Health-care costs shoot up, millions in U.S. left gasping

Grok Headline matches for Health-care costs shoot up, millions in U.S. left gasping

Kerry Bashes Bush on Health Care Costs
(AP)

Kerry Bashes Bush on Health Care Costs
(AP) 05/10/2004 03:03 PM
AP - Democratic presidential candidate John Kerry said Monday his health care proposal to reduce soaring premiums and cut fraud and waste is the remedy for a system "badly broken" under President Bush.

Making 'Sense' of Health Care Costs and
Other Complex Challenges

Making 'Sense' of Health Care Costs and
Other Complex Challenges 06/05/2005 11:12 PM

When does the pursuit of 'best practices' make sense, and when do we need to apply less precise but more effective approaches instead? This week's New Yorker has another interesting column by James Surowiecki, entitled Local Knowledge, which laments the fact that there are huge anomalies in health care in the US from community to community, a result of a combination of local customs, patient demographics, and the varying supply and accessibility of practitioners and facilities. Great variations in treatment have been noted in many diseases and conditions, including serious and controversial ones like cesarean sections, spinal fusions, mastectomies, and coronary-bypass surgeries. Different treatments and variances in hospital stays mean great variations in medical cost, Surowiecki says, and this could be costing the US health care system billions it can't afford. His prescription? Not a new government standards body, but increasing awareness of people about these differences, so that the 'inefficiencies' are driven out of the system by informed patients and caregivers. What Surowiecki seems to be looking for is what in business is called 'best practices'. What's interesting to me is that business has recently become disenchanted with 'best practices': In a world where every job, every situation, every context is different, the applicability of some documented 'best practice' in any situation other than the one it was identified in is increasingly dubious. Dave Snowden articulates these three 'heuristics' about real-world knowledge: Knowledge can only be volunteered; it can't be conscripted. People always know more than they can tell and can tell more than they can write. People only know what they know when they need to know it. Human knowledge is contextual and triggered by circumstance. So what we have here is a clash of two new and exciting philosophies: Surowiecki's argument that tapping the Wisdom of Crowds can allow much better answers to emerge than relying on experts, versus Snowden's argument that such 'wisdom' is possible and useful only in relatively simple situations where apples can clearly be compared to apples, and doesn't work in the majority of more complex situations where every case is arguably significantly different. An identified 'problem' in Surowiecki's article is the large number of facilities and practitioners providing over-long stays to patients in Florida, compared to other states. They are drawn there, of course, because that's where the customers are, and, as in all things, the work tends to expand to fill the available space, money and time. In public health services we seem to try to offset these 'market' tendencies by making sure both facilities and practitioners' time are in constant short supply, in the presumption that this will yield less waste and force greater efficiency, rather than posing a serious threat to public health. And this is exactly the problem with applying mechanistic, industrial, simple-situation prescriptions to complex-situation challenges. So what should we do when doctors in one community perform appendectomies and tonsillectomies four times as often as they do in the next community, of the same size, a stone's throw away? Surowiecki thinks we need to figure out "how to pay doctors for the quality, rather than the quantity, of the care they provide" and hopes that "eventually people will start paying attention to the data and recognize how costly these variations can be". But even he seems dubious of the possibility of either of these things happening. Of course patients need to be better informed about preventative health care, self-treatment and new knowledge about less invasive and unnecessary procedures. But health care isn't like widgets, where differences in 'unit' product cost, quality and service are conspicuous. Every situation is truly different, and we'll never come up with either a formula for determining the right health care answer, or an expert system that will tell us precisely where the 'inefficiencies' in health care are and how they can be eliminated. Surowiecki suggests the problem is geography and parochialism. But geography is just one way of slicing community, and these days it's not even the most important one. The issue isn't isolation of community, it's incomparability of situations with infinitely many different contexts. When the data is a million cases of one, the significance of patterns is likely to be illusory. And health care isn't the exception either -- most of the products and services that are essential to human well-being, like education, nutrition, freedom, justice, security, transparency of government and a healthy environment are also enormously contextual, circumstantial and relative. Experts and advocates in these fields have torn out their hair trying to find benchmarks, standards, measures, scorecards and 'best practices' that will allow us to cajole improvements in performance from those we assess to be falling short. It can't be done. Complicated solutions don't solve complex problems. The essence of Snowden's new approach to sense-making and management 'science' is to first assess whether the situation lends itself to simple-to-complicated solutions and approaches (like root cause analysis, systems thinking and The Wisdom of Crowds), or if it requires more complex approaches (like cultural anthropology, pattern-seeking, Open Space and emergent understanding techniques like the AHA! Discovery Framework diagrammed above). It doesn't take much thought to realize (a) that most of the challenges we face in business and society today are complex, and (b) attempts to force simple and complicated-situation solutions in complex situations, like the deliberate starving of the health and education systems (and like the ubiquitous imposition of lousy service in all areas of business today), in the ill-conceived belief these will somehow mechanically force efficiency and productivity improvements in them, are doomed to make the situations worse, not better. It's time we woke up to the realization that industrial-age solutions are increasingly inapplicable in the information age, and it's time we got over our discomfort with the imprecision, uncertainty, lack of causality, and non-amenability to command-and-control hierarchy that complex approaches entail. Managers, grit your teeth and prepare for some revolutionary new, difficult and important learning. So sorry, health care fans desperate for solutions to spiraling costs. No 'best practices' or 'popular wisdom' answers here. Move along, please.

