There are over 16,000,000 American children (21.8%) who live in official poverty and double that number who are just poor. This is not happening in an obscure country, in a continent far away. It is happening right here, across the street from you. For those enjoying a good episode of Duck Dynasty, these are not children of illegal immigrants, and the vast majority is white kids. Over 44,000,000 American children (more ...

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Conflicting state versus federal incentives confuse doctors I get paid by Medicaid to see patients. How much? Exactly $52.28 if it is an easy patient issue, like a cold, and $78.54 for a harder one, like a kidney stone. Who decides when the issue is easy and when it is hard? I do. But I have to follow some complex rules when deciding whether to bill a 99213 ...

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We all want the advantage.  We put our kids in special preschools so they have the advantage.  We work 100 hours a week so our kids can do 8 activities and get the advantage. Tall people have an advantage, we’re told.  Poor people are “disadvantaged.” Well folks, there are a whole bunch of senior citizens in Massachusetts who are about to get disadvantaged starting September 1. UnitedHealthcare (UHC) will be
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A Veterans Affairs hospital in Fort Collins Colorado, it was recently revealed, falsified its wait times for outpatient clinic appointments. In order to appear to meet the goal of clinic appointments within 14 days, the hospital taught its clerks how to falsify the appointment records to create the illusion that the appointment goals were being met. Many of the 6,300 veterans treated at this clinic actually waited months ...

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Despite the political angst, the doomsday predictions and a very rocky launch, the Affordable Care Act has enabled more than 8 million Americans to acquire insurance coverage through the public exchanges. Health insurance increases the probability that patients will access the medical care they need. And my colleagues at Kaiser Permanente are already seeing some positive stories emerging as a result. They’ve shared dozens of stories with me about patients with undiagnosed ...

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Did you ever read a seemingly inconsequential sentence somewhere and it then just refused to leave your mind for days on end, triggering avalanches of thoughts way beyond the original intent, if there even was one? It just happened to me a few days ago when I read one more industry article about the recent Medicare data dump. The following remark was attributed to a primary care doctor: “The U.S. is ...

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I was working overnight in Tiny Memorial Hospital, located in scenic rural America.  My call room there was a converted patient room.  As such, my bed was a hospital bed.  Lying there one night, I rolled to the side and raised the head of the bed using the button on the rail.  The blanket was standard hospital fare: stiff and thin.  And the television remote, fully two pounds and connected ...

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What a shame: Reimbursement rates are going up for private Medicare Advantage plans. Contrary to its April 7 announcement that private Medicare reimbursement rates would be reduced, the Centers for Medicare & Medicaid Services has just reversed course and announced that it will increase overall Medicare Advantage rates. The change in policy came after pressure from the political parties and insurance companies. As Medicare spending per beneficiary grows at a ...

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Medicare released the most comprehensive ever look at how Medicare dollars are paid out to physicians across the United States.  In the name of transparency, this data drop will “provide consumers with an ability to compare doctors and treatments in a way they have never had until now.” Will it really? Let’s look a bit closer at the data release. According to the Centers for Medicare and Medicaid Services, the payment data release aims to “make our ...

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"Health insurance is not health care." That is not original. I borrowed it from Los Angeles County Department of Health Services Director Mitchell Katz's JAMA Internal Medicine editorial about problems with ensuring access to health care for Medicaid recipients whose cheap public insurance usually doesn't even pay doctors enough to recoup costs of care, let alone earn a living. But somehow, during the impassioned political debates that preceded Obamacare, the botched rollout of ...

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