My employers wellness program is such a joke. We all participate for the premium discount, but very few people actually make changes to improve their health solely because of the program. It's illegal to force people to change and all the added paperwork is such a headache.
Usually, I never comment on video's, but this one is so convincing that I become unable to stop myself from saying something about it. You’re doing a great job Man, Keep it up.
So I'm a Firefighter/Paramedic in the US applying to Physician Assistant school with an undergrad in public health. Applying to PA school because I'm really interested in how to provide universal coverage in efficient and effective ways. I think community based advanced practitioners, possibly through the fire and EMS departments, can provide that. The fire service has been socialized for two hundred years now. I've never had anyone suggest that we should go back to private, unregulated, for-profit fire departments watching over our communities. With the change to universal coverage or single payer there's obviously going to be a huge incentive on prevention. I think it would be interesting if you did a video on healthcare under communist states. They obviously did lots of things terribly wrong. Some of their ideas are being brought back and touted as new and unique though, because they were effective. China's use of "barefoot doctors" after their revolution. Essentially advanced practitioners similar to a PA or Nurse Practitioner, providing care in isolated rural environments. en.wikipedia.org/wiki/Barefoot_doctor
As a healthcare administrator, I remembered doing a project over the bundle payment program, and in fact over Maine Community Health Options which is one of the 9 that survived. It was not just the bundle payment, but the risk pool associated.
What a concept - Politicians authorizing proper, rigorous, high quality evaluations of policies and programs, then making continuing policy decisions based the results of the studies instead of based on who they get the most political contributions from. Who would have ever thought that would be a useful practice? (Full on snark mode, if you can't tell)
Let's talk about MIPS. This was a CMS program that was supposed to collect data from every doctor in the country, pay more to the best performing doctors, and less to the worst. Great idea, huh? Except in worked in the reverse. Those who rigorously collected the data spent about half an hour per week on the data collection effort. Of those, only the top got the bonus, of 1.69%. Those who ignored the program got no bonus, obviously, but didn't have to spend the time on the data collection. Notice the flaw here? Half an hour per week is more than 1.69% of one's time. So, the one's who got the bonus LOST money compared to those who ignored the program altogether. The majority of docs who participated, and didn't get the bonus, simply lost double. The net effect was that the best docs were penalized, the worst docs rewarded.
Healthcare insurance companies want to attract people who won’t need them and shoo away people who do, because it is more profitable. For example, some companies offer health and wellness packages (like access to a gym) to incentivize people who already workout to join their company because their health premiums will be lower, not the other way around. Feels like we need a new model for health insurance that incentivizes private insurers to help people who need it, not more research on how effective interventions are. It won’t matter if the system is still trying to optimize for low utilization, imo.
Love your channel but I really wish you didn't always focus so much on the United States. It probably would have been more interesting and insightful to compare health policies across various countries.
@Chad Mojito - You should take a look back at the Healthcare Triage video archives on their You Tube channel page. As I member, from late 2015 to 2017 they did several videos comparing health care systems in other countries during the same time period that universal health care was being discussed as a result of the Presidential campaign.
There are no miracle approaches, no universal panacea to fix the health care system--or, more accurately, the healthcare payment system. Medicare for all, even with expansion of the program coverage to cover cradle to grave, would not be perfect, but would be a pretty efficient approach to reducing waste and improving outcomes. It would increase administrative costs for Medicare above current levels, but would still afford administrative costs far less than private, for profit insurance plans can achieve. It would go a long way toward reducing the extremely expensive and wasteful 830+ million man hours spent by doctors and their staff on insurance prior authorizations and other obstacles and red tape. It would result in an estimated savings of roughly $4,000 per year to families of four in the United States. And it is expected to afford better outcomes on the metrics measuring healthcare outcomes and quality. Estimates and hypothetical outcomes provided by models are, however, subject to proof from experience when the healthcare payment model is implemented. As the statement attributed, I believe, Napoleon puts it: "No plan survives contact with the enemy." Even if a Medicare for All single payer system cost roughly the same as the current system, if it fulfilled its promise of superior outcomes and improved overall health for the American people, it would still be a much better deal than the current system and its dismal performance in delivering good outcomes and quality care. I think it would be worth a try. I say this as a doctor whose income would be reduced by transitioning to a Medicare for All single payer system.
It seems like we can't make healthcare work here in the USA. Why don't our leaders look at what other countries are doing and see what works and what doesn't. Britain and Canada see like models we don't want to follow, but what about countries like Germany, Switzerland, Japan, and Australia which do healthcare at much lower costs but don't compromise quality? What are they doing that is working? Maybe answering that question will save on a lot of research.
It also have to considered that some societies are healthier than the US. For example Japan eats less proxess and more natural foods. And some societies walk more than drive.
I watched the episode and understood it, but I can see how this jargon filled episode would not be very accessible to the average casual viewer. For this reason, I occasionally watch this show but I wouldn't subscribe. Health care being complicated seems to be the single issue made very real by this and other occasional episodes I catch. My ears perked up as I am a resident of Oregon, but all I got was.. the trail helped people with depression but not general health? I mean.. I'm not even sure what that means or if it's the actual outcome.. Confusing. Please consider working toward a simpler way to share your message.