NY State has one of the worst legal systems in the country (readMedia)

Thanks to readMedia for the piece on the Pacific Research Institute study which evaluated NY state's legal system. Not surprisingly, my own home state of New York was described by PRI as being one of the worst of the 50 US states.  The PRI study Executive Summary states:

"By standard measures, New York State has a failed tort liability system. Because of the enormous political influence of personal-injury lawyers in New York, the state now faces a perfect storm of high tort costs, high tort-litigation risks, clogged courthouses, and nearly no tort reforms to balance a lopsided civil justice system. New York State is consistently at the bottom of the barrel in various measures of state tort performance. It has the second-highest direct tort losses, the fourth-worst relative tort losses, the fourth-worst relative tort-litigation risks, the third-worst tort system overall, and the third-worst tort rules and reforms on the books. Its excessive costs and risks negatively impact individuals and businesses both in New York State and across the country. The climate of fear is forcing people and jobs from New York and particularly threatens the quality of health care."

Little Benefit Seen, So Far, in Electronic Patient Records (NY Times)

The NY Times has  summary of a study led by Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health. The study basically concludes that electronic patient records have done little to nothing to either improve information transfer or save money.

Is this surprising? Well, not to me. My practice has been at the forefront of instituting electronic patient records. All that I have discovered (after a number of years experience with electronic record keeping) is that I spend several hours each evening entering all the data into the electronic database. The vast majority of this information cannot be entered into the system by paraprofessionals or technicians. The net result is that my workday now begins roughly between 7 and 7:30 AM (depending on whether I have surgery scheduled) and ends at 9 or 10 PM. My experience seems to be no different that that encountered by my colleagues in other medical specialties. And although I am not a computer "geek", I am still comfortable with the software (which is more or less well-designed). But heaven help my fellow physicians who are not "computer literate". The experience is enough to force one into early retirement.

Electronic record keeping is not a panacea. But the medical software segment of the economy is certainly a growth industry.

Who do you trust?

There used to be a TV game show, Who do you trust? and that is still a key question in the minds of Americans, when it comes to health care reform. Earlier this year, the Gallup organization posed the question in an opinion poll:

Although the numbers may be slightly different today, than when the survey was taken, it does show who should be crafting the health care reform legislation. It's clear that the public believes that providers, who are in the front lines in health care, have a better understanding of the issues and solutions, than do politicians, drug companies and insurance executives. The full results of the Gallup Poll can be found here.

Is Health Care really a growth industry?

The most recent data (2007) regarding US Industrial sectors is from Fortune Magazine. Although you can sort the list in various ways, the two most interesting sort orders are by a) profit and b) 5 year (2002-2007) growth in profit. Here's the ranking of various health care-related sectors, first, by profit:

1. Pharmaceuticals  15.8% (3rd overall)
2. Medical Products & Equipment  15.2% (4th)
3. Insurance, Life and Health (stock) 10.6% (9th)
4. Health Care: Insurance and Managed Care  6.2% (28th)
5. Health Care: Medical Facilities 3.3% (40th)
   
6. Health Care: Pharmacy and Other Services  2.6% (43rd)
7. Wholesalers: Health Care 1.1% (47th)
   

Note, limiting Insurance company profits to 3%, as I have suggested, would save some serious cash. But the more interesting list is by growth of profits over a 5 year time frame:

1. Insurance, Life and Health (stock)  +43.3% (5th)
2. Health Care: Insurance and Managed Care +33.9% (9th)
3. Medical Products & Equipment  +17.2% (18th)
4. Wholesalers: Health Care  +12.6% (22nd)
5. Pharmaceuticals  +0.8% (34th)
6. Health Care: Medical Facilities  -0.6% (35th)

From 2002 to 2007, profits from insurance company stocks increased over 43% and the profits made by health insurance companies increased almost 34%. Even though the 5 year growth in pharmaceutical company profits was modest, the actual profit level in 2007 was quite high. In any case, every dollar spent on health care is a dollar that can't be spent on consumer electronics, real estate, food and other sectors.

Conclusion? Health care in the US is a growth industry. Although some pundits will point to the recent downturn in health care profit margins, this drop is primarily dues to the weak global economy.

Urban hospitals could lose out in health care reform effort (NY Times)

A provision in the proposed health care reform bill would likely result in urban hospitals having their Medicare reimbursement rates cut. As a result, rural hospitals could benefit. Read more about  this issue here in the NY Times.