Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled "ObamaCare Is Already Damaging Health Care." While I'm not sure I'm ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, with ...

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At the heart of medicine is the relationship between a doctor and a patient. The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files -- I can vouch that knowing ...

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One aspect of religious dogma that has entered the medical world is that fee-for-service pricing of medical services is bad and should be replaced by a capitated, or global, arrangement that establishes an annual budget for care for different risk groups of patients. Like other religious beliefs, this is often offered without rigorous analytic support. Some insurance companies are particularly pleased ...

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The U.S. Department of Health and Human Services (HHS) advocates the "creative destruction" of the traditional system of U.S.physicians practicing solo or in small groups operating as small businesses. Republicans and Democrats approve of ACOs in concept. The Affordable Care Act of 2010 calls for shifting from fragmented care provided ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. A wise physician once said, "Health is not valued til sickness comes." The same can certainly be said about health insurance. This concept is at the heart of our current debate about individual responsibility for health insurance coverage. While we hope never to need surgery or chemotherapy or to have an unexpected accident or illness, it’s certain that many of ...

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by William Schumacher, MD Am I the only one excited about the future of healthcare? With all the prevailing pessimism about America’s "dysfunctional" health" system, optimists (and I am one) sometimes feel stranded on our own lonely islands. It’s not that we don’t know what the challenges are.  I have been practicing emergency medicine for over 30 years, and there ...

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The patient entered her private solo physician’s office and handed her medical ID card to the doctor.  He put the card in his desktop reader and reviewed her medical history.   All of her visits, vaccinations, medications, tests, x-rays etc from all providers were inscribed on the data chip in the card.  The card also included insurance and billing information.  At the end of the visit, he updated her information on ...

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On March 31, 2011 CMS issued its proposed rules for Accountable Care Organizations (over 400 pages). There is now a 60-day comment period.  Shortly thereafter, the final rules will be issued.  I am sure there will be changes in the proposed rules as there were changes in the “meaningful use” rules for electronic health records (EHR’s).  Yet, much of the intent of ...

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As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes "providers" to consolidate along the lines of major hospital networks this injustice will only worsen. A decade-or-so ago when I started private practice it was obvious that referrals came to me because of my association with an established ...

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One year after passage of the Affordable Care Act, the Department of Health and Human Services (HHS) has unveiled two programs that will most certainly be transformative for U.S. healthcare, affecting both quality and safety. With the announcement of the first-ever National Quality Strategy in March, HHS signaled a strong commitment to improving the quality of healthcare. In essence, ...

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