Word: careful
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...system, there are few financial incentives for providers to take proactive measures to keep people healthy: the longer and more extensively a doctor or hospital treats a patient, the more income they recoup. That's why the American College of Physicians and others are calling for reform in health-care reimbursement, with the Federal Government and large insurance companies setting up "Patient Centered Medical Homes" in which a portion of doctors' pay will be linked to performance targets. As in Germany, these homes will target chronic diseases by allowing doctors, nurses, dietitians and therapists to educate all patients - especially chronic...
Preventing these conditions from developing in the first place is helped by a holistic approach to preventive medicine that encourages changes in what people eat or how much exercise they get. But for those patients already battling a chronic illness, there are steps health-care providers can take to keep them stable and out of hospital - as Germany's experience shows. The solutions can be as simple as educating patients about their condition, having nurses call patients to make sure they are staying on top of their medication and allowing doctors to compare their success rate with other physicians...
...million chronic patients. The results are promising. One survey by the University of Heidelberg of some 11,000 patients in the Saxony Anhalt and Rhineland-Palatinate regions found that the death rate in older diabetics in the program was about 8% lower than among diabetics who received regular care. And when one of Germany's largest insurers tracked 20,000 coronary heart disease and diabetes patients enrolled in disease-management programs for 15 months, it found the percentage of patients requiring hospitalization dropped from 4.3 to 2.9 - and 25% of the patients also gave up smoking...
Placing a cap on drug costs could save U.S. health care billions. But it's not without controversy. England and Wales have set up a body called the National Institute for Health and Clinical Excellence (NICE) which reviews treatments to decide which are the most cost-effective and which the National Health Service (NHS) should pay for. A new drug has to offer value for money - and if it doesn't, whether it is life-saving or not, NICE won't approve...
Aware that the idea of "rationing" health care would prove controversial in the U.S., advocates of reform - from the American College of Physicians to the advocacy group Center for Medicine in the Public Interest - have suggested a system of review that doesn't take into account the cost of new treatments. This would help doctors decide a course of treatment, as currently they have no way of comparing the efficacy of different drugs for the same condition. But it could also raise prices. "In a free-market economy the manufacturers may use the effectiveness review to charge higher prices...