shutterstock_39558046 The weakest aspect to Obamacare is in its cost control strategies, or lack thereof.  The predicted savings from converting to electronic medical records (EMR) have failed to materialize.  And the Rube Goldberg-esque plan to save money by penalizing hospitals and doctors for having poor HCAHPS scores has reaped its own set of unforeseen complications. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is the Press-Ganey ...

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dreamliner If you think that medical errors are a thing of the past, you are mistaken. It has been 14 years since the Institute of Medicine's report "To Err Is Human" shattered the myth that most, if not all, physicians are all-knowing practitioners with flawless skills and infallible judgment. The story of what happened in the report's wake was predictable:

When the Lexington, Kentucky VA Medical Center pioneered the “disclosure and offer” risk management strategy in 1987, it sought to make patients whole without the need to litigate.  As part of this process, before meeting with injured patients, VA risk managers contacted the patient and recommended they seek their own legal counsel who they were welcome to bring to the meeting.  The VA viewed this as a necessary step for ...

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shutterstock_86514196 It can be difficult to keep up with the jargon, countless proposals and complicated policies that surround the debate over Medicare reform.  Whether you are discussing premium support, changing the eligibility age or Medicare for All, there is one relatively simple concept that patients should make a point to pay attention to – one that directly impacts them – and is the ...

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shutterstock_108241016 Over the past decade, there has been yet another debate about whether pay-for-performance, the notion that the amount you get paid is tied to some measure of how you perform, “works” or not.  It’s a silly debate, with proponents pointing to the logic that “you get what you pay for” and critics arguing that the evidence is not very encouraging.  Both sides ...

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California doesn’t have enough doctors to provide healthcare to newly insured patients. California state senator Ed Hernandez asks, "What good is it if they [state citizens] are going to have a health insurance card but no access to doctors?" Wait. Health care insurance doesn’t mean that patients will have access to health care? Where have I heard that being said for more than 3 years? The government is going to ...

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From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and deductibles that people had to pay, and then they observed their use of the health care system. As you might expect, those who had to pay more out of their ...

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shutterstock_30561922 Over the past several months, the state of Oregon has been pursuing an aggressive approach to solving the healthcare crisis that many states are dealing with. A couple of years ago Oregon was facing a $2 billion deficit in their Medicaid program, with few solutions to repair the situation. The governor was reluctant to take the obvious step of cutting doctors' pay for ...

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Should marijuana be legal, for either medical or recreational use? I think the best initial answer to this is: It's a crummy question! We are good at those. It's a crummy question, because it calls for answers based on unsubstantiated opinion. Answering it does not invoke or even encourage any relevant evidence, or precedent. So what would a better question be? How about: On what basis should any particular substance be ...

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Cleveland and northeast Ohio are not hospitable to private practice medicine.  I should know.  I’m one of them.  Private practice is fading as health care reform suffocates it by design.  When this occurs, the public will have lost physicians who, in my view, have practiced patient advocacy and service at a higher level than our employed counterparts. Keep in mind that the first half of my professional career was spent as ...

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