Outsourcing, Rising Health Care Costs
and HSAs Highlight Media Coverage in
First HR Intelligence Trend Report for
2005

Outsourcing, Rising Health Care Costs
and HSAs Highlight Media Coverage in
First HR Intelligence Trend Report for
2005 03/29/2005 03:55 AM
HRmarketer.com, the no. 1 online marketing and PR service in the human capital industry, has introduced monthly trend reports that will track companies and topics receiving most media attention, the top advertisers, and the overall health of the human resource marketplace. [PRWEB Mar 29, 2005]

AHLA - Links to Selected Health Care and
Health Law Sites

AHLA - Links to Selected Health Care and
Health Law Sites 11/10/2003 10:50 PM
AHLA - Links to Selected Health Care and Health Law Sites
http: //www.healthlawyers.org/weblinks/weblinks_health.cfm

American Health Lawyers Association comprehensive set of links to selected healthcare and health law sites.

The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies

The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies 06/05/2005 11:58 PM
Under the direction of Dr. Pat Ladewig, Dean, Rueckert-Hartman School for Health Professions, Regis University established the Center for Health Care Ethics and Emerging Technologies. Dr. Mark Meaney, Executive Director, stated that the goals of the Center include the examination of the ethical and social implications of emerging biotechnologies such as nanobiotechnologies, pharmacogenomics, and stem cell research. [PRWEB May 22, 2005]

Millions left in closed accounts

Millions left in closed accounts 07/31/2004 12:27 AM
Around £452m is still being held in National Savings traditional savings accounts after they closed.

'Penniless' Brando left millions

'Penniless' Brando left millions 07/10/2004 02:38 AM
Movie icon Marlon Brando left a fortune worth more than $20m, his lawyer has revealed.

Internet travel costs Florida millions

Internet travel costs Florida millions 03/19/2005 03:16 AM
Miami.com - Fri Mar 18, 12:04 pm GMT

Millions 'illiterate' about health

Millions 'illiterate' about health 08/03/2004 09:32 PM
Millions of people in the UK do not understand even basic health information, a report says.

Spam costs businesses millions every
year: report

Spam costs businesses millions every
year: report 06/28/2004 03:29 AM
ZDNet Australia Jun 28 2004 7:54AM GMT

Bay area message board costs papers
millions

Bay area message board costs papers
millions 12/28/2004 05:41 PM
Beatniks at Craigslist rule classifieds

Health-Care Opportunity

Health-Care Opportunity 02/11/2004 03:12 PM
Health Net looks like a value-priced managed care company.

