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.
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 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 Reform: A Quasi-experimental Study
Ann Intern Med. 2014;160(9):585-593. doi:10.7326/M13-2275
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:
USA will implement this mode of payment in 2019 here:
Developing countries have already experienced these kind of payment here:
Below are other links related to the way Doctors will be payed in the future:
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:
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”
2) The Swiss report on homeopathy: a case study of research misconduct
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.
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:
And videos of the congress can be accessed here: