Health

Healthcare has taken a front seat in the political debate as well as one of the glaring issues in the gasping economy. Gas is through the roof, mortgages are in trouble and healthcare costs seem to prevent us from taking advantage of the world’s best system. Costs for the simplest procedures are growing exponentially and it is evident we need change. The big question is do we really need a big change or a small one.

Why has the cost risen so quickly?

We do celebrate the most advanced healthcare system in the world. We as Americans demand the best and receive the best and therefore should expect to pay for the best but our current healthcare system has given us a false sense of entitlement. The reality is healthcare is expensive.

We spend $2.3 trillion a year on healthcare of which the US government contributes 44%. Almost one third of our population receives some type of government subsidized healthcare. When so much is provided at so little cost to the consumer we tend to take it for granted. In addition, our employer based insurance system creates a false sense of cost for the employee. The employer pays a portion and the rest is deducted from payroll making the employee out of touch with the true cost of that insurance premium. Rising healthcare costs has forced the employer to shift increases to the employee casting a critical eye on the industry.

Our government run system is unable to track enrollees and what they spend and where they spend it. We pay out $75 billion dollars a year in claims that should be paid out by private insurance but we lack the technology in place to account for it. We allow 11 million illegal aliens to partake of our healthcare and you and I foot the bill for $250 billion per year.

What are the real issues?

Our healthcare technology system has been stuck in the 20th century. We spend $0.80 of every healthcare dollar on paper. American physicians have not adapted to an electronic record which would save over a $500 billion yearly. Physicians are forced to duplicate expensive tests such as MRI’s and blood tests because they do not have access to electronic records from the hospital or referring physician a $50 billion issue. This practice also causes malpractice premiums to soar as physicians live in fear of lawsuits.

Who has the solution?

Our would-be presidential candidates agree on several issues. They agree that costs are rising and reform is the solution. They agree that we need tort reform to stop unwarranted lawsuits against physicians. They agree that all Americans should have access to healthcare but they each have a different approach to resolution.

Senator McCain’s healthcare plan puts families in charge. He proposes a multi-tiered system where government subsidized healthcare is provided for the elderly and underprivileged. He believes in a fair market system creating competition with the private sector insurance providers that also allows for portability and uninterrupted coverage from early adulthood to grave. He believes in providing tax deductions for individuals and shifting the responsibility to the employee so that a focus is on the consumer and what they have to contribute. McCain proposes incentives to improve preventive care and develop a national medical records network to enhance care of people with chronic diseases. He also proposes Pay-for-performance standards that will provide substantial financial rewards for organizations that are able to meet best practices and efficiently report quality data.

Both Clinton and Obama have called for more government involvement to expand health care coverage. The major difference is that Clinton mandates coverage for all Americans. Obama would make all parents provide coverage for their children. Clinton and Obama would not make any major changes in the tax treatment of healthcare benefits just the tax increase to pay for it. The government picks up 44% now making the only way to increase coverage is to increase taxes.

Clinton’s plan would cost $110 billion a year, Obama’s between $50 billion and $65 billion. The US currently picks up the tab for almost 1/3 of Americans at a cost of almost $1 trillion. Both candidates want to ensure the additional 47 million Americans without insurance are covered or an increase of 50%. The math does not add up as we would have a trillion dollar shortfall or a trillion dollar tax increase. Either way I would not want the role of economic advisor to either candidate.

The solution is Obvious

Big changes in our antiquated healthcare technology system would solve rising costs. Adding an electronic system to healthcare would save $75 billion on Medicare/Medicaid, $50 billion on duplicate testing, $250 billion on illegal aliens, and $500 billion on wasted paper. The onetime cost, which is often described as prohibitive, would be less than $30 billion. Couple this with consumer focused changes and a fair market system and U.S. healthcare will continue to dominate the world. Solving the healthcare crisis with technology, big change, the cost, small change, voting for the wrong candidate short changed.

Mark Tumblin CEO ASCENT Integrated Medical Solutions

Healthcare has taken a front seat in the political debate as well as one of the glaring issues in the gasping economy. Gas is through the roof, mortgages are in trouble and healthcare costs seem to prevent us from taking advantage of the world’s best system. Costs for the simplest procedures are growing exponentially and it is evident we need change. The big question is do we really need a big change or a small one.

Why has the cost risen so quickly?

The reality is healthcare is expensive.

Rising healthcare costs has forced the employer to shift increases to the employee casting a critical eye on the industry.

We allow 11 million illegal aliens to partake of our healthcare and you and I foot the bill for $250 billion per year.

What are the real issues?

Our healthcare technology system has been stuck in the 20th century.

Who has the solution?

Our would-be presidential candidates agree on several issues. They agree that costs are rising and reform is the solution. They agree that we need tort reform to stop unwarranted lawsuits against physicians. They agree that all Americans should have access to healthcare but they each have a different approach to resolution.

The Solution is Obvious

Big changes in our antiquated healthcare technology system would solve rising costs. Adding an electronic system to healthcare would save $75 billion on Medicare/Medicaid, $50 billion on duplicate testing, $250 billion on illegal aliens, and $500 billion on wasted paper. Solving the healthcare crisis with technology, big change, the cost, small change, voting for the wrong candidate short changed.

