Showing posts with label everything. Show all posts
Showing posts with label everything. Show all posts
Everything You Need to Know About Health Care Reform Thanks to a 25 Minute Video Courtesy of Managed Care Magazine
Tuesday, January 28, 2014
Thanks to Managed Care Magazine, the Disease Management Care Blog can post this interesting 25 minute interview with Princeton healthcare economist Uwe Reindardt. Suitable for desk-bound meal-break viewing by overachieving DMCB readers, the modest and insightful Dr. Reindardt gets it mostly right:
No, the slowdown in the U.S. rate of health care costs cannot be ascribed to passage of the Affordable Care Act. It started wayyyy before Obamacare was passed and is more likely due to the economic slowdown and increased consumer cost-sharing.
Accountable Care Organizations remain an "iffy" experimental proposition because they "dont go all the way like Kaiser."
Republican proposals to let health insurers sell their products across state lines are hardly a health orm panacea, because prices (and theore premiums) are not a function of where the insurer is domiciled, but where the care is rendered. Texas insurers would still have to pay New York prices.
Americans use fewer pills, occupy less bed-days and see fewer doctors, but we pay more because providers can charge more. Despite being relatively small vs. the behemoths like Aetna and Cigna, regional hospitals have considerable market power that translates into take-it-or-leave it local single seller monopsonies. Europeans, in contrast, have lower prices because their system is dominated by single purchaser monopolies.
Were headed toward a three-tier system comprised of 1) the indigent safety-net public programs, 2) the middle class "erence pricing" "networks" where consumers pay the difference if they want to buy up and 3) "boutique" health care for the 5%.
Theres reason to be optimistic about the next five years thanks to a sluggish labor market (making it easier to impose networks and even more cost sharing) and innovation (computational capacity is putting meaningful quality measurement within reach, while techy gizmos are making self-care simultaneously cheap and fun).
Plus, theres reason to be of good cheer. Compared to the U.S. education and the legal systems, health care is far more efficient and consumer-friendly. Stop beating up on yourselves.
(The DMCB didnt quite agree with Dr. Reinhardts views on worksite wellness. He finds the notion counterintuitive and intrusive, perring that insurers own wellness. He neglects to mention that the employers who invest heavily in wellness are typically self-insured and that employers have an arguable stake in improving the quality of their human capital.)
No, the slowdown in the U.S. rate of health care costs cannot be ascribed to passage of the Affordable Care Act. It started wayyyy before Obamacare was passed and is more likely due to the economic slowdown and increased consumer cost-sharing.
Accountable Care Organizations remain an "iffy" experimental proposition because they "dont go all the way like Kaiser."
Republican proposals to let health insurers sell their products across state lines are hardly a health orm panacea, because prices (and theore premiums) are not a function of where the insurer is domiciled, but where the care is rendered. Texas insurers would still have to pay New York prices.
Americans use fewer pills, occupy less bed-days and see fewer doctors, but we pay more because providers can charge more. Despite being relatively small vs. the behemoths like Aetna and Cigna, regional hospitals have considerable market power that translates into take-it-or-leave it local single seller monopsonies. Europeans, in contrast, have lower prices because their system is dominated by single purchaser monopolies.
Were headed toward a three-tier system comprised of 1) the indigent safety-net public programs, 2) the middle class "erence pricing" "networks" where consumers pay the difference if they want to buy up and 3) "boutique" health care for the 5%.
Theres reason to be optimistic about the next five years thanks to a sluggish labor market (making it easier to impose networks and even more cost sharing) and innovation (computational capacity is putting meaningful quality measurement within reach, while techy gizmos are making self-care simultaneously cheap and fun).
Plus, theres reason to be of good cheer. Compared to the U.S. education and the legal systems, health care is far more efficient and consumer-friendly. Stop beating up on yourselves.
(The DMCB didnt quite agree with Dr. Reinhardts views on worksite wellness. He finds the notion counterintuitive and intrusive, perring that insurers own wellness. He neglects to mention that the employers who invest heavily in wellness are typically self-insured and that employers have an arguable stake in improving the quality of their human capital.)
Is everything we eat associated with cancer
Sunday, January 19, 2014
The authors of this study aimed to examine the conclusions, statistical significance, and reproducibility in the literature on associations between specific foods and cancer risk.
Design: We selected 50 common ingredients from random recipes in a cookbook. PubMed queries identified recent studies that evaluated the relation of each ingredient to cancer risk. Information regarding author conclusions and relevant effect estimates were extracted. When >10 articles were found, we focused on the 10 most recent articles.
Results: Forty ingredients (80%) had articles reporting on their cancer risk. Of 264 single-study assessments, 191 (72%) concluded that the tested food was associated with an increased (n = 103) or a decreased (n = 88) risk; 75% of the risk estimates had weak (0.05 > P ≥ 0.001) or no statistical (P > 0.05) significance. Statistically significant results were more likely than nonsignificant findings to be published in the study abstract than in only the full text (P < 0.0001). Meta-analyses (n = 36) presented more conservative results; only 13 (26%) reported an increased (n = 4) or a decreased (n = 9) risk (6 had more than weak statistical support). The median RRs (IQRs) for studies that concluded an increased or a decreased risk were 2.20 (1.60, 3.44) and 0.52 (0.39, 0.66), respectively. The RRs from the meta-analyses were on average null (median: 0.96; IQR: 0.85, 1.10). Conclusions: Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak. Effect sizes shrink in meta-analyses.
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