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Insurance Companies Impede Ability of Physicians to Care for Patients

Insurance carriers are incapable of defining and measuring quality, and their attempts to do so degrade the care physicians are able to provide, according to this author

The Lund Report, March 21, 2016
by Dr. Mike Henderson

OPINION -- The healthcare system is failing patients and physicians. In a recent article, a 46 year old woman initially presented with shoulder pain, and according to her lawyer, eventually had a heart attack, possibly requiring a future heart transplant. This article isn’t about the merit of this particular lawsuit or tort reform in general. I am an internal medicine physician and see the larger issue of a system failure, and such examples are inevitable. Physicians are set up to fail with resulting patient harm. The reason for this article is to delineate the basic flaws. Understanding how they interrelate answers the questions of how and why the system is failing.

Quality care demands continuity of care, but continuity is too frequently broken. The patient mentioned above presented with typical symptoms for a common, benign condition, yet that incident was the needle in the haystack. She then saw multiple providers.

Current documentation is more about data entry for the purposes of research, avoidance of malpractice and billing than for the purported goal of documenting care, compounding the negative effects of the lack of continuity of care. Each provider no doubt tediously entered a note into an electronic health record. Should physicians concentrate on the patient or clicking boxes? One can’t be done without compromising the other. Electronic records sound great, but they are a distraction, producing generic, template driven notes for subsequent providers to use. The patient is reduced to a pattern of checkboxes and nonsensical pull down statements. The patient’s meaningful narrative is lost. This improves billing, but is terrible for documenting clinical analysis.

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So you want me to climb Everest?

OHSU Student Speak:March 4, 2016
by Kelsey-Jo Moss

I was lucky enough to attend the annual OSNA Convention at PCC Sylvania where nursing students from programs all over Oregon came to expand their horizons as future or current nurses. There were breakout sessions led by professionals from many different areas of health care and leadership, from flight nursing to social innovation, and everything in between. I had the opportunity to sit in on a few breakout sessions, one of which delved into healthcare equity, and I was amazed, yet again, at the depth and width there is in the nursing profession.

The women who led the Healthcare Equity session, Nancy Sullivan and Christine Tanner, walked us through the limitations and injustices within our current insurance system. They not only shared statistics, but also stories about the people behind the numbers: stories about families crippled by monthly medical expenses and individuals who still aren’t able to navigate our convoluted system. Sitting there trying to soak in, question, and grapple with everything these women were sharing, I began to feel like I was dropped off in front of Mt. Everest and expected to give it a go – I mean for the sake of humanity. I’m the person that shows up without a rain coat or accidentally wanders off a trail because I am out of breath a quarter mile in. Everest has about zero appeal to me, and actually the idea of climbing it makes me want to pass out. Essentially, the level of brokenness in our healthcare system was so overwhelming it made me want to pass out a little.

The presenters then began to share what they felt was part of the solution, a single payer system that covers everyone from the time we are born to the end of our days through a collective tax premium. They argued that the United States could drastically reduce administrative costs by simplifying the insurance system, the way many developed countries already successfully do.

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One way to help Americans? Medicare for All

   Professor Paul f. deLespinasse

Professor Paul f. deLespinasse

The biggest obstacle to convincing people that Medicare for All would save them money is that most Americans grossly underestimate how much medical insurance already costs them. They only see co-pays, deductibles and the so-called “employee share” of employment-based insurance.

Statesman Journal, March 7, 2016
by Paul F. deLespinasse

Win or lose in his presidential quest, Bernie Sanders will have contributed greatly if he convinces Americans that Medicare for All is a good idea. To date, however, he has not done this.

It does not help that he has grossly understated the tax increases for ordinary Americans necessary to finance his proposed single-payer insurance system.

One does not finance a system accounting for 18 percent of the gross domestic product by increasing a family’s taxes by $500, so his claim is not credible on its face. It invites charges that he is just another demagogue promising to pay for expensive programs by soaking only the rich. Everyone knows that something sounding too good to be true probably isn’t.

Speaking frankly about the necessary tax increases would make it harder for Sanders to convince people they will come out ahead financially despite the increased taxes. But there is actually a very strong case Sanders could make that this would be true for most people.

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