Mark Tumblin CEO of ASCENT Integrated Medical Solutions

The great debate for 2008 has healthcare playing a major role as we select a president. Gasoline, the economy and the rising cost of healthcare are the focus of our daily lives and now we are at a crossroads to define healthcare for the coming years. Shall we reform the most advanced healthcare system in the world to be more efficient and streamlined for the consumer or allow the government to transform it into a generic delivery of government policies where everything has strings attached?

Facts on Rising Costs

Nationally over the last five years we have seen an increase in family premiums paid out by the employee by 24% while their pay increased only 15% over the same period. If gas and milk price hikes seem steep, check out health insurance premiums. They have increased 10 times faster than incomes in recent years, a study shows. At the same time about 1% of employers dropped health insurance as a benefit offering to the employee.

Most current information puts the number of uninsured at 47 million Americans. The majority of these uninsured Americans are of the young adult age group where it is not a high priority to the other extreme of low income families who just don’t know how to enroll. Almost 25% of this number is represented by illegal aliens who receive care by walking into any emergency room and receive coverage.

These are trends in which we should be concerned but are not as alarming as politicians and the media portray them. They do however target an issue of reform where our healthcare system needs a fair market competitive system for purchasing insurance that would drive down premium costs. We need to implement information technology for tracking patients in our public systems so that duplication of services and provision of healthcare to illegals is eliminated. This alone would save over $75 billion annually in charges to Medicare and Medicaid.

Dems/GOP

It is a lot simpler to spend more money — like the Democrats want to do — than it is to stop spending money. To provide health insurance to all Americans, Sens. Clinton and Obama would spend about $110 billion a year, relying on raising taxes and on cutting services to help pay the bill.
Sen. McCain’s proposal is one of reform to include information technology, tax benefits to the employee and a fair market system to drive down the costs of premiums. A regulated government system coupled with affordable premiums and personal responsibility to improve health initiatives and add health savings accounts makes much more sense than moving to a diluted government controlled healthcare system.

All three candidates would promote use of generic medicines, including the introduction of generic versions of biotech drugs. All three say some sort of tort reform is needed to prevent doctors from ordering unneeded tests and procedures because they fear lawsuits if they don’t, though the candidates disagree on the scope of the solution.

Either way, with annual health spending close to $2.7 trillion in 2006, experts agree that controlling costs is an important matter. If successful, cost controls would benefit every business, consumer and, dramatically, the federal government, which spends more than $400 billion a year on health care. State and local governments kick in another $300 billion-plus every year.

Pros/Cons

We do have the most advanced system in the world in place however, one in four Americans — about 12 million people — who don’t have health coverage are eligible for Medicaid and the State Children’s Health Insurance Program (SCHIP) but aren’t enrolled. Reasons cited for the lack of enrollment include: They’re not aware of the programs; they don’t know how to enroll, they fear being linked with a publicly financed program; and it can be difficult to stay enrolled. We should support an education program which consistently enrolls these people on the provided plan and keeps track of their usage through available information technology.

We should demand a fair market system controlled by information technology that empowers the patient and the physician to be in control of healthcare. Insurance companies need to find themselves competing for the consumer dollar while at the same time work closely with physicians to provide 21st century medicine at a reasonable price. Our current system encourages labor intensive efforts by physicians to collect payments, dramatic inefficiencies among insurance companies to waste dollars and the patient holding the final bill.

No Strings Attached

We possess the most advanced healthcare system in the world. The facts will show a system that is gaining yearly in healing technology but grossly inefficient in information technology. It is time our most advanced healthcare system adopted our most advanced health information technology. The facts will also show that a government controlled national healthcare system is not our guide for when it comes to Politics and Healthcare there should be no strings attached.

Mark Tumblin CEO of ASCENT Integrated Medical Solutions

Shall we reform the most advanced healthcare system in the world to be more efficient and streamlined for the consumer or allow the government to transform it into a generic delivery of government policies where everything has strings attached?

Facts on Rising Costs

Nationally over the last five years we have seen an increase in family premiums paid out by the employee by 24% while their pay increased only 15% over the same period. If gas and milk price hikes seem steep, check out health insurance premiums. They have increased 10 times faster than incomes in recent years, a study shows. At the same time about 1% of employers dropped health insurance as a benefit offering to the employee.

Dems/GOP

Dems spend GOP reforms.

Either way, with annual health spending close to $2.7 trillion in 2006, experts agree that controlling costs is an important matter. If successful, cost controls would benefit every business, consumer and, dramatically, the federal government, which spends more than $400 billion a year on health care. State and local governments kick in another $300 billion-plus every year.

Pros/Cons

We do have the most advanced system in the world in place however, one in four Americans — about 12 million people — who don’t have health coverage are eligible for Medicaid and the State Children’s Health Insurance Program (SCHIP) but aren’t enrolled.
Our current system encourages labor intensive efforts by physicians to collect payments, dramatic inefficiencies among insurance companies to waste dollars and the patient holding the final bill.

No Strings Attached

The facts will show a system that is gaining yearly in healing technology but grossly inefficient in information technology. The facts will also show that a government controlled national healthcare system is not our guide for when it comes to Politics and Healthcare there should be no strings attached.

We may spend more on any industrialized nation but we get more.

What do we spend?

We spend $2.1 trillion a year on healthcare. On hospitals, physicians, pharmaceuticals and diagnostic tools. Why do we spend more money on healthcare?

Our advanced healthcare system has eradicated 8 diseases through vaccines in the last 100 years. We are now curing many cancers and can prevent up to 35% of them by simply understanding how our personal eating habits affect our health.
From 1980-2000, the overall mortality rate from heart attack fell by almost half.

