Technology has the ability to both improve and provoke health care costs, quality and access in the reformed US health care system. The unnecessary use of technology can increase costs while patients receive the same quality and outcome of care as they would with the absence of the highly technical procedure. When technology can aid to improve quality and outcomes of medical procedures, it can be more cost effective in the long run. We have come up with some ideas on how we would like to see technology used appropriately in both aspects.
As mentioned in our first proposal, we feel that having a universal paperless system could be beneficial in many ways. According to chief medical officer Harry Greenspun, "The more data you have, the greater your ability to make better decisions." Most health care providers would agree that it would be beneficial for the provider to have a full medical history of the patient. With appropriate privacy regulations, a universal paperless system could be shared among health care providers across the US containing a complete health care background on patients. A thorough background could lead to higher quality treatment and also help reduce the need for unnecessary procedures. Providers could have access to past test results or scans, for example, and perhaps avoid re-running tests or re-assessing patients. This could also save time and make health care more efficient. This way, we can utilize technology with universal access to electronic health records as well as avoiding the use of unnecessary, repetitive technology such as expensive scans and lab tests.
According to HIMSS, the increased spending in healthcare over the years can directly correlate with the prevalence of chronic diseases like hypertension and diabetes. It is estimated that the 45% of Americans suffering from chronic diseases account for nearly 75% of health care spending and 70% of deaths. We believe that a health care reform should focus much more of its spending on preventative means for these chronic conditions and, in turn, less spending on the management of them. Technology can aid in the prevention process just as well as it has previously aided in the management process.
To help reduce health care spending on the management of chronic diseases, the government should increase investments in grants for the research and development of preventative health care. Currently, preventative care includes early detection procedures such as pap smears, mammograms and colonoscopies. The problem with our current preventative health care lies within the cost, quality and access of the procedures.
Due to the high costs of these procedures, many Americans, especially the uninsured, simply cannot afford a procedure for a condition they may or may not have. A colonoscopy, for example, can cost anywhere from $2,010 to $3,764. Even with insurance, there are many limitations to how and when one can receive preventative procedures. For example, most insurance companies will not cover the costs of a colonoscopy until a person reaches a certain age. With the technological development of more cost effective procedures, more people can utilize procedures and perhaps have better insurance coverage.
Many Americans do not utilize our current preventative procedures due to the quality of them. A colonoscopy is not a pleasant procedure. The evasiveness and risks alone would scare off even the insured from receiving, for some people, a life saving procedure. With the development of a higher quality, less evasive procedure that didn’t require anesthesia, more people would be willing to utilize certain preventative procedures.
Lastly, many Americans simply do not have access to preventative procedures. In order to receive a procedure such as a mammogram or colonoscopy, they have access to a primary care physician or clinic. However, the 46 million uninsured Americans are likely to be turned away at a primary care clinic due to inability to pay and therefore do not have access to most preventative procedures. They usually do not receive any health care unless their condition is bad enough to send them to the emergency room where doctors are obligated to give them care, which defeats the purpose of preventative health care all together.
We believe that with the development of cost efficient preventative procedures as well as universal access to them, chronic diseases could be greatly prevented and health care costs much reduced. With appropriate government grants, research and development of new procedures can aid in the reform of our health care system by focusing on preventative cares rather than management cares.
- Leigh Manske
References:
1. Cervical Cancer: Prevention and Early Detection. American Cancer Society. 2009.
http://www.cancer.org/docroot/CRI/content/CRI_2_6x_cervical_cancer_prevention_and_early_detection_8.asp?sitearea=PED
2. Colonoscopy Cost. Costhelper. 2010. http://www.costhelper.com/cost/health/colonoscopy.html
3. Sternstein, Aliya. Technology and the Business of Government. Next Gov. 2009. http://www.nextgov.com/nextgov/ng_20090803_8322.php
4. HIMSS. Enabling Healthcare Reform Using Information Technology. Arlington, Virginia. December, 2008. www.himss.org/2009calltoaction/HIMSSCallToActionDec2008.pdf
5. Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America A Systems Approach. Sudbury: Jones and Bartlett, 2007. Print.
