Medicaid is a federal program for the very poor implemented by grants to states, which do the administration.  Medicaid typically pays doctors about 60 percent of what Medicare pays.  In Florida, a typical primary care visit might pay the doctor $32.  In Alabama, doctors who agree to be the primary care physicians of record for Medicaid patients get a whopping $2.60 per beneficiary per month, a fee with which the ...

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I recently spent time at the New York eHealth Collaborative's Digital Health conference. The meeting was full of interesting seminars, informational sessions, presentations on innovative technology looming on the horizon, and talk about the future digital face of health care. The hallways outside the conference rooms were full of administrators, legislators, consultants, and representatives of companies building and designing new resources to help transform the health care system as they see it. Over and ...

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You couldn't invent a worse health care system than the nightmare we have created in the U.S. Our medical costs are almost twice as high per person as they are in most other similar countries but produce only mediocre outcomes. There is massive overtreatment of people who don't need it, while many who desperately do have no coverage at all. The payment incentives for doctors are perversely misaligned to produce the wrong ...

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Whatever happened to “first, do no harm?” One of the findings included in a Senate investigative committee’s report on the U.S. government’s post-9/11 torture program was that it was designed by two psychologists.  They were paid “$80 million to develop torture tactics that were used against suspected terrorists in the wake of the September 11 attacks on the Pentagon and the World Trade Center” -- including “waterboarding and mock burial on some of ...

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Last year, hospitals and health systems underwent 98 consolidations, a 51 percent increase from 2010.  Many of these mergers and acquisitions arose in response to declining government reimbursement and the Affordable Care Act.  Smaller hospitals are having increasing difficulties maintaining a margin and many face high debt burdens, bankruptcy or even closure. But is consolidation the clear-cut answer? Here are 4 reasons bigger actually may not be better for all hospitals: 1. Disparate ...

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In the giddy days after the passage of ACA, I was chatting with a PhD student in health economics. He was in love with the ACA. He kept repeating that it would reduce costs, increase quality and increase access. Nothing original. You know the sort of stuff you heard at keynotes of medical meetings; "Healthcare post-Obamacare" or "Radiology in the new era." Talks warning us that we were exiting the ...

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shutterstock_157424303 I think I will become a neurosurgeon. Tomorrow. It shouldn’t be too hard, right? I’m a breast cancer surgeon, and that is kind of like being a neurosurgeon, isn’t it? I wear scrubs and know how to tie knots really well. OK, maybe I don’t know much about the brain, and the last time I was on a neurosurgical team was during ...

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An excerpt  from The Myths of Modern Medicine: The Alarming Truth about American Health Care (Rowman & Littlefield). Myth 1: "The United States boasts the best health care in the world." Betsy Lehman trusted her life to the American health care system. An award-winning journalist, Lehman was a rising star at the ...

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One of the most pernicious lies about Obamacare is that it establishes “death panels” to ration needed care, especially care of seniors.  Although thoroughly discredited by independent fact checking sites, the death panel falsehood remains a staple of attacks on the Affordable Care Act. But it isn’t just that Obamacare doesn’t have death panels or anything remotely like them (the law actually prohibits denying benefits based on cost); we now have ...

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shutterstock_109983080 There is controversy about whether or not there will be a doctor shortage in the near future. I wonder why there is so much speculation. The Association of American Medical Colleges estimates that we will be short 90,000 physicians by 2020 and 130,000 physicians by 2025. If things stay as they are now, of course there will be a shortage. The ...

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