We now lose less than 1% of babies born premature in the United States.

From 1980 to 2000, every dollar spent on healthcare led to between $2.40 and $3.00 worth of health gains. Much of the technology advancements in the last several years have enabled us to be proactive with our healthcare with home testing as well as preventive testing.

How can we save?

One is to promote technology, such as electronic medical records, to increase efficiency. The other is to streamline care for millions of Americans who have chronic illnesses, such as diabetes and asthma. Early care for those patients could reduce expensive hospital stays or other avoidable complications.

A word of caution

When political leaders pass a law requiring everyone to have health insurance, government authorities must decide what qualifies as acceptable coverage. The insurance market quickly morphs into a government-regulated utility, as politicians, rather than the marketplace, determine the terms of the coverage and regulate how much people must pay for the premiums.

Americans suffer from our own devices. We as American spend 44% of our household income on eating out. We spend almost 14% on fast food with less than 7% toward healthcare. Why then should we take offense to spending more on the most advanced healthcare system in the world?

What do we spend?

We spend $2.1 trillion a year on healthcare. Government funded healthcare equals about $924 billion as a nation and the rest, $1.176 trillion comes from private insurance and private pay. As a nation, about 7% of the $2.1 trillion is spent on administrative costs. We pay $462 billion to physicians and $680 billion to hospitals. Americans spend more than $210 billion yearly on pharmaceuticals and an equal amount on diagnostic testing. Our advanced healthcare system is indeed expensive but that is why we enjoy the benefits.

Why do we spend more money on healthcare?

Our advanced healthcare system has eradicated 8 diseases through vaccines in the last 100 years. We are now curing many cancers and can prevent up to 35% of them by simply understanding how our personal eating habits affect our health. We are replacing limbs and organs, helping blind people see, deaf people hear, and our average life expectancy is 77.8 years up from 47.6 in 1900. Our healthcare system has made unprecedented advancements for clinical and diagnostic delivery which we realize every year. In the past decade, 12 Nobel Prizes in medicine have gone to American-born scientists working in the U.S., and three have gone to foreign-born scientists working in the U.S. Just seven have gone to researchers outside the country. Yet when you research the benefits of the American Healthcare System and the benefit it produces on quality of life, 95% of all documents are politically driven and condemn our current delivery system.

Heart disease and its consequence, heart attack, is the leading cause of death in the U.S. and a good example of how new technology has changed the treatment and prevention of a disease over time. In the 1970s, cardiac care units were introduced to lidocaine for irregular heartbeat, beta-blockers to lower blood pressure in the first 3 hours after a heart attack, “clot buster” drugs began to be widely used, and coronary artery bypass surgery became more prevalent. In the 2000s, better tests became available to diagnose heart attack, drug-eluting stents were used, and new drug strategies were developed (aspirin, ACE inhibitors, beta-blockers, statins) for long-term management of heart attack and potential heart attack patients. From 1980-2000, the overall mortality rate from heart attack fell by almost half.

Another example of how advances in technology have changed health outcomes over time is in the treatment of pre-term babies, for which very little could be done in 1950. But by 1990, changes in technology, including special ventilators, artificial pulmonary surfactant to help infant lungs develop, neonatal intensive care, and steroids for mother and/or baby, helped decrease mortality to one-third its 1950 level, with an overall increase in life expectancy of about 12 years per low-birthweight baby. We now lose less than 1% of babies born premature in the United States.

From 1980 to 2000, every dollar spent on healthcare led to between $2.40 and $3.00 worth of health gains, U.S. healthcare expenditures per person rose from $2207 in 1980 to $4461 in 2000. But during that same period of time, the age-adjusted death rate dropped 30%. Life expectancy rose from 70.0 to 74.1 for men and from 77.4 to 79.5 for women. The disability rate of people over 65 dropped from 26.2% in 1982 to 19.7% in 2000. And the number of days in the hospital declined from 129.7 per 100 persons in 1980 to 56.6 per 100 persons in 2000.

Much of the technology advancements in the last several years have enabled us to be proactive with our healthcare with home testing as well as preventive testing.

How can we save?

One is to promote technology, such as electronic medical records, to increase efficiency. The other is to streamline care for millions of Americans who have chronic illnesses, such as diabetes and asthma. Early care for those patients could reduce expensive hospital stays or other avoidable complications.

The business of healthcare at the physician/patient level is 10-20 years behind in technology. When you consider all your patient records are recorded on paper, there is no interaction between your lab results and the diagnosis of your physician, your insurance company gets a claim that has been handled by not less than four pairs of hands who each stake a claim to the financial outcome, it is no wonder physicians collect $0.63 on the dollar and are satisfied. This is unacceptable to every other business in the U.S. why do we accept it in healthcare.

A word of caution

Uncompensated care for the uninsured amounts to less than 3% of total healthcare spending—a real concern but hardly a crisis. If you believe you don’t have healthcare walk in to an emergency room as they are required to treat you by law no matter your insurance status. When political leaders pass a law requiring everyone to have health insurance, government authorities must decide what qualifies as acceptable coverage. The insurance market quickly morphs into a government-regulated utility, as politicians, rather than the marketplace, determine the terms of the coverage and regulate how much people must pay for the premiums.

