With the roll out of the Affordable Care Act and perhaps more significantly the approach of the 2012 elections, public discussions of healthcare reform has been drowning in an alphabet soup of ACOs (not to be confused with the above ACA), CMS, SCHIP, and RUVs, just to name a few. The challenge is twofold. Most of these plans/systems/agencies deal with how to better pay for a seriously flawed system.  ...

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A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP ACP: ACOs – On to the final ruleRecently, I commented on cost saving, quality, and care coordination requirements in the proposed rule that physician practices will likely need to meet to be eligible for additional Medicare payments. The public comment period on the proposed rule for the ...

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If we're serious about cutting Federal health care expenditures over the long term, here are two changes that will do just that. 1. Requiring HHS to negotiate with pharma for Part D drug costs would reduce annual expenditures by over $20 billion. As I've noted repeatedly(but unfortunately few in the mass media have), Part D's perhaps the biggest deficit problem we have - the ultimate unfunded liability is now over $20 trillion. ...

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Recently, the Board of the American Academy of Family Physicians (AAFP) announced that, for now, it would continue participating in the Relative Value Scale Update Committee (RUC), the secretive American Medical Association committee that, through a longstanding relationship with the Centers for Medicare and Medicaid Services (CMS), has heavily influenced physician reimbursement. At nearly the same time, Medicare announced that it will go broke in 2024, a decade sooner ...

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It’s getting scary. We are facing, before the end of this decade, a bifurcated future. The way things are going now—with the economy wheezing, doctors bailing, chronic disease rising fast, boomers sliding out of the Viagra years into the Depends years, reimbursements getting squeezed ever tighter, Medicaid sputtering on fumes, and 30 million or more new people soon swarming our doors with insurance cards—if we don’t pull a rabbit out ...

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by Rishi Manchanda, MD, MPH Mr. M walked into the community clinic where I work with a portable oxygen tank in tow. At 62, he's gaunt and winded, battling a disease that is progressively scarring his lungs. Every breath is a fight. Instead of the clear flow of air, I hear the sound of velcro ripping when I place my stethoscope on his chest. In medicine, his ...

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The Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain. Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an estimated 400 billion in taxpayer money to subsidize the purchase of these plans. Is this the best way to spend our money? Many of us in the health field remain skeptical ...

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by Terry O’Keefe The State of Vermont just passed the nation’s first single-payer universal healthcare system. While there are still some bureaucratic hurdles to cross, Vermont will soon install the kind of system that healthcare progressives have been drooling about for decades. And whether you think that puts Vermont on the high road to healthcare nirvana, or the low road to socialized medicine, I think we ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. There is said to be an old Chinese curse: May you live in interesting times. As I wrap up my year traveling the country as President of the AMA, I can without a doubt say physicians are living – and practicing medicine – in interesting times. This can be a challenge, but does not need to be a curse. There are ...

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Whether specialists make too much money depends on whom you ask. Policy experts If you ask policy experts, most of whom are progressives, they will say  "yes, of course, specialists make too much money." Too many specialists making too much money spoil the national health care broth. Just look at any other country, especially countries with government-run systems. Specialists there make one-half of what our specialists bring home. Look at their total ...

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