Friday, March 12, 2010
Monday, March 1, 2010
Technology Reform Proposal 1
Health Care Reform Proposal 1
We believe that the impact technology has on the quality of medical care received by Americans is significant enough for Congress to consider while passing new legislation. Technology provides new procedures that provide better diagnosis, quicker cures, and an overall increase in efficiency and precision in the medical field. This new legislation should provide the right amount of emphasis on the importance of technology within the field of medicine. We believe that if Congress does this successfully, the quality of care will continue to increase, costs of care will decrease, and accessing medical care information will become more efficient between providers. Our first proposal suggests that Congress pass new legislation that reforms the malpractice system and implements electronic records for all health care settings.
It is fair to say that most health care providers go through their work day thinking about how to protect themselves from lawsuits. To avoid such situations, providers practice defensive medicine. One example of defensive medicine that pertains to our topic of technology is the overuse of unnecessary diagnostic tests. Performing tests such as MRI’s, CT scans, and PET scans are just a few examples of some technological procedures that could have been otherwise avoided in some diagnostic cases. However, because the provider was afraid of a malpractice lawsuit, the tests were ordered anyways and the costs of care just increased significantly.
In the case of defensive medicine, technology has the ability to hurt the cost and quality of health care. We believe that to turn this situation around, Congress should lower the cost of premiums for malpractice insurance and put strict caps on the cost of damages received by patients, so the amount of damage actually done is compensated for appropriately. According to the Wall Street Journal, if defensive medicine was eliminated, the United States could save 200 billion in health care costs annually. This money saved could help instead of hurt the health care system by using it for useful clinical trials and medical research.
The second part of our proposal is for Congress to implement paperless medical records. The Healthcare Information and Management Systems Society (HIMSS) defines health information technology as “ the use of computers and computer programs to store, protect, retrieve, and transfer clinical, administrative, and financial information electronically within and between health care providers.” We believe that electronic records will improve the overall efficiency and effectiveness of our health care system. We also believe that it will provide more privacy and safety with patient’s health care records. To achieve this, Congress must pass legislation that allows the Office of the National Coordinator for Health Information Technology (ONC) to coordinate health information technology programs across the United States. So far, ONC has not had the proper authority to coordinate such activities because it has not yet been codified into law. However, if passed into legislation, using electronic medical records could save the United Sates $81 billion each year.
Another important issue we propose Congress address is electronic processing of payments and claims. According to the HIMSS, 60% of all claims payments are paper-based and the health care system consumes more than 15% of its total expenditures on processing payments. Also, it costs approximately eight dollars per item for paper-based claims and this high cost of transmitting paper-based claims could easily be exempt through a revised legislation. If we increase the rate of electronic payment of claims to 90%, the United States could save around six billion dollars.
Overall, this health reform proposal aims at decreasing the two trillion dollars spent on health care last year by using the benefits of technology, and using them wisely. Congress can achieve this by implementing a reform on the malpractice system and give the ONC the authority to coordinate electronic health care records and payment systems. According to the Wall Street Journal, 83% of Americans agree with our proposed plan that Congress needs to change the medical malpractice system. A compromise needs to be made within the system of our government to reform malpractice in a way that will help, not hurt, the health care quality and costs of Americans. Lastly, putting into practice an electronic medical records and payment system will not only make it easier for employers to handle, but it will be more efficient and decrease the costs of health care.
-Andrea Hartley
References:
1. Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America A Systems Approach. Sudbury: Jones and Bartlett, 2007. Print.