Until November of 2008 all Americans become lobbyists and the candidates become saviors. Healthcare is one of the hotly debated issues that will eventually land one of the contestants a seat in the White House. American Healthcare is in need of reform but are we truly in crisis or accepting a fabrication of half truths.

Justification for a National Healthcare System

The Democratic Party would have us believe we are in desperate need of a National Healthcare delivery system. Justification is offered in an amazing display of half known facts. The United States cannot possibly have the greatest health care system in the world when America spends over 16% of GNP on health care.

First of all, would we not expect superior healthcare to cost more? Spending more on Healthcare does not make our system inferior but rather superior. We as a nation spend 56% more on healthcare than any of the other 7 industrialized nations. These nations all have a National Healthcare System that is almost totally funded by the government and that government in turn controls healthcare. The U.S. government contributes less to Healthcare than any other industrialized nation by an average of 44% and as much as 91%. The most compelling statistic in all of this is the 56% more the United States spends is almost exactly the amount covered by private health insurance.

We have the lowest tax rate of any other industrialized country except Switzerland. The Swiss however spend more per patient than any other country in the world. The reason for this is behind the layers of delivery in their system. The national system buys one level of healthcare and each preceding level is a function of private pay. These countries have higher tax rates because of the need for funding for their nationalized plans. Each also has a critical situation in which their hospitals are closing at alarming rates due to lack of funds. In other words for America to go to a nationalized delivery system of healthcare our tax rate would increase no less than 10% and our current system would still be underfunded.

Health or Healthcare

In addition to cost we receive other alarming partial statistics. Surprisingly, Americans, the citizens of the wealthiest country in the history of the world, have a lower life expectancy rate, higher rates of heart disease and cancer, and an infant mortality rate that is twice as high as other rich industrialized nations. Even Cuba has a lower infant mortality rate than the United States according to CIA Fact Book.

These issues are all a matter of health not healthcare. Heart disease is by far the number one killer in the United States, although a third of those deaths could be prevented if people followed better diets and exercised more, this from a report from the American Heart Association. Additionally, 50 million Americans have high blood pressure, 12.6 million have coronary heart disease and 4.6 million have suffered stroke. The crisis in healthcare is that all of the top killers in the US are related to eating and stress. If we could control these two conditions in our lives, most of us could live to 100 and be fully functional.

One of the most alarming statistics is the infant mortality rate which is slightly higher on average, in the US. Our rate is attributed to minorities, low birth weights and poor prenatal nutrition. However, the most alarming statistic that is never pointed out is the number one killer of prenatal infants in the U.S. is abortion and this act is enabled by the Democratic Party. This statistic is a sad commentary on the United States as a nation yet it has nothing to do with inferior healthcare. The US births more babies each year than the industrialized nations and 500,000 are born premature. We should focus on the fact that we have more who survive than any other country in the world. Of these 500,000 we lose less than 1% because of a superior healthcare system.

Healthcare reform begins with technology

As is the case in each of the industrialized nations the US has escalating costs and a lack of Healthcare funding. We see 98,000 deaths each year caused by medical errors that would be drastically reduced if healthcare providers had access to comprehensive patient information. The U.S. Department of Health and Human Services reports electronic medical records would reduce the cost of healthcare by 30% annually and provide a permanent solution.

Health Information Technology is available today to the physician that literally will pay for itself in less than a year. When you consider IT eliminates the disparity payments to a physician between $.63 and $1.00 or 37%, a physician already has a handsome return on investment. When paper changes to electronic charts each physician saves over $15,000 per year. Add to these the elimination of duplicate tests, lost charts, lost charges, coding, diagnostic testing and on and on we need to wake up and realize the reality is we cannot afford to put this off any longer.

Conclusion

Candidates seeking office will promise anything to gain position. A careful examination of the facts will find that much of what they say is at best half of the detail. We are blessed to live in the most advanced civilization in the world and placing the wrong ideology in office can take away our most valuable resource, healthcare. Placing the right candidate in office will reform our current system and maintain our world dominance in healthcare and technology.

Mark Tumblin - CEO
ASCENT Integrated Medical Solutions

Our American Healthcare System has long been in disarray. As we approach yet another election, the debate on Healthcare falls, in some opinions, second behind the economy or third behind the war in Iraq. As critical as the economy and the war are, it is obvious Americans have had enough of the current state of Healthcare.

It seems we are headed for the perfect storm. We as consumers have reached our limit on what we can spend on quality healthcare. Our physicians have reached their limit on a fee for service system that not only dictates how medicine will be practiced but randomly decides what will and will not be reimbursed by insurance companies. Our government has begun the monumental task of reforming the healthcare infrastructure but many of the obstacles to reform are too political for effectiveness. Last but not least, several of our choices for the upcoming presidential election would have you believe universal healthcare is the only solution. We are forced into healthcare’s perfect storm as reform one way or another will happen. We must decide to influence the storm toward true reform or depend on our government to protect us from levy system straining at the pressure.

We as Americans enjoy the most advanced healthcare system in the world. The price we pay for our advanced healthcare system is by far a world leader as well. Because of increased costs, governmental reform, rising inflation, slowing economy, democrats pushing for a nationalized system and republicans for a free market system, we find ourselves in the midst of a perfect storm for healthcare. All of the influencing factors are colliding into a process that will truly put us on the road to reform or send us back to the dark ages of governmental control.

