There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand (like supporting a candidate that has no chance of winning). Supporting health care reform is probably a little of both. Even if any of the currently proposed health care reform plans pass, ...

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As the health reform debate rages on, the central issue of how to improve care while reducing costs remains unaddressed. Fee-for-service has reduced doctors to assembly line pieceworkers, paid by the office visit and procedure rather than by effectiveness of treatment. The result is an inefficient, costly and dangerous system. It is not unusual for a five minute office visit, which excludes clinical examination or note taking. Many patients/consumers can be ...

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Originally published in MedPage Today by Michael Smith OK, don't take this the wrong way, but .... Chill. Relax. Give the other guy the benefit of the doubt. Don't jump to conclusions. And most of all, think before you speak, blog, natter, comment, or otherwise pontificate on issues of the day. And when I say 'think,' I don't mean trying to find the ...

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What we're learning from the 21% Medicare pay cut to physicians that occurred today: * There really must be a cost-control crisis with Medicare and the only politically-acceptable way to implement those cost controls are by cutting working physicians' payments. * There’s was widespread political support for blocking the scheduled pay cuts to doctors, but central government control moves very slowly. That's because doing so is expensive. For now, doctors have been ...

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Doctors will soon be wagging the reform dog. Look at it this way. Expansion of insurance coverage to the 31 million more Americans, as envisioned in the current reform bill, will require more doctors to care for them. The starting entry of 78 million baby boomers in the Medicare pool, starting in 2011, will also take more doctors. As everybody knows, coverage does not equal access. This is most vividly illustrated in ...

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Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Occurrence of some so-called "never events" in hospitals may depend partly on unmodifiable risk factors such as patient characteristics, undermining the rationale for denying Medicare payment for their treatment, researchers said. Analysis of some 890,000 surgeries performed in 1,368 hospitals showed that patient age and pre-existing conditions such as weight ...

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There's lots of talk about primary care doctors threatening to refuse Medicare and Medicaid patients. As some commenters point out, "If you don't like the system, just drop out." Why, then, do so many doctors continue to see patients on Medicare and Medicaid? Two words. Duty and conscience. Primary care doctor Rob Lamberts has an excellent post on this, entitled, Good conscience is bad business. He notes how Medicare (and ...

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The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog. With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most Americans wondering what’s in it for them.” For reform to succeed, the problems facing most patients today, ranging from their deteriorating relationship with doctors to the consequences of medical malpractice, have ...

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Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following quote from a "healthcare expert." "I'm not at all sympathetic with the cardiologists,'' said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a ...

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by David Allen, MD Should health care be controlled or provided by the government? I believe that years of answering 'yes' to this question has been at the root of most of the problems in the American health care system. Let's explore a few of these 'yes' answers: Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. ...

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