Musings on Medicine and the Health Care System

10 Surprising Things In Healthcare Reform (Senate version) Part 2

Pile of red ring bindersSo sorry for the delay in getting you Part 2 of my health care reform article (and if you’re wondering where Part 1 is, it’s here).  Every now and again I actually have to do some work that pays the bills.

But here you go with the final six surprising things in the Senate version of healthcare reform. So those of you who have barricaded yourselves in the bathroom and gone on a hunger strike awaiting my next post can now emerge.

(full disclosure: My source for this is a fabulous side-by-side comparison of the Senate and House versions from the Kaiser Family Foundation).

5. Require chain restaurants and food sold from vending machines to disclose the nutritional content of each item. In English: We’re going to know how many calories and how much fat, salt, and sugar are in the foods we adore (i.e., all those foods that are bad for us). A great article in today’s Washington Post covers this in more detail, including the fact that when restaurants display (or have to display) … Continue Reading

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healthcare reform nursing homes payment prevention

Medical Writing in 2010: Resolutions

I’m sure you’re all sick of reading predictions and resolutions. Well, too bad. You’re going to read one more.

I’ve been thinking a lot about what the next year will bring. It’s my 11th year as an independent (read: freelance) medical writer, a major milestone in my book. I’ve gone from writing $50 newsletter articles to authoring entire books. From shying away from scientific writing like CME and journal articles to getting to the point where they make up the bulk of my business. So what do I plan in the next 365 days?

1. To continue to organize my marketing efforts with the help of my virtual assistant (thanks, Katy!). This includes the database she’s established, this blog, quarterly email newsletters, following up with potential clients on a regular basis and delving deeper into Linked In and the potential it holds for business development.

2. To develop a book proposal on my own for my own book, no coauthors. Idea is there; just need to write the proposal!

3. To market myself as a speaker at professional meetings on writing, freelancing and medical communcations.

4. To expand the part of my business related to meeting coverage. I LOVE covering … Continue Reading

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medical writing resolutions

10 Surprising Things In Healthcare Reform (Senate version) Part 1

I promised in an earlier blog to list 10 things in the Senate version of the healthcare reform bill that you might not be aware of. Since it’s New Year’s Eve, technically a holiday, I’m only working at partial speed so you only get a partial list today. More to come over the next few days.

1. Support comparative effectiveness research by establishing a non-profit Patient-Centered Outcomes Research Institute to identify research priorities and conduct research that compares the clinical effectiveness of medical treatments.   

In English: The government will fund research to directly compare treatment A to treatment B to determine which works best and is most cost effective.  

Major weakness: the Senate bill specifically notes that the results of such research “may not be construed” as mandates, guidelines, or recommendations for payment, coverage, or treatment or used to deny coverage.

Huh? What is the point of finding out that treatment A works better than treatment B if you don’t use it to make coverage decisions???

Prediction: Most insurers will use this information to make coverage decisions, much to the chagrin of many pharmaceutical and medical device companies. In the not-too-distant-future, Medicare will join the party. After all, … Continue Reading

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They Did It!!

So President Obama, the Democrats, and, yes, the American people got their much-awaited Christmas gift–healthcare insurance reform. Oh, sure, the Senate bill has to be reconciled with the House bill, but I’ll bet you my weekly copy of JAMA that’s a no brainer.

So now (or next Monday when the world returns to work) we can expect a slew of criticism and predictions of doom from people unhappy with the bill as passed. I want to head off some of this at the pass by saying this: No, the bill is not perfect. No, the bill will not reform the healthcare system. No, the bill will not save billions of dollars and reduce the amount of GDP (currently at 17 percent) that our country spends on healthcare.

But, as a wise friend once told me, perfect is the enemy of good.