Let us first take a look at what healthcare costs from a consumer perspective. We spend more household income on Healthcare than on cars and gasoline combined. Healthcare spending is 4.3 times higher than what we spend on the national defense. Employers often times spend more on healthcare than on the raw materials it takes to run their businesses. In 2006, employer health insurance premiums increased by 7.7 percent or two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $11,500. The annual premium for single coverage averaged over $4,200. Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by 2008. We pay all this money for healthcare and the physician collects $0.63 on every dollar. Insurance companies are making a killing while we all begin to suffer. Imagine the grocery store accepting a percentage of the price for a gallon of milk.

Our advanced healthcare system has eradicated 8 diseases through vaccines in the last 100 years. We are now curing many cancers and can prevent up to 35% of them by simply understanding how our personal eating habits affect our health. We are replacing limbs and organs, helping blind people see, deaf people hear, and our average life expectancy is 77.8 years up from 47.6 in 1900. Our healthcare system has made unprecedented advancements for clinical and diagnostic delivery which we realize every year, yet in a 20 year period we continue to document on paper and transfer critical lifesaving information by mail, by hand, or by fax machine. We replicate costly services because one caregiver does not know the test was performed by another or access to information is cost prohibitive or nonexistent. In essence, we practice 21st century medicine with a 19th century delivery system. It is no wonder emergency rooms collect $0.43 on every dollar.

Our elected officials, and those that will aspire to be, feel they have solutions from reforming the current system to totally gutting it and starting over. Both political parties recognize the need for change but they offer clearly different paths. Republicans emphasize the need to reduce the high cost of healthcare and are leery of an increasing role for the federal government. By contrast, Democrats focus on a major expansion of coverage for the uninsured with government controlled mandates. Cost is a Republican issue, and coverage is a Democratic concern.

The Democrats believe in a National Healthcare delivery system. They would have you believe the government needs to take control of this spiraling, out of control system and pattern it after other world countries that deliver healthcare to all citizens. When political leaders pass a law requiring everyone to have health insurance, government authorities must decide what qualifies as acceptable coverage. The insurance market quickly morphs into a government-regulated utility, as politicians, rather than the marketplace, determine the terms of the coverage and regulate how much people must pay for the premiums.

Senator Clinton would have you believe that although we have the most advanced healthcare system in the world we are trailing countries with National and Socialized medicine in the areas of obesity, infant mortality, heart disease, high blood pressure, diabetes and cancer. Senator Clinton seems to confuse health with healthcare. Americans suffer from our own devices. We as American spend 44% of our household income on eating out. We spend almost 14% on fast food with less than 7% toward healthcare. The U.S. has a high incidence of smokers with 35% of men and 22% of women who smoke. Even though healthcare costs are skyrocketing we spend more on the things that harm us than on those that will cure us. It is the health not the healthcare of Americans that needs reform. Senator Clinton’s solution requires everyone buy health insurance, along with the need for more insurance regulation. This would create a government insurance option for everyone and a tax hikes to pay for it. On several occasions Senator Clinton even suggested an employee’s pay might be garnished to pay for her healthcare plan. Some would have you believe the Bill and Hillary healthcare plan of the 90s was the solution but it died on the operating table. In essence, the TennCare System adopted by Tennessee was that plan and has been a bankrupt system since day one. Patients are allowed to go anywhere for care with no tracking system. They are allowed to fill prescriptions at any pharmacy yet fill them again a day later without an accountability or charge capture system in place. In essence, eat at the all you can eat healthcare buffet for one government funded price. Senator Clinton would have you believe that because almost 50 million people don’t have health insurance they don’t have healthcare yet by law anyone can walk into any emergency room and receive healthcare. In addition, uncompensated care for the uninsured amounts to less than 3% of total healthcare spending — a real cost, no doubt, but hardly a crisis.

Senator Obama is also for a National Healthcare system and likes what Senator Clinton has to say yet his mandate would only apply to children. He argues that the reason many people aren’t insured is because it’s too expensive, not because they don’t want it. Mrs. Clinton counters that coverage can’t be “universal” without a mandate therefore the government will control healthcare at any expense. The logic of Mr. Obama’s approach is that policy makers should target those who are priced out of coverage. The Census Bureau says 38% of the uninsured earned more than $50,000 in 2006, 19% above $75,000. They are not a major public policy problem — except that a big reason they lack coverage is because it is more expensive than it needs to be thanks to government market interference. In addition, 29% earn under $25,000, which means they probably qualify for existing subsidy programs like Medicaid or State children’s health insurance programs but again many have not enrolled. Obama’s plan will save the typical family $2,500 year.

Senator Obama will have you believe there has been no national leadership under Bush to enable the healthcare cause yet in the past five years the Bush administration has allocated more grants toward reform than any other in the last twenty years. In 2004, Bush allocated $160 million for exploration of Electronic Health Records and hired the Healthcare Czar to empower states toward reform. In 2005, the Certification Commission for Health Information Technology (CCHIT) was formed in order to standardize IT delivery in Healthcare. In 2006, $140 million was allocated to the states to form Regional Health Information Systems to have a collaboration of information across pharmacy and build a foundation for Health Information state wide, then nationally. We were a full 10 years behind in Healthcare IT until President Bush took office. We have made more progress in the past 5 years than in the last 20 combined.

