Magic bullets come and go in the world of health policy, but the accountable care organization (ACO) is likely to be a durable reform. Except for group practices like Geisinger, Harvard Vanguard, Kaiser Permanente, systems like the VA, and local communities in which independent practitioners have established cooperative collaborations, health care has been grotesquely uncoordinated in the U.S. ACOs speak to that structural lesion. Title III of the Patient Protection and ...

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At an Orlando meeting recently, Florida Medical Association (FMA) members fumed that their parent, the AMA, isn’t adequately representing Florida’s private practice doctors. After talk of secession and forming a new group, they settled for writing a stern letter urging the AMA to straighten up. The FMA dustup began with a resolution written by Douglas Stevens MD, a Fort Myers cosmetic surgeon – you can’t make this stuff up – complaining ...

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One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong. Effective, in that it has been widely reported that seniors are more likely to express negative views of the ACA than other age groups. (Although the Kaiser Family Foundation's Drew Altman, citing the group's most recent tracking polls, writes that seniors' opposition to health ...

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Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill. Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of ...

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by Joanna Fief About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration.  It wasn’t pretty, and I was desperate for something – anything – to ease my pain and stop my vomiting. Gratefully, within minutes of receiving an IV with medications for pain and nausea, my symptoms subsided.  After a couple of blood tests ...

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by William Bayer Buying health insurance across state lines and health savings accounts are good - but they do not resolve the core issue. The core issue is that the employer is making the main choice for the employees, leaving them essentially with a choice between small, medium or large. That may satisfy the most important needs, but it does not encourage competition because the ...

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The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?” Hopes for a true rebirth of health care turned into the Year of Screaming Inanely, then took that long slide from what we might hope for to what we might settle for. Yet suddenly it seems like ...

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I live in New York. Last week my daughter in Chicago called to say that a five dollar charge had been refused at a local coffee shop. My credit card company had identified an unusual pattern of purchases, and had put a hold on the card. No similar process exists for the Medicare system, where cost savings could be realized by systems that identify unusual patterns of charges and outright abuse ...

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A revealing article in Bloomberg recently described the latest way in which elderly patients are getting screwed by the system. Medicare reviews all admissions and if the patients don’t meet indications for admission, the hospital doesn’t get paid by Medicare. Medicare has also recently implemented a mercenary system called Recovery Audit Contractors (or RAC for short) in which third parties audit hospital charts to see whether Medicare “overpaid” for a patient’s ...

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Like it or not, “garbage in, garbage out” is the rule rather than the exception for the vast majority of bureaucratically dictated “quality control” programs that we’re ever likely to launch.  There are three primary reasons for this. First and foremost, there’s Goodhart’s Law:

“Originally, an economic theory stating that if a particular definition of the money supply were to be used as the basis for monetary policy, the stability ...

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