NYT: Obamacare’s Other Surprise

[babylonsister]

http://www.nytimes.com/2013/05/26/opinion/sunday/friedman-obamacares-other-surprise.html?_r=0

Obamacare’s Other Surprise
By THOMAS L. FRIEDMAN
Published: May 25, 2013


LISTENING to the debate about President Obama’s health care plan, some critics argue that Obamacare is going to need Obamacare — because it’s going to be a “train wreck.” Obama officials insist they’re wrong. We’ll just have to wait and see whether the Affordable Care Act, as the health care law is officially known, surprises us on the downside. But there is one area where the law already appears to be surprising on the upside. And that is the number of health care information start-ups it’s spurring. This is a big deal.

The combination of Obamacare regulations, incentives in the recovery act for doctors and hospitals to shift to electronic records and the releasing of mountains of data held by the Department of Health and Human Services is creating a new marketplace and platform for innovation — a health care Silicon Valley — that has the potential to create better outcomes at lower costs by changing how health data are stored, shared and mined. It’s a new industry.

snip//

Among the start-ups I met with are Eviti, which uses technology to help cancer patients get the right combination of drugs or radiation from Day 1, which can lower costs and improve outcomes; Teladoc, which takes unused slices of doctors’ time and makes use of it by connecting them with remote patients, reducing visits to emergency wards; Humedica, which helps health care providers analyze their electronic patient records, tracking what was done to a patient, and did they actually get better; and Lumeris, which does health care analytics that uses real-time data about every aspect of a patient’s care, to improve medical decision-making, collaboration and cost-saving.

Obamacare will be a success only if it can deliver improved health care for more people at affordable prices. That remains to be seen. But at least it is already spurring the innovation necessary to make that happen.

[Bluenorthwest]

1. Interesting spin, that we need more profit based 'innovation' to do what other countries have done

for decades. Like high speed rail, we pretend it has even to be invented while others speed along their merry ways.

[ErikJ]

3. Even Uzbekistan has high-speed rail now.

Its obvious Big Oil/GOP partnership is behind the shameful absence of HSR in the US.



The Tashkent to Samarkand high-speed rail line is a 344-kilometre (214 mi), high-speed rail connection between the two largest Uzbek cities of Tashkent and Samarkand and through four provinces: Tashkent, Sirdaryo, Jizzakh and Samarqand in Uzbekistan. The train operates seven times a week under the brand Afrosiyob.


Construction began on the line on 11 March 2011, with completion planned for later that year at a cost of roughly $70 million.[1][2] The line includes both new and rebuilt trackage, as well as adding modern signaling systems to the route.[3] In addition to building trackage capable of supporting high-speed service, track of lower standards was built to the cities of Bukhara and Khiva as part of the project.[2] The 344 kilometres (214 mi) high-speed line is capable of speeds up to 250 km/h (160 mph), with a total travel time between Tashkent and Samarkand of about two hours.[3] The line is planned to open for commercial operation in September 2011.[4] However as of September 18 only 35 km of high speed track were installed and railway company reportedly lacked the money to upgrade the entire route.[5]
http://en.wikipedia.org/wiki/Tashkent%E2%80%93Samarkand_high-speed_rail_line

[BlueCaliDem]

2. Well, then Speaker Pelosi *has* said that ObamaCare would help create about 2 million jobs, and

it appears that her predictions (even if she merely relayed them) are coming to fruition. This is good news and everyone who actually wants this president to succeed should be glad to read it.

[Igel]

7. This is post hoc reasoning.

3 and 4 years ago the health care "conglomerate" I went to was busy converting over. They'd started a couple of years before.

The reasons were simple.

Doctors got a single place to check all prescriptions. Software could look for dangerous interactions between drugs.

Doctors could read each other's notes and see each other's test results. Faster. Cheaper for the patient. Better health care.

Prescriptions were transmitted to the pharmacist immediately. However, if you didn't know your pharmacist's name/address then you had to go home, find it, and let the doctor know. They had no other way of writing a script.

This all meant the likelihood of fewer torts brought against the health-care provider.

It was expensive. Very expensive. It required a lot of retraining. And it was buggy to begin with. If the system crashed, it crashed and doctors had no records that they hadn't printed. (Result: They printed everything. Instead of having a single file the doctor printed everything everytime the patient came in or needed the patient's records.)


It's a cost and increased costs in the short term. Whether it will decrease costs in the long term is a guess. My provider said it would, but a lot of that was because it increased doctor productivity. They had a tool for dictating their notes immediately after a patient visit; a transcriptionist would download the mp3 file and transcribe it the next day.