2. Howard K., Philip. Why Medical Practice is Off Limits. Wall Street Journal, October 15, 2009. http://online.wsj.com/article/SB10001424052970204488304574432853190155972.html?mod=googlenews_wsj
3. HIMSS. Enabling Healthcare Reform Using Information Technology. Arlington, Virginia. December, 2008. www.himss.org/2009calltoaction/HIMSSCallToActionDec2008.pdf
4. Medpac. Report to the Congress: New Approaches in Medicare. Information Technology in Health Care. June, 2004. http://www.medpac.gov/publications%5Ccongressional_reports%5CJune04_ch7.pdf
5. Kaiser. CBO: Medical Malpractice Reform Would Save $54 Billion Over 10 Years. Kaiser Health News. October, 2009. http://www.kaiserhealthnews.org/Daily-Reports/2009/October/09/Tort-Reform.aspx
We believe that the impact technology has on the quality of medical care received by Americans is significant enough for Congress to consider while passing new legislation. Technology provides new procedures that provide better diagnosis, quicker cures, and an overall increase in efficiency and precision in the medical field. This new legislation should provide the right amount of emphasis on the importance of technology within the field of medicine. We believe that if Congress does this successfully, the quality of care will continue to increase, costs of care will decrease, and accessing medical care information will become more efficient between providers. Our first proposal suggests that Congress pass new legislation that reforms the malpractice system and implements electronic records for all health care settings.
It is fair to say that most health care providers go through their work day thinking about how to protect themselves from lawsuits. To avoid such situations, providers practice defensive medicine. One example of defensive medicine that pertains to our topic of technology is the overuse of unnecessary diagnostic tests. Performing tests such as MRI’s, CT scans, and PET scans are just a few examples of some technological procedures that could have been otherwise avoided in some diagnostic cases. However, because the provider was afraid of a malpractice lawsuit, the tests were ordered anyways and the costs of care just increased significantly.
In the case of defensive medicine, technology has the ability to hurt the cost and quality of health care. We believe that to turn this situation around, Congress should lower the cost of premiums for malpractice insurance and put strict caps on the cost of damages received by patients, so the amount of damage actually done is compensated for appropriately. According to the Wall Street Journal, if defensive medicine was eliminated, the United States could save 200 billion in health care costs annually. This money saved could help instead of hurt the health care system by using it for useful clinical trials and medical research.
The second part of our proposal is for Congress to implement paperless medical records. The Healthcare Information and Management Systems Society (HIMSS) defines health information technology as “ the use of computers and computer programs to store, protect, retrieve, and transfer clinical, administrative, and financial information electronically within and between health care providers.” We believe that electronic records will improve the overall efficiency and effectiveness of our health care system. We also believe that it will provide more privacy and safety with patient’s health care records. To achieve this, Congress must pass legislation that allows the Office of the National Coordinator for Health Information Technology (ONC) to coordinate health information technology programs across the United States. So far, ONC has not had the proper authority to coordinate such activities because it has not yet been codified into law. However, if passed into legislation, using electronic medical records could save the United Sates $81 billion each year.
Another important issue we propose Congress address is electronic processing of payments and claims. According to the HIMSS, 60% of all claims payments are paper-based and the health care system consumes more than 15% of its total expenditures on processing payments. Also, it costs approximately eight dollars per item for paper-based claims and this high cost of transmitting paper-based claims could easily be exempt through a revised legislation. If we increase the rate of electronic payment of claims to 90%, the United States could save around six billion dollars.
Overall, this health reform proposal aims at decreasing the two trillion dollars spent on health care last year by using the benefits of technology, and using them wisely. Congress can achieve this by implementing a reform on the malpractice system and give the ONC the authority to coordinate electronic health care records and payment systems. According to the Wall Street Journal, 83% of Americans agree with our proposed plan that Congress needs to change the medical malpractice system. A compromise needs to be made within the system of our government to reform malpractice in a way that will help, not hurt, the health care quality and costs of Americans. Lastly, putting into practice an electronic medical records and payment system will not only make it easier for employers to handle, but it will be more efficient and decrease the costs of health care.
-Andrea Hartley
References:
1. Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America A Systems Approach. Sudbury: Jones and Bartlett, 2007. Print.
