Sarah Kliff

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Coronavirus and the Recurring Mistake of Fighting the Wrong Wars

What do the coronavirus and Navy ships have in common? For that matter, what do our military spending and our healthcare spending have in common? More than you might think, and it boils down to this: we spend too much for too little, in large part because we tend to always be fighting the wrong wars.I started thinking about this a couple weeks ago due to a WSJ article about the U.S. Navy's "aging and fragmented technology." An internal Navy strategy memo warned that the Navy is "under cyber siege" by foreign adversaries, leaking information "like a sieve." It grimly pointed out...

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Hospital CEOs Behaving Badly And The Devastating Consequences On The Middle Class

Dave Chase | Forbes | August 26, 2016

When big health insurers propose mergers, it makes for good antitrust enforcement theater to try to block them. However, if government officials want to address anti-competitive activities that have a dramatically bigger impact, they should shift their focus to local market provider M&A activity that consistently show prices increase after the deal is done. However, the most rapacious, anti-competitive practices I’ve seen in my entire career have come from hospitals–frequently from tax-exempt “nonprofits” that would make John D. Rockefeller blush with their brutal actions. The combined impact has created a middle class economic depression that has driven populist presidential campaign success, which was highlighted in a recently released Brookings study.

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Is Cloud Faxing the Solution to the Health IT Usability and Interoperability Crisis?

The Healthcare industry is in profound crisis as the HITECH Act of 2009 led medical facilities across the United States to spend in excess of $3 trillion on the purchase and implementation of expensive electronic health records (EHRs) under the Meaningful Use program. Yet, the most fundamental goals of electronic records Nirvana that were promised have not been achieved. For multiple reasons, EHRs have turned out to lack usability and be non-interoperable. In fact, most monopoly EHR vendors are engaged in what is commonly called “data blocking.” In most cases physicians are unable to obtain medical records for the patients they are seeing and patients have a hard time getting a hold of their own medical records. That means that the medical records are not available at the most important moment, the caregiver/patient encounter, and are not available to the patients themselves and their family members.

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Is Health Insurance Itself the Problem with the System?

I worked in the health insurance industry for a long time.  I helped introduce consumer-driven/high deductible plans to help foster cost-awareness.  I bought into the protection-against-big-expenses meme.  I personally have never not had health insurance.  So, by most standards, I should be biased in its favor.  But I'm beginning to wonder if health insurance itself is the problem, or at least a big part of the problem. I've written before about some of the new entrants into health insurance; more power to them, and the more the merrier.  What I continue to be disappointed by is that we're not really seeing fundamentally new approaches to what health insurance is.

Is The 1.5+ Trillion Dollar HITECH Act a Failure?

Hopefully, the public statements made by President Obama and Vice President Biden will lead to a public debate over the monumental problems that the HITECH Act and proprietary EHR vendors have caused the American people. While the press continues to report the figure of $35 billion as the cost of implementing EHRs, that figure does not tell the entire story. Perhaps the next step is to provide accountability and transparency. That would start with firm numbers regarding the real costs of EHR implementations forced on an unprepared healthcare system by the HITECH Act.

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Mystery Consent Forms and the Scourge of Surprise Medical Bills

We are, it appears, shocked -- shocked! -- that there are "surprise" bills in healthcare. That is, bills from out-of-network healthcare professionals, even when patients thought they were going to in-network professionals/facilities. The problem is bad enough that even our deeply divided Congress has bipartisan agreement that it should act (although whether it will, of course, remains to be seen). Of course, surprise billing shouldn't come as a surprise to anyone who knows much about healthcare; it is more of a symptom of problems with our healthcare system than a problem itself. Kaiser Health News/NPR deserve much credit for getting more attention for the issue, with their Bill of the Month crowdsourced investigation.

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Obama and Biden Blast EHR Vendors for Data Blocking

As they are winding their terms in office, President Barack Obama and Vice President Joe Biden dropped a stink bomb on the health IT industry. Speaking at different events on Friday, January 9th, the President and Vice President both criticized proprietary electronic health record (EHR) vendors as the primary obstacle to the success of their administration’s health care strategy. This is the highest level acknowledgment so far of the serious impact that “lock-in” EHR software vendors are having on America’s medical infrastructure and the ability of physicians to provide medical care.

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Obama’s Surprising Answer on Which Part of Obamacare Has Disappointed Him the Most

Sarah Kliff | Vox | January 9, 2017

There was this moment, about 50 minutes into our interview with President Barack Obama last week, that genuinely surprised me (and surprised other health care journalists, like David Nather, too). My colleague Ezra Klein had asked the president a question about which part of the law had overperformed his expectations, and which part of the law had underperformed. The president gave a surprisingly frank assessment of something his administration has tried, and failed, to do: Get doctors off paper and on to digital medical records...

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The Fax of Life

Sarah Kliff | Vox | October 30, 2017

When you walk into the Arlington Women’s Center, you see a spacious waiting room with artwork on the wall, maroon chairs, and a friendly receptionist sitting at the front desk. The obstetrics and gynecology practice serves a high-income suburb of Washington, DC. Framed photographs on the wall advertise the center’s physicians who’ve made lists of the city’s best doctors. It’s a modern, upscale doctor office. But when it needs to share patient records, it turns to an outdated technology: the fax machine...

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