Fortunately, the 27% reduction in Medicare payments to physicians that is set to take place in a matter of weeks unless congress acts is getting some press. Fox News published a piece recently, as did the Washington Post. Writer Merrill Goozner breaks things down nicely in his article, "Is There a Doctor Fix in the House ... and Senate?"However, one thing that seems to be getting confused in all ...
Posts tagged Health reform
Technological advances can solve our current healthcare crisis
It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will soon force physicians and healthcare professionals to change how we take care of our patients. Just as the days of housecalls are gone, so is our current system of delivering care.The rising cost of healthcare now has the government and insurance companies placing more emphasis on controlling costs, ...
Government and insurance companies should have little say in death
My colleagues who advocate improvement to our healthcare often say, “It’s a non-issue. We all benefit from better care.” Yet the political vehicle that’s to drive the reform has stirred emotions and controversy at almost every turn, leaving us baffled. Why wouldn’t anyone want better coverage, lower cost, and more evidence-based treatments? These targeted goals improve healthcare, which is why they poll well. When asked for a general impression of the ...
Rigid regulation can become detrimental to patient care
The last four days have provided a sharp glimpse into the future that awaits those of us in the health care profession, physicians in particular. Over the last few years physicians have been burdened with mountains of paperwork, most of which contributes little to patient care, but does take time away that could be better utilized caring for our patients. However, the last four days have demonstrated that the administrative ...
A disconnect between medical resources and health care delivery
Imagine what health care in the United States could look like if we devised a system that was based on sound medical practice and proven cost effectiveness. What if we put our brains, energies and passion behind designing the smartest health care system possible?That was the question that kept poking through my train of thought as I read a study that appeared in the most recent issue of Pediatrics, the ...
ACP: What’s a small group practice to do?
A guest column by the American College of Physicians, exclusive to KevinMD.com.In 1998 I started a period of national service to the American College of Physicians leading to my term as President for 2010-2011. During that time I kept an almost full time private practice in Fayetteville, Tennessee. Moving between the worlds of health policy and "the trenches," I ...
What happens if the Supreme Court strikes down the individual mandate?
Any ruling by the Supreme Court on the constitutionality of the Affordable Care Act's controversial individual mandate isn't likely for at least another several months, but it's worth thinking about what might happen after the case is decided. The first scenario is easy: If the Court upholds the mandate, the ACA goes forward as planned to the continued objections of many conservative Americans and politicians. The second scenario is less ...
Changing the incentives in the operating room
Last year I wrote about a few strategies for decreasing costs in the operating room. Since being in fellowship operating many days per week, I’ve come up with a new idea, this time a bit more radical.In Freakonomics, Leavitt and Dubner posit that in all things, human beings respond to incentives. If you want to understand human behavior, all you have to do is identify the incentives that drive ...
Looking back at how primary care has changed
It is almost impossible for me to believe that my views on primary care in the United States have changed so radically in fifty years. When I graduated from medical school in 1961, I was determined to become a primary care doctor. I completed residencies in both medicine and pediatrics to prepare for a career as a general physician in rural Vermont. That dream was put on hold by an ...
AMA: Health insurance monopolies hurt patients and physicians
A guest column by the American Medical Association, exclusive to KevinMD.com.Anyone making a major purchase wants to maximize value by exploring their options. Shopping for the best option drives market competition and promotes innovation and efficiency. Shopping for competitive health insurance options can be difficult when a market is controlled by one or two large commercial insurers. The lack a competitive ...
Why we must Occupy Healthcare
Why do we need to occupy healthcare? Why are we here, on this website, calling for change? We are so often told that America has the best healthcare system in the world. If that were so, then there would be no need to change anything. We could continue running things as we currently are, and all would be well ...Except that we do not have the best healthcare system in ...
Why do non-profit hospitals compete with each other?
While we are talking about things that drive health care costs up, this one has bothered me since I was in practice years ago. I am a believer in competition, I think it forces us to be creative and provide better, cheaper, more efficient products and services.But there is the mindset of leadership at play as well. Are we competing to provide better patient services to improve patient care, or ...
How the crises of healthcare and education are related
There are two crises in America, both of which have a profound effect on the economy. The cost of healthcare is eating away at our ability to finance other needy areas. Poor performance of our educational system is weakening our international competitiveness. Both healthcare and education are at the precipice of complete collapse. They both deliver glaringly inferior results with prohibitive expenditures. The performance of our healthcare system relative to ...
The new definition for a medical emergency
The recent budget crisis in many state Medicaid programs has led the directors of these health care programs for the poor to cast about for ways to cut their costs, and many have landed on a ‘solution’ that puts lives at risk and undermine the financial viability of an emergency care safety net that is already severely underfunded and overwhelmed. Some 21 states use a variation of the old definition ...
Why can’t the United States have a smarter health care system?
Why can’t the United States have a smarter health care system?That was the frustrating question that kept poking through my train of thought as I read a study from the most recent issue of Pediatrics, the official journal of the American Academy of Pediatrics (AAP). The study, out of UCLA, examined the association between length of well-child visits and quality of the visits, including things like developmental screening and ...
Personal responsibility in promoting individual health
In March 2010 President Barack Obama and the Democratic-led Congress passed the single largest change in the American health care industry since the introduction of Medicare and Medicaid in 1965. The Patient Protection and Affordable Care Act (PPACA) aims to drastically change the way that health care is delivered and financed. It partially draws upon the idea of personal responsibility and its role in promoting individual health. Some states, notably ...
Is it possible to implement a list of essential health benefits?
What is an essential health benefit? I suppose that is a health or medical action, product, or process that should be paid for by someone other than the patient, in a society that provides so-called "third party coverage."Many very smart people and strong organizations have struggled with this issue for many decades.Prior answers, such as they are, have come from staff model HMOs like Kaiser Permanente, the Veterans Health Administration, ...
Why patients get unnecessary referrals to consultants
Recently, a physician colleague asked me a question about a patient. The patient, who had already been seen by another allergist, was referred to another physician ("the consultant") for evaluation. The consultant was in the same healthcare system as my colleague, but the allergist was not. In evaluating the patient, a specific allergy question came up.The consultant asks my colleague about this question. What was interesting was that the consultant ...
How to control health care costs in the USA
We are finally in the midst of American football season again, after so many dull months. Are you ready for: "We're Number 1; we're Number 1"?School pride; conference pride; regional pride; confirmation of identity; proof of manhood.Think Summer Olympics in London, 2012. As the Gold Medals add up, the chants will ring out ... U.S.A, U.S.A.Goose bumps; spine tingles; national pride.Years back, when John McKay coached the USC Trojans, he ...
Why CMS should settle with primary care plaintiffs
By mid-November, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) must respond to the legal complaint filed in a Maryland federal court by six Augusta, Georgia family physicians.These doctors are not asking for money, but for relief from the negative effects brought about by CMS’ twenty year reliance on the American Medical Association’s Relative Value Scale Update Committee (RUC) ...
