Policy

Do doctors already have a source of comparative effectiveness research?

Comparative effectiveness research is the current, trendy buzzword in the health care debate.

And certainly, doctors need an authoritative, unbiased, source in which to base their decisions on.

But, do we already have that kind of information? Why, yes, we do. It’s called UptoDate.

For those who don’t know, UptoDate is a peer-reviewed, evidence-based, medical encyclopedia available via DVD or online that’s revised every 3 …

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Calling health care a right limits opposition and crushes dissent

I don’t believe that health care is a right.

That has been debated many times here before, but in reading the ACP’s Bob Doherty, he brings up another reason I hadn’t thought of.

“Once something is defined as a right,” says Mr. Doherty, “it paints people who disagree as wanting to deny those same rights. This places people who have legitimate concern about the role of government …

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Does pay-for-performance work, and will it improve health care quality or patient outcomes?

Currently, most physicians are paid by the number of patients they see, or the amount of procedures they do.

Pay-for-performance, a payment system where doctors are paid based on meeting patient outcome measures, is how most insurers, along with Medicare, would like to see the payment system be reformed.

But does it really improve health care quality?

Pauline Chen looks at the data, and finds precious …

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Most Americans have health insurance, and what health reform is going to do for them

Backed by more than $600 billion, there appears to be genuine health reform momentum.

Much of the focus has been on covering the 15 percent of Americans who are uninsured, but as Ezra Klein points out, that also means that 85 percent of the country have health insurance. In fact, 95 percent of the people who voted for Obama are insured, and as Mr. Klein quotes one of …

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What happens if the safety net clinics start refusing to see Medicare or Medicaid patients?

Patients on Medicare and Medicaid tend to utilize the health care system more frequently.

Combined with the fact that an increasing number of physicians are closing their doors to such patients, the so-called “safety net” clinics and hospitals are finding themselves with much more work than they can handle.

In this case in California, one such clinic was seriously considering shutting its doors to Medicare. …

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More coverage requires more doctors, my take in The New York Times

I was invited by The New York Times’ Room for Debate Blog to give my reaction to President Obama’s health care remarks during his speech to Congress last night.

My piece, More coverage requires more doctors, warns the President that we should heed the lessons from Massachusetts’ health reform experiment.

Universal coverage must go hand in hand with providing better health care access, or else …

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Op-ed: More coverage requires more doctors

The following op-ed was published on February 25th, 2009 in The New York Times’ Room for Debate blog.

With the number of the uninsured having risen to 48 million Americans, clearly the need for reform is dire. But President Obama made no mention of who exactly will take care of these patients, even if they get insurance under a successful health reform initiative.

As a primary care physician in southern New …

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Is Daschle’s Federal Health Board an idea from Hitler’s Nazi Germany?

Perhaps it was satire.

But the right-leaning Washington Times (via Matthew Holt) sounds the alarm about the proposed National Coordinator of Health Information Technology, a post that has gained significant publicity since the economic stimulus bill was signed.

Bluntly put, yes, health care needs to be rationed in order to have any hope in controlling health care spending. Ideally, an entity free of political and industry …

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PNHP can threaten health reform

PNHP is a fringe physician group that advocates for a single-payer health system.

The Massachusetts branch came out recently and railed against the state’s health reform plan, which incidentally, is similar to what President Obama is likely to propose.

According to its leadership, “nothing less than single-payer national health reform will work.”

I’ve always thought they should compromise their stance on a single-payer system, which has next to zero chance of being passed. …

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We need comparative effectiveness research, or, I agree with Paul Krugman for the first time ever

I usually disagree with pretty much everything that liberal rock star Paul Krugman writes from his pedestal at the New York Times.

However, when it comes to comparative effectiveness research, I’m with him 100 percent. Physicians need an authoritative source of unbiased data, untainted by the influence of drug companies and device manufacturers.

