Comments on: Chronic Care http://www.john-goodman-blog.com/chronic-care-2/ Insights on Health Care Reform | NCPA Tue, 16 Mar 2010 03:08:04 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Getting Ready for the Health Care Summit | John Goodman | NCPA http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-53773 Getting Ready for the Health Care Summit | John Goodman | NCPA Tue, 16 Feb 2010 16:32:03 +0000 http://www.john-goodman-blog.com/?p=4046#comment-53773 [...] Allow Special Health Savings Accounts for the Chronically Ill. One of the most successful Medicaid pilot programs is Cash and Counseling, under which the homebound and disabled manage their own budget and are free to hire and fire those who provide them with services. We should use this experience as a model to liberate the chronically ill and empower them in a newly-competitive medical marketplace. (See details in a previous Health Alert on chronic illness and Health Savings Accounts.) [...] [...] Allow Special Health Savings Accounts for the Chronically Ill. One of the most successful Medicaid pilot programs is Cash and Counseling, under which the homebound and disabled manage their own budget and are free to hire and fire those who provide them with services. We should use this experience as a model to liberate the chronically ill and empower them in a newly-competitive medical marketplace. (See details in a previous Health Alert on chronic illness and Health Savings Accounts.) [...]

]]> By: Eric Brown http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-49489 Eric Brown Thu, 26 Nov 2009 17:57:44 +0000 http://www.john-goodman-blog.com/?p=4046#comment-49489 Change is constant. Don't fear it. Your greedy old white man ways are history. Change is constant. Don’t fear it. Your greedy old white man ways are history.

]]> By: Dr. Don Havey http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-47417 Dr. Don Havey Thu, 22 Oct 2009 21:29:34 +0000 http://www.john-goodman-blog.com/?p=4046#comment-47417 John, Thank you for your initiative in sensible Healthcare reform. Government is not interested in sensible healthcare reform but greater control over people and with that, control over the trillions of dollars in healthcare. Place this back into a free market economy with a structure as you have so eloquently outlined, I believe the results would lead to greater efficiency, lower costs, improved patient satisfaction - and I pray to God (if I can still do that)- less government involvement!! John, Thank you for your initiative in sensible Healthcare reform. Government is not interested in sensible healthcare reform but greater control over people and with that, control over the trillions of dollars in healthcare. Place this back into a free market economy with a structure as you have so eloquently outlined, I believe the results would lead to greater efficiency, lower costs, improved patient satisfaction – and I pray to God (if I can still do that)- less government involvement!!

]]> By: Can Walk-in Clinics Provide Chronic Care? | John Goodman | NCPA http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-46088 Can Walk-in Clinics Provide Chronic Care? | John Goodman | NCPA Mon, 14 Sep 2009 13:17:04 +0000 http://www.john-goodman-blog.com/?p=4046#comment-46088 [...] the only thing standing between chronic patients and a dynamic, competitive market that provides low-cost, state-of-the-art chronic care is the third-party payer [...] [...] the only thing standing between chronic patients and a dynamic, competitive market that provides low-cost, state-of-the-art chronic care is the third-party payer [...]

