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Web 2.0 and your health

December 21, 2010

Healthcare loves web 2.0.  Consumer driven health care, plans where the consumer plays a larger role in healthcare decisions, is the future of healthcare.  Americans have become lazy when it comes to health care.  Insurance is partially to blame.  So is peoples sense of entitlement.  Anyway, what do you know, we are finding it difficult to afford healthcare as we know it.  Maybe it’s time for people to become aware of how there healthcare dollars are being spent and why they are in need of health care in the first place.  Web 2.0 is going to be insturmental in helping consumers take charge of their health care spending.  Here are a few websites that help consumers. 

Google Health

https://www.google.com/accounts/ServiceLogin?service=health&nui=1&continue=https://health.google.com/health/p/&followup=https://health.google.com/health/p/&rm=hide

Main Street Medica

http://www.mainstreetmedica.com/

Healthcare .gov

http://www.healthcare.gov/

ARRA HITECH

December 21, 2010

Last night I was watching the Bears lay a shelacking  on the Vikings when an IBM commercial came on that showed a baby covered in little digital images.  Here is the link http://adland.tv/commercials/ibm-smarter-planet-data-baby-2010-30.  Use “IBM Commercial Baby” for a search if the link doesn’t work.  My first reaction was, is this a threat.  This commercial seems strikingly similar to a commercial you would see promoting Skynet in the movie Terminator.  My second reaction was, there are billions of dollars being invested in healthcare technology.  The country is relying on new technologies to help control the cost and quality of health delivery.  This reliance on technology creates a whole new set of legal issues.  One issue is fraud.  There is going to be a lot of change involved with inserting more technology into healthcare delivery.  That change will be serviced by investment (public and private).  There will be competition for those investment dollars, and that’s where capitalism can turn ugly.  The other issue that comes to mind is privacy.  Is your clinician going to know everything there is to know about your mind and body, load this on the internet, and generate new revenue streams with it.  This information is incredibly valuable. 

Do you think clinicians should be able to sell your healthcare information for profit?  What if that revenue went to subsidizing your healthcare costs?

The American Recovery and Reinvestment Act of 2009, a.k.a. the stimulus bill, a.k.a. ARRA, provided the healthcare industry with 20 billion dollars to invest in new information technology.  More specifically the Health Information Technology for Economic and Clinical Health Act (HITECH), which is part of ARRA provided these appropriations.  This enormous cash infusion into the industry is ripe with fraud.  There was an article in the WSJ yesterday that identified a strange correlation between back fusion operations performed at a Kentucky hospital with payments made to the hospital physicians by a large Twin Cities device manufacturer.  The payments to the providers were for their role in inventing a procedure that uses the very expensive parts produced by MedTronic.  Some say fraud, some say business.  Anyway you throw 20 billion into an industry you are going to have many similar situations. 

As for the privacy issues.  I work in health care privacy.  I see a lot of mistakes happen, but in 6 years have not run across any malicious acts.  HITECH gave the privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) some serious teeth.  Health and Human Services Office of Civil Rights are conducting much more detailed investigations of privacy related complaints, covered entities are required to notify individuals whose information was disclosed and could be harmed by that disclosure, and the penalties for privacy violations are high.  Penalties can be in the millions for covered entities that were willfully negligent. 

What do you think about healthcare privacy laws?  Do you think that your privacy trumps health delivery innovation?  Do you worry about your healthcare information being placed in the wrong hands?  What do you think could result in your information being placed in the wrong hands?

Healthcare.gov

December 20, 2010

I’m really impressed with the government’s health insurance website.  Health insurance companies around the country have been providing the government with tons of data to put this site together.  On healthcare.gov you will find information about purchasing a health insurance policy, information on preventive health benefits, tools to measure the quality of the health care you can receive, and general information about health reform.

