With the 2020 election cycle already moving into high gear, we are hearing a lot about Medicare for all. But is it a serious campaign promise, a catchy bumper sticker or a viable national program?
Supporters suggest it will be a panacea for our nation’s health insurance needs. Others are less sure. And some are downright opposed. So where do we go? As a starting point, there are things we can …
The evolving politics of single-payer health care conflate the concepts of universal coverage, health care on demand and free health care. To the indiscriminate progressive mind, all three are part of the holy grail. The fly in the ointment is that highly attractive and altruistic politics runs into the brick wall of reality. As Thomas Sowell — a noted Stanford economist — wrote: “The first lesson of economics is scarcity: …
Medicare for all is one of the leading campaign issues among the Democratic presidential candidates.
Michigan Rep. John Conyers first introduced the idea in Congress in 2003. It went nowhere, but as the one-time party of JFK morphed into something much further left, Medicare for all rose from the dead.
Medicare for all promises universal coverage, so that no one is without insurance. Unfortunately, it is cost prohibitive, costing as much as …
Like many accountable care organizations, Austin Regional Clinic (ARC) in Texas is building a record of success on the Medicare Shared Savings Program’s (MSSP) so-called “Track One.” Now looming, however, is an automatic transfer of ARC to the MSSP’s riskier “second track” after years of hard work implementing our value-based, population health treatment model.
On the first track, ARC and other ACOs assume “upside risk,” getting rewarded for taking on overall …
Everyone thinks of “Medicare for all” as a liberal idea, an extremely liberal one embraced by the socialist wing of the Democratic Party. It’s an idea Democrats were hesitant to embrace in the Obama era, for being too far out of mainstream political thought. It was thought of as an idea that was too easy to demonize as socialism.
What everyone seems to be forgetting is that “Medicare for …
While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, there are other issues which seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures in the wallet.
In 2015, Congress asked CMS to analyze the global period data to ensure procedure weighting accurately reflected the actual work done by physicians. Of course, …
American physicians dole out lots of unnecessary medical care to their patients. They prescribe things like antibiotics for people with viral infections, order expensive CT scans for patients with transitory back pain, and obtain screening EKGs for people with no signs or symptoms of heart disease. Some critics even accuse physicians of ordering such services to bolster their revenue.
So what happens when uninsured patients make it to the doctor’s office …
I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am hopeless. No matter how many times I have had the rules explained to me, or how much feedback I have been given about specific visits, or which “pocket guide” to …
The word “historic” is often used by PR professionals to hype something that is, well, pretty run-of-the-mill. They figure that no one is going to read a news release that announces “[Name of organization] proposes small change that really won’t make much of a difference.” The problem is that when something is done that really measures up to being historic, the recipient is less likely to believe it, kind of …
Until genuine rights are extended to all patients, the ongoing health-care-reform saga perpetrated by Congress and executive leadership will continue to fail the American people. Many Americans have suffered and died because of a broken health-care-delivery system. One of us lost a 19-year old son due to lack of certain patient rights – specifically the right to evidence-based medicine and the right to a complete discharge plan from his hospital. …
The tide is finally rising under the idea of health care for all in America. It is no longer possible to tar this simple and ubiquitously implemented idea as a bid to “take away our freedom” or “destroy the free market.” Hearteningly, the debate is shifting towards the harder questions of when, and how.
One popular idea is to expand Medicare to cover all Americans — essentially turning the government into …
From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to a system that pays for value and quality — but how we define value and quality today is a problem. We all know it: Clinicians and hospitals have to report …
Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to successfully navigate the program and avoid penalties for 2017.
A recent survey by the American Medical Association (AMA) …
Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …
I was browsing the latest issue of the Journal of the American Medical Association, as I often do, and an article by one Andy Slavitt, MBA, and Gail Wilensky, PhD, titled “Reforming Medicaid,” caught my eye. From 2015 to 2017, Mr. Slavitt served as the Acting Administrator for the Centers for Medicare & Medicaid Services (CMS). In that role, he oversaw the government’s awful Meaningful Use EHR program, and helped …
In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians.
It includes most payments for services …
Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support conventional Medicaid, as opposed to supporting a much-needed revamp of this program, have succumbed to false advertisements. So let me review some facts, and suggest some common sense changes that …
At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America.
First and foremost we must recognize we do not have “a health care system” — rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, …
I already know I sound like a broken record. Yet, I can’t fathom why I seem to be the only person talking about this. There have been numerous articles in both syndicated journals and the blogosphere about the many things wrong with the American health care system, including the overspecialization which we know leads to higher costs (but not necessarily better outcomes). Just as I feared, the New York Times …
In our recent paper criticizing how industrial quality improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward.
This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or practices whether physicians like it or not, or whether it’s really useful and fair or …
Get free updates delivered free to your inbox.