2. Howard K., Philip. Why Medical Practice is Off Limits. Wall Street Journal, October 15, 2009. http://online.wsj.com/article/SB10001424052970204488304574432853190155972.html?mod=googlenews_wsj
3. HIMSS. Enabling Healthcare Reform Using Information Technology. Arlington, Virginia. December, 2008. www.himss.org/2009calltoaction/HIMSSCallToActionDec2008.pdf
4. Medpac. Report to the Congress: New Approaches in Medicare. Information Technology in Health Care. June, 2004. http://www.medpac.gov/publications%5Ccongressional_reports%5CJune04_ch7.pdf
5. Kaiser. CBO: Medical Malpractice Reform Would Save $54 Billion Over 10 Years. Kaiser Health News. October, 2009. http://www.kaiserhealthnews.org/Daily-Reports/2009/October/09/Tort-Reform.aspx
Tuesday, February 16, 2010
History and Overview
Imagine you are a soldier in the 16th century. While on the battlefield, you are shot in the leg and carried to a wooden bench. Your surgeon has the same educational background as your barber, and he is attempting to remove the bullet from your leg. The pain is unbearable and there are no anesthetics available, so the nurse offers you some whiskey to drown the pain. The surgeon pours boiling water over your wound in an effort to remove any infection, unaware that this process does more harm than good. After a few unsuccessful tries to remove the bullet, he decides amputation is the only option, and in a few gruesome minuets later your right leg is completely gone.
Now imagine you are solider in Iraq in 2010 with the same gunshot injury. You are carried to a chemical and biologic protective shelter and immediately given anesthesia. Your trained and licensed doctor takes a radiograph of your leg to see where the bullet is, and it is quickly and painlessly removed using a bacteria-free technique. Because of the technology that was available to you, in just a few months you are walking again.1
The growth of medical advancements in the last couple hundred years is astounding. Mostly because of new technological advancements, the life expectancy in America has grown from 41 in 1900 to 77 in 2010.2 This had been made possible by improvements in drugs that can stabilize chronic conditions, vaccines that can eliminate potential epidemics, and machines that can provide doctors with valuable information on how to cure a disease. We feel that when it comes to health care reform, advancements in health care technology should not be compromised in order to reduce health care costs.
Improvements in health care technology definitely do come with a large cost. According to Delivering Healthcare in America: A Systems Approach, technological innovations are the leading cause of medical cost inflation in the 2nd half of the 20th century.3 In 20 years, the total cost of our nation’s medical care has increased from less than $50 billion to over $500 billion.4 Much of this cost increase is due to advancements in technology. When new technology is implemented in a hospital, many costs come along with this including trained professionals, new facilities, and an increased demand from both consumer and providers to use the technology.
We feel that instead of concentrating only on the huge price tag that comes along with new technology, one must also consider the value of medical advancements. The impact on quality of care that comes along with a better diagnosis, faster cures, and preventative care is astounding.5 Many American’s agree with us that the quality of care received because of advancements in technology is worth the cost. According to a random telephone pole, 63 percent of Americans agreed that they are willing to pay a modest tax increase in order to fund medical research.3
Although technology has opened many doors in the medical field, millions of people do not have access to the improved quality of care. This may be because they live in a geographically remote area or simply because they lack health insurance.3 According to an article written at Santa Clare University, over 37 million Americans, including 12 million children, do not have any health insurance at all and therefore are at a disadvantage to take advantage of technological advancements that could improve the quality or even save their life.4 This article brings up a lot of examples of the ethical dilemmas that come along with the fact that not all Americans have access to health care.
Certainly, high-tech health care is an inflator of health care costs. At the same time, we feel that providers can make investment decisions based on their community’s best interest by using technology appropriately. The quality of health care that is possible because of technological growths is something that should be of value to all Americans, and going along with this we want to ensure that all American’s have access to any technology that will improve their quality of life. When considering options for health care reform, it is essential that enough money is allocated to cover technology in the medical field.
