Archive for the ‘patient advocacy’ Category
Americans Speak on Health Reform
March 22nd, 2009 | 
Author: Below is a summery of the recent report put out by the Dept. of Health and Human Services. As a San Jose chiropractor, I realize that the state of health care directly affects both myself and my patients. For more information on patient advocacy groups and what took place go to www.healthreform.gov
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In December 2008, the Presidential Transition Team invited Americans to host and participate in Health Care Community Discussions to talk about how to reform health care in America. Friends, family, neighbors, and co-workers, representing the views of both health care patients and providers, came together in homes, offices, coffee shops, fire houses, universities, and community centers with a common purpose: to discuss reforming the health care system. The Health Care Community Discussions focused on concerns about a “broken” health system, access to health insurance and services, rising premiums and drug costs, being “uninsurable,” medical mistakes, and the system not being “for them.” In 30,603 Participant Surveys, the top concerns were cost (55%), lack of emphasis on prevention (20%), pre-existing conditions limiting insurance access (13%), and concerns about the quality of care (12%). The Health Care Community Discussions offered a wide range of specific suggestions for fixing the system, including making health insurance more accessible through a public plan, creating scorecards on quality and cost, improving the nutritional content of school lunches, implementing electronic medical records, and creating an AmeriCorps for health workers.
What, Patients Don't Count as Stakeholders?
As you may recall, the debate over the economic stimulus featured an intense argument over whether to fund comparative effectiveness studies–that is, research into which drugs, devices, and procedures actually work best and for whom. CE, as the wonks call it, is an essential ingredient of a high-functioning health care system. But the idea came under assault from conservatives who objected to the intrusion of government into medicine and from interest groups whose members profit from less effective treatments.
These opponents failed. But the work of creating a research infrastructure has just begun. And, as Merrill Goozner reports, it’s not clear the government is going about it in the right way.
The Institute of Medicine panel slated to make recommendations for the $1.1 billion earmarked for comparative effectiveness research has no representation from broad-based consumer or patient advocacy groups, according to the Center for Science in the Public Interest. … While the proposed 16-member panel included five physician specialists, three medical technology assessment experts, three insurers (two of which are also provider networks), and three officials currently or formerly associated with Medicare, the only patient or consumer representative named to the panel’s tentative roster was from the Alzheimer’s Association, a single-issue patient advocacy group that receives substantial support from the drug industry.
Merrill has the rest of the story over at his blog, Gooznews (which, by the way, you should start reading regularly if you aren’t already).
–Jonathan Cohn
Medical Chess: How the Drug Companies Use Doctors As Their Pawns
Over the last five years, the number of medications being prescribed by doctors has grown drastically from 2.1 billion, to well over 3.5 billion. The increase is a combination of doctors receiving incentives from the large drug companies that give the patient a prescription to solve there problems even when no medication is necessary, and also a growing number of new generalized illnesses that are easily treated with high priced medication. Nope, doctors usually prescribe the same popular medication that the other doctors are prescribing for that illness. It all depends on who is offering the highest incentives to prescribe their drugs, otherwise known as bribes.
For example, drug companies will offer luxurious cruises and vacations to resorts in exchange for the doctor to listen to a short lecture about a new drug they are about to market. Drug companies have even gone as far as to raise the average wholesale price of their drug, then offer it directly to the doctors for cheaper, and let Medicare reimburse the doctors for the full amount. This might not seem like a big deal but when you’re talking about 2 to 3 hundred dollars extra per prescription that adds up to a lot of money the doctors get to put into their pocket, not to mention your tax dollars are paying for it. Doctors are receiving more incentives than ever to prescribe medication. An astounding 77% of new drugs released have been proven by the FDA to have no advantage over similar drugs already on the market.
They are just remakes of old drugs that drug companies rename then send to the FDA to get approved for a different use. The corruption in the medical industry not only has defrauded the American public out of nearly 100 billion dollars, drug companies continues to raise their already outrageous drug prices to compensate for the money it uses to pay to essentially bribe doctors. Is there anyway to avoid the high prices the American drug companies are charge?
Posted in patient advocacy | 
Tags: consumer advocacy, fraud drug companies, medical doctors, outragous drug prices | 
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Medical billing company expands into patient advocacy
A medical billing company is trying its hand at patient advocacy. “We felt a little bit unfilled doing (billing for providers) and wanted to really help patients,” he said. “Our main focus is to represent a patient if they have an issue on a medical bill. It’s kind of insurance for your insurance to make sure that you paid correctly. So this is our way of doing it on a local level.” When the company started, it had two employees and has since grown to 35.
The Las Vegas-based company has its offices on West Sahara Avenue near Buffalo Drive. “We feel like we’re making a good impact on things.” The company decided to roll out Universal Solutions as a unit that will serve as a patient-advocate business beginning last month. For $25 a month, the company goes to bat for the health care consumer, looking over bills and working with doctors and insurance companies to fix overcharges. At first, the company considered making Universal a nonprofit organization, but decided to keep it under the umbrella of Strategic. There is a low profit margin, he said, especially because Universal’s main customers are coming in with bills they’d like audited. Besides alleviating human resource staff from employees’ questions about particular health insurance issues, if Universal corrects medical billing problems, the cost to the company and the employee can be cut through reduced expenditures.
Universal also offers employers workers’ compensation containment, another area of potential fraud or incorrect billing. The company also wants to move to the national level and is working with national companies to provide the patient advocate service. “It’s going to manage the cost of the employer, it’s going to manage the cost of the patient and the insurance company. There is so much fraudulent billing going on, too, that when we’re auditing stuff, we can see that.”
Posted in patient advocacy |
Tags: medical billing, medicard, patient advocacy, patient rights |
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