With entries dating back to 2004, here are 10 classic blog posts on President Obama: 1. How the primary care doctor shortage threatens Obama’s health reform plan 2. The Obama health care summit, and did the President offer any clues to the upcoming health reform effort? 3. Is Physicians for a National Health Program the biggest threat to Obama’s health reform plan? 4. Did Obama provide any health care clues ...

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I have a piece in The New York Times' Room for Debate blog, discussing how reforming physician incentives is a key to health reform. Here's an excerpt:

Some health policy analysts blame the medical profession entirely for the role they play in rising health care spending. And indeed, doctors have tremendous influence in the tests being ordered and treatments prescribed. But singling out ...

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It's not because of what you think. The common thought is that health insurers will quiver at the sight of a government plan, with the public option offering lower premiums to patients due to leaner administrative burdens. But Charlie Baker, CEO of Massachusetts' Harvard Pilgrim Health Care, isn't so worried about that. Instead, he first wonders about the government's competence in handling another large bureaucratic program:

I worry less about the impact ...

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I was seeing patients during the actual speech, so I had to rely on the transcript. The points that interested me the most were any language pertaining to malpractice, addressing the AMA's recent concerns about the public plan option, and reforming the physician payment system. I think he did pretty well. Regarding the physician payment system, he again addressed McAllen, Texas, which is fast becoming the symbol of what's wrong with American ...

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Or is it a red herring? President Obama is making a much-ballyhooed address to the American Medical Association today (and will be live-Tweeted over at MedPage Today), and perhaps not coincidentally, there's a piece in today's New York Times saying that Obama himself is one of the few supporters willing to address the issue of malpractice reform. According to the piece, "In closed-door talks, Mr. Obama has been making the ...

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Health reform is rapidly gaining momentum, with details of the proposed plan coming into focus. Yesterday, The New York Times reported on the AMA's supposed opposition to the controversial public plan option, which has been the polarizing issue du jour. The AMA has since clarified their views. I'm opening up a Live Q&A at 11:30am Eastern today to answer your health reform questions. I don't pretend to be a ...

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A 90-year old man with a pancreatic mass, almost definitely pancreatic cancer, was admitted to a hospital. Surgeon Jeffrey Parks does the initial surgery consult on this terminal case, and recommends hospice care. The next evening, he's shocked by the "astounding amount of medicine [that] had been practiced" during the day:

Consults had gone out to GI, oncology, and nephrology. The GI guy had ordered an MRCP and, based on some mild ...

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Health policy experts rightly state that the physician payment system, which pays fee-for-service, financially encourages doctors to order more tests. The opposite extreme, as we've heard many times, is the Mayo Clinic, which salaries their doctors. But could there be unintended consequences to placing physicians on fixed pay. For one, you are going to seriously dent productivity. Now, some say that may be a blessing in disguise, since the ...

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Frustrated by Medicare's price-fixing tactics? One idea is to introduce a competitive bidding system. It's a well-known fact, and one that strongly influences current health policy decisions, that some areas of the country have more doctors and provide more medical services than others, with no additional, appreciable benefit. In an op-ed in The New York Times, pulmonologist Peter Bach, former senior adviser to the administrator of the Centers for Medicare ...

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Most of us are now familiar with the estimates that as much as one-third of our health care dollars are squandered on ineffective, often unnecessary, unproven and overpriced products and services. But which third? The fat in our health-care system is not hanging out conveniently on the edges of the steak, waiting to be trimmed. It will take a scalpel, a keen eye, and a steady hand to remove at least ...

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