We all know about Medicare, the federal government health insurance program for Americans who are over the age of 65 and/or disabled. We know that as we have begun to live longer, the Medicare population has ballooned and the costs of the program are, by most estimates, “unsustainable.” We also know that Medicare, despite being a government program, is beloved by America’s seniors. If it was an unpopular program, Congress would ...

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An elderly doctor passes away, and he find himself standing before the Pearly Gates.  The Almighty greets him and says,  “In recognition of your stellar life of service to your patients, family and community,  I welcome you to paradise.  And because I know that doctors have a great sense of curiosity about all things, you can now ask me any question—any—and I will answer it.”   The doctor ponders for a ...

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Medicare patients should care about the way we pay providers It can be difficult to keep up with the jargon, countless proposals and complicated policies that surround the debate over Medicare reform.  Whether you are discussing premium support, changing the eligibility age or Medicare for All, there is one relatively simple concept that patients should make a point to pay attention to – one that directly impacts them – and is the ...

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From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and deductibles that people had to pay, and then they observed their use of the health care system. As you might expect, those who had to pay more out of their ...

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Look to Oregon to see if Obamacare will succeed Over the past several months, the state of Oregon has been pursuing an aggressive approach to solving the healthcare crisis that many states are dealing with. A couple of years ago Oregon was facing a $2 billion deficit in their Medicaid program, with few solutions to repair the situation. The governor was reluctant to take the obvious step of cutting doctors' pay for ...

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The RUC survives and now our health system is worse off On January 7, 2013, a federal appeals court rejected six Georgia primary care physicians’ (PCPs) challenge to the Centers for Medicare and Medicaid Services’ (CMS) 20-year, sole-source relationship with the secretive, specialist-dominated federal advisory committee that determines the relative value of medical services. The American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC) is, in the court’s view, not subject to ...

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AMA: Join physicians and medical students in advocating on key issues AMA: Join physicians and medical students in advocating on key issuesThis week, hundreds of our fellow physicians and medical students gathered in Washington, D.C., for the AMA’s National Advocacy Conference, which is held in the capital city each February. Attendees heard from members of Congress, top administration officials including HHS Secretary Kathleen Sebelius, journalists and other experts about the health policy issues ...

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10 reasons why I love Medicare as a physician I know. I know.  Medicare is the insurance that all of us love to hate.  But being both an internist and geriatrician, I have learned to see the good side of the sometimes annoying government program for several reasons: 1. Medicare’s fee schedule. It’s bad, but not that bad. Sure, Medicare’s fee schedule has only increased 3.1% over the past 12 years, while ...

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“Pay for performance” made headlines again this week, when Health and Hospitals Corporation (HHC), the multi-billion dollar corporation which operates New York City’s public hospitals, announced that they will be linking physician reimbursement to pre-determined “quality” metrics and patient satisfaction scores. This announcement comes quickly on the heels of details recently released by the Centers for Medicare and Medicaid Services (CMS) regarding its first Medicare payment adjustment to hospitals under the ...

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This series is brought to you by MedPage Today. 1. ACOG Takes on Sexual Coercion. Clinicians need to offer "discreet and confidential contraception" to patients who have been coerced into pregnancy by intimate partners because of a "known link" between such coercive behavior and violence. 2. J&J Projects 37% Revision Rate for Hip Implants. An internal study by Johnson & Johnson into failure rates of its now-recalled ASR-XL hip implant ...

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