Tag: Healthcare

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Elon Musk announced his Neuralink project this week. As this video explains, the goal of enabling communication and control through thought alone is arguably given some credibility by medical solutions already in use. More

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Drug Pricing Made Easy

 

President Trump was both lucky and smart this week in his approach to the thorny issue prescription drug pricing. Lucky, because a district court threw out on First Amendment grounds his executive order that drug companies supply list prices for all the drugs that they produce. Smart, because at the eleventh hour he decided against issuing an executive order that would have required pharmaceutical companies to offer a system of “most-favored-nation” pricing, which would cap the prices that drug companies could charge in the United States to the lowest price charged for that drug in any country outside the United States. Eliminating poor price signals is a modest benefit. But the implementation of the executive order would have slashed revenues, putting pharmaceutical companies at serious financial risk and perhaps ruin.

The basic flaw behind both proposals is that they assume that there is a unique “price” at which pharmaceutical drugs sell. That assumption often works in competitive markets in which the costs of development are low relative to the marginal (i.e. additional) cost of production for each unit. But so-called marginal cost pricing does not work for new pharmaceutical drugs whose development costs are already high and getting ever higher. Companies are constantly researching and trying to develop new drugs with strong therapeutic properties and tolerable side effects. They also face huge costs in shepherding promising drugs through three stages of clinical trials, each one more complicated than the last. Many promising new drugs wash out in these clinical trials, which means that a pharmaceutical company can remain solvent only if its blockbuster drugs yield enough revenue to offset the costs of its duds. And finally, companies incur huge financing costs as they bring drugs to market. Development and clinical trials take years to complete, and drug companies have to find ways to finance expenditures made in year one with revenues that will only start, typically, some eight to 10 years later.

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The G-BA is the worst

 

A group of regulators from Germany published in the British Medical Journal a recommendation on how drug companies should design clinical trials. These “recommendations” curiously align with Germany’s unwillingness to pay for efficacious drugs.

There are two regulatory bodies in Germany that check whether a new drug is better than an old treatment and pay accordingly, IQWiG and the G-BA. Not surprisingly when the Germans decided to check most new drugs they found that a majority of them (56%) showed “no added benefit.” Notwithstanding the obvious conflict of interest with the German government both approving and paying for new drugs, there are two major problems with Germany’s approval process. The unnecessary cost they are asking the drug companies to absorb and the capricious way they judge whether a drug is efficacious.

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Should We Just Let Them Die?

 

I just logged onto our computer system at work to see what our patient list is looking like and if there have been any emergency surgeries this weekend. I noticed something peculiar about the bed assignment of one of our young patients. I opened a nurse’s note to discover that just two days after we operated to repair one of the heart valves that had been damaged by this patient’s IV drug use, the patient was discovered using IV drugs while in the bathroom.

Of course, they deny any wrongdoing but the evidence is overwhelming. I have no idea how this young person’s life will turn out after the follow-up visits are done, but I can say the chances are they will end up like so many of our other patients that require open heart surgery because of their drug use — dead.

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Jim Geraghty of National Review and Greg Corombos of Radio America think President Trump did alright in his speech and agree that his presentation was better than the stiff stares of Chuck Schumer and Nancy Pelosi. They also shake their heads in wonder as more Democrats embrace huge tax increases and government-run health care and […]

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Jim Geraghty of National Review and Greg Corombos of Radio America embark on the second half of their six-episode saga known as the 2018 Three Martini Lunch Awards. Today, Jim and Greg offer up their selections for the best political idea, worst political idea, and boldest political tactics for 2018. More

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93% of Republican Women Support Trump

 

According to Daniel Henninger, the deputy editor of the opinion page of the Wall Street Journal, 93 percent of Republican women support Trump. His information came from a recent Fox News Poll that also reported the women were even more supportive than their male counterparts who support Trump to the tune of 85 percent. The poll is extensive, so make sure you scroll down for the section where party identification begins.

Lest you believe these women are off in blind la la land, Henninger says, “Which brings us to what may be the greatest Republican political blunder of this generation — failing to fix ObamaCare. The percentage of GOP women who express concern about health care is 77%.”

