USA Healthcare Spending Continues to Outstrip All Developed Economies

Despite spending almost double most developed economies per person (as a percentage of GDP), America’s healthcare system continues to operate in shambles. Spending continues to grow, reaching a staggering $3.5 trillion in 2017. This amidst tens of millions of Americans remaining uninsured, and many more millions unable to afford needed care. 

The American health system is a demonstrable demonstration of how a “free-market” health care program operates. It’s far more expensive for less coverage. Yet as a whole, America can’t seem to get a grip on a way forward. Many suffering from the ideology of anti-“socialism”, decrying any form of single payer system that would provide health coverage to all citizens. The same people are fine with trillions of dollars to the military, but struggle with “socialist” healthcare. 

The trouble with this approach is quite simple, Americans pay the most, yet the receive staggeringly less health care than any other developed nation on the face of the planet.

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Who has the least health coverage – USA by State

We know that in all of the developed countries in the world, America pays the most money per capita yet receives worst coverage as a whole. Those who have healthcare coverage tend to see the doctor too many times, and those who do not have coverage never see the doctor. That has pushed America down in terms of standard of living.

Here’s an interesting grout that depicts the level of healthcare coverage by state.

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Top 5 Joint Commission Non Compliance Issues

The percentage figures are for the level of non compliance. Honestly, if we included some level of IT systems there would be further non compliance. Our sense is that is another place of weakness in many organizations.

1. The hospital provides and maintains systems for extinguishing fires — 86 percent

2. The hospital manages risks associated with its utility systems — 73 percent

3. The hospital provides and maintains building features to protect individuals from the hazards of fire and smoke — 72 percent

4. The hospital reduces the risk of infections associated with medical equipment, devices and supplies — 72 percent

5. The hospital established and maintains a safe, functional environment — 70 percent

For the complete list visit JC.

Fascinating Data Life Expectancy and Health Expenditure of USA v Developed Countries

And this stunning graph that should raise a few eyebrows. (What are Americans spending their tax revenues on?)

Firstly, all countries in this graph have followed an upward trajectory (life expectancy increased as health expenditure increased), but the U.S. stands out as an exception following a much flatter trajectory; gains in life expectancy from additional health spending in the U.S. were much smaller than in the other high-income countries, particularly since the mid-1980s. And secondly, the gains for all countries (except for the U.S.) were not diminishing, as in the previous graph. This suggests that there are many other factors affecting life expectancy, that are not determined by healthcare spending. Indeed, as we have pointed out before, healthcare is just one of many inputs to produce health.

Source: Esteban Ortiz-Ospina and Max Roser, Financing Healthcare, 2017. Published online at

Additional insight on this data and more

And some another article on negative side of upcoming Republican healthcare plan.

Joint Commission Text Messaging Orders Saga Ends

The December 2016 issue of Perspectives clarified the position on text messaging orders saying, “although its prior data privacy and security concerns had been addressed, concerns remained about transmitting text orders even when a secure text messaging system is used”, and therefore texting orders is not permitted. Specifically, TJC, with CMS’s input, found that:

Joint Commission requires organizations to have a written policy addressing the privacy of health information, and this requirement applies to the privacy of health information transmitted through text messaging.’

Part of the document.

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JC New National Patient Safety Goals

The Joint Commission anticipates the new and revised National Patient Safety Goals will improve patient safety and quality of care by reducing morbidity and mortality, as well as health care costs and length of stays associated with CAUTIs. The R3 Report is available here.

It‘s Not Just Old Age – Depression in the Elderly

The following scenario is played out with increasing regularity in the nation: An elderly person, let’s call her Edith is living alone because she has lost her husband. Due to one or more chronic conditions she has decreased independence. Maybe she can’t drive any more and needs to use a walker or wheelchair. Her condition requires a regime of prescription medications. The chronic condition causes pain. If Edith has family that can visit her they are likely very busy or may not live close enough to visit regularly. Consequently she spends a lot of time alone, and may possibly feel a loss of significance. In this scenario it would not be easy to maintain a positive outlook of the future and life itself.

Depression in the elderly is often unrecognized and undiagnosed. Yet there is a growing awareness that many life factors that the elderly must cope with in fact contribute to the likelihood of depression. Also age affects the structure of the brain. Mental and physical health affect each other. Many elderly suffer from one or more chronic conditions which can cause or worsen depression. Untreated depression can cause chronic conditions and the condition itself or it’s medical treatment can cause depression. Depression also affects treatment compliance or self management of physical conditions.

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Texting Patient Orders Still up in the air with Joint Commission

The new policy unraveled in May of this year put out by the Joint Commission would have opened the door for texting to be used as an effective communication tool to exchange patient orders.

Initially, the policy what is welcome news because it would’ve made sharing patient info easier. Summarized, it stated, along with some caution,

Eeffective immediately, The Joint Commission has revised its position on the transmission of orders for care, treatment, and services via text messaging for all accreditation programs. Licensed independent practitioners or other practitioners in accordance with professional standards of practice, law and regulation, and policies and procedures may text orders as long as a secure text messaging platform is used and the required components of an order are included.

Now it seems that policy change is on hold.

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The Joint Commission Center for Transforming Healthcare release Oro™ 2.0

The Joint Commission Center for Transforming Healthcare has released Oro™ 2.0, an online assessment and resource library designed to assist hospital leaders with determining their organization’s level of maturity in multiple components of high reliability and striving for the goal of zero preventable harm.

Oro 2.0 is a Web-based assessment for hospital leadership that is accessible on the Center for Transforming Healthcare website. The assessment process guides the leadership team through a series of questions which allows for discussion and alignment on key strategic performance issues. Once an assessment is completed, a report is generated that identifies strengths and opportunities for improvement and directs the user to resources specific to their organization’s high-reliability maturity level. The content included in the Oro 2.0 Resource Libraryfocuses on the areas of leadership commitment, safety culture and performance improvement.

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