Everything seems to be pointing toward two years of partisan and ideological confrontations over health reform. The leadership of an emboldened Republican party has made it clear that it will use its newfound House majority to seek to "repeal and replace" the Affordable Care Act (ACA), and if that doesn't work, to "defund" it. Huge GOP gains in statehouses make it likely that more states will resist implementation. Meanwhile, President ...
Posts tagged Obama
Childhood obesity and chronic illnesses that result from being overweight
Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control.I am speaking of obesity -- and, in particular, its increasing prevalence in American adolescents and children.Almost every study that has been done concerning obesity shows a correlation with soda consumption. As a result, some states and municipalities have tried to implement initiatives that make it more ...
Why the sustainable growth rate formula (SGR) is here to stay
According to the Washington Post, it is highly unlikely that Congress will undo the planned "sustainable growth rate formula" (SGR) mandated Medicare fee schedule cuts. While there's an outside chance of a fix, the American Medical Association, as well as other organized physician groups, can't be happy about the constant threat of the 20% payment reductions.Recall that the SGR was signed into law back in 1998. It was designed to ...
Why general internists are quitting clinical medicine
The Association of American Medical Colleges predicts that by 2025, the US health system will have 46,000 fewer primary care physicians than it needs.If the prediction proves correct and we fail to develop effective mitigation strategies, the manpower shortage will create quite a mess. Ironically, the health reform law signed by President Obama in March will exacerbate the problem by increasing demand for services provided by primary care physicians.The American ...
Who really benefits from President Obama’s health reform plan?
I don’t know about you, but as I watched coverage of President Obama signing the health care bill three months ago, it was hard not to notice the constant ads for power wheelchairs. Emblazoned across the ads was a flashing notice reminding viewers: Medicare may cover this!Don’t get me wrong. As a primary care doctor who takes care of low-income patients, I was glad to see something being done to ...
Health blog posts of the week, ending April 23, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. Will Bret Michaels survive his subarachnoid hemorrhage?2. High blood pressure treatment that patients need to know3. Medical conditions as seen in the movies4. President Obama should have had colonoscopy without sedation5. Top doctors may not always be the best physicians
Politics shouldn’t be discussed in the exam room
Jack Cassell is either Florida's most hated, or loved, urologist, depending on your point of view.He famously taped a sign outside his office, advising President Obama supporters to seek care elsewhere.
Slate wrote a piece saying, from a civil rights perspective, Dr. Cassell is probably in the clear: "While the law bars physicians from excluding patients on the basis of traditionally protected ...
President Obama should have had colonoscopy without sedation
by Michael Kirsch, MDDoes anyone out there know why President Obama underwent a virtual ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For ...
How health reform can be popular with the American public
The health reform legislation was decidedly unpopular, with a variety of polls showing the majority disapproved of the bill.What did the people want?The ACP's Bob Doherty linked to a post by Princeton's Uwe Reinhardt, who observed 10 things that the public wants in health care reform:
1. Lets only patients and their own physicians determine how to respond clinically to a given medical condition, never an insurance clerk or, even ...
President Obama bets big on health care reform
President Obama has decided to place all his bets on an “up and down vote” on his health care bill.The stakes are enormous and rests on ten risky Obama bets.Bet One – His legacy depends on the outcome. If he loses, he may be a one-term president, and Democrats may lose their majorities in the House and Senate come November.Bet Two - The American people will ultimately recognize this is ...
Virtual colonoscopy and the message President Obama sent
President Obama had a well-publicized routine health exam last week.One of the more controversial issues was the virtual colonoscopy he received. It's been well covered here that virtual colonoscopy doesn't have the same diagnostic accuracy as a traditional colonoscopy, and in fact, is not covered by Medicare or most third party payers.With the President obtaining one, does that send out the wrong message?Of course, radiologists -- who stand ...
Why being President of the United States is a health hazard
Originally published in MedPage Todayby Liz O'BrienExactly whom are we honoring on Presidents (or is it President's) Day?A. George Washington B. George Washington and Abraham Lincoln C. All presidents
The answer is more complicated than you'd ever expect. Probably A is most correct, but if it were up to me, I'd pick C.Certainly every one of these 43 men has earned the ...
How President Barack Obama’s State of the Union speech will impact healthcare reform
Originally published in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentPresident Barack Obama's State of the Union speech Wednesday night will likely focus on job creation and the economy and not -- as many Democrats once hoped -- on congratulations for the passage of healthcare reform. In the week following the election of Republican Scott Brown to the U.S. ...
When political discourse is like borderline personality disorder
When I was a kid in Odessa my Dad and I went to see The Sound of Music at least 17 times in the span of 3 months. Remember that song sung by the nuns when Maria is late for the vespers, "How do you solve the problem like Maria?" One nun says "She's an angel", another one counters "She's a demon", when the voice of reason from Mother Superior ...
Analysis of the Senate Finance Committee health care reform bill
Originally posted in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentThe Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week. After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it ...
The left, right, and health care reform poetry
Into the valley of health reform Bestrode the one hundred senators. Comprehensivists to the left, Incrementalists to the right. Squarely in the middle sat the arcane, Senator Olympia Snowe of Maine.Bespoke the comprehensivists. It must be done all at once. Evoked the incrementalists. No, it must be done one at a time.Bespoke the comprehensivists. We simply cannot wait any longer. Evoked the incrementalists, Why not,you've waited a century already.Bespoke the comprehensivists. It must be done right now. Evoked the incrementalists. No, it must be ...
Medical malpractice reform by President Obama and the White House
by Emily P. Walker, Washington Correspondent, MedPage TodayThe White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases. In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on ...
Ten top medical blog posts, July 2009
Here are the top posts from the past month, based on the number of times they were viewed.1. Did propofol, or Diprivan, kill Michael Jackson?2. The AMA and Sermo break up, and how it’s getting ugly3. Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club4. America’s failed attempt at a single-payer system, the Indian Health Service5. Can doctors ...
Rationing care is inevitable to control health care costs
Those on the left will pretty much sacrifice everything to attain their goal of universal coverage.But, in this well-reasoned piece by conservative economist Tyler Cowen, expanding coverage won't necessarily control costs, which is a more imperative issue. The bandied about means of cost control, such as electronic medical records, cutting provider payments, and preventive care, all will have little nor no impact in controlling costs.Take physician reimbursements, for ...
Can the American Medical Association still be an influential voice in health reform?
The repercussions after Obama's speech to the AMA's delegates continue to be felt.Not least of which are the murmurings of the other professional physician groups, who say that the AMA does not represent a majority of physicians. In this piece from pediatrician Rahul Parikh, he notes that about 30 percent of physicians are AMA members. Remaining doctors belong to groups with more liberal political leanings, including the ...