Senator McCain is for a free-market, consumer-based system. He opposes any mandate requiring everyone to have a government run healthcare system. McCain will continue to provide tax credits for employers and employees and is pledging an affordable healthcare system for every American. McCain sees controlling health costs as a top priority making plans portable and accessible across state lines. His plan will provide $2,500 tax credits ($5,000 for families) and will revise tax codes to “eliminate the bias toward employer-sponsored health insurance.” He will move to compensate medical providers based on the quality of their work. McCain will bring greater competition to drug markets by safe re-importation of drugs and streamline the process for introducing generic drugs. McCain is against raising taxes for affordable healthcare but rather sees reform of the current system as our best solution. McCain must maintain the current level of spending for states and keep tax policies in place.

To build a future of quality health care, we must trust patients and doctors to make medical decisions and empower them with better information and better options. It is critical we install 21st century business systems into 21st century healthcare to maximize delivery. We must adopt measures to advance our current processes enabling both the physician and patient toward an efficient cost effective delivery system. We must encourage and establish Health Savings Accounts so that every patient is in control of his or her healthcare. We must adopt the sharing of medical information among the disciplines; enforce quality of care and standardized pricing across all caregivers both public and private. We must improve Health Information Technology. Implementing a statewide foundation of healthcare information technology, then empowering the physician with electronic medical records, coupled with truly integrated practice management, will create enough efficiency within healthcare to totally reform our current system. In essence, healthcare IT will pay for itself and create a savings which will fund all other programs. Medicaid paid out $63 billion in 2006 that should have been paid by private insurers. The amount saved by Medicaid alone would pay for technology to be in place, drastically reducing healthcare costs. The technology exists today to prevent a single dollar from mistakenly being spent by Medicaid. We should establish association health plans for small business, reform frivolous lawsuits for medical liability and give the consumer the freedom to buy insurance anywhere. Most importantly, we as a country must focus on health and wellness through prevention and be proactive in our own healthcare. We currently spend only $0.04 of every healthcare dollar on prevention. The role of the federal government should be that of enabler, not problem-solver, the engine of healthcare reform. The consumer will drive reform as long as the incentives are aligned around the patient and the physician is again given the reigns to deliver our superior healthcare system. We must educate the public on the need for – privacy and security and the issue of cost.

The perfect storm is upon us. Each of the healthcare players is caught up in a whirlwind of reform as the physician is told how to practice at a fraction of the payment. The patient is forced to do without procedures due to uncontrollable costs and an insurance system that has no regard for who it serves. The candidates are proclaiming they each have a solution while your government is enacting dramatic IT reform that is twenty years in the making. When the perfect storm subsides and the sun breaks through will we have built a foundation on information technology systems and truly reformed healthcare? When the winds of change have ceased to blow will we have implemented an interoperable system of integrated solutions beginning at the patient/physician level? Will these systems communicate with state and national healthcare information pipelines or will we line up for government housing healthcare and be satisfied with what they have determined is our healthcare need.

Biography Mark Tumblin, Healthcare Expert

Mark Tumblin has spent 25 years observing all aspects of healthcare in the United States. Having a strong grasp on the challenges and solutions for our current healthcare system, Mark incorporates thought provoking and witty examples while exposing major issues and problems within the healthcare industry as it relates to the political arena.

Mark is a frequent guest on talk shows in his home state of TN where he is called upon as a Healthcare expert. He has an uncanny knack of being able to pinpoint solutions for the vast array of healthcare difficulties currently facing our nation. Mark’s commentary on healthcare can be read at www.southernledger.com.
Mark Tumblin is currently the CEO of ASCENT Integrated Medical Solutions; a highly specialized Medical Information Systems, Engineering and Consulting Company. ASCENT is a wholly owned subsidiary of Southeast Cancer Corporation serving the Oncology community with management and technology services.

Previous to Ascent, Mark spent 12 years at Roche Diagnostics in Clinical Chemistry and toxicology. He developed highly specialized toxicology labs which serviced the Nuclear Regulatory commission and the American Medical Association as the founding partner of Workplace Wellness.

Mark also founded technology company “Integrated Management Solutions” which developed information systems for laboratories interfacing the judicial system with toxicology labs. In 2004, Mark led Microsoft’s largest enterprise solution provider, ePartners in the development and interfacing of business to clinical solutions in the hospital market. This position developed into a $60 million pipeline in two years.

Americans love to talk in idioms. Idioms are words or phrases which help us simply describe a situation with common every day terms. The tail wagging the dog, for instance, means the least important part of a situation has too much influence over the most important part. This certainly seems to be the case in healthcare and in my opinion, the dog has several tails.

The single most important part of health and therefore healthcare is the patient. As a patient, when was the last time you felt you had the most influence over your healthcare delivery? We spend more household income on Healthcare than on cars and gasoline combined. Healthcare spending is 4.3 times higher than what we spend on the national defense. Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by 2008. We spend 80% of every healthcare dollar on chronic diseases such as diabetes, hypertension, obesity and emphysema. We must reform healthcare beginning with the patient or have the “chronic disease tail” wag the healthcare dog.

The physician, by way of the insurance company, is one of many tails on the dog. Insurance companies have influence over the physician by deciding how much, and often times if, it will pay a physician for the treatment delivered to the patient. Physicians have become desensitized to treating the patient and more concerned over the effort required to collect payments and the cost to reimbursement of services delivered. Physicians are reimbursed by the insurance company from a set fee schedule published by the insurer. Many commercial insurers use Medicare’s fee schedule in developing their own fees. The centers for Medicare and Medicaid Services proposed a 5% decrease in payments to physicians in 2007 with more to follow in the following 9 years. In fact, projected cuts would equal 37% in that period while the increase in the cost to treat a patient will increase 22%. Pay scales established by private insurance companies will then be expected to follow suit and the patient will feel the “physician influenced tail” wag the dog.

