Tag Archives: end of life care

Health Policy Updates: October 29 2016

The federal government recently confirmed that health insurance premiums on the Obamacare exchanges will be, as previously warned, getting significantly more expensive next year. There is a lot of variation, with prices going up by a lot more in some states and actually declining in others, but the overall average increase is going to be about 22%.

Sarah Kliff at Vox.com explains what this means:

“In either case, these numbers are bad news for Obamacare — we just don’t know how bad, exactly, the news is at this point.”

The NYTimes offers a summary as well:

“Most people are unaffected by the rate increases because they get their insurance through an employer or are covered through government programs like Medicare, Medicaid or the Department of Veterans Affairs.”
Continue reading Health Policy Updates: October 29 2016

Health Policy Updates: June 11 2016

After this study made the news several years ago, it became common knowledge that “doctors die differently” from the rest of us. Having been behind the scenes in providing care to dying patients, the story went, doctors know how ineffective and truly painful such care can be. As a result, they are more interested in Hospice care, and they forgo such interventions such a CPR when they finally reach the end. If only everyone knew what doctors know, then they could be spared the agony and indignity of dying in a hospital!

In contrast, a more recent study finds that doctors really don’t differ from everyone else. It seems like they spend just as much time in the hospital, and in the ICU. I was surprised by this finding; if true, it makes me more pessimistic about the ability of more information or education to help people to avoid painful, costly, low-value care at the end of life.

“They found that the majority of physicians and non-physicians were hospitalized in the last six months of life and that the small difference between the two groups was not statistically significant after adjusting for other variables. The groups also had the same likelihood of having at least one stay in the ICU during that period”
Continue reading Health Policy Updates: June 11 2016

Health Policy Updates: January 22 2016

Bernie Sander’s new single-payer health care plan was introduced at the beginning of the week, and Ezra KIein of the left-leaning Vox media was not so keen. Big promises of new benefits, but where exactly was the money to pay for it coming from?

“All in all, Sanders wants to raise taxes by a bit over a trillion dollars per year — which may not sound like much to those who remember the Obamacare debate, but remember that the numbers that got thrown around for Obamacare were 10-year estimates. Adding inflation, Sanders will be raising taxes by close to $15 trillion when the Congressional Budget Office applies its normal scoring window.”

Continue reading Health Policy Updates: January 22 2016

Health Policy Updates: August 15 2015

You may have heard of the “21th Century Cures Act,” which is winding its way through Congress. If you want a summary of the act, with some opinion on its merits and drawbacks from the physician’s perspective, check out this summary on the Science Based Medicine blog.

“The central question regarding my supporting the 21st Century Cures Act is whether the decent—but not spectacularly so—provisions in the bill outweigh the bad and the ugly. To answer this question, let’s take a closer look. In examining this bill, it is important to note the central assumptions behind the bill.”

Continue reading Health Policy Updates: August 15 2015

Health Policy Updates: July 26 2015

A very fair question: why is anyone going to be in favor of health care reimbursement reform, when all the incentives are to maintain the status quo? That is, doctors and hospitals make out just fine under the fee-for-service system we have right now – why would they want to scrap that and move to a capitation model or bundled payment system? A US New article asks that question this week.

“Attempts at changing payment models in the past, however, have yielded only modest savings at best. Also, what remains unclear is why hospitals would buy into a payment system voluntarily that likely would reduce their bottom lines.” Continue reading Health Policy Updates: July 26 2015