Unaffordability Ebola is Spreading Throughout US Healthcare | healthcare

Driven by “The Number One Concern of Adults and Businesses in the US,” an insatiable, immutable ‘Unaffordability Ebola is attacking another compliant US host: The US Healthcare System.According to experts at Harvard, Johns Hopkins and Mercer, the US System is sick; its prognosis, poor.”We’re reaching the outer limits of affordability,” said Arnold Milstein, MD, Medical Director of PBGH and Chief Physician at Mercer. Milstein was addressing an international conference of providers, educators, brokers and facilitators on Global Health when he said, “We’re seeing an upward spread of The ‘Unaffordability Ebola.”WHAT HAPPENS IN VEGAS…
At the first, International Medical Tourism Conference in Las Vegas in April, Milstein was one of the prominent canaries singing an early warning of a virus attacking the seemingly immune US Healthcare System – “The Best System in the World.” The Canaries were singing at all venues in ‘Vegas but what happened there WON’T stay there. The Ebola is spreading faster than many people will admit…500,000 U.S. PATIENTS ABROADThe National Coalition of Healthcare estimates 500,000 people left the US for treatments last year; 500,000 international patients will visit India this year infusing $2.2Billion into its economy; 200,000 patients visited Singapore in ’05; 100,000 visited Malaysia that same year. It’s a $60 Billion Global Business that’s growing 20% a year.A presentation titled: “Leveling the Global Healthcare Playing Field,” Harvard Medical International President Dr. Robert Crone argued:1.) Regional Health Systems have achieved quality services at lower cost than US systems;2.) Global Standards and Benchmarks of quality are emerging;3.) Medical Tourism is growing, and global insurers will participate. Privately, he said, “they’re going to eat our lunch.”BARK, AND A BITE!Dr. Crone knows what’s he’s talking about. He has the credentials one would expect of a guy who’s at the top of the food chain at Harvard Medical. He’s lectured and implemented health education and delivery system programs in more countries than the average American could spell – or find on a map! A Top Dog in global healthcare, Dr. Crone has the bedside manner of a Junk Yard Dog: both his bark – and bite – hurt!”In the Flat Medicine World,” he said, “US facilities may be seriously disadvantaged, and adversely impacted in the global marketplace. Oh well,” he said smugly, “we had our Century.”Crone rattled off the maladies running rampant throughout the US system today, then piled on several scary scenarios ahead. It was a foreboding message for anyone planning to access US Healthcare today, or tomorrow. (Meaning, probably, every single American: rich, poor, healthy, sick!)Like other industries, healthcare has globalized and the new, uber competitive marketplace is introducing unimagined (some say impossible) features and benefits to consumers: Cheap, Comparable Outcomes and Outstanding Customer Service…What’s not to like?Let’s say you are uninsured and need a new knee? (What if you needed something less invasive like, say, your annual physical?) What if you wanted a face lift; a breast reduction; tummy tuck or a sex change? Since you’re responsible for the FULL price, you’re probably going to shop around a bit (after you self-diagnosed yourself, of course).As you’re shopping, you’re probably trying to find other important things to study and measure besides reputation and credentials alone. Unfortunately, there is very little accessible, comparable consumer information on cost, quality and care in the US. As a result, even the most unsophisticated buyer of healthcare is drawn to the international healthcare bizarre on the internet – and a sale can be made half way ’round the earth in the dead of night. That’s the new world of medicine.JOE SIXPACKLet’s say you’re a self insured employer – responsible for the first $50,000 or so on each employee. Would you consider recommending old Joe from Sales consider an awake, beating heart coronary artery bypass grafting at a superspeciality hospital in India – instead of the local provider? Would you ask/beg Joe (and his wife) to go halfway around the world for three weeks of treatment for the financial health of the company? Would you rewrite your Plan Document to take advantage of global pricing? Would you consider Singapore as your new Preferred Provider Network?And what about a good deal for taxpayers? Should the US Government send Medicaid patients packing? What about Medicare? Should taxpayers shell out $65,000 for grandma’s new hip when she can get hip resurfacing for $13,500 in India (including air fare and a week on the beach)?And how about all those new, high deductible health plans being sold in the US – where your best interest (maybe your only interest) is buying the most cost-effective care you can find?Would you fly 10,000 miles for a couple new crowns – plus a week on the beach – if you’d save $1,000? A TIME Magazine poll in May ’06 found that 45% of uninsured people said they would; 19% of insured people said they would, too.When asked if they could save $5000, 61% of the uninsured and 40% of insureds said they would travel 10,000 miles for an elective procedure.HOLD THE MAYOImagine your Executive Physical at a Mayo vs Maya? (Come on, guys, wouldn’t you be more inclined to actually have an annual physical – even with a colonoscopy – if it included a week on the beach with a martini and a massage for less than you’d spend for three days in Rochester, Minnesota?)Medical Tourism is Hot. (Some call it: “Medical Value Travel;” to others, it’s Consumer Driven Healthcare at its most driven level.) Whatever YOU call it, it’s economics applied to healthcare for the first time in more than 50 years.Medical Value Travel has been going on in the world for a long time, but most tourism has been inbound to the Mayos and the Cleveland Clinics of the world. Since 911, however, inbound Medical Travel has all but dried up in the US while outbound tourism is growing by leaps and bounds. Instead of Cleveland, it’s Chennai; Mumbai instead of Mayo. The Brave New World of Healthcare.Nicolet Bank Business Pulse© is a quarterly economic study of CEOs, O&Os and GMs in 10 Northeastern Wisconsin counties. (Businesses from all sectors and all sizes are represented in the sample.)In January, Nicolet Bank posed several questions about Medical Tourism: 52% of the CEOs, O&Os and GMs never heard of Medical Tourism; 23% heard of it, but didn’t know much about it; 17% were somewhat familiar; 9% very familiar.The Nicolet Bank Business Pulse© also asked: How interested would you be in traveling to another country for a routine procedure (e.g. your Executive Physical) if you knew the cost would be considerably less – and the care would be equally good?”Nearly a third said they’d be interested,” said Dr. David Wegge, president of IntellectualMarketing, LLC – the firm that conducts the studies for Nicolet Bank of Green Bay. “I don’t know how this compares to national CEO data; I suspect we’re the first ones to ask.”Wegge was surprised that a third of the CEOs would be interested, “especially among CEOs who probably have health insurance and fewer financial worries.” 30% were definitely not interested; 23% were probably not interested; 19% said, “It depends on the country.” (Of the countries listed, Canada was the overall preferred provider; Russia was dead last – definitely an OUT of network provider!)Nicolet Bank also asked CEOs 1.) “Would you be more interested if a medical trip were combined with a business opportunity and; 2.) Would you be more interested if it included a vacation with spouse/partner. “The levels changed substantially,” Wegge said.**Contact Wegge for detailed analysis: 920.217.7738