Insurance Companies often determine what level of care will be delivered to the patient through levels of reimbursements for specific treatments. A recent study on insurance payments for chemotherapy determined that providers who were more generously reimbursed prescribed more-costly chemotherapy regimens to metastatic breast, colorectal, and lung cancer patients which had a more rapid outcome on disease management and patient outcomes. The very foundation of the patient/physician encounter is influenced by the evaluation and management codes used to determine the level of care given by the physician during the visit and how much will be reimbursed for that level of care. The encounter based system often times strongly influences quantity rather than quality in the patient/physician visit. A time based reimbursement system, which is paid based on the amount of time spent with the patient, would encourage more quality time resulting in better patient outcomes. Patients understand the value of a physician’s time and shifting to a time based system would reimburse the physician for time spent while ensuring the patient receives full attention. Insurance companies directly impact “how a physician sees a patient” making this one of the largest tails in the healthcare dog.

Politicians, our elected officials, and those who will aspire to be, feel they have solutions for healthcare from reforming the current system to totally gutting it and starting over. Both political parties recognize the need for change but they offer clearly different paths. Republicans emphasize the need to reduce the high cost of healthcare and are leery of an increasing role for the federal government. By contrast, Democrats focus on a major expansion of coverage for the uninsured with government controlled mandates. Cost is a Republican issue, and coverage is a Democratic concern.

The Democrats believe in a National Healthcare delivery system. They would have you believe the government needs to take control of this spiraling, out of control system and pattern it after other world countries that deliver healthcare to all citizens. When political leaders pass a law requiring everyone to have health insurance, government authorities must decide what qualifies as acceptable coverage. The insurance market quickly morphs into a government-regulated utility, as politicians, rather than the marketplace, determine the terms of the coverage and regulate how much people must pay for the premiums.
A recent article published in Annals of Internal Medicine (Annals of Internal Medicine March 31, 2008) proclaimed “Most Docs Favor National Health Insurance”. The study goes on to say “A recent survey shows 59% of U.S. physicians support national universal health insurance, up from 49% just five years ago”. Careful reading of this article will reveal that the study polled 2,193 physicians. And even though it’s the largest poll of its kind taken, it represents 0.2% of the more than 834,000 physicians in practice in the U.S. Quite conversely the American Medical Association (AMA) with more than 250,000 members and the American College of Physicians (ACP) with more than 125,000 physicians were opposed to national health care by definition and increased government control on healthcare.

Speaking to the Association of Health Care Journalists on Saturday, Elizabeth Edwards said that she and Sen. John McCain, R-Ariz., have something in common in addition to being cancer survivors: “Neither one of us would be covered by his health policy. “ McCain offers increased tax credits for those in a special pool. Tax credits which are increased under his plan. In addition, creating competition among the insurance companies drives prices down making insurance affordable for all. We should as consumers be able to purchase insurance at age 19 and retain it until death. These programs eliminate the worry over pre-existing conditions and provide affordable healthcare for every patient. Placing a patient electronic medical record in the physician office and supplying the patient with electronic health records would support this healthcare initiative and eliminate the current loss seen in government programs. “Increased government control” should never be the tail that wags the healthcare dog.

Government payment programs currently in place through Medicare and Medicaid are losing money daily off of a payment system that is totally inefficient. In 2006 the combined programs paid out over $75 billion in payments that should have been covered by private insurance companies. These patient payments were never screened for private pay insurance, therefore the government payments were left to be paid. State run agencies currently deny having this problem in their programs. A simple software solution (which our company has developed) would screen every patient for private pay initially, then revert to government funds for final payment. One third of this savings would equip every physician in America with the technology to screen these payments. We rely on government programs to provide healthcare for those who cannot afford it. These same government agencies ignore inefficiencies within their own system which would fund the reformation of our entire healthcare system. This is the best case for not allowing the tail to wag the dog.

To build a future of quality health care, we must trust patients and doctors to make medical decisions and empower them with better information and better options. It is critical we install 21st century business systems into 21st century healthcare to maximize delivery. We must adopt measures to advance our current processes enabling both the physician and patient toward an efficient cost effective delivery system. We must encourage and establish Health Savings Accounts so that every patient is in control of his or her healthcare. We must adopt the sharing of medical information among the disciplines; enforce quality of care and standardized pricing across all caregivers both public and private. We must improve Health Information Technology. Implementing a statewide foundation of healthcare information technology, then empowering the physician with electronic medical records, coupled with truly integrated practice management, will create enough efficiency within healthcare to totally reform our current system. In essence, healthcare IT will pay for itself and create a savings which will fund all other programs. We should establish association health plans for small business, reform frivolous lawsuits for medical liability and give the consumer the freedom to buy insurance anywhere. Most importantly, we as a country must focus on health and wellness through prevention and be proactive in our own healthcare. We must educate the public on the need for – privacy and security and the issue of cost. Information technology in the hands of every physician provides knowledge to the patient, empowers the physician, controls the insurance company and supports the government programs necessary to continue our world dominance in healthcare. It is time we eliminated the tails that wag the healthcare dog and celebrate the quality of life that is ours to enjoy.
Expecting the government to reform your healthcare would be putting the cart before the horse.

