Five A’s of Health Care Access

There are many catch-22’s in the health care system. A managed care company reimburses providers and hospitals for services rendered to beneficiaries at a certain payment level. The payment is just enough for hospitals and providers to maintain a contractual relationship with the managed care company and just enough for the insurance company to expense the least possible reimbursement to maximize profits. This reimbursement amount is a major factor in maintaining a large and stable network of providers that beneficiaries can choose from and can easily obtain care. The catch? Only if the payment is enough!

Access to health care is important. If you were taught under the same school of thought, the Five A’s of ACCESS are affordability, availability, accessibility, accommodation, and acceptability.

Hot of the RWJ Press: To Improve Health and Health Care Vol XI

Just received my Robert Wood Johnson Foundation Anthology To Improve Health and Health Care, Volume XI. The website for the book is not even up yet, but here are the past volumes:

After 2001, the foundation changed the associated years to volumes. Perhaps because with each year, there is marginal improvement in health and health care that all the ideas begin to sound the same from year to year. A volume label will help readers understand that there really has not been a monumental change. Because of the health care beast, inching improvements are subtle and easily awash with a slightly bigger issue, like the war. The illustrations all portray a look of somber wishful thinking and hopeful future outlook but with a big * sigh *. So I hope to read the most recent volume and be caught up with the last few volumes.

Jonathan Cohn’s The Untold Story of America’s Health Care Crisis and the People Who Pay the Price

Browsing through my inbox, for whatever reason, Steve Heilig of the San Francisco Medical Society has my work email and spammed my inbox with his San Francisco Chronicle book review of The Untold Story of America’s Health Care Crisis and the People Who Pay the Price by Jonathan Cohn.

Why did I choose to pursue health care policy as a lifetime career? Poignant anecdotes arouse my anger. Steve points out a story on family’s unmet medical are simply due to lack of affordability and how the industry born from compassion employs incompetent people with lack of sensitivity:

“One strength of “Sick” is that Cohn illustrates his factual and historical information with real-life stories, albeit invariably sad ones. There are far too many from which to choose, but consider Steven and Elizabeth Hilsabeck of Texas, whose son was born with cerebral palsy; physical therapy is indicated to help people with this incurable condition, but the family’s “managed care” insurers suddenly stop paying for it. A clerk informs them wrongly that they are only covered for 60 visits per lifetime; and then asks them, idiotically, “When is he getting over the cerebral palsy?” The couple considers divorce just so Elizabeth might become poor enough to qualify for Medicaid. Instead, they sell their home and move into a cramped trailer to afford care for their kids. Other unfortunate people profiled here wind up in other trailers, and some of their lives end with suicide, brought on by the despair of never getting the care they need.”

How can people work in the health care industry, regardless of what medical or business role, and ask when a person will get over cerebral palsy. Health care is inefficient due to the lack of passion, innovation, and forethought from ignorant people occupying health care jobs. I wonder how much the nation pays for putting the wrong people in these health care positions. What proportion of these inefficient costs drives the unaffordable prices?