Think about what Pelosi said. In order to decrease costs, they're going to have 2 million jobs, each paying $35k on average. That's $70 billion. Per year, presumably, otherwise Pelosi is being disengenuous. That money either was going to somebody's pockets and the "new" jobs come at the expense of somebody else's salaries or it's an increased cost.

[lhooq]

9. those inefficient jobs IT will replace

I used to work for the major healthcare provider in Eastern Maine. That inefficient healthcare system that Tom Friedman would like to see automated also provides lots of good-paying, good-benefits jobs in a state not known for that. Still I agree with Tom. And, in any case, more IT in health is likely inevitable.

So what will become of those who jobs are automated away? Are we also serious about retraining? And who will pay for that? Tuition inflates faster than the rest of the economy, and Congress looks like it will allow the interest rate of federal student loans to go way UP.

[SunSeeker]

4. K & R

[DallasNE]

5. Improvements Will Come In Unexpected Places

Recently a boys life was saved when a 3-D printer was used to create an implanted devise that wasn't available elsewhere and it didn't cost an arm and a leg to build so this is one avenue that will expand greatly as it becomes better understood.

Also, Obamacare requires insurance companies to pay out at least 85% of its premium amounts in care so that limits price gouging. When technology drives down the cost of care it will also drive down the cost of insurance premiums because of this feature.

Lastly, the fear that sick people would drive up insurance costs is more fear than fact. It is not private insurance but Medicare that covers most of these sick people because so many of them are 65 and older. This is behind why Republicans want to raise the Medicare Part A eligibility age to 67 so they can drive some of this cost onto private insurance and make those insurance rates higher, creating a backlash to Obamacare.

[vinny9698]

6. That's why the GOP is hell bent on repealing it now

Because with time the people will begin to see the great benefits and lowering costs it will then become like SS and medicare very liked programs.
Remember Medicare and SS also help the middle class because the middle class does not have to pay for their parent;s needs.

[Cha]

8. thank you, vinny.

thanks for the OP, babylonsistah

[zipplewrath]

10. Another description of something that hasn't happened

We keep getting these predictions of how great Obamacare will be due to some secondary effect. Of course none of them have happened yet. In the end, the reality will almost assuredly be that they aren't any where near as effective as predicted, but they won't be total failures either. And we'll be left arguing if it is "good enough" or if "something is better than nothing", the whole time the rate of inflation of health CARE will be going up at several times the rate of inflation. It is all unsustainable and until we do something about that, none of the current plans or systems are going to be sustainable over the long run. And that includes the plethora of government run health care plans.

[elleng]

13. Oh?

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

http://krugman.blogs.nytimes.com/2013/05/24/obamacare-will-be-a-debacle-for-republicans/

[zipplewrath]

15. Yes

Evidenced by the fact that no where in that propoganda was anything about the actual inflation rate of health CARE being under any kind of sustainable rate.

[bhikkhu]

16. Here:

http://www.aei-ideas.org/2013/02/how-choice-and-competition-are-slowing-the-rise-in-the-us-healthcare-costs/

its not a steep decline so far, but the rate of increase is slowing, which is important. The ACA was modelled after the most efficient and cost-effective existing systems, and the long-term effect should be predictable.

[elleng]

11. Thanks.

[underpants]

12. Baucus's "train wreck" comment was only about the communication of information

I have heard that line read as gospel on RW radio so I had to look it up. Totally out of context, of course, he was only commenting on the flow of information from HHS out to the public.

[madrchsod]

14. i find it amusing that people think this is a money grubbing idea spawned by evil corporations

due to the complexity of my heart attack i have medical professionals at 4 different locations across northern illinois.every procedure,all my medications,list of doctors, all the technical information and images now shared instantly between all of them. in fact i'm supposed to go to a rehab facility for final testing and another heart procedure at my local hospital that was discovered during the first go around. i also had a brain scan over an image that was discovered during the procedure during the recovery of the first attack. could all this be done without instant access across all these different areas medical conditions and procedures? i suppose it could have been but it would have been a lot slower and may have cost me my life.

the care i received and the cutting edge procedures i had were never questioned .why? medicare. there were only a few things medicare won't pay for but the facilities and the doctors knew how to get around those obstacles.

the system is being set up for a huge influx of patients who have never had affordable access to true health care . it will only get better when the country decides that medicare system should be the only provider for healthcare.