GE Bets on Health Care

GE Bets on Health Care 04/13/2004 02:20 PM
Closing a $9.5 billion deal for the U.K.'s Amersham assures a major role for GE Healthcare.

More health care have-nots

More health care have-nots 07/01/2004 01:45 PM

Health care conundrum

Health care conundrum 06/20/2004 03:53 AM
Boston Globe Jun 20 2004 7:13AM GMT

Here's to Your (Cheaper) Health Care

Here's to Your (Cheaper) Health Care 09/16/2004 03:27 PM
More Americans are looking to Canada for ideas on fixing the health-care crisis.

Study: U.S. health care not always the
best

Study: U.S. health care not always the
best 05/04/2004 02:01 PM

The Health Care Implosion

The Health Care Implosion 05/25/2004 01:22 PM

Mercury News: Health costs hurting more small businesses. The cost of health insurance -- ranked the top concern of small businesses since 1986 -- still holds that dubious distinction, a new nationwide survey shows. But the percentage of firms affected by those costs has grown substantially.

The health care system, or at least the insurance system through which our health-care dollars flow, is in a slow-motion collapse. This story is just one more data point. Sooner or later, we'll have to make a choice. Should the U.S. go to national health care, as every single other industrialized nation provides for its citizens? Or should we go to a totally free-market system -- not the bogus pretense of one we have now -- that leaves millions without care of any kind? Or something else? The insurance industry is systematically excluding people who will someday need care -- shifting costs wherever possible to taxpayers. This may be rational capitalism, but it's lousy public policy. I'm working on some columns on this topic. Let me know what you think.

America's Health Care Mess

America's Health Care Mess 07/14/2004 03:30 PM
Another chapter in the health care meltdown: Sometime in the next few weeks, barring a surprising turn of events, the state of California will formally approve the merger of two health insurance giants. An Indiana company called Anthem will acquire WellPoint Health Networks, the Southern California outfit that owns Blue Cross of California, for about $16.4 billion. The deal has drawn harsh criticism for many reasons. Not least is the display of raw greed by the insider executives who stand to collect somewhere between $200 million and $600 million in payouts after the buyout is concluded. More...

XP SP2 puts the squeeze on health care

XP SP2 puts the squeeze on health care 08/10/2004 09:44 PM
You think IBM has problems? How about being a hospital dependent upon devices that run Windows? They want to have the latest Windows security patches installed, but how can they when the device manufacturers haven't certified that their products run...

World Health Care Congress

World Health Care Congress 01/25/2004 11:41 AM
I'm in DC in a hotel with a nice view of the J. Edgar Hoover building. Facilitating a Socialtext Eventspace for the World Health Care Congress. The World Health Care Congress is the first focused and inclusive conference to determine...

IBM chalks up two health care wins

IBM chalks up two health care wins 08/18/2004 06:40 PM
The deals with a university medical center and a California health care provider come two weeks after a win with the Mayo Clinic.

Kerry Focuses on Health Care (AP)

Kerry Focuses on Health Care (AP) 05/11/2004 02:10 AM
AP - Democrat John Kerry is focusing on health care reform in a very complex environment, one complicated by the furor at home and abroad over the abuse of Iraqi prisoners by U.S. soldiers.

Health Care IT Czar Speaks

Health Care IT Czar Speaks 05/19/2004 02:52 PM
On the job only a few days, Dr. David Brailer made his first major speech to attendees of an industry conference entitled "Toward Electronic Patient Records" in Fort Lauderdale, Fl. this morning.

