Policy

Health care wins, losses, and lessons

Policy

September 19, 2023

Albert Einstein determined that time is relative. And when it comes to health care, five years can be both a long and a short amount of time.

In August 2018, I launched the Fixing Healthcare podcast. At the time, the medium felt like the perfect auditory companion to the books and articles I’d been writing. By bringing on world-renowned guests and engaging in difficult but meaningful discussions, I hoped the show would have …

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Health care wins, losses, and lessons

Maximizing care amidst provider shortages: the power of measurement-based care

Tom Zaubler, MD

Policy

September 18, 2023

Since the pandemic, the shortage of behavioral health professionals has become more dire as the need for more comprehensive mental health care has increased. As of March 2023, 160 million Americans lived in areas with mental health professional shortages. 55% of counties in the U.S. have no psychiatrists, and 77% report a severe shortage.

In some states, such as Maine, there was a 50% drop in the number of …

Unveiling excessive medical billing and greed

Amol Saxena, DPM, MPH

Policy

September 16, 2023

Recent op-eds have questioned medical billing and doctors’ pay, as both seemed high. Medical “greed” has become more apparent in the past two decades and has been well highlighted by two of my Dartmouth MPH Professors, Elliot Fisher, MD and Thom Walsh, PhD, DPT. Dr. Fisher has documented that higher billings compound the U.S. health care crisis, including medical debt, and …

Chronic health issues and homelessness

Michele Luckenbaugh

Policy

September 16, 2023

In 2022, over 500,000 people in the United States found themselves homeless, without a permanent shelter to offer a sense of stability in their lives. This poses a far-reaching problem for the individuals who find themselves in this situation, but also for our society as a whole.

Homelessness can be caused by a combination of factors, such as poverty, unemployment, lack of affordable housing, mental and substance disorders, trauma,, and violence, …

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Chronic health issues and homelessness

The impact of certificate of need laws on rural health care

Jaimie Cavanaugh, JD and Daryl James

Policy

September 9, 2023

Rural communities have a problem. Their health care options continue to shrink, as medical facilities close or consolidate. The trend has accelerated in recent years, but Westfield Memorial Hospital in Western New York wants to expand.

The tiny facility on the shores of Lake Erie has four inpatient beds, and has plans to double its capacity to eight. The $700,000 project would not require an additional wing or any new floor …

Don’t disrupt success in Medicare

Theresa Forster and Logan Hoover

Policy

September 9, 2023

Each year, Congress goes through its annual budget process to determine how to spend more than $6 trillion on America’s priorities. This year, as part of the discussions on how to spend Medicare’s $900 billion budget, we are being told the Medicare Trust Fund, which is projected to spend $415 billion in 2023 for Part A expenditures, which cover inpatient hospital, skilled nursing facility, nursing home, home health, and hospice care, …

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Don’t disrupt success in Medicare

Transparency, not charity: a real solution to America’s medical debt crisis

Sami Alahmadi and Fadi D. Masoud

Policy

September 7, 2023

A recent act of kindness from Trinity Moravian Church in Winston-Salem, North Carolina, has gone viral for its creative method of tackling medical debt. It involves the church paying off $3.3 million in medical debt belonging to 3,355 local families – complete with a cathartic video of the oppressive debt being burned to ashes – by purchasing it for pennies on the dollar from debt collectors. Though heartwarming at first …

“System-ness”: the key to successful health care transformation

Robert Pearl, MD

Policy

September 4, 2023

Value-based health care, the holy grail of American medicine, has three parts: excellent clinical quality, convenient access, and affordability for all.

And as with the holy grail of medieval legend, the quest for value-based care has been filled with failure.

In the 20th century, U.S. medical groups and hospital systems could — at best — achieve two elements of value-based care, but always at the sacrifice of the third. …

Physicians divided: SCOTUS affirmative action ban sparks debate

Arthur Lazarus, MD, MBA

Policy

September 2, 2023

The fallout from the recent decision of the Supreme Court of the United States (SCOTUS) to ban racially conscious admissions at Harvard and The University of North Carolina has had major repercussions throughout the medical profession. I would say that physicians are highly divided on the issue of affirmative action, with many believing that meritorious performance should determine admission to medical school rather than race and ethnicity. In fact, a Read more…

Physicians divided: SCOTUS affirmative action ban sparks debate

The burden of bullets: Leadership needs to treat gun violence as a public health issue

Stephanie Duggan, MD and Peter Angood, MD

Policy

August 28, 2023

Regular mass shootings are a uniquely American phenomenon. The United States is the only developed country where mass shootings have happened every year for the past 20 years, according to Jason R. Silva, an assistant sociology and criminal justice professor at William Paterson University. According to the Gun Violence Archive, by the end of June 2023, there were more mass shootings in the United States than days in 2023 — at …

