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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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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Everything seems to be pointing toward two years of partisan and ideological confrontations over health reform. The leadership of an emboldened Republican party has made it clear that it will use its newfound House majority to seek to "repeal and replace" the Affordable Care Act (ACA), and if that doesn't work, to "defund" it. Huge GOP gains in statehouses make it likely that more states will resist implementation. Meanwhile, President ...

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Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control. I am speaking of obesity -- and, in particular, its increasing prevalence in American adolescents and children. Almost every study that has been done concerning obesity shows a correlation with soda consumption. As a result, some states and municipalities have tried to implement initiatives that make it more ...

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According to the Washington Post, it is highly unlikely that Congress will undo the planned "sustainable growth rate formula" (SGR) mandated Medicare fee schedule cuts. While there's an outside chance of a fix, the American Medical Association, as well as other organized physician groups, can't be happy about the constant threat of the 20% payment reductions. Recall that the SGR was signed into law back in 1998. It was designed to ...

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The Association of American Medical Colleges predicts that by 2025, the US health system will have 46,000 fewer primary care physicians than it needs. If the prediction proves correct and we fail to develop effective mitigation strategies, the manpower shortage will create quite a mess. Ironically, the health reform law signed by President Obama in March will exacerbate the problem by increasing demand for services provided by primary care physicians. The American ...

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I don’t know about you, but as I watched coverage of President Obama signing the health care bill three months ago, it was hard not to notice the constant ads for power wheelchairs. Emblazoned across the ads was a flashing notice reminding viewers: Medicare may cover this! Don’t get me wrong. As a primary care doctor who takes care of low-income patients, I was glad to see something being done to ...

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Here are the top posts from this past week, based on the number of times they were viewed. 1. Will Bret Michaels survive his subarachnoid hemorrhage? 2. High blood pressure treatment that patients need to know 3. Medical conditions as seen in the movies 4. President Obama should have had colonoscopy without sedation 5. Top doctors may not always be the best physicians

Jack Cassell is either Florida's most hated, or loved, urologist, depending on your point of view. He famously taped a sign outside his office, advising President Obama supporters to seek care elsewhere. Slate wrote a piece saying, from a civil rights perspective, Dr. Cassell is probably in the clear: "While the law bars physicians from excluding patients on the basis of traditionally protected ...

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by Michael Kirsch, MD Does anyone out there know why President Obama underwent a virtual  ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year? In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For ...

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The health reform legislation was decidedly unpopular, with a variety of polls showing the majority disapproved of the bill. What did the people want? The ACP's Bob Doherty linked to a post by Princeton's Uwe Reinhardt, who observed 10 things that the public wants in health care reform:

1. Lets only patients and their own physicians determine how to respond clinically to a given medical condition, never an insurance clerk or, even ...

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President Obama has decided to place all his bets on an “up and down vote” on his health care bill. The stakes are enormous and rests on ten risky Obama bets. Bet One – His legacy depends on the outcome. If he loses, he may be a one-term president, and Democrats may lose their majorities in the House and Senate come November. Bet Two - The American people will ultimately recognize this is ...

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President Obama had a well-publicized routine health exam last week. One of the more controversial issues was the virtual colonoscopy he received. It's been well covered here that virtual colonoscopy doesn't have the same diagnostic accuracy as a traditional colonoscopy, and in fact, is not covered by Medicare or most third party payers. With the President obtaining one, does that send out the wrong message? Of course, radiologists -- who stand ...

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Originally published in MedPage Today by Liz O'Brien Exactly whom are we honoring on Presidents (or is it President's) Day? A. George Washington B. George Washington and Abraham Lincoln C. All presidents The answer is more complicated than you'd ever expect. Probably A is most correct, but if it were up to me, I'd pick C. Certainly every one of these 43 men has earned the ...

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Originally published in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent President Barack Obama's State of the Union speech Wednesday night will likely focus on job creation and the economy and not -- as many Democrats once hoped -- on congratulations for the passage of healthcare reform. In the week following the election of Republican Scott Brown to the U.S. ...

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When I was a kid in Odessa my Dad and I went to see The Sound of Music at least 17 times in the span of 3 months. Remember that song sung by the nuns when Maria is late for the vespers, "How do you solve the problem like Maria?" One nun says "She's an angel", another one counters "She's a demon", when the voice of reason from Mother Superior ...

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Originally posted in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent The Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week. medpage-today After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it ...

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Into the valley of health reform Bestrode the one hundred senators. Comprehensivists to the left, Incrementalists to the right. Squarely in the middle sat the arcane, Senator Olympia Snowe of Maine. Bespoke the comprehensivists. It must be done all at once. Evoked the incrementalists. No, it must be done one at a time. Bespoke the comprehensivists. We simply cannot wait any longer. Evoked the incrementalists, Why not,you've waited a century already. Bespoke the comprehensivists. It must be done right now. Evoked the incrementalists. No, it must be ...

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by Emily P. Walker, Washington Correspondent, MedPage Today The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases. medpage-today In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians ...

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