Bartering for Health Care

December 20, 2010

I ran across an article today that discussed how citizens of Zimbabwe barter their chickens and goats for health care.  One clinician said that she actually works for peanuts.  This shouldn’t come as much of a surprise since Zimbabwe is one of the worlds poorest countries.  I can’t imagine bringing a bag of peanuts for my copay the next time I see my physician.

According to the US Census Bureau, US health care expenditures were  $6947 per person in 2007.  Cash is king here in the US.  I’ve been very fortunate to have always carried a health insurance card.  Things can get pretty dicey for those without insurance.  Out of pocket expenses are vicious. According to 2007 US Census data Americans pay an average of 10% of annual health expenditure out of their own pocket.  This figure doesn’t include health care premiums.  According to a Kaiser Health Foundation study the average health premium in 2009 was $4824 for an individual and $13375 for a family.  It’s hardly official, but according to answers.com you can buy a chicken for $5.00.  If my math is right the average American family could buy 2675 chickens for the price of 1 year of health insurance.

The Cornhusker Kickback

December 15, 2010

I have to admit, I am fascinated with the political process and the smokey backroom bargaining that takes place in making new laws.  The Cornhusker Kickback refers to a bargain that Senate Majority Leader Harry Reid made with Nebraka’s Senator Ben Nelson to secure his vote for the PPACA.  Securing Senator Nelson’s vote was very important to Senator Reid, because it was the last vote needed to prevent a Republican filibuster.  Apparently Senator Nelson had already threatened to filibuster when language preventing federal payment of abortions was removed.  In the end a provision for providing Nebraska 100 percent reimbursement for Medicaid expansion was agreed to and PPACA passed the Senate with a 60 to 39 vote.  Senator Bunning was the only Senator to miss the vote, which had not real impact on the passage of this bill. 

Not so fast Senator Nelson.  The Cornhuser Kickback received a lot of attention in the week leading up to the Healthcare and Education Reconciliation Act of 2010.  No doubt, this is why it was one of the first elements of PPACA to be eliminated.  The Reconciliation Act was passed in the Senate by a 56-43 vote;  Senator Nelson being one of 3 democrats voting no. 

I can’t quite put my finger on it, but it appears that someone was outsmarted or isn’t very smart to begin with.  To be a fly on the wall.

Constitution

December 14, 2010

The Wall Street Journal had a great article today regarding two Virginia federal judges decisions on the compulsory health insurance mandate within PPACA.  I’m having trouble including the link so the name of the article is “Judges Divided on Health-Care Law”.  I find this article to be very interesting in two ways.  First, I like the controversey over this health reform.  I don’t think the reform measures have received enough public attention and I think a good constitional dust up will put this thing front and center.  Second, I just took a Constitutional Law Powers exam yesterday and am all to familiar with the Commerce Clause, which is what the US is hanging its hat on with the requirement for individuals to have health insurance or face a penalty.  Article 1, Section 8, Clause 3.  In the WSJ article they mention Wickard v. Filburn, which established that Congress’ power to regulate commerce extends to activities with a substantial economic effect on commerce.  The WSJ continues to mention a case involving the Gun-Free School Zones Act and the Violence Against Womans Act.  Is it possible that the WSJ is referring to U.S. v. Lopez and U.S. v. Morrison.  I think so.

Diagram of Regulations Impacting Health Insurance

December 7, 2010

Yesterday I posted an outline of the PPACA.  When you read through the outline you see how vast this legislation really is and how expansive the US health delivery system is.  I work in the health insurance industry; the compliance and privacy department, to be more specific.  I’m also in law school.  I intend to make a career specializing in health law.  Considering how complicated, and some would say broken, the healthcare system is,  I think opportunities for lawyers to assist in the untangeling are plenty.  Here is a link to a diagram that illustrates the web of regulations that impact a portion of the US healthcare delivery system.

http://www.americanhealthsolution.org/assets/Reform-Resources/AHIP-Reform-Resources/HealthPlanRegulationChart.pdf

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