]]> By: n.v.srinivasan,m.d http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-45443 n.v.srinivasan,m.d Thu, 27 Aug 2009 17:45:13 +0000 http://www.john-goodman-blog.com/?p=4046#comment-45443 APH is a great idea.however some drastic actions need to be taken.END OF LIFE CARE needs to be addressed at once and first if we are serious about cost containment.mds need to seriously educate and induce patients and families to consider advance directives and hospice care.{let us not talk about death panels}.multiple consultations,trying to salvage patients who have no hope of not only survival but also quality of life,escalate health care costs astronomically. nursing home patients who have end stage illnesses, and those patients who keep making repeated visits to ed should be encouraged to sign advance directives.eds should have holding areas where patients can be stabilized and observed for few hours and then returned to extended care facilities. too many cts[brain,lung,etc} are ordered by edmds.internists who care for patients in nursing homes avoiding unnecessary patient trips to eds and hospitalizations should compensated by medicare medicaid, and insurers,Adequately.too many unnecessary tests are being ordered,consultations done,inpatients followed in hospital when no more needed,for various reasons by my peers {cardiologist myself}, and they should act more responsibly in the present health care status.OF COURSE ULTIMATELY TORT REFORM IS THE MOST BASIC SOLUTION TO THE PROBLEM.in addition the current practices of the insurance companies,hospitals, and the drug companies as well as the administration of CMS and its coding system need a thorough overhaul and reform. also the medical Academics,for a change, should be more aware of the intricacies of care of patients by their physicians in the trenches. by the way i am a card carrying republican. please give some thought to my suggestions. thanks. APH is a great idea.however some drastic actions need to be taken.END OF LIFE CARE needs to be addressed at once and first if we are serious about cost containment.mds need to seriously educate and induce patients and families to consider advance directives and hospice care.{let us not talk about death panels}.multiple consultations,trying to salvage patients who have no hope of not only survival but also quality of life,escalate health care costs astronomically. nursing home patients who have end stage illnesses, and those patients who keep making repeated visits to ed should be encouraged to sign advance directives.eds should have holding areas where patients can be stabilized and observed for few hours and then returned to extended care facilities. too many cts[brain,lung,etc} are ordered by edmds.internists who care for patients in nursing homes avoiding unnecessary patient trips to eds and hospitalizations should compensated by medicare medicaid, and insurers,Adequately.too many unnecessary tests are being ordered,consultations done,inpatients followed in hospital when no more needed,for various reasons by my peers {cardiologist myself}, and they should act more responsibly in the present health care status.OF COURSE ULTIMATELY TORT REFORM IS THE MOST BASIC SOLUTION TO THE PROBLEM.in addition the current practices of the insurance companies,hospitals, and the drug companies as well as the administration of CMS and its coding system need a thorough overhaul and reform. also the medical Academics,for a change, should be more aware of the intricacies of care of patients by their physicians in the trenches. by the way i am a card carrying republican. please give some thought to my suggestions. thanks.

]]> By: Tom H. http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-43584 Tom H. Wed, 01 Jul 2009 15:37:38 +0000 http://www.john-goodman-blog.com/?p=4046#comment-43584 Congrats on the petition. Congrats on the petition.

]]> By: Stephen C. http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-43577 Stephen C. Wed, 01 Jul 2009 10:41:07 +0000 http://www.john-goodman-blog.com/?p=4046#comment-43577 Lacy: Fixing means liberating. The market will naturally spur entrepreneurs to solve the most difficult problems (greatest needs) if allowed to do so. Lacy: Fixing means liberating. The market will naturally spur entrepreneurs to solve the most difficult problems (greatest needs) if allowed to do so.

]]> By: Lacy Bain http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-43570 Lacy Bain Tue, 30 Jun 2009 21:11:25 +0000 http://www.john-goodman-blog.com/?p=4046#comment-43570 A Mobile Medicine Platform such as American Physician Housecalls is a very clear solution to the most expensive patients that Medicare and Medicaid serve. We can't fix everything at once; why not start with one of the most expensive (and fastest growing) populations first? A Mobile Medicine Platform such as American Physician Housecalls is a very clear solution to the most expensive patients that Medicare and Medicaid serve. We can’t fix everything at once; why not start with one of the most expensive (and fastest growing) populations first?

]]> By: Don Levit http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-43563 Don Levit Tue, 30 Jun 2009 16:21:03 +0000 http://www.john-goodman-blog.com/?p=4046#comment-43563 Devon: Do you think the wellness test would be applicable to a plan in which premiums are not assessed according to risk, but according to ability to pay? The benefits would vary in direct contributions to premiums paid, less claims made. This "formula" would help to alleviate concerns that the plan premiums are based on health status. Ron: One potential way around the HSA/HDHP limitations is to structure a plan around a separate savings account and corresponding insurance plan. As I understand it, the Roth IRA will be available to all income levels next year. A separate portion of that could serve as the savings vehicle. The insurance portion could be designed as I briefly explained in my comment to Devon. Don Levit Devon:
Do you think the wellness test would be applicable to a plan in which premiums are not assessed according to risk, but according to ability to pay?
The benefits would vary in direct contributions to premiums paid, less claims made. This “formula” would help to alleviate concerns that the plan premiums are based on health status.

Ron:
One potential way around the HSA/HDHP limitations is to structure a plan around a separate savings account and corresponding insurance plan.
As I understand it, the Roth IRA will be available to all income levels next year. A separate portion of that could serve as the savings vehicle.
The insurance portion could be designed as I briefly explained in my comment to Devon.
Don Levit

]]> By: Joe S. http://www.john-goodman-blog.com/chronic-care-2/comment-page-1/#comment-43561 Joe S. Tue, 30 Jun 2009 13:49:07 +0000 http://www.john-goodman-blog.com/?p=4046#comment-43561 Very good. Very original. Readers are not going to find this type of analysis anywhere else. Very good. Very original. Readers are not going to find this type of analysis anywhere else.

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