When Prescription Information Looks Like A Rubiks Cube...

A lot of what I've talked about on this blog so far centers around small improvements that can be made to the U.S. healthcare system. Small improvements like checklists for surgeons and less administrative costs could lower spending more than you could imagine. I want to bring up another small improvement: focusing on health literacy and making sure patients understand the medications they are putting into their body.

Each year, millions are spent treating patients in the ER who misunderstand their medication. Who is to blame? The Wall Street Journal Health Blog posted recently about the FDA stepping in on this issue. They propose making the information that comes with medication more efficient. Instead of medication coming with multiple pages of information and additional promotional material from drug companies, it would come with a simple one- sided sheet with only the most important information. The bottom of the sheet would direct patients to a website for more information.

Some have harshly criticized this idea. Saying that 1 page is not enough to cover all important medical instructions. Others have said 1 page is enough to cover a bullet-ed list of essential medication instructions.

My opinion is two part:

1) The amount of information that comes with medications now is out of control. I recently picked up a prescription and had no idea where to start. Pages of information, promotional material, stickers. 1 page is definitely enough. Show me the dosing information, how to take the medication, and a number I can call if I don't understand something.

2) It doesn't end with simplifying the information. If you want to reduce medication misunderstandings, communication between patients, doctors and pharmacists MUST be stressed more. Patients should feel comfortable enough to ask when they don't understand. Doctors and Pharmacists should be willing and able to communicate with their patients.

Doing so will save a ton of time and money. I'm curious if anyone else has had a similar experience? Are you often confused by a medication you receive? If so, how can this be improved? Can essential information fit on one page?

Fixing Medicare

When ideas of healthcare reform began the question being asked was: Should we fix Medicare? With debates about the federal deficit swirling, the question has now become: How should we fix Medicare? The shift in positions and increase in urgency has come from the acknowledgement that Medicare is broken, and its costing the U.S. a ton of money.

It's easy to say we should fix Medicare; Actually figuring out how is a tad more difficult. As outlined in this New York Times article, President Obama's deficit reduction committee has considered a number of options. These options include (but are not limited to) :

1) Increasing the eligibility age for Medicare from 65 to 67
2) Requiring beneficiaries to pay higher premiums
3) Charging Co-payments for home health services
4) Paying doctors in "lump" amounts for entire treatments as opposed to paying for each step (tests, procedures) individually

The list goes on. For the complete range of options, check out the article. It's hard to say which option is best because all have pros and cons. For example, raising the eligibility age would save the government money for those two years, but those 65 and 66 year old patients might now be eligible for Medicaid. This just displaces the cost from Medicare to Medicaid.

Whichever solution is chosen, it will have to be supplemented with one thing: more efficient care. Changing the structure of Medicare will do nothing if health care is still administered in an inefficient way. This means, reducing medical errors, hospital infections, and administrative costs. More efficient care means cheaper care in the long run.

Fixing Medicare will probably require a pretty creative solution. What do you think is the best way to tackle this problem? Do you agree that any change needs to be supplemented with better health care? Will raising premiums do anything?