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France’s social security scheme for self-employed workers

17 Oct

In addition to the general scheme (salaried workers), the agricultural scheme, and the special schemes (which cover certain specific lines of work), France’s Social Security system also has a scheme for self-employed workers not involved in agriculture. These workers’ compulsory Social Security coverage is provided by the Régime Social des Indépendants (RSI).

Full article from the Centre of European and International Liaisons for Social Security available here:

http://www.cleiss.fr/docs/regimes/regime_france_independants_en.html

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algorithms detecting deviant health care use in French Health Insurance databases

11 Nov

French health insurance for salaried executes algorithms on its databases with a public health purpose. The following published articles aim to target potential deviant behaviours or abuses that put at risk the health of the insured.

Patterns of methylphenidate use and assessment of its abuse and diversion in two French administrative areas using a proxy of deviant behaviour determined from a reimbursement database: main trends from 2005 to 2008.

Frauger E, Pauly V, Natali F, Pradel V, Reggio P, Coudert H, Thirion X, Micallef J.

CNS Drugs. 2011 May;25(5):415-24. doi: 10.2165/11587640-000000000-00000.

PMID:
21476612
Select item 206927782.

Which indicators can public health authorities use to monitor prescription drug abuse and evaluate the impact of regulatory measures? Controlling High Dosage Buprenorphine abuse.

Pauly V, Frauger E, Pradel V, Rouby F, Berbis J, Natali F, Reggio P, Coudert H, Micallef J, Thirion X.

Drug Alcohol Depend. 2011 Jan 1;113(1):29-36. doi: 10.1016/j.drugalcdep.2010.06.016. Epub 2010 Aug 8.

PMID:
20692778
Select item 198204053.

Estimation of clonazepam abuse liability: a new method using a reimbursed drug database.

Frauger E, Pauly V, Thirion X, Natali F, Pradel V, Reggio P, Rouby F, Coudert H, Micallef J.

Int Clin Psychopharmacol. 2009 Nov;24(6):318-24. doi: 10.1097/YIC.0b013e328330ae4b.

PMID:
19820405
10.

Assessment of abuse potential of benzodiazepines from a prescription database using ‘doctor shopping’ as an indicator.

Pradel V, Delga C, Rouby F, Micallef J, Lapeyre-Mestre M.

CNS Drugs. 2010 Jul;24(7):611-20. doi: 10.2165/11531570-000000000-00000.

PMID:
20527997

where you stand . . . depends on where you sit

17 May

Living with Open Hands

“Where you stand . . . depends on where you sit . . .” The viewpoints you are most likely to advance (your stance politically, your opinions) are decisively determined by the place you occupy economically, in your career, in your community, in your organization, in society. We must not ever presume to speak for others; especially those outside of our scope, like the poor, the battered and bruised, the broken hearted, the “least of these.” We must ‘live’ there . . . and listen.

Three years ago, I sat in a very different place in life with very different viewpoints.
An entrepreneur, a social entrepreneur at that, making enough money to actually pay the bills.
Two income family.
Home owner.
Living in a middle class neighborhood.
Going to a middle class church in a poor neighborhood. (Made me feel better about church)
Wondering why those people in that poor…

View original post 882 more words

In NEJM: Protection or Harm? Suppressing Substance-Use Data

16 Apr

This post is jointly authored by Nicholas Bagley and Austin Frakt. Yesterday evening, the New England Journal of Medicine released a Perspective piece that

via In NEJM: Protection or Harm? Suppressing Substance-Use Data.

Health insurance: a matter of life and death

7 May

Health insurance would be a matter of life and death suggests the study referenced below:

Benjamin D. Sommers, Sharon K. Long, Katherine Baicker; Changes in Mortality After Massachusetts Health Care ReformA Quasi-experimental StudyChanges in Mortality After Massachusetts Health Care Reform. Annals of Internal Medicine. 2014 May;160(9):585-593.

The results are widely reported in the media and blogosphere.

Drs. Sommers and Baicker work in the Department of Health Policy and Management, Harvard School of Public Health, Kresge Building, Room 406, 677 Huntington Avenue, Boston, MA 02115 and Dr. Long works at the Health Policy Center, Urban Institute, 2100 M Street NW, Washington, DC 20037.

Since the design is purely observational, results must not serve to inference nor be generalized nevertheless they go in the same direction as common sense, and logic: health insurance therefore care accessibility therefore life prolongation. But until now that chain of events had still to be observed at a large-scale (state-scale) and this is the merit of this study.

