada conundrum, cutting fees is a surrogate for rationing. It encourages providers to short-cut care by reducing time spent with complex patients.  The dangerous flip side of that ugly coin is that the cuts encourage emphasis on increasing the number of shorter visits.

 

tyler-shandro
Health Minister Tyler Shandro says enforcing new rules on Alberta doctors is necessary to meet budget targets. (Colin Hall/CBC)

Last fall, Premier Jason Kenney’s United Conservatives passed Bill 21, which gives the government the right to unilaterally end the agreement.

A decade ago, Alberta added in an extra fee — called a complex modifier — to recognize that some patients have multiple or complex issues and doctors should be compensated for overly long visits.

If a visit went more than 15 minutes, doctors were able to extend it 10 minutes and bill the province a complex modifier fee of $18, for a total of $59.

As of April 1, the fee will be halved from $18 to $9, for a new total fee of $50.

As of April 1, 2021, the $18 complex modifier will return. But physicians won’t be allowed to bill for it until the 25-minute mark.

Doctors warn of cutting visits

Shandro’s ministry says the change is necessary for two reasons: more time is needed to assess complex patients and the current complex modifier is being abused, with too many doctors billing the $59 right at the 15-minute mark.

At a news conference announcing the changes, Shandro said the modifier was being used for almost 50 per cent of visits.

The Alberta Medical Association, the bargaining arm for doctors, has said extending the length of a visit to 25 minutes would reduce fees by a total of $200 million and devastate many family and rural practices.

The AMA has argued the complex modifiers are not only for exceptional cases and take into account all the work — preparation, follow-up and face-to-face time — needed for patients with complex needs. It also says it keeps those patients out of the hospital.

The issue has riled up some doctors, many of whom have put up signs warning patients they may have to cut future visits short to recoup funds needed to keep their practices going.

https://www.cbc.ca/news/canada/calgary/alberta-government-doctors-pay-ama-agreement-1.5470352

Posted in American Presidents, big government, Education, Free Society, Government Regulations, Liberty, Philosophy, Policy Issues, Representative Republic vs. Democracy, Rule of Law, U.S. Constitution, Uncategorized

Without Free Speech, All Speech Becomes Government Speech – Foundation for Economic Education

By Barry Brownstein

A new survey conducted in the United States by the Campaign for Free Speech found 51 percent of Americans agreed with this statement: “The First Amendment goes too far in allowing hate speech in modern America and should be updated to reflect the cultural norms of today.” 48 percent thought, and a majority of millennials agreed, “hate speech” should be outlawed. An astonishing 54 percent of millennials thought jail time should be the consequence penalty for hate speech. Hate speech was not defined in the survey.

In a future democratic socialist administration mired in economic collapse, is it a stretch to predict that protection of free speech will continue to wane making criticism of government policies verboten?

If disagreement over the number of genders can’t be tolerated, surely disagreements on a debt jubilee or a wealth tax wouldn’t be tolerated either.

https://fee.org/articles/without-free-speech-all-speech-becomes-government-speech/

Posted in Education, FDA, Government Regulations, Medical Costs, Patient Safety, Policy Issues, Technology, U.S. Security, Uncategorized

Is that a Centipede I See in My Capsule?? | MedPage Today

Eban: They knew I was coming. They had let me come in, but I saw a very different world within these plants through whistleblowers. I worked with a lot of whistleblowers who had contacted me — or I had made contact with them — who were showing me documents, showing me photographs, giving me really the sort of gory details of what was happening in these plants and the kinds of crazy decisions that were being made like failing drugs, drugs that had glass particles in them were being approved to be dispensed. Broken down, rusted equipment that was leaving metallic fragments in pills. Those were being dispensed.

Illicit use of ingredients. You can’t just swap ingredients. But they had drugs that were dissolving improperly, so they just haphazardly changed things up to try to get better data to show the FDA. All of this was taking place in a kind of lawless regulatory environment. They’re not afraid of their own regulators. They’re afraid of the FDA, but what they have built is an elaborate system to trick the FDA. Our FDA has all but volunteered to be tricked because we announce our inspections in advance overseas. We give 3 months’ notice. They send in data fabrication teams.

https://www.medpagetoday.com/podcasts/anamnesis/84501

Posted in Access to healthcare, advance-pricing, Consumer-Driven Health Care, CPT billing, Defined Contribution Benefit Plans, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Government Regulations, Health Insurance, Healthcare financing, Patient Choice, Policy Issues, Uncategorized

Why Value-based Payment Methods Won’t Fix Healthcare

I’ve read several posts today on so called “Value-based payment” strategies and I couldn’t resist adding my 2-cents.

VBP can’t fix these fundamental problems because it is still based on a price-opaque shell game I like to call Fee-for-Coding, which results in:

1) Price insensitivity on the utilizer’s part.

2) Misaligned incentives on the provider’s part.

3) Lack of important price signals between buyers and sellers due to lack of advance pricing capabilities.

VBP utilizes the same fundamentally flawed economic system as our current billing model.

Moving to value-based care will require…

1) A system where prices are known in advance of care (not trauma or emergency care where extent of injuries or illness are unknown at onset – but even still a lot of those can be estimated ahead of time based on scenarios).

2) …that physicians be paid to be available to solve our problems, where payment is not tied to documenting work in a chart.

3) …that we move to a system that is based on defined contributions as opposed to defined benefits. As John C. Goodman is fond of saying, “money should follow people”, not programs and insurance policies.

Value will be elusive until we let the discipline of the market work in healthcare.

https://www.linkedin.com/pulse/why-value-based-payment-methods-wont-fix-healthcare-robert-nelson-md/