Comments on: Complexity of Managing Health Care Quality http://www.mikecritelli.com/2009/04/15/complexity-of-managing-health-care-quality/ Mike Critelli's Blog Tue, 24 Jan 2012 03:39:21 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Ray Mather http://www.mikecritelli.com/2009/04/15/complexity-of-managing-health-care-quality/comment-page-1/#comment-3855 Ray Mather Mon, 11 May 2009 04:20:48 +0000 http://www.mikecritelli.com/?p=231#comment-3855 Mike, following your blog and reading of your activities in health care has sparked my interest in this topic. This weekend I attended the United Curch of Christ Ct Conference Annual meeting and listened to presentations on healthcare perspectives by Juan Figueroa (re Sustinet) and Dr. K J Lee who is working on President Obama's task force regarding Health Care initiatives. I am curious what your thoughts are regarding SustiNet and the proposed CT legislation, and also wondered if you have provided input to the Obama administration. It sees to me you would be a valuable resource. Ray I have had the opportunity to offer input to the Obama Administration, as well as to members of Congress and their staffs. Relative to the proposed Connecticut legislation, I have the following views: -While it makes sense to have a pooling of state and local government employees in a self-insured government employees health plan, I am not in favor of pooling small business employees or non-profits into that plan. Given the technical aspects of the state insurance regulatory system, the likely effect is that the poorest insurance risks and the most expensive participants and businesses will migrate to the State Plan. -There are many causes of our large uninsured population around the country, but the biggest one is the exorbitant cost of health insurance. Two contributing factors to that are the cost added by states that fail to pay doctors and hospitals adequately for treating Medicaid and SCHIP patients (In CT, the SCHIP program is called HUSKY), the high cost of unnecessary coverage mandates imposed on insurance companies, and the inadequate focus on prevention and wellness. For example, in Connecticut, an insurer of small businesses cannot ask smokers to pay more than non-smokers for health insurance, although it can demand higher payments for life insurance. This is misguided. Sustinet is a good start in addressing this issue, but it does not go far enough. -We need reform in terms of how we pay doctors and hospitals. We should pay for results, not activities. Sustinet does not have a comprehensive solution for this. All that being said, I share the goals of Sustinet to get universal, affordable coverage, and it is a good starting point. Mike, following your blog and reading of your activities in health care has sparked my interest in this topic. This weekend I attended the United Curch of Christ Ct Conference Annual meeting and listened to presentations on healthcare perspectives by Juan Figueroa (re Sustinet) and Dr. K J Lee who is working on President Obama’s task force regarding Health Care initiatives. I am curious what your thoughts are regarding SustiNet and the proposed CT legislation, and also wondered if you have provided input to the Obama administration. It sees to me you would be a valuable resource.

Ray

I have had the opportunity to offer input to the Obama Administration, as well as to members of Congress and their staffs. Relative to the proposed Connecticut legislation, I have the following views:

-While it makes sense to have a pooling of state and local government employees in a self-insured government employees health plan, I am not in favor of pooling small business employees or non-profits into that plan. Given the technical aspects of the state insurance regulatory system, the likely effect is that the poorest insurance risks and the most expensive participants and businesses will migrate to the State Plan.
-There are many causes of our large uninsured population around the country, but the biggest one is the exorbitant cost of health insurance. Two contributing factors to that are the cost added by states that fail to pay doctors and hospitals adequately for treating Medicaid and SCHIP patients (In CT, the SCHIP program is called HUSKY), the high cost of unnecessary coverage mandates imposed on insurance companies, and the inadequate focus on prevention and wellness. For example, in Connecticut, an insurer of small businesses cannot ask smokers to pay more than non-smokers for health insurance, although it can demand higher payments for life insurance. This is misguided. Sustinet is a good start in addressing this issue, but it does not go far enough.
-We need reform in terms of how we pay doctors and hospitals. We should pay for results, not activities. Sustinet does not have a comprehensive solution for this.
All that being said, I share the goals of Sustinet to get universal, affordable coverage, and it is a good starting point.

]]> By: George D. Burns http://www.mikecritelli.com/2009/04/15/complexity-of-managing-health-care-quality/comment-page-1/#comment-3847 George D. Burns Wed, 22 Apr 2009 20:45:01 +0000 http://www.mikecritelli.com/?p=231#comment-3847 The problem with "best practices" and "Quality care" is that many of the items which get those designations were never deserving or valid in the first place and should never have been afforded that status. Statins are a fine example of this. The medical profession seems to simply regurgitate whatever is being promoted as the item of the day. As a result treatments proposed have to be questioned. The problem with “best practices” and “Quality care” is that many of the items which get those designations were never deserving or valid in the first place and should never have been afforded that status. Statins are a fine example of this.

The medical profession seems to simply regurgitate whatever is being promoted as the item of the day. As a result treatments proposed have to be questioned.

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