In a little piece of legislation known as the Affordable Care Act, preventive services are mandated to be covered with no out-of-pocket expense to consumers. According to the Healthcare.gov website, approved insurance plans must cover a “list of preventive services for children without charging a copayment or coinsurance.” Number 18 on that preventive care list is childhood immunizations for children from birth to age 18, acknowledging regional variation in the standard ...

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I hope you read this letter. I doubt you will. I know you’re busy rebuilding Washington, reshaping the international order and doing a lot of other weighty stuff.  Full disclosure, I voted for you.  Not because you promised to repeal the Affordable Care Act, or because you tweeted at me about it, but because our health care system is hopelessly broken and requires an overhaul that does not simply convert ...

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Nonprofit hospitals have higher profit margins than most for-profit hospitals after accounting for their tax obligations. 3900 (62 percent) of U.S. Hospitals are nonprofit and therefore tax-exempt — they pay no property tax, no federal or state income tax and no sales tax. An article published in Health Affairs found seven of the nation’s 10 most profitable hospitals were of the nonprofit variety, each earning ...

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The Affordable Care Act Medicaid expansion resulted in unanticipated negative consequences for many patients and physicians in rural, underserved or medically isolated communities across America. Consolidation of health care entities was financially incentivized by the ACA, and slowly my beloved corner of the Pacific Northwest is becoming a medical wasteland. In a beautiful community on the Olympic Peninsula, just north of where I live and practice, it happened again; another private ...

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Sean MacStiofain said, “most revolutions are caused … by the stupidity and brutality of governments.” Regulation without legitimacy, predictability, and fairness always leads to backlash instead of compliance. Here’s a prediction for you: If something is not done to stop MACRA implementation, more physicians will opt-out of Medicare and Medicaid than is fathomable. Once DRexit begins, there will be no turning back. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is ...

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There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance and the government. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs and, ultimately, reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back ...

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Watching events unfold at United Airlines over the last few days have filled me with shock, awe, and horror.  As a result of this public relations disaster, their motto “flying the friendly skies” has turned into “not enough seating, prepare for a beating.” America stands as a beacon of freedom from oppression.  United Airlines was an iconic American company until last Sunday, with a responsibility to uphold the intent of ...

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Recently, the AHCA was pulled from the House floor after not enough votes could be secured in favor of its passage.  A Washington Post article reported President Trump’s thoughts on the matter: “We couldn’t get one Democrat vote, not one. They [Democrats] own Obamacare.  So when it explodes … we make one beautiful deal for the people.” Journalist Robert Costa asserted “there was little evidence that either Trump or House Republicans ...

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Transparency -- including price, quality, and effectiveness of medical services-- is a vital component to lowering costs and improving outcomes.  However, it is imperative transparency go hand-in-hand with financial incentives for patients and consumers; otherwise, the quest will be in vain.  The single best way of reducing costs while not worsening health outcomes is to redistribute resources from less cost-effective health services to more cost-effective ones.  Americans are extremely uncomfortable ...

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The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed, “We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients, and they’re equal that we prioritize the commercial insured patients enough so … We can ...

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