Health care gets more high-tech

Health care gets more high-tech 04/10/2005 12:54 PM
Chicago Tribune Apr 10 2005 2:26PM GMT

"lgf: Kerry: Lying About Health Care"

"lgf: Kerry: Lying About Health Care" 08/22/2004 04:11 AM

Growth in Health Care Spending Again
Drops (AP)

Growth in Health Care Spending Again
Drops (AP) 06/09/2004 07:36 AM
AP - The rate of growth in health care spending fell for the second year in a row in 2003 as demand for health services dropped because workers were forced to pick up more of the tab for their care and a surge from a change in managed care policies ebbed.

Canada Looks for Ways to Fix Its Health
Care System

Canada Looks for Ways to Fix Its Health
Care System 09/12/2004 03:10 AM
Polls indicate that public confidence in Canada's health insurance system is eroding, although politicians remain reticent to privatize services.

Wide U.S. Inquiry Into Purchasing for
Health Care

Wide U.S. Inquiry Into Purchasing for
Health Care 08/20/2004 11:43 PM
The case appears to be focused on whether hospitals are fraudulently overcharging Medicare and other programs for goods.

AP Poll: Health Care, Terror Worries
U.S. (AP)

AP Poll: Health Care, Terror Worries
U.S. (AP) 01/19/2004 02:51 AM
AP - Concerns over health care and unemployment have edged higher in the public's consciousness over the last year as worries about the overall economy eased, an Associated Press poll found.

SBC workers start strike over health
care

SBC workers start strike over health
care 05/21/2004 02:33 PM

Canada to boost Inuit health care

Canada to boost Inuit health care 09/13/2004 09:45 PM
Prime Minister Paul Martin announces plans to improve health care for Canada's indigenous people.

Saddam Hussein, an example for health
care reform

Saddam Hussein, an example for health
care reform 03/17/2005 03:24 AM

Over breakfast at a favorite little French cafe in Harvard Square today a friend who is getting a master's in Public Health at Harvard mentioned that under Saddam Hussein Iraq's entire health care system had a budget of $18 million and that under U.S. occupation this has subsequently grown to $1.8 billion.  How well did Saddam do with his $18 mil?  http: //www.cia.gov/cia/publications/factbook/geos/iz.html shows Iraqi life expectancy at birth to be 68 years versus the U.S.'s 77 years. Those extra 9 years are nice, of course, but they come at a cost of about $1.9 trillion per year or 100,000 times Saddam's budget.

Schwarzenegger Budget Denies Some Health
Care

Schwarzenegger Budget Denies Some Health
Care 01/17/2004 10:38 PM
Governor Schwarzenegger has proposed capping enrollment in Healthy Families, a state-federal health insurance program for the near-poor, at the current level.

Kerry releases health care study

Kerry releases health care study 05/10/2004 02:41 PM

Briefly: IBM chalks up two health care
wins

Briefly: IBM chalks up two health care
wins 08/18/2004 06:40 PM
roundup Plus: Vonage users dial 311 for city info...Mozilla makes Japanese push...Macromedia offers Flash video tool.

HHS names former CareSciences CEO as
health care IT czar

HHS names former CareSciences CEO as
health care IT czar 05/07/2004 04:33 PM
The Department of Health and Human Services also announced the adoption of new standards that will serve as the bedrock of a national electronic health record for every American.

F/OSS: Let's drop the K-12 campaign,
champion health care

F/OSS: Let's drop the K-12 campaign,
champion health care 04/30/2004 07:09 PM
Listening to one of last week's recorded CFP plenaries, I was struck by how often open source advocates point to the need for ubiquitous computing resources in K-12 schools. Given the evidence to the contrary, this is not a compelling...

VA Health Care Faces Wave of Returning
GIs (AP)

VA Health Care Faces Wave of Returning
GIs (AP) 05/16/2004 08:57 PM
AP - More than 20,000 soldiers have sought care from the Veterans Affairs Department since returning from Iraq and Afghanistan. With thousands more expected to seek benefits and health care, the VA faces its biggest challenge since the early 1990s.
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Health-care costs shoot up, millions in U.S. left gasping

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