Cost stops the proposal dead in its tracks:

Without a cost affixed to it, the so-called single-payer plan was approved 12-7 by the legislature's insurance committee last month. It is awaiting action by the House of Representatives and the Senate.

The legislature's nonpartisan Office of Fiscal Analysis estimated the costs at $11.8 billion to $17.7 billion, depending on variables. Gov. M. Jodi Rell has proposed a state budget of ...


A piece detailing the historical efforts resisting reform. Although current polls allegedly seem to support it, "the other side has not yet begun to fight." (via a reader tip)

Treatments for rare diseases are not profit generators for Big Pharma, so research is funded in part by patients:

Last May, Lee Hollett received an unsettling letter.

He had been taking an experimental drug as part of a clinical trial for patients with a fatal degenerative disease called amyotrophic lateral sclerosis, or ALS. But the trial's supply of the drug was running low, the letter warned, and there ...


The threat of physician fines stemming from the UnitedHealth's LabCorp decision has hit the WSJ:

The strategy threatens to backfire. A backlash brewing among physicians and regulators is creating a public-relations mess as the company continues to struggle to recover from a stock-options backdating scandal. It also comes on top of a series of rancorous contract negotiations with doctors and hospitals in California, Colorado and other parts of the ...


Applying never ends

Maria details the application journey from high school to fellowship.

Single payer myths

A pseudo single payer system has already been tried in the US - it was called HMOs, and look how that debacle turned out:

The United States has tried something roughly equivalent to the private insurance version of a single-payer system. Health Maintenance Organizations (HMOs) were designed to keep health care costs down by restricting certain types of treatment. However, it quickly became apparent that HMOs were not the panacea ...


The WSJ had an op-ed last week on the incentives driving American medicine, provoking some thoughtful discussion.

Dr. Rob:
While I applaud the overall approach to the problem, I think there is an important component missing. It seems the main reason Mr. Goodman gives for innovation is to become more efficient (i.e. to save money). The primary focus of any reform, however, should be in that of ...


Ed Silverman and Peter Rost are keeping the pressure on this exploding affair.

A neurologist comments:

. . . it probably wouldn't be good. "We can anticipate that landing on Mars, after 6 months in microgravity, will incur substantial muscle damage," the authors of the report write. "It is impossible to predict how much motor dysfunction will occur after the 6-month return voyage to Earth and reintroduction to 1g except to say it has the potential to be enormously disabling."

More Canadian physicians are opting to work in the US:

As both sides of the border contend with nationwide doctor shortages, the flow of new doctors south of the border each year is equivalent to having two Canadian medical schools existing solely to produce medical graduates for the U.S.
(via White Coat Notes)

What it means, what it symbolizes, and why some attendings still prefer short white coats.

A recent study found that poor communication by surgeons led to a significant proportion of malpractice claims.

It's looking mighty unlikely they're going get near blogs after the Zubillaga scandal.

Not always, according to this new study. (via The WSJ Health Blog)

Of course, plaintiff lawyers sees this study as part of a conspiracy by insurance lawyers defending medical malpractice defendants.

Following in Paul Levy's footsteps, Harvard Pilgrim's CEO Charlie Baker has started his own blog, entitled Let's Talk Health Care.

Breast MRIs haven't been studied in the general population. So, what constitutes a woman at a high-risk for breast cancer, thus warranting the screening breast MRI?

"The only way to get into that [MRI screening] bracket is to have a significant family history of breast cancer," Russell says.

That means more than just having a relative with breast cancer. A woman would be considered at high risk ...


What will be the next discredited medical practice? Financial incentives is one reason why procedures are favored. However, don't forget about patient demand, the public who won't accept the evidence-based studies, and the media that perpetuates the myth that more testing is better medicine. (via OnThePharm)

Robert Centor thinks they've misinterpreted the study, showing again how economists shouldn't be an authority ...


Couples surgery is becoming the in thing for cosmetic procedures.

Dr. Gott perpetuates a common myth that nuts are to be avoided in patients with diverticulitis. There are no studies supporting this old wives' tale, yet many physicians continue to recommend this anyways.

With P4P on the horizon, over 80% of physicians feel this way:

"I have 10 to 15 patients whom I would have to fire," one respondent said. "The poor, unmotivated, obese and noncompliant would all have to find new physicians."

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