The reality is that the Senate bill is a first step on a very long journey to contain our out-of-control health system. There will be many more such steps before we even get close to stuffing this evil genie back into the bottle. Why? Because we have allowed our system to become the kudzu of our culture. For those … Continue Reading

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healthcare reform

Why You Should Ration Your Healthcare

Questions and Answers signpost A few months ago my 72-year-old mother told me she was having a CT scan because she had a lot of back pain. Her doctor thought it was a bulging disc. Given her age, it was most likely related to degenerative disc disease, i.e., old age. He had already prescribed physical therapy and some anti-inflammatories.

So why, I asked her, are you having a CT scan? How would your doctor’s treatment plan change based on what the CT shows? Are you going to have surgery? Take stronger drugs?

She couldn’t answer. She couldn’t answer because she never asked the questions. Just as she never asks her doctors why they prescribe one medication over another, or why they recommend knee arthroscopy for her aching joint (which studies find no more effective than conservative medical treatment) instead of knee replacement (which studies find extremely effective both from a medical and a cost perspective because it keeps keep older people active, reducing the risk of additional medical problems and improving their quality of life).

Now, this is not to pick on my mother … Continue Reading

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cost managed care rationing

Making a List and Checking it Twice. . .

CheckNo, I’m not Santa but I’m still making a list. Unlike Santa’s list, this one only includes those who have been naughty. Specifically, companies that use freelance medical writers but do not pay within a timely manner (i.e., 45 days from invoicing); do not pay at all; or significantly change the scope of the project but balk (or walk away) when the writer tries to change the scope of the fee.

This list was triggered by a Tweet from someone about Time Inc., and NBC charging freelancers a percentage of their fee if they want to be paid in a timely manner. Imagine that. If you want to be paid within a month or so, you have to agree to give up 4% or so of the money owed you.

There is just so much wrong with that thinking I don’t even know where to start. My outrage might be the result, in part, of my own payment woes. As I wrote in an earlier post, I have a client who just informed me they are paying at 90 days … Continue Reading

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The TRUE Cost of Health Care

Medical Records & StethoscopeThree years ago, my husband left his perfectly secure job (read: with benefits) and became a full-time consultant for his old company (read: without benefits) so we could have a much nicer lifestyle in Williamsburg, Va than we did in the small Pennsylvania town in which we’d lived for nine years (no offense to Pennsylvanians, but I’m a Virginia born-and-bred gal and I needed to get back to the Commonwealth, where the daffodils bloom in February and we can wear flip flops before June).

Needless to say, we lost the benefits (read: employer-provided health insurance) that had allowed me to go out on my own as a freelance medical writer seven years before.

No problem, I thought. I’m a healthcare expert. Heck, I once managed the provider relations department for a mid-sized managed care company, contracting with doctors and convincing them that they hated our HMO less than the other HMOs in the area (I was pretty darn good at it, too). I’ll just go out and find us some health insurance.

I started on the individual market. For my sons … Continue Reading

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health insurance healthcare reform high-deductible health plan mammograms

Working on the Weekend

deskHow was your weekend? Get a lot of Christmas shopping done? Clean your house? Spend some quality time with the kids?

I spent my weekend working, trying to get a jump on a book I’m writing for two doctors.

And that’s ok.

In fact, that’s one thing I always tell “newbies” (people who are thinking about or who have just decided to go into freelance medical writing who ask me for my trade secrets). Looking for a 9 to 5 work schedule? Fuggedaboudit!

When you’re a freelancer you are also a business owner. And your business doesn’t stop at 5 p.m., especially in these days of 24/7 access. That means being available to your clients, current and potential, around the clock at least to the point of responding to emails in a timely manner, even emails that come in on a Saturday.

I’ve been freelancing for 10 years now and I can count on two hands the number of full weekends I’ve taken off (defined as not sitting in front of my computer for anything other than e-mail checks). I work during vacations, I … Continue Reading

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freelance work/life balance

Why You Need a Freelance Medical Writer

(With apologies to David Letterman)

1. The account exec just brought in a new client–and a project due in two weeks.2. The in-house medical writer’s water broke three weeks early.3. You need a writer with experience in more than two therapeutic areas.4. You need to turn something around in four days–and two of those days are Saturday and Sunday.5.

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