New Maine Pot Law Clouds Rules On Drug Use | laws and issues

If one of your employees failed a drug screen, what would you do?If you’re like most employers, you have clear procedures on how to respond, particularly if you fall under federal guidelines.Now, what would you do if that same employee suddenly flashes a registry identification card issued to him under Maine’s new medical marijuana law? Do you follow the same procedures?Maine’s new law is about to change all the rules on drugs in the workplace. Many of the personnel procedures that businesses have in place just went up in smoke with the new law.Now an employee who is a “qualifying patient” and who has been issued a registry identification card is protected against disciplinary action for the use of medical marijuana.In addition, employers cannot refuse to hire and cannot penalize someone just because they are registered as a qualifying patient.So what are employers supposed to do? Is it now acceptable to come to work stoned?Well, there is a lot more that we don’t know about the new law than we do, but the short answer is, the law does not permit a person to perform any task while under the influence, and that includes operating a motor vehicle.So let’s look at what we know about the law.To begin, the law does not require an employer to allow the use of a drug at work or permit an employee to work under the influence. While it may be difficult for a manager to prove that an employee is impaired, employers can still demand that employees are fully able to work before they report to work.When faced with an employee you believe is impaired and under the influence, document your findings, focus on observable behavior and unless you’re a medical doctor, don’t diagnose. In fact, even if you are a doctor, you might want to refrain in this case, too.Treat the use of medical marijuana in the same manner that you would deal with other prescribed medications that would impair an employee’s ability to safely do the job — particularly when operating dangerous equipment. Consistency is the key.While Maine law allows the use of medical marijuana, it is still illegal under federal law. As a result, employers will have to deal with employee situations differently, particularly when faced with federal government mandates.As an example, employers who fall under federal guidelines, such as the federal Department of Transportation rules, must still follow their rules including the testing mandates. As a result, any worker who tests positive for drugs, including marijuana, cannot report to duty, remain on duty or perform safety-sensitive functions.In addition, the employer may not permit the worker to perform any safety-sensitive functions until the worker has a substance test indicating a negative result.However, it is not clear what employers can do next.Sending an employee to rehabilitation would be the next logical step, but how do you rehabilitate someone who has been medically prescribed the drug? Termination may also be out. So what should employers do?Since federal guidelines do not allow an employee to resume driving, for example, with a positive drug screen and since marijuana stays in the body’s system for weeks, employers may be forced to place an employee on medical leave until he gets a negative test result.Employers will need guidance from the Legislature or the courts on this and should consult with a lawyer in the interim.Employers may find themselves in a difficult spot — caught between a new law legalizing, in limited situations, what is illegal under federal and in most state laws. And what complicates it more, guidance from the state is slow in coming. Without it, employers may have to wait for the courts — and no one wants to be the test case.In the interim, employers still must run their businesses and should put procedures in place for dealing with employees who are allowed medical marijuana. In addition, employers should continue to follow federal requirements including the mandated testing.However, do not terminate employees who test positive without consulting legal counsel first. Consider putting these employees on medical leave. And if you currently have a state-approved drug testing policy, consider excluding the testing of medical marijuana.Educate your managers and supervisors on the changes in the law so they can properly handle these employee situations. And finally, consult with your attorney before taking any adverse actions with an impaired employee or those who test positive on a drug screen.There is a lot we still don’t know about Maine’s new medical marijuana law.We are in uncharted territory, and it is safe to say that it is only a matter of time before many employers will be faced with an employee who is legally using marijuana.Take what steps you can to prepare now, including updating your policies and procedures and training your managers and supervisors. In the short term, dealing with this new law is going to complicate managing your work force.


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