Archive for Tom Emerick

Hospital charges $9,000 to bandage cut middle finger, report says

Yes, you read that headline correctly. According to a Fox News report, a man went to the Bayonne Medical Center with a cut on his finger. Per the article, “…he was sent home after he got a tetanus shot from a nurse practitioner who also sterilized the cut, applied some antibacterial ointment to it, and put a bandage on it.”

He bill was nearly $9,000. Sounds like the hospital “mugged” the patient.

The CEO of the hospital, Mark Spektor, gave an absolutely hilarious response when questioned about the charge, He said the patient’s “… visit cost so much because his insurance carrier United Healthcare refuses to offer fair reimbursement rates.” (Emphasis mine.)

The CEO’s comment is the ultimate non sequitur. So the hospital charged an outrageous fee to an innocent patient because…what?…Bayonne Medical Center doesn’t like United’s fees? How absurd.

I’ve written about cowboy doctors who are wasting hundreds of billions in healthcare dollars.  There are cowboy hospitals too.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Get off the fence and chose sides

It is time to get off the fence and choose sides. Corporate benefit managers, listen up.

This is part 2 of a recent post about Dr. Sandeep Jauhar’s welcome expose’ of poor healthcare in America, in his book, “Doctored: The Disillusionment of an American Physician”

His book is an important one, but on key issues he wants to have it both ways.

On the one hand he laments physicians who order expensive, invasive, and futile care for patients even when the patients clearly don’t want it. On the other hand he complains about his frustration with having to get authorization from insurance companies for care he wants to deliver to his patients. Those two notions are mutually exclusive.

Equivocation on important healthcare problems has created the healthcare chaos we have today. Concerned parties need to choose sides, especially corporate benefit managers.

BWT: “Medical school applications have risen by 38% from 2003 to 2013,” according to an article in the WSJ by Thomas Stossel.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Cardiologist Speaks From The Heart About America’s Medical System

This is the headline in an NPR story about Dr. Sandeep Jauhar. It is a truly sad story about what is wrong with the practice of medicine in America.

Jauhar wrote a memoir about his career and a cardiologist, called “Doctored: The Disillusionment of an American Physician”. The picture he paints is not a pretty one, but the themes he explores will be familiar to regular readers of Cracking Health Costs.

According to Jauhar, doctors are increasingly unhappy with their work. [That] growing discontent has serious consequences for patients.”

Of so-called “defensive medicine”, e.g., ordering excessive tests, etc., he says some is associated with fear of litigation, but much is simply convenient and profitable.

He writes if you have a rare and dread disease you’re lucky to live in America.  “But if you have run-of-the-mill chronic diseases like congestive heart failure or diabetes, the system is not designed to find you the best possible care.”

One of the most dangerous aspects of care in America is “uncoordinated care by multiple specialists”. Further, “Today if you go to a hospital, it’s rare that you won’t have multiple specialists on your case.”  Lack of genuine coordination among specialists leads to misdiagnoses and poor treatment plans.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Pioneering new injection to cure heart failure without need for major surgery

So reads a headline in a good article in The Telegraph, a UK newspaper.

Per the article, “The technique, which involves a simple injection, could aid the recovery of hundreds of thousands of heart failure patients – and could even consign heart transplants to history.”

Great news, yes?  Not so fast…

But before anyone goes GaGa over this news they need to consider this: if this technique proves out, it will have a small impact in the US. The problem here is that many of the invasive heart procedures in the US now have safer, effective, and less expensive medical alternatives, but “cowboy” doctors in the US disregard such alternatives in a wholesale way.

Why do so many US doctors ignore effective, proven, medical alternatives to surgery? Because they get rich doing so. That’s why.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

‘Cowboy’ Doctors Could Be A Half-A-Trillion-Dollar American Problem

That is the title of a terrific article published in Common Health—Reform and Reality.  The author is Carey Goldberg.

“Cowboy” doctors are defined as ones who “…who deviate from professional guidelines, often providing more aggressive care than is recommended — are responsible for a surprisingly big portion of America’s skyrocketing health costs. The paper concludes that ’36 percent of end-of-life spending, and 17 percent of U.S. health care spending, are associated with physician beliefs unsupported by clinical evidence.’ ”

Oddly, some of the more elementary doctor rating systems tend to be biased in favor of Cowboy doctors in their methods by giving higher ratings to specialists who do comparatively more surgery that their peers, the very ones who may well may be the Cowboys this article describes. My advice about doctor quality ratings: caveat emptor.

