Danielle and Robb Deaver are living proof of the awful reality of Nebraska’s ill-conceived “fetal pain” law. The law, which took effect last October and is the only one of its kind in America, prohibits abortions in the state after the 20th week of pregnancy. It is based on the discredited notion that a fetus may feel pain at that stage of development. Physicians who break the law face ...

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Health care leaders are busy talking to attorneys and consultants about how to set up Accountable Care Organizations (ACOs). A recent Advisory Board survey found that 73 per cent of hospital finance executives said that creating such an organization was a top priority for their health system.

Last year my most popular keynote topic was patient-centered medical home creation; this year everyone wants a presentation on ACOs. However not ...

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There is no "right" answer to the healthcare reform issue. There are facts, opinions, myths, politics and reality, all in no particular order of magnitude. Unfortunately, thus far and likely in the future, the reform will be political and thus costly and painful and will not address the core issues involved in fixing the inherent systemic problems. There have been many things written with regard to this topic and I ...

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Republican budget guru Paul Ryan had a plan to end Medicare as we know it to be replaced with a series of less-generous vouchers. The House of Representatives has voted to implement this plan. The political side of this has been written about a lot, and I am not going to rehash what has been better covered elsewhere. I do want to address what seems to be a persistent ...

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The revelations about the huge golden parachute given the outgoing CEO of ostensibly non-profit Massachusetts Blue Cross Blue Shield induced some public discussion about the disconnect between executive compensation and the mission of health care organizations. First, new proxy statements revealed the compensation of executives of two large for-profit health care insurers/managed care companies. Cigna As reported by the AP, via ABC News, the CEO got a big raise:

Cigna Corp. ...

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Sometimes you just don't want to be right.  Over the past 5 years, I have seen an alarming pattern arise in my profession.  Many of my patients have heard me talk about Soylent Green, an old Charleton Heston movie.  The premise of the movie seems absurd.  Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death? David ...

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Medical malpractice reform is one of the few health care policy issues where there is a real possibility of agreement between the White House and Congress. A common refrain is that the fear of lawsuits leads physicians to practice defensive medicine, ordering too many tests just to cover their behinds in case of a lawsuit. It drives up costs without creating benefits. There’s some truth to this argument, ...

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Washington has been touting Accountable Care Organizations (ACOs) as the end-all solution to health care’s woes. Designed to reduce Medicare spending and increase care coordination across a large number of patients, members of an ACO – hospitals, primary care physicians, specialists – would be paid if and when their patient population received outstanding quality of care. However, as the Centers for Medicare and Medicaid Services (CMS) finalize their ACO ...

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At UC Berkeley in the 70s, the secretary in the Department of Psychology pasted a bumper sticker on her desk positing the question: "… yes, but are we asking the right questions?" For some reason, this subtle invitation remains with me today, echoing amidst the ACO fervor of "… better care at lower costs."

… the good news is we’re making great time, the bad news is we don’t know where ...

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AMA: Health insurers denial rates are down, but error rates are upA guest column by the American Medical Association, exclusive to KevinMD.com. Billions of dollars in administrative waste would be eliminated each year if health insurers sent a timely, accurate and specific response to each physician claim, and while this year’s AMA National Health Insurer Report Card shows promising improvements in denial rates, more work needs to be done. The AMA’s fourth annual ...

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