acp new logo A guest column by the American College of Physicians, exclusive to KevinMD. Although I work for the American College of Physicians, I’m writing this as a general internist who has practiced both primary care and hospital-based medicine for over 25 years. Hopefully by now, you are aware of Better is Possible: The American College of Physicians’ ...

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I became a physician to help people. So isn't fighting for issues that help protect my patients such as racial equality, LGBTQ rights, gender pay equity, access to health care, and education all part of patient care? Don't my patients want to have a doctor who is fighting for them both in the office and outside it? When I started working as a resident physician and later went on to my attending ...

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Readers of my articles know that no one has been more critical of Obamacare's flaws––particularly over the impact the program has had on middle-class consumers in the individual health insurance market. And, readers already know that no one has been more supportive of the Medicaid expansion from the very beginning. Now, the Trump administration wants to give states the option to abolish the open-ended federal funding of Medicaid ...

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Our local newspaper recently ran an article on the top of its front page, stating that our monopoly health system is now “expanding health care cost discounts.”  The article was actually a press release - free advertising on the front page. As a primary care physician who refers patients to this health system, I wanted to know what these discounts really meant. So, I asked the newspaper in an editorial, “what ...

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We constantly argue about how to fix the U.S. health care system. But what we must understand is that the most important issue isn’t how to fix health care. The issue is how to get our Congress, the President, and the health care industry to allow anything of importance to change at all. The problem is that all three have a vested interest in the current system. The health care ...

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I write this hoping to appeal to common sense. When are we going to stop putting the cart before the horse? 99 percent of the rhetoric surrounding health care costs centers on a “fair” way to pay for it, “fair” reimbursement levels, and who should pay this “fair” level of payment, when the real issue is the amount being charged in the first place. What exactly is “fair”? The real central, ...

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In a New York Times article, “The Huge Waste in the U.S. Health System,” it stated that the estimated waste is at least $760 billion per year: “That’s comparable to government spending on Medicare and exceeds national military spending, as well as total primary and secondary education spending.” Why is waste so prevalent? There are many sources. The biggest one, and the one that should most concern ...

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Alexa Karsdan’s medical bill for a sore throat reached over $28,000. NPR told her story recently, but I want you to know why I am actually glad this happened. Why is it good news that her charges were so exorbitant, and that her insurance paid over twenty-five thousand dollars for one laboratory test? This story is a brilliant illustration of fundamental flaws in our health care ...

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Americans are not fans of socialized medicine. Sure, some people want socialized health care payment, including many people who are fans of Medicare for all. But even most Bernie Sanders supporters probably aren't in favor of socializing the entire U.S. health care system, thereby making hospitals and medical clinics into government property. Americans are proud of the high quality of care offered by non-government providers, from their local community ...

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In an earlier post, I pointed out that there is no better chance of passing a Medicare for all health care plan through Congress in the coming years than there was in 1977, or 1993, or 2009. Then Elizabeth Warren showed us just how politically unrealistic single-payer health care is when she released her funding plan and then quickly backtracked to the public option ...

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“Listen to your patient; he is telling you the diagnosis.” This quote from famous physician William Osler is as true today as it was 100 years ago. And yet the latest version of President Trump’s executive order on Medicare threatens what patients overwhelmingly want: a physician involved in their care. Section 5-C of the President’s order focuses on payment parity and supervision of mid-level providers. Changes to either issue would create unintended ...

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The practice of medicine is limited by what we can control. As students, we are taught to believe in the power of science, the importance of hard work, and the momentum of technological advancement as prime determinants in our patients’ outcomes. However, as we get further along in our careers, we come to realize that many of the factors that contribute to poor health are beyond our control at ...

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The Republicans don't yet have a health care plan less than a year before the 2020 elections. But based upon their 2017 Obamacare repeal and replace efforts, as well as a major document recently issued by the House Republican Study Committee, what might a Republican plan look like? First, let's review the plan House Republicans passed in 2017 during their failed repeal and replace efforts. House Republicans would have repealed the Medicaid expansion ...

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As the year winds down and must-pass year-end spending bills are completed -- and with that, any chance of attaching and approving health care legislation -- the special interests have won big, and consumers have lost big. Employers, unions, and insurance companies won big with the repeal of the "Cadillac" tax on high cost-benefit plans at a cost of $200 billion over ten years as well as the repeal of the ...

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Next in a series. The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or insurers) have a natural incentive to fulfill each of those jobs. Those incentives arise naturally, but the big challenge is shaping ...

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Fixing Obamacare and adding a public option is the health care policy territory first staked out by Democratic Presidential candidate Joe Biden. Writing about Biden's plan recently on my blog, I said:

If the Democrats capture the White House, keep the House, and take over the Senate, no matter who they elect as President, this Biden health care outline, not Medicare for all, will likely be the plan Democrats ...

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As presidential hopefuls debate health care reform, it is becoming increasingly difficult to distinguish statements rooted in fact from fiction. According to PolitiFact, only 27% of politicians’ media statements regarding health care — whether from Democrats or Republicans — are true or mostly true. Discerning the truth in a growing state of convolution is becoming increasingly difficult. In such a medical and political quagmire, it behooves health ...

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There are few things in our health care system that are more unfair than surprise medical bills. Consumers think they have good coverage and are getting treatment in their health plan network only to get a huge unexpected bill in the mail because it turned out that something like the anesthesiologist at their recent surgery wasn't covered. How were they to know that? As you're sitting on the gurney about to ...

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Next in a series. The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or insurers) have a natural incentive to fulfill each of those jobs. Those incentives arise naturally, but the big challenge ...

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Dear Congress: For the vast majority of you, I am not your constituent.  But you should listen to me anyway.  I am writing to show you that health care in America is not a political issue; it is a human one.  The same can be said for immigration or education or any other issue that you work on. Let my patients explain this for me. I walk into clinic to a full ...

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