With treatments and medications announced daily, having an entity definitively compare these newer, …

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How the recession will help Canada’s doctor shortage

With many investments declining up to 40 percent in the past year, Canadian doctors are not immune to the financial pain.

Many physicians who are close to retiring are changing their career plans, and opting to continue working. Luckily, medicine, especially in Canada’s single-payer system, is pretty much recession-proof, meaning that there is always work to be found.

Indeed, in the midst of the current economic downturn, …

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Medicare covers more cancer drugs, did they cave in to the pharmaceutical lobby?

Medicare recently expanded their coverage for off-label use of cancer drugs.

These medications are among the most expensive, and especially in cases of end-stage treatment, there may not be a lot of evidence supporting their use.

For the most part, oncologists and patients (via the WSJ Health Blog) have hailed the decision, but others say that the increased ability to give off-label drugs “let physicians avoid …

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Op-ed: Medicare’s mistake

The following op-ed was published on January 14th, 2009 in the USA Today.

Every patient’s worst nightmare is going to the hospital for a procedure only to have a surgical instrument left in his body, the wrong limb or organ operated on or, worse, dying from a medical mistake. These types of mistakes should never happen.

So when Medicare recently instituted a plan to deny hospital payments for …

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USA Today op-ed: Medicare’s never events and the unintended consequences affecting patient care

My latest USA Today op-ed was published this morning: Medicare’s mistake

I discuss Medicare’s recent “never event” initiative, the program where hospitals are denied payment for catastrophic medical errors.

However, the rapid expansion into not paying for “reasonably preventable” events, like hospital acquired infections and patient falls, can paradoxically have a detrimental effect on patient care.

Enjoy.

Why Medicare for all won’t work

Medicare for all is much easier said than done.

Maggie Mahar (via Ezra Klein) points to some real reasons why expanding Medicare will be difficult, and filled with unknowns. As Ezra puts it, “when you take a program with 44 million beneficiaries, all of whom are in the same age range, and scale it to 300 million beneficiaries across all age demographics, a lot of uncertainty is introduced …

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Does Medicare secretly want pay for performance to fail?

By the way it’s currently designed and implemented, it certainly seems that way.

Medicare seems intent on burying the P4P concept. Bob Doherty notes that “successful quality improvement programs provide regular feedback to clinicians on how they are doing. Rewards for reporting should be greater than the costs and hassles of reporting. The rewards should be predictable (if I do x, I will receive y). And the …

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Medicare to cover handguns?

The FDA quickly put an end to that thought.

Apparently a company tried to get FDA approval for their handgun, which was “ideal for seniors, disabled, or others who may have dexterity limitations or difficulty sighting and controlling a traditional revolver or semi-automatic pistol.”

It was a long-shot (so to speak) for the company, as it was reported that the specially-designed gun would be approved as a medical …

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When primary care refuses to accept Medicare

It’s never a problem, until it affects you.

Baby Boomers are going to be Medicare beneficiaries within the next few years, and some are finding out how difficult it is to find a primary care doctor.

Nationwide, about 30 percent of Medicare patients had difficulty finding a primary care physician during the past year.

As one patient puts it, “I must have made 12 calls before …

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Bed sores are on the rise, despite being a Medicare "never" event

The news on bed sores is not good.

Hospital admissions increased by 15 percent between 1993 and 2006. The incidence of bed sores however, disproportionally jumped 79 percent.

Of course, Medicare wasted no time in making advanced bed sores a so-called “never” event, despite the fact there are no studies that guarantee total prevention.

In 2006 alone, over half a million patients developed bed sores …

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PNHP is hurting health reform

Physicians for a National Health Plan (PNHP) is a group of radical left-leaning doctors in favor of single-payer health care. As progressive blogger Ezra Klein writes, they are opposed to any measure that isn’t single-payer:

Their take on Obama’s health plan is that it’s not single payer, so they don’t support it. And their take on Health Care for America Now coalition is that it’s not pushing single payer, so …

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