Worried about a government takeover of health care? You should be, but it isn’t the bureaucrats and politicians in Washington that you should be most concerned about.  Instead, it is the growing propensity of state legislators to dictate to physicians what they can and can’t say to their patients, what tests they must provide, and what advice they must give to them—the patient’s wishes, the medical evidence, and the physician’s clinical ...

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I told you so. Three months ago, I blogged about the Medicare (CMS) “never events” list, diagnoses that Medicare will no longer reimburse hospitals for. In Medicare’s eyes, these diagnoses are totally preventable, should never happen and will not be reimbursed. I pointed out that several were in fact not 100% preventable despite any institution’s best efforts, and the rates of many of these occurrences would not fall to zero. Now ...

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Wherever health care reformation and transformation is discussed, sooner or later the imperative of patient engagement is sure to materialize. Patients, it seems, are no longer content to be passive spectators while care is administered to them, and instead are demanding to be active participants in their own health care decisions. Gone are the paternalistic days of doctor knows best, replaced by informed and educated patients on an equal footing ...

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New York Times columnist Nicholas D. Kristof wrote a heartfelt piece "A Possibly Fatal Mistake" about his college roommate Scott Androes, who recently was diagnosed with metastatic prostate cancer. His story illustrates the problem with the current health care system.  It isn't about the lack of health insurance. It's about the obstacles all patients face in making the right decisions and the right treatment. Something that will increasingly be ...

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At our first meeting years ago, Tom Emerick, Walmart's then VP of Global Benefits, told me, "No industry can grow continuously at a multiple of general inflation. It will eventually become so expensive that purchasers will simply abandon it." He said it casually, as though it was obvious and indisputable. Health care is playing out this way. From 1999 to 2011, health care premium inflation grew steadily at 4 times the general ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. Every physician caring for Medicare patients knows that the current payment system isn’t working. Most seniors know it too. For much of the last decade, patients and physicians have joined together to tell their elected officials that the system is broken. The response from members of Congress has been to ...

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It sounds like heresy, but recent evidence challenges the long-held belief that the annual physical is beneficial for healthy adults. Researchers at the Nordic Cochrane Center in Copenhagen wrote that although a regular check-up with multiple screening tests might seem to offer the advantage of catching problems like heart disease and cancer early, their review of studies involving some 180,000 adults actually found no benefit. People who had ...

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Seniors need more Medicare choices, or do they? The answer depends, of course, on who’s doing the asking. Republicans and others advocating a voucher plan for Medicare invoke the choice argument as the rationale for transforming Medicare from social insurance provided by the government to privatized arrangements between individuals and the marketplace. Under a voucher system, the government would give seniors and people who are disabled a fixed amount of money ...

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I grew up in Rochester, NY.  Statistically, this means that I probably had a family member who worked at Eastman Kodak, as the company employed over 62,000 people in Rochester at its peak.  I did, in fact, have two: my father and my brother-in-law.  My brother and I both worked there during two fun and profitable summers of our college years in the delightful “roll coating” division.  It actually paid ...

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In the ancient and oft-told story of the blind men and the elephant, several sightless men seek to learn the nature of the great beast, none of them familiar with it prior to the encounter.  One, who feels the trunk, describes the elephant as powerful and snake-like.  Another who examines one of the mighty legs, opines that the animal is like a great tree.  Still another, having first touched a ...

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