Works Cited
1. 1. Peoples, George. The New England Journal of Medicine. “Caring for the Wounded in Iraq.” 2004.
http://content.nejm.org/cgi/content/full/351/24/2476
2.2 2. Life Expectancy. World Bank, World Development Indicators, 2010. http://www.google.com/publicdata?ds=wbwdi&met=sp_dyn_le00_in&idim=country:USA&dl=en&hl=en&q=life+expectancy+trends
3. 3. Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America A Systems Approach. Sudbury: Jones and Bartlett, 2007. Print.
4. 4. Unhealthy Delimas. The Markkula Center for Applied Ethics. 2008.
5. 5. Frank, Ryan. “Medical Technology and 5 Significant Advancements.” http://www.goarticles.com/cgi-bin/showa.cgi?C=1717059
Sunday, February 14, 2010
Beliefs & Values
According to a white house affiliated website, the United States spent approximately $2.2 trillion on health care in the year of 2007, which comes out to $7,421 per person1. This is nearly twice the average of other developing nations across the globe. The Congressional Budget office estimates that at this rate, by 2025 one of every four dollars of our economy will be “tied up” in the health care system. Obviously, there needs to be a change. We feel that the democrat views are most similar to our own. We value the quality of technology available, equality among everyone who wants to use it, and accessibility for everyone as well.
We, along with many other Americans have high expectations about what medical technology can do for curing diseases and other sicknesses. According to Shi and Singh’s textbook, “Delivering Health Care in America”, 35 percent of Americans believe it is essential to have access to the most advanced tests, drugs, and medical procedures2. We believe that our nation needs to focus more on primary care and preventive services rather than specialty care. The nation’s expectations of doctors and patients are very high when it comes to use and availability of all technology. We are against supply-side rationing, and we believe that this would not be the correct solution to the problems our nation is facing with health care. This would only lead to longer waits and lower level of access among everyone. In some countries, people have to wait ten weeks for an MRI or four weeks for a CT scan. These tests are sometimes crucial for diagnosis and essential to know the results immediately. The long waits would result in more deaths.
The quality of our technology needs to continue. Technology continues to offer “improved remedies that are more effective, less invasive, or safer2. It was estimated that $2.5 trillion are wasted each year on the duplication of tests and unnecessary procedures. That statistic is absurd and should not even be a concern. We believe that records for all patients across the nation should be networked electronically. This would make health care more proficient and “provide valuable insights about costs and care”3. It would save tens of billions of dollars each year from reduced paper work and much quicker communication.
Access is also an issue. We value equality and accessibility. Our third and final belief is that everyone should be able to use the best technology if it is out there, despite any financial circumstances. Geographic access can be further improved by providing mobile equipment for communities that lack the necessary tools allowing new technology to be available to more people2.
Some believe that the topic of technology is being over relied on as a solution to health care problems. They believe that if we focus too much on the technology aspect it would affect the quality of care that patients receive. “Efforts to find a quick technological fix will likely run up against cultural challenges”3. However, we believe that if the technology is effectively used, it will enhance the present health care system and will lead to substantial savings and improvements in the quality of care that one can receive. Robert O’Harrow Jr., a Washington Post staff writer has done an incredible job at analyzing how technology can be used to enhance our nation’s health care system from all points of view.
Advancements in technology have the potential to save billions of dollars; however, if not controlled correctly it could possibly drive health care costs higher. Technology has huge impact on the delivery of health care. It has influenced the quality of care that people receive and access of new technology in remote areas has been improved as well.
REFERENCES
1. “Health Care”. The White House. Accessed February 13, 2009. http://www.whitehouse.gov/Issues/health-Care
2. Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America A Systems Approach. Sudbury: Jones and Bartlett, 2007. Print.
3. O’Harrow Jr., Robert. “The Machinery Behind Health-Care Reform”. Washington Post. Accessed February 13, 2009.
<http://www.washingtonpost.com/wp-dyn/content/article/2009/05/15/AR2009051503667.html>
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