Healthcare Reform - Are We Disconnected?
January 9, 2023
Good Day Healthcare Advocates
Every day we advocate for better healthcare for all of us is a good day. Thank you also to all of you advocates who have recently subscribed and to those who have asked for particular topics. Please send topics in the comment button below. Thank you.
Mission
The Healthcare delivery system in the United States is a patchwork that leaves much to be desired. It is the most expensive system among the top 35 industrial countries and covers far fewer participants delivering lower levels of quality care than many of our peer nations. This blog will provide:
Current problems in healthcare
Actions you can take
References.
Errata - Pharmacy Benefit Managers
Recently I reported on Pharmacy Benefit Managers. They stand to make money between you and your pharmacist. One of the topics I covered was the contractual gag rules or non-disclosure agreements PBMs have with pharmacies that prevent the pharmacist from telling you there is a cheaper way to obtain the prescription.
CORRECTION: in 2018 gag clauses in those contracts were ruled illegal at the federal level. The pharmacist can now offer lower cost ways to purchase drugs. But they don’t have to.
ASK THE PHARMACIST ANYWAY, Not all pharmacies will offer a cheaper alternative way to purchase if you don’t ask. Mine didn’t last Thursday. I dropped the price from $95 on insurance to $43 for cash.
If you’re interested here is a link to a PBS news article about PBMs and one link from the Wall Street Journal.
By the way, if the PBM your insurance company uses does not have an agreement with your pharmacy, your insurance won’t work there. Ask for a cash price anyway.
Current State of Affairs – Disconnected Healthcare
Today we discuss a problem that Universal Healthcare can fix, having easy, timely, access to your medical records.
France’s insurance card, the Carte Vitale 2 is not just your medical ID. It is a smart card (has a chip) and contains all your Electronic Medical History. Diagnoses, prescriptions, images, it is all there so any physician you go to has a complete history available. The physician keeps the card in the computer during the visit. When you’re done the doctor has automatically billed for the visit, and your records are updated. Of course, insurance maintains a backup of your data, just in case you lose your card.
Germany recently implemented the system and as a humorous note one German said “I’m sad that we are picking a system from France. However, We are still far ahead of the Americans”. They were right.
Today in the US it is a cumbersome process to arrange for medical records to be transferred from one doctor to another unless they use the same software system (like EPIC) or an interoperable system. The US government is working to standardize medical records and certify software packages to be interoperable, that is read data produced by another certified package. That’s a start but when you are in the doctor’s office for that visit, and you’re a new patient, there is a significant delay for your new doctor to get your records. Thus lessening the productivity of that visit.
This happened to my daughter recently. She began a new job as a chaplain at a NY state hospital. She has Lupus. She went to her new primary care doctor for a sore throat. He did not have her records yet, discovered she had Lupus and insisted on prescribing Plaquenil. This is often a first line of treatment that she has had but after about 5 years of use the risk of blindness is great. She refused, the doctor would not budge. Had the doctor had a common record system they might have made more progress.
We all have limited time but I was surprised that 14 years after we began using electronic medical health records the government is still refining standards and there is no guarantee that your records can be read by a new doctor, nor do you, necessarily, have easy access to all your records. Universal systems with common software, common standards, and easy access by providers and patients facilitates health. We can do better. Much better.
What You Can Do – Contact Legislators
Use Resistbot below or call/email your senators and representative and say
“My name is __________________(name) and I live in __________________(zipcode) and I am your constituent. We all deserve a healthcare system that works for all of us. We need Universal Healthcare like HR1976 now so that everyone is covered and we can share medical records quickly between providers to help facilitate better healthcare.
And as long as we are at it I also want you to support the bi-partisan bill S.4293 - THe Pharmacy Benefit Manager Transparency Act of 2022 proposed by Senators Cantwell and Grassley and work to enact new legislation that passes 90% of the rebates (kickbacks) pharmacy benefit managers receive on to consumers. Thanks. We need you to do this.
Resistbot
Text SIGN PZNHAK to 50409 to send the letter below to your representative and senators.
We all deserve a healthcare system that works for all of us. We need Universal Healthcare like HR1976 now so that everyone is covered and we can share medical records quickly between providers to help facilitate better healthcare.
And as long as we are at it I also want you to support the bi-partisan bill S.4293 - THe Pharmacy Benefit Manager Transparency Act of 2022 proposed by Senators Cantwell and Grassley and work to enact new legislation that passes 90% of the rebates (kickbacks) pharmacy benefit managers receive on to consumers. Thanks. We need you to do this.
References
Contact elected officials
Senate email/phone
https://www.senate.gov/senators/senators-contact.htm
House of Representatives email/phone
https://www.house.gov/representatives/find-your-representative
Health Information Technology
State of Health IT https://en.wikipedia.org/wiki/Office_of_the_National_Coordinator_for_Health_Information_Technology#Programs
HealthIT (US Gov’t Website)
Standards Group
(https://www.healthit.gov/topic/interoperability/standards-and-technology )
Advisory Committee (they aren’t done)
https://www.healthit.gov/hitac/committees/health-information-technology-advisory-committee-hitac
Universal Healthcare Resources
Healthcare-NOW
https://www.healthcare-now.org/
Physicians for a National Health Plan
Done!
1/10/23 Hello Again Alan. I'll send the Resistbot for the second time to my legislators about electronic medical records. Back in 2010-2011 I studied medical transcription and my instructor, older like me, had visited Congress to implement universal electronic medical records. She had been a medical transcriptionist in hospitals and clinics (before they outsourced to working from home, a sweatshop in one's own bedroom) for decades.
Because of this fragmented healthcare system and from my medical transcription instructor's advice, I always now write up a medical history for each new doc or surgeon I see; some don't bother to read them and try to dictate to me what my issue is solely from diagnostics without knowing my medical history and how to resolve it (two hip surgeons told me I'd never run again after total hip replacement and were immediately fired, found the good hip surgeon now no longer performing surgery due to the 25% increase in malpractice insurance, barely made it in time--outstanding surgeon, what a tragedy).
With universal EMR I would recommend still giving new docs a patient medical history summary, but they wouldn't have to keep taking duplicate diagnostics for the same condition if it were on our lifelong medical records and the patient wouldn't have to make copies of hospital records if they were in their universal medical records.
Leave it to the USA t make simple procedures extremely complicated.