As our medical system attempts to evolve to better deal with the modern epidemics of lifestyle-driven chronic disease, much time and attention is being placed on the clinical models for prevention. Rightly so, and various viable models are popping up with names like lifestyle medicine, preventative medicine, and functional medicine. But one area that is hardly addressed is the payment structure and business model of the practices. Are there structures that ...

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Of all the radical changes affecting health care that have sent providers reeling, we are about to experience the knockout punch: the effort to change health care reimbursement from a quantity-based to a quality-based system. Of all the changes to health care, I can't think of any other that has been based on more false assumptions. Given the fact that there is always low hanging fruit, supporters of the quality-based ...

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Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid -- two government programs facing potential cutbacks in 2015 -- many rural hospitals may be fighting a losing battle.   Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious ...

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If I could drop our health insurance altogether, I would. With a high deductible of $4,000 for in-network providers, my family of three has yet to reach our collective deductible over the last three years. This means we have to pay out of pocket for medical care until we reach that amount. To make matters worse, our health insurance premiums increased by 10 percent, forcing us to find a less ...

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Last year, I had the opportunity to attend the American Medical Association’s interim meeting in Dallas, one of the two annual conferences held by the organization. I went to the meeting to present at a research symposium, but I stuck around for a few extra days because I was curious about the inner workings of organized medicine. As someone interested in health care systems and the delivery of medical care, ...

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We all know that the U.S. system of paying for health care is tremendously complex and inefficient: a multitude of insurers, thousands of insurance plans, innumerable medical bills, countless incorrect and denied claims. But just how much do we waste on this administrative morass? I led a research team that recently reviewed all the available evidence and published our findings. The resulting numbers are staggering. Compared with countries that have a single health ...

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As we enter year two of the Affordable Care Act, we have seen many issues arise during implementation.  Through both executive order and executive memorandum, President Obama has unilaterally changed the law more than 100 times in order to advance his political agenda. When it became important to publicize enrollment and increased coverage of the uninsured, the president, and the ACA provided for an increased payment scale for patients with Medicaid. ...

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I wish lowering health care costs was as easy as “cost awareness,” but as one patient put it, “I never pay the first few bills, because the amount changes every time a new bill is sent.”  The payment system is so fragmented that it’s hard to know what will become an expense with any given illness.  Even the savviest of consumers of health care have difficulty with hospital payment systems.  ...

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Part of the fun of ringing in the New Year is looking back on the achievements of the previous one. And in 2014, there were plenty of health care success stories to celebrate: major medical advances, new technologies and the Affordable Care Act’s unexpectedly good first year. At the same time, many of the health care changes in 2014 yield potential risks for patients, employers and the nation as a whole. ...

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shutterstock_22140319 If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. ...

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