A standing ovation greeted every paper delivered at one of the sessions I attended at the American Public Health Association annual meeting in San Francisco. I thought the first paper or two were good, but the standing ovations seemed generous to a fault. Then it dawned on me that the session was organised by the […]
Category: US healthcare
Gabriel Scally: Obama cares, and so does public health in the USA
Having the opening day of a major health conference on a Sunday seems slightly unusual to a British or Irish conference goer but thousands gathered in the gorgeous autumn sunshine of California to meet and debate on public health at a crucial time of health and healthcare in the US. The Annual Meeting of the […]
Tracey Koehlmoos: Training the next generation of NCD researchers in developing countries
Who will be the leaders working on the front lines in the battle against the rising tide of non communicable diseases in developing countries? Who will prepare them to take on this task? More practically, how will we pay for this and how will there be enough strength in numbers to make a difference? If […]
Andrew Brunskill on Obamacare – can we keep politics out of this picture?
At a recent meeting in Washington State an attender denounced the evils of The Affordable Care Act (ACA), or as it has become known “Obamacare.” He argued that requiring compulsory health insurance was a major restriction of personal liberty. When I asked what should happen to someone who becomes ill but does not have any […]
Andrew Brunskill: The strike zone—nothing to do with pensions in the USA
Doctors don’t strike about employee pensions in the USA. This is because many of them are not employees and few have defined pensions from the employers. Most doctors are in defined contribution schemes. Defined contribution means that the employer contributes to an investment fund (which will include some combination of bonds or equities with additional […]
Vijaya Nath: The secret of Kaiser Permanente’s success
Much has been written about the integrated healthcare system that the Kaiser Permanente health group makes possible in the eight states and nine regions which it serves in America. But what did the participants who ventured to Kaiser in our recent study tour learn from the experience? And what is the value of taking NHS […]
Muir Gray: How doctors working in systems could rescue healthcare
“We have nothing as bad as America’s worst, and nothing as good as America’s best,” wise words said to me by someone many years ago, and this principle has stood the test of time. There are certainly many dreadful things in American healthcare, but there are also wonderful services and excellent innovation with a rigorous […]
Martin McShane: Integrated reflections concluded
Here is my third and final blog on the USA trip: After Seattle’s integrated care organisations, we visited CalPERS. They fund $6.7bn worth of healthcare for 1.3 million people (roughly twice what we have per person in Lincolnshire). They see themselves as “active” purchasers: managing the market to reduce costs. About two thirds of their members […]
Martin McShane: Integrated reflections continued
Following our visit to Kaiser Permanente, we travelled north to Seattle and visited the Virginia Mason hospital and Group Health. Linked but distinct, the relationship between the two provided a contrast to Kaiser Permanente – though, as organisations seeking integrated care, there were common themes. We spent a day at Group Health and yet again […]
Martin McShane: Integrated reflections
Sir William Osler advocated the concept of a “quinquennial brain dusting“: which was my justification for taking a week out to visit some integrated care organisations on the West Coast of the USA, with a group from the NHS. I know we feel challenged in the UK, but the scale and nature of the challenge […]