Recently I posted a piece, describing research out of Johns Hopkins, showing that when patients come to ERs -- either with no insurance or insurance that is out-of-network -- they often face charges that are four, six, or even ten-fold greater than what Medicare would pay for the same services. After the post, I was inundated with angry tweets and emails, mainly from emergency medicine ...

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If you get health insurance through your job, beware: you might be picking up more of the cost of your medical care than you realize. With increasing frequency, employers are directing their workers to the kind of high deductible, high out-of-pocket insurance plans that leave workers financially responsible for a surprising portion of their health care expenses. Not long ago, having insurance coverage meant your costs were largely ...

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It has been well publicized that premiums for Obamacare insurance plans have been rising at a disturbing rate. Local news is filled with reports of 21.5%36.3% and even higher price hikesPresident Trump complained in February that Obamacare premiums “have increased by double and triple digits,” even remarking that premiums in Arizona “went up 116% ...

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Cancer screening can save lives. Mammographies reduce the chance women will die of breast cancer; and colonoscopies reduce the chance people will die of colon cancer. But should my 93-year-old father receive a screening colonoscopy? The test is uncomfortable, carries risks, and costs money. Even more importantly, my dad probably won’t live long enough to benefit from the test. That’s why most medical experts think people like my dad—people unlikely to ...

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How excited would you be about a medication that lowered your risk of cardiovascular death, heart attack or stroke by 1.5%? Excited enough to spend a few thousand dollars a year on the drug? I expect not. What if, instead, the drug reduced those same terrible outcomes by 20%? That’s probably enough benefit to interest some in the drug. Well, those statistics come from the same clinical trial, evaluating the same drug. ...

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Medical appointments are getting shorter by the year. Sometimes it feels like doctors have no time to spend with their patients. What’s to blame for these brief clinical interactions? It could be the electronic health record, or EHR. Because of changes in how insurance companies and the government pay for medical care, doctors increasingly need to document their care on the computer, causing many physicians to spend more time with their ...

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Growing up Republican, I have long believed in personal responsibility. In junior high school, when I observed close relatives who struggled with obesity, I vowed to never let myself get out of shape. (“Junior high” is what we called middle school back in the day.) When hip surgery gone wrong dramatically reduced my level of physical activity two and a half years ago, I cut back on what I ate ...

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It has become trendy in health policy circles to believe that behavioral economic interventions are the key to health system improvement. After all, traditional economic interventions like pay per performance have generated underwhelming results, with little or no change in physician behavior. Why not try a non-financial, psychological intervention: like performance feedback! Well, a study conducted in the last couple years in Switzerland raises questions about the effectiveness of ...

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There are some sad truths about being an aging male. Your muscle mass usually declines. You start feeling tired more easily. And there’s a good chance either you start losing interest in sex or start experiencing a decline in sexual performance. Here’s another truth: Your testosterone level probably ain’t what it used to be. Which raises a question: Would testosterone supplementation restore some of your youthful vitality? That is certainly what manufactures ...

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Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week -- eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93. If rheumatoid arthritis progresses unchecked, it is as debilitating of a disease as can be imagined. Don’t think garden variety arthritis that only interferes with activities like, um, gardening. Think: finger and wrist joints so inflamed it feels like your ...

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