 

Changes in Mortality After Massachusetts Health Care ReformA Quasi-experimental Study

Benjamin D. Sommers, MD, PhD; Sharon K. Long, PhD; and Katherine Baicker, PhD
Ann Intern Med. 2014;160(9):585-593. doi:10.7326/M13-2275
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How we pay our Doctors

2 Mar

Before the health insurances era Doctors were often payed in nature with eggs, chicken or other farm products. Needless to say that they were often poorly paid, furthermore people called them so lately that the care was unable to keep them alive and the doctors lost their patients in the same time. Once the Doctors and the people they cared got the health insurances to be created Doctors received currencies for their services and could see more than once their patients. The issue of payment was transferred to the insurer. In the beginning insurers reimbursed with a fee for service model like the patients did previously. But the increasing amount of money needed made them think of an alternative payment model. And here came the Pay for Performance model.

France has already put in place such a payment model here:
http://www.csmf.org/upload/File/Conv_med/conv_med_annexes_110726.pdf

USA will implement this mode of payment in 2019 here:
http://www.medpagetoday.com/PublicHealthPolicy/Medicare/40568

Developing countries have already experienced these kind of payment here:
http://www.esciencecentral.org/journals/impact-of-pay-for-performance-on-utilization-of-health-services-and-quality-of-care-in-low-and-middle-income-countries.hccr.1000116.pdf

Below are other links related to the way Doctors will be payed in the future:

http://theincidentaleconomist.com/wordpress/can-the-better-care-lower-cost-act-live-up-to-its-name/

http://advocacyblog.acponline.org/2013/07/house-sgr-bill-promotes-medical-homes.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=Feed:+AcpAdvocateBlog

http://advocacyblog.acponline.org/2013/04/does-measurement-improve-performance.html

http://doctorscaucus.gingrey.house.gov/news/documentsingle.aspx?DocumentID=364922

http://energycommerce.house.gov/markup/markup-committee-print-amend-title-xviii-social-security-act-reform-sustainable-growth-rate

The effects of Expanding health coverage

8 Feb

The Affordable Care Act (aka Obamacare) is practically a laboratory experiment at the scale of a continent that allows health economists to observe the effects of expending the health coverage to a whole population (a thing that Europeans have done and that they call modestly Universal Disease Coverage, in French couverture maladie universelle or CMU). Starting from his reading of a
Congressional Budget Office (CBO) report the health economist Austin Frakt lists the incentives and disincentives to work that a mandatory health coverage creates. But in my view the point is: does the labor market need workers anymore, with or without health coverage? If it really needs workers then it would be better that they could afford care and rehabilitation, it is the interest of both the employer and the employee. If it doesn’t, the labor market will always consider that the costs are to high.
The blog the incidental economist is about health economics, below is the post with a link to the CBO report:
http://theincidentaleconomist.com/wordpress/cut-out-the-noise-and-read-the-cbo-report/

Homeopathy will continue to be reimbursed in Switzerland (followed)

20 Nov

In a previous post I pointed that homeopathy is reimbursed in Switzerland.

But the reimbursement is still under the following condition:  homeopathy has to be evaluate within 6 years with adequate Randomized Controlled Trials.

You can see recent developments in the two links below.

We are thankful to Alan Henness, Director of the Nightingale Collaboration, which campaigns against misleading healthcare advertising to the general public, for having signaled this information.

1) The report “Homeopathy in healthcare: effectiveness, appropriateness, safety, costs” is not a “Swiss report”

http://www.smw.ch/content/smw-2012-13723/

2) The Swiss report on homeopathy: a case study of research misconduct

http://www.smw.ch/content/smw-2012-13594/

International Health Policy: Comparative Health Care Systems

10 Dec

How to explain the differences across North America and Western Europe regarding the policies of health coverage (mandatory in one hand, private initiative in the other hand)? The response has to be searched in the past history on both side of the Atlantic Ocean. Feudalism in Europe made government to be considered by people as a good thing which liberated them from oppression of the King and feudal lords while in North America, Government rules are associated in people’s mind with the oppression of the English government which imposed taxes before the independence. At least it is the theory exposed by Henry J. Kaiser Jr. Professor of Health and Research Policy Emeritus at Stanford.

Universal health coverage

6 Dec

At the second global symposium on health systems research in october 31th of 2012 some dreamers recently gathered in Beijing to promote a World Wide Universal Health Coverage.
But dreamers have always been the ones who changed the world!
Here is the report in Adam Wagstaff’s blog:

http://blogs.worldbank.org/developmenttalk/when-the-snow-fell-on-health-systems-research-a-symposium-sketch

And videos of the congress can be accessed here:

http://www.hsr-symposium.org/index.php/programme-/plenary-webcasts

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