EdisonHealth carefully screens to ensure the doctors in it’s Centers of Excellence programs are not, repeat not, Cowboys.

Many of the worst Cowboy doctors are in cardiology and orthopedic surgery, but Cowboys are even doing a load of transplants that are clearly contraindicated for the patients at an average five-year cost of about $1.5 million.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged 55 or Younger

Vik Khanna wrote a great piece on his blog with the title above.

He writes, “Al Lewis and I are frequently attacked by the wellness ignorati when we claim that many of the diseases their programs purport to prevent are virtually non-existant in working age adults.”

Further, (A) new data brief from the CDC proves us right. The prevalence of coronary artery disease or stroke in working adults under age 55 is less than 3.0%.”

Heart attacks and strokes are overwhelmingly a function of aging which, of course, is not preventable. Workplace wellness will be effective in preventing heart attacks and strokes only if it can morph into the Fountain of Youth. Period.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

They said what?

This is a new blog by the brilliant and always entertaining Al Lewis, with whom I co-wrote the book Cracking Health Costs.

He has created “TheySaidWhat?”, which identifies “possible mistakes in high-visibility contexts and offers those who committed the mistakes the opportunity to correct, apologize for or retract their mistakes…or explain how their positions are correct and we have made a mistake by questioning them.”

Al offered “wellness companies $1000 to answer simple questions about their own claims, and all except one refused.” That one had made an error.

Further, TheySaidWhat? has a fun section called “The (Even) Lighter Side”.  Check it out…it’s fun.

Whatever Al does is both entertaining and most insightful.  I hope you enjoy his new blog.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

The Battle Against Misdiagnosis

The WSJ just published an op ed with that title. (Subscription required)  The author is Hardeep Singh who is chief of Health Policy, Quality and Informatics at the Michael E. DeBakey VA Medical Center, and an associate professor at Baylor College of Medicine.

Singh writes that according to studies, “…more than 12 million adults are misdiagnosed every year, and our study may understate the magnitude.” Those misdiagnoses often have quite tragic consequences and always harm the patient waste health dollars.

Readers of CHC know that errors in diagnosis are a huge problem in United States. When editorials on this topic are making the pages of the Wall Street Journal, perhaps corporate benefit managers will be motivated to take this on in an aggressive way. Centers of Excellence, like the ones with which large companies are directly contracting, do an outstanding job of getting diagnoses right the first time, and correcting misdiagnoses.

EdisonHealth offers a Centers of Excellence program which just about any company large enough to be self-insured can easily access. I helped found EdisonHealth, which does not charge a PEPM of PMPM fee, just for that reason, i.e. to make sure small and medium size companies can access  and elite Centers of Excellence program too just like the giant companies like Boeing, Lowes, etc.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

In Treatment, There Can Be Too Much of a Good Thing

That is the title of a good article in the WSJ (subscription required) by Laura Landro.

Yes, too much treatment harms your health. Laura writes, “…a new study suggests some patients may be getting too much treatment (for diabetes and high blood pressure), increasing their health risks.”

Adding fertilizer to your garden can be a good thing, but too much an kill your roses. That’s intuitive, I know. The same applies to medical treatment. In the US we excel in over-treatment of variety of diseases…not just high blood pressure and diabetes, but over-treatment in cancer can be lethal too.

People ask me sometimes why I write negative articles about corporate wellness programs. One off the big reasons is many such programs promote over-treatment and over-diagnosis.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

The $1,000 pill

The WSJ posted a good article on specialty drugs written by Karen Ignagni. (Subscription required.)

One quote stuck out:  “A recent study by CVS Caremark…predicted that the price of new hepatitis C treatments like Sovaldi could increase premiums for everyone with private insurance by as much as $300 annually. And that’s to treat one disease. Many more similarly expensive treatments are coming.” (Emphasis mine.)

With this kind of pricing for new drugs we are left with four choices:

  1. Ration the use of such drugs,
  2. Implement price controls on specialty drugs,
  3. Face a long-term recession induced by health care prices, and/or
  4. Increase the number of uninsured by pricing people out of the market for health insurance.

Alas.  I hope someone can show me I’m wrong.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.