In a large lecture hall of fellow clinicians-to-be, I was told that my job as a physician is not to be concerned with costs but rather to treat patients. My wrist, moving frantically left to right on my page taking notes, stopped. I looked up and my mind wandered: What an odd message to tell those who will be listening to ill people's symptoms, prescribing medicine, ordering tests and orchestrating ...

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The great irony of health care reform is that really, nothing is new.  Everything, it seems, remains cloaked in secrecy. Yes, there are things called exchanges now.  And millions upon millions of dollars will be spent on Internet, social media, TV, print, and radio advertising touting the law.  There will be counselors there to help people make an informed choice. But there's still a new complicated, unreadable law that promises much, but ...

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More than three years after being signed into law, and more than a year after surviving a Supreme Court challenge, the Affordable Care Act, more commonly known as Obamacare, finally begins to fulfill its promise. Most of this country has long since taken sides, despite appalling gaps in popular understanding of what the law means, what it does, and what it doesn't do. Let me admit that I've never had particularly ...

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The Affordable Care Act (ACA) will make insurers unable to exclude Americans with serious health problems from enrolling in insurance plans. This is among the most popular aspects of Obamacare. It is also the most likely explanation for huge premium increases in plans for individuals not on employer group policies. Persons employed by companies with insurance plans for their employees, usually called group plans, routinely accept all eligible employees, regardless of ...

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When the next phase of the Affordable Care Act (ACA) kicks into gear January 1, 2014, each state will be required to offer its residents access to health care insurance through an online marketplace, often referred to as a “health insurance exchange.” These exchanges are now open for business on Oct. 1, 2013, allowing individuals to sign up online, by phone or in-person, with health insurance coverage starting next year. Until now, buying health ...

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Obamacare is here. It’s really here. You might be wondering what’s been going on in the hospital or office -- the contact points where health care actually happens. The funny thing is: nothing seems any different. And this is the problem with Obamacare. It hasn’t, won’t, or perhaps couldn’t, change the fundamental problem with US health care. Namely, that it is too big, too disruptive, and too devoid of nuance. In this way, health care ...

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“Thank God you’re still here, Doc! It looks like they already laid off half the pharmacy department! The line is out the door!” “Don’t worry, Mr. Golati! It’s just a regular day at the VA!” I replied. October 1st at the VA Hospital was like every other day in most ways. It was still hard to find a parking space in the far-too-small lot. The hallways still bustled with white coats, smiling vets, ...

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As deliberations over how to make healthcare more cost-effective continue to play out in forums across the country -- from the U.S. Congress to state governments to health systems and hospitals -- it strikes me that we are paying insufficient attention to what should be an obvious consideration – the cost of supplies. Supplies run the gamut -- from operating tables, artificial knees, intravenous solutions, and wound dressings to bed linens, ...

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Due to ever increasing health care costs, stakeholders in the health care system rely heavily upon front-line workers to assist in containing costs to help make health care more affordable. Since nursing is the largest sector of front-line workers, the field has an opportunity to greatly impact cost containment. Currently, there are 2.7 million nurses in the workforce, with an expected growth rate of 26% over the next decade; however, ...

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shutterstock_229395838 I recently saw an article about Vanderbilt University Medical Center's nursing staff. The administration there came up with the brilliant idea of cutting back on the housekeeping staff and making nurses do some of the cleaning, though it's not specified how much. Nurses would be expected to take out the trash and linens, and mop up spot cleans on the floors, among other ...

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