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In the latest Urbane Cowboys podcast, we talk with Avik Roy of the Foundation for Research on Equal Opportunity about healthcare policy, equal opportunity, and social capital. https://soundcloud.com/…/ep-9-a-spoon-full-of-sugar-with-av… More

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According to the Fraser Institute, the average annual cost of Canada’s public healthcare regime is about $4,640 per taxpayer. For most people, that does not include prescription drugs, dentistry, optometry, psychiatry, medical devices (wheelchairs, home oxygen, etc.), or any other medical goods and services delivered outside of a hospital or a GP’s office. It also […]

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For those unfortunate enough to be “covered”* by an ACA insurance plan, paying cash at an out-of-network practice, apparently, constitutes an act of fraud. Never mind that a thousand financial-planning websites advocate exactly this practice. No, it’s fraud. Evil. Contemptible. Horrible. Hideous. A family member of mine learned this great, undeniable truth recently, after she […]

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From Commodity to Transformation: How Selling Coffee Points the Way to the Future of Healthcare Delivery and Why it is So Hard to Get Right

 

In his 2006 book The Starbucks Experience: 5 Principles for Turning Ordinary Into Extraordinary, Joseph A. Michelli outlines how Starbucks takes a service (preparing coffee) and turns into an experience, a transformation that has not been without struggles and has proven difficult to maintain over time.

In the book, Michelli outlines the hierarchy of sales, showing that the highest margins are from those sales based on experience, using coffee as an example:

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My Experience with the VA

 

On Monday I went to visit my parents back in Ohio. Mom and dad are now in a nursing home. Dad needed me to take him to the VA to get his hearing aids checked and repaired — I hadn’t been able to talk on the phone with him for a month, and finally found out his hearing aids were “broken.”

This particular VA office (On Waterloo Road in Akron) had open hours of Mondays and Tuesdays, 9–11 am. No appointment was necessary — just walk in (or in my dad’s case, roll in). I was ready to settle in for a daylong wait.

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What Your Hospital CEO Is Thinking: A Reality Check and Rebuttal

 

Ms. Amy Schley made an interesting post that seemed to spur some conversation on cost-based health care services. Due to her increasing legal experience working on memos for a hospital, she let us in for a little behind the scenes peek at what some of her bosses’ emails had taught her. For one, I’m glad that people are thinking about healthcare once again.

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“The Resident” Should Be Allowed to Die a Natural (Swift) Death

 

Always one to watch and critique medical dramas, I sat down with a beer to watch the newest entry to the genre. “The Resident” is the Fox network’s answer to other edgy shows that promote liberal agendas.

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Addiction, Homelessness, and Healthcare

 

I’m really tired today after coming off of working three days in a row. That may not seem like a lot to the regular work-a-day folks, but when you’re in healthcare, the hours are often long and arduous. I’ve worked about 40 hours in the past three days, and I work in a busy Emergency Department in Portland, OR. Every day that I worked, the ED was on divert — meaning ambulances were directed to not come to us because we were so busy.

When I left work last night, there were 30 patients in the waiting room. Many had been waiting three to five hours just to be put in a room; the wait time to see a physician after being roomed was even longer. Staff scurried about looking haggard, pulled in a million directions. At one point I counted 17 patients in the department that had been admitted to inpatient services waiting for a bed, but since the hospital was full they continued to board in the ED. Multiple patients were there with mental health crises that had landed them with psych holds.

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Wards of the State: Social Responsibility

 

In difficult times, we may turn to the rigid rules of the government. It is then that we realize that things are not so simple. When we age, if we are incapacitated without a designated next of kin, we could become a Ward of the State. That should be on every adult’s list of horrors.

Being a Ward of the State means that it takes a judge’s order to define certain life states and procedures. You are not your own person because you have no people to fight for you. Anyone with any sense should fear this future.

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Intentional Transmission of HIV: OK in CA!

 

I cannot believe that I live in a state like this.

Governor Brown and his lackeys have determined that intentionally transmitting HIV is only a misdemeanor. Transmission of a life-altering, and eventually life-ending, disease has now been demoted to an afterthought.

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