The high “cost” of waste in U.S. health care, and what we can do about it

Lalitha Sundararaman, MD

Policy

August 21, 2023

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

The U.S. spends the largest amount of money on health care in the world – around $4.3 trillion annually. However, an estimated 20% to 30% of this is wasted, with no benefit reaching the populace. Culprits contributing to this waste include administrative …

As suicide and gun violence rise, we need gun purchase waiting periods now

Taytum Kahl

Policy

August 19, 2023

In 2018, physicians began #ThisIsOurLane, a movement arguing that gun violence is a public health epidemic that medical professionals have a vital role in dismantling. Gun suicide rates are increasing across America – particularly in states with the fewest gun laws. Guns are the most lethal method of self-harm, with a fatality rate of 90%, yet only 11 states are enforcing …

The government should establish a Youth Behavioral Health Advisory Council

Mitchell Berger, MPH

Policy

August 19, 2023

Even as the declared public health emergency for COVID-19 ended on May 11, two other public health emergencies continued. The first such emergency, the opioid crisis, was initially declared in October 2017, more than two years before COVID-19. A second emergency was declared for youth mental health in October 2021 by three major national associations, including the American …

Kaiser-Geisinger vs. Amazon, Walmart, CVS: Who will reign supreme?

Robert Pearl, MD

Policy

August 6, 2023

For decades, research studies and news stories have concluded the American system is ineffective, too expensive and falling further behind its international peers in important measures of performance: life expectancy, chronic-disease management and incidence of medical error.

As patients and health care professionals search for viable alternatives to the status quo, a recent mega-merger is raising new questions about the future of medicine.

In April, Read more…

Kaiser-Geisinger vs. Amazon, Walmart, CVS: Who will reign supreme?

How junk food marketers exploit children’s impact on family food choices

Monique Potvin Kent, PhD

Policy

August 5, 2023

Would you let a clown influence what brand of car you buy? How about choosing your household appliances based on the advice of a cartoon bird or tiger?

Probably not. But young people in your family will likely let cartoons and mascots influence where your family eats out or what cereal you buy – indeed, many of your food purchases. Those choices and many others like them will, in turn, affect …

The physician’s crucial role in combating climate change

Megan McLaughlin

Policy

August 4, 2023

Jet skis on the highway and sharks in the street: these are some of the images that may come to mind when you remember the record-breaking flash floods that occurred in Fort Lauderdale in April of 2023. Due to global warming, lethal weather such as this is becoming more common across the globe, and it is taking the lives of our patients. One of the largest contributors to the …

Health misinformation’s deadly impact

Neha Gour

Policy

July 29, 2023

Turning into vegetarians can cure COVID-19, birth control pills cause abortions, or eating ginger is 10,000 times more effective than chemotherapy at curing cancer were some casually trending health misinformation in the past year. But what is health misinformation, and why is it a serious public health concern?

Health misinformation refers to health-related information that is false, unverified, and lacking scientific evidence. It poses a significant threat to public health as …

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Health misinformation’s deadly impact

Medical school applicants do not need to “check” a box to succeed

Arthur Lazarus, MD, MBA

Policy

July 27, 2023

Medical pundits are predicting that the recent U.S. Supreme Court ruling striking down race-conscious admissions will have dire consequences for medical schools and the composition of the physician workforce.

The concern is that the high court’s decision to restrict public and private higher education institutions from considering an applicant’s race or ethnicity in admission decisions will negatively impact medical schools’ diversity and the nature of future physicians.

The fear …

The evolution of lighting vs. cholesterol treatments: a tale of innovation and value

James B. Rebitzer, PhD and Robert S. Rebitzer, MBA

Policy

July 20, 2023

In a famous essay, Nobel prize-winning economist William Nordhaus studied the evolution of lighting. From medieval times until the …

What an occupational health lens reveals about clinician burnout

Mara Buchbinder, PhD, Tania M. Jenkins, PhD, John Staley, PhD, Nancy Berlinger, PhD, and Liza Buchbinder, MD, PhD

Policy

July 20, 2023

Clinician burnout is one of the most tenacious problems facing the contemporary health system. Recent years have seen a plethora of guidance on reducing burnout and improving health care workers’ well-being following the pandemic, but little evidence of improvement. Seeing the problem through an occupational health lens can reveal different solutions.

Occupational health is a subfield of public health concerned with promoting workers’ health, safety, and well-being. From …