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 Access to healthcare, big government, Economic Issues, Government Spending, Government Stimulus, Health Insurance, Healthcare financing, Medical Costs, Medicare, Organizational structure, Philosophy, Policy Issues, Uncategorized

5 Charts That Explain the Student Debt Crisis – Foundation for Economic Education

The commonality between the insatiable rise in both healthcare costs and college tuition, post 1965, should be obvious:  Massive amounts of other people’s money in the form of government programs, payments, subsidies and loan guarantees; which economists call the 3rd-party payer effect.

As exposited in the FEE article below, the U.S. Higher Education Act introduced “incentives” into the market for higher education, encouraging both the supply side and the demand side to make decisions that they would not be as likely to make under “non-stimulated” market situations.

Similarly, the passage of Medicare in 1965 sent huge surge of money into the healthcare system. The predictable consequence of this massive revenue stream was an incentive for healthcare providers to enter the market and expand services at an unprecedented magnitude and rate.  Essentially, demand was spurred by new source of financing.  Amy Finkelstein, et.al have done excellent work in this area.  Her work indicates that Medicare funding may have allowed hospital to spend 6-fold more than what individual levels of insurance would have predicted.  And that the spread of 3rd party insurance from 1950 – 1990 may explain about 50% of the increase in real per capita spending over that time period. https://economics.mit.edu/files/788

 

 

“As Bernie Sanders tweeted last year, the cost of education, in nominal dollars, has increased by roughly 3,800 percent since the mid 1960s.

What Sanders didn’t mention was that this was when the US Higher Education Act was passed (1965), which directed taxpayer dollars to low-interest loans for students pursuing college. This increased accessibility to higher education, but the flood of federal money also caused a surge in demand and costs.

The problem isn’t unsolvable, but it will require significant changes to universities and the federal loan program. “Free” tuition and student debt forgiveness will only make the problem worse.

Instead, as University of Maryland economist Peter Morici recently argued, market discipline must be brought back to our institutions of higher learning as part of any debt forgiveness.

While policy wonks offer no shortage of proposals for tweaking the federal loan program to improve it, perhaps the best solution would be to get the federal government out of the loan business all together.”

https://fee.org/articles/5-charts-that-explain-the-student-debt-crisis/

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 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 Access to healthcare, Doctor-Patient Relationship, Healthcare financing, Medical Practice Models, Organizational structure, outcomes measurement, Patient Choice, Patient Safety, Policy Issues, Protocols, Uncategorized

How Chaos at Chain Pharmacies Is Putting Patients at Risk | New York Times

They struggle to fill prescriptions, give flu shots, tend the drive-through, answer phones, work the register, counsel patients and call doctors and insurance companies, they said — all the while racing to meet corporate performance metrics that they characterized as unreasonable and unsafe in an industry squeezed to do more with less.

“I am a danger to the public working for CVS,” one pharmacist wrote in an anonymous letter to the Texas State Board of Pharmacy in April.

“The amount of busywork we must do while verifying prescriptions is absolutely dangerous,” another wrote to the Pennsylvania board in February. “Mistakes are going to be made and the patients are going to be the ones suffering.”

Posted in Economic Issues, Education, emotional intelligence, Organizational structure, outcomes, outcomes measurement, Philosophy, Uncategorized

Watch “Why Did I Say “Yes” to Speak Here? | Malcolm Gladwell | Google Zeitgeist” on YouTube

Fascinating research reveals a phenomenon of Elite Institution Cognitive Dissonance (EICD).

The data demonstrates that the effects of Relative Deprivation, as predictors of success, applies predictably to students at elite and non-elite institutions.

Take-home: Your place within your immediate hierarchy matters more than your place within the universal hierarchy of rank order.