Mark Tumblin, CEO ASCENT Integrated Medical Solutions

Copyright 2008 The Southern Ledger. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

We live in the most advance society in the world. As Americans we have the opportunity to accomplish anything we might dream. The reason behind our freedom is we have chosen not to be controlled by our government. How then can we actually consider electing government officials that would champion taking our most valued possession, healthcare? The driving force behind true healthcare reform is the “Power of the Patient”.

Consider these facts; Since 2001, premiums for family health coverage have increased 78 percent. In 2007 premiums averaged $12,106, of which workers paid $3,281. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers’ compensation costs, with the remaining money going to wages. We currently spend more household income on healthcare than on cars and gasoline.

The current Democratic presidential candidates would have you believe a National Healthcare Program is the solution for dramatic increases in healthcare and in health insurance premiums. One-third of Americans — even those with health insurance — say high costs force them to skip needed medical care. It is a fact we are spending more on healthcare but let’s take a closer look at the reason behind the increase.

The largest percentage of our healthcare dollar, about 80%, is spent on chronic illness, diabetes, hypertension, obesity and heart disease. These diseases are primarily a result of lifestyle. We spend 14% of household income on fast food or $7,159. This is more than we spend as employees on healthcare premiums. We spend 9 times more of our day watching TV than we do on activities or exercise. The cost to treat obesity alone will top $80 billion in 2008. If we would choose a change in lifestyle rather than elect a president to change our healthcare we could significantly decrease the healthcare spending and increase our quality of life.

Maybe it is time we focused on wellness and prevention…only $0.04 of every healthcare dollar is spent on prevention. Our current government-run healthcare system will not pay for screening tests for prevention or early detection of diseases. When it comes to the cost of screening and early-stage vs. advanced-stage cancer treatment, “paying now” often proves to be much more cost-effective and spares patients much pain and suffering. The introduction of cholesterol fighting drugs has greatly decreased the incidence of heart disease and open heart surgery. However, our government run system does not allow for many to have access to these drugs and regimens resulting in disease and a higher expenditure on surgery and long term treatment.

The business of healthcare at the physician/patient level is 10-20 years behind in technology. When you consider all your patient records are recorded on paper, with no interaction between diagnostic, clinical and business systems, it is no wonder physicians collect $0.63 on the dollar and have come to accept it. A paper chart costs $15 to create and $8/yr to maintain allowing a single physician the savings of over $15,000 per year on an electronic system. We currently have more technology in the grocery than in the physician office allowing Wal-Mart to know more about us than our physician. We are focused on patient privacy but we can’t share the critical information with the hospital, diagnostic lab or a referring physician that might actually save a life.

We see 98,000 deaths each year caused by medical errors that would be drastically reduced if healthcare providers had access to comprehensive patient information. The U.S. Department of Health and Human Services reports electronic medical records would reduce the cost of healthcare by 30% annually. In the state of Alabama where costs rose 30% last year, a one year savings pays for an infrastructure that eliminates the rise in cost plus creates a permanent solution.

When it comes to reforming American Healthcare, do the costs outweigh the benefits or is the cost as prohibitive as some would have you think. A healthy lifestyle of diet, exercise and prevention will increase quality of life and longevity and decrease the need for costly healthcare expenditures. We can remove the threat of chronic disease by having the discipline to control our own lives. We must demand access to screening tests and preventive healthcare eliminating costly disease management not to mention pain and suffering. Health IT would eliminate costly duplicate testing and allow patients to manage their own healthcare. The same technology that instantly tracks your ATM card usage can link doctors to secure and complete patient information. Medical errors would be eliminated and comprehensive patient information would be available to all healthcare providers. The technology exists today to make all of these things a reality and save billions in rising and existing costs.

I would propose the answer to healthcare reform is not in electing officials who will take our most precious of resources but rather taking control of our own lives and returning the power to the patient.

Biography Mark Tumblin, Healthcare Expert

Mark Tumblin has spent 25 years observing all aspects of healthcare in the United States. Having a strong grasp on the challenges and solutions for our current healthcare system, Mark incorporates thought provoking and witty examples while exposing major issues and problems within the healthcare industry as it relates to the political arena.

Mark is a frequent guest on talk shows in his home state of TN where he is called upon as a Healthcare expert. He has an uncanny knack of being able to pinpoint solutions for the vast array of healthcare difficulties currently facing our nation. Mark’s commentary on healthcare can be read at www.southernledger.com.
Mark Tumblin is currently the CEO of ASCENT Integrated Medical Solutions; a highly specialized Medical Information Systems, Engineering and Consulting Company. ASCENT is a wholly owned subsidiary of Southeast Cancer Corporation serving the Oncology community with management and technology services.

Previous to Ascent, Mark spent 12 years at Roche Diagnostics in Clinical Chemistry and toxicology. He developed highly specialized toxicology labs which serviced the Nuclear Regulatory commission and the American Medical Association as the founding partner of Workplace Wellness.

Mark also founded technology company “Integrated Management Solutions” which developed information systems for laboratories interfacing the judicial system with toxicology labs. In 2004, Mark led Microsoft’s largest enterprise solution provider, ePartners in the development and interfacing of business to clinical solutions in the hospital market. This position developed into a $60 million pipeline in two years.