My identify is John Ross and I’ve spent my total 40 + 12 months profession in well being care. Particularly, my background and expertise is in growing and managing proof planning, reimbursement purposes, and well being economics methods for a variety of fortune 500 well being care expertise companies. Briefly, my job was to assist the businesses that I labored for to grasp the well being care market place from three vital views. The primary was to reply the query; “What can we expect to be paid for the medical technologies we are developing and planning to market? The second question; “will the outcomes and/or decrease prices related to using these medical applied sciences justify the cost degree we predict they deserve? Lastly, what product growth, advertising and marketing and gross sales methods do we have to make use of to insure that our future medical applied sciences are rapidly accepted by hospitals, physicians, payers and sufferers? Clearly with such a spotlight I needed to cope with Medicare (medical health insurance for people over age 65 and the disabled), Medicaid (state-run insurance coverage applications for the much less lucky) and industrial medical health insurance firms (the businesses that insure and administer employer-based medical health insurance plans). I additionally spent loads of time assessing the wants of physicians, hospitals and enormous built-in well being care supply networks that buy and use a wide selection of medical applied sciences.From a funding standpoint I’ve seen America’s well being care system go from virtually “anything goes” to as we speak’s growing deal with price and outcomes. Outcomes, is simply one other approach of asking the query; “for the dollars we are spending nationally or on a particular patient’s disease or injury are we getting a good value in return? In other words, is the price of the drug, medical device, procedure, diagnostic or surgical intervention worth the cost in terms of better results and lower costs compared to how we would traditionally manage this patient’s condition?This blog is a forum for talking “actually” about:1. Where health care in America is going?2. Why it is going there?3. What can we expect from tomorrow’s health care system compared to what we have become used to?4. What we can do to the best of our ability to use less of it (think preventive health strategies)?5. How we should think about and help those unfortunate individuals, young and old, who need more of it than we do?6. How can we help to make sure those who need health care get access to good health care when they need it?7. What can we do to increase the chances that state of the art health care will be there when we need it and at a price we can afford?I will also provide education as to how the health care system works from the various perspectives of the stakeholders. It is vital that we understand these perspectives, what drives them and the many conflicts that exist. Areas to cover will be:1. What is happening to hospitals and physicians in this changing health care landscape?2. What is happening to the development of innovative future medical technologies and pharmaceuticals?3. Where is Medicare policy going with regard to payments to physicians and hospitals and other care settings?4. What is the future of employer-sponsored health insurance plans?5. Where is changing with regard to private health care insurance companies?6. What will happen to patient costs?7. What can I do to avoid premature, unnecessary or unproven health care interventions?8. What role will “proof and knowledge” play in the future in giving us more information from which to make personal or family member health care decisions?I would like this to be the place that you can visit when you hear politicians or anyone else for that matter promising something from health care that just doesn’t make sense. We all know the feeling we get when we hear an “it is too good to be true” story. When we hear such fantastic promises, we better check it out and this will be a place where you can do that. So, bring your concerns and questions and I will do my best to help you to check them out!Have you heard this one; “underneath my well being plan, you needn’t to fret. Your prices will stay cheap, you may preserve your physician and you should have entry to state-of-the-art well being care”. Or, “it’s each ones proper to entry the perfect in well being care, younger and outdated, wealthy and poor regardless of your capacity to pay.” This would be nice but it is simply not reality and it is time that we talk about these things and deal with them with our rose-colored glasses removed. So, no matter what your point of view on this subject I encourage you to visit ask and comment. We need a grass-roots effort aimed at understanding health care and in particular we need to talk about its funding limits and what we can do to assure that those who need it – get it, and at a level of quality and at a manageable cost such that we can afford it as a nation. If we don’t do this it is highly likely that health care as we have known it America will not be available when we face our own or a family members serious and costly illness.The fundamental flaw in our individual approach to health care is the notion that we have no responsibility for it except to expect it to be there, with no delay, and at state of the art levels of care. And that for the most part it should be paid for by someone else. Most politicians right now are not leveling with us. They don’t want to address the areas that I have addressed even in this my first edition health care blog. Well, I think that we are better than that! I think with the right information we can manage through the changes that are coming. We want to do the right thing but to do so we have to be informed as to how stretched the health care system is and what we can do to unburden this precious resource.First, we can stretch health care dollars and resources by taking better care of ourselves. The goal is to do what “we” can do in terms of learning about and practicing preventive disease strategies, thereby reducing the amount and cost of health care interventions we need. By behaving this way we free up our local health care systems funding and limited physical capacity to treat those who are truly in need. Every one of us that invests in preventive disease strategies will find that the beneficiary is you, your family, and your finances. Pretty tangible benefits wouldn’t you say? Perhaps bigger than that is what this behavior and better health for yourself and the avoidance of chronic diseases such as high blood pressure, heart disease, pulmonary (breathing) conditions, diabetes and a host of other conditions can do to unburden the nation’s health care system. We need to preserve it, both in terms of resources and dollars, for those who are less fortunate and have to access the system for serious health problems. How good would that feel?Some would say that America is a scary place to be these days. The events of 9/11, the Iraq and Afghanistan wars, continued threats from terrorism, the housing and subsequent financial meltdowns, the political infighting that gets us nowhere, and yes the health care crisis. These all create the tendency to make us want to “wring our palms” instead of “wringing the necks of politicians” that refuse to provide the leadership that we need.I have come to a conclusion. I have seen enough to know that the leadership we need has to come from us, the individuals who make up the electorate. Waiting around for politicians to act means we don’t understand the world of politics. Politicians only move in one direction or another when an exercised and voting electorate (that’s us) frames the issues and leads the way to a solution. It is almost never the other way around.Bringing it back to health care and the question of what one individual can do to improve things, it starts with one individual and another until we have millions pulling in the same direction. If we manage our health to the best of our ability (and I want to emphasize, truly to the best of our ability) and access the health care system only when we need it, paying a little more out-of-pocket for the incidental and non-life threatening ills and spills we all experience, the system could accommodate us all when we really need it.So there it is in a nut shell – I have spelled out what I believe is our responsibility; that if we all pulled in the same direction as described above (think of disease prevention and what this can do for you and those who do need to access the health care system) we would dramatically and permanently free up this precious and finite resource and it would be there for others in need and, when we need it and in most cases at far less cost. We are all in this together folks, rich and poor, the older among us and the younger and if we just act responsibly and for the good of others in this matter, we would solve the problem. And then, we could work on the next challenge and the next one after that until we see clearly the power of teamwork – “all for one and one for all”. That sort of pondering and habits can work wonders. Everyone knows it deep down – so let’s simply do it!Search for a weekly e-newsletter and articles that can cope with every little thing about well being care in America. Search for weekly newsletters that debate adjustments coming to employer sponsored well being care advantages, adjustments coming to Medicare and Medicaid plans, new applied sciences that ought to be of curiosity, and articles and commentary with regard to state and nationwide healthcare insurance policies as they develop within the months and years to return. Any sort of query you will have about well being care I may also help to level you to sources that can reply these questions. The specifics about your employer sponsored insurance coverage plan, Medicare, Medicaid and how one can incorporate illness prevention methods into your life with their large advantages. Ask away and if I do not know or cannot discover the reply, possibly certainly one of this blogs participant’s will know. We’re all on this collectively and so long as we consider that and look out for one another – every little thing can be alright!
