Health Policy

Physicians writing on KevinMD about the rules they practice under: prior authorization and the algorithms now deciding it, gold card laws, scope of practice and who may practice without supervision, Medicare and Medicaid, the Affordable Care Act, drug pricing, rationing that is done and not named, and the policies that decide which patients get care. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Race and medicine: what physicians say, in their own words, and Medical ethics: what physicians say, in their own words.

Why Medicare and health care should be deregulated

Kevin

Health Policy

February 20, 2010

by David Allen, MD

Should health care be controlled or provided by the government?

I believe that years of answering ‘yes’ to this question has been at the root of most of the problems in the American health care system. Let’s explore a few of these ‘yes’ answers:

Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. …

Why is President Obama ignoring the doctors when it comes to health reform?

Kevin

Health Policy

February 15, 2010

by Ernesto Gutierrez, MD

There is a lot of discussion about what Obama did right and wrong in managing the politics of passing health insurance reform. What strikes me as the most obvious is the failure to engage physicians. Sure there was support from the AMA, ACP, and AAFP, but the support was lukewarm at best. The position letters sent out to society members outlining their support seemed forced …

What should free health care to members of Congress be called?

Kevin

Health Policy

February 14, 2010

Originally published in MedPage Today

by Charles Bankhead

Recently, I learned that members of Congress have their very own medical clinic. I guess I shouldn’t have been surprised. Being a member of Congress is a tough job, filled with stress and posturing and righteous indignation. I know that if I had to decide whether to spend tax money on a Bridge to Nowhere or a pet airport that has flights to …

AMA: Why patients should care about fixing the Medicare physician payment cut

Kevin

Health Policy

February 11, 2010

The following is part of a series of original guest columns by the American Medical Association.

by J. James Rohack, MD

Prominently displayed at the top of the AMA’s Web site this week is a “countdown clock” to this year’s 21 percent Medicare physician payment cut, which will hurt physicians ability to care for all Medicare and …

Increasing copays will increase costs for health insurance companies in the long run

Kevin

Health Policy

February 9, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Raising seniors’ copayments for ambulatory care to offset increasing healthcare costs may backfire on insurers, researchers asserted.

Seniors enrolled in Medicare plans that increased copayments had significantly fewer outpatient visits but spent more time in the hospital than patients in plans that left copayments untouched, according to Amal Trivedi, MD, …

Differences between the Senate and House approach to health insurance exchanges

Kevin

Health Policy

February 4, 2010

by Deborah Maggart

It’s a very exciting time to be a part of the health care world.

The U.S. Senate and House were in deep negotiations attempting to reform health care in America by reconciling their separate visions into a single bill and – just as reform was deemed imminent – a special election in Massachusetts complicated matters by ending the Democrats’ filibuster-proof “supermajority” and with it the possibility of strictly partisan …

Why did Canadian premier Danny Williams come to the United States for heart surgery?

Kevin

Health Policy

February 4, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It is rare that a simple matter of patient choice causes an international flap.

But that’s what happened when 60-year-old Danny Williams of St. John’s, Newfoundland, decided to go to the U.S. for heart surgery.

That’s because Williams isn’t just any old Newfoundlander — he’s the premier of Canada’s easternmost …

Why there are so few leaders in medicine and how to fix it

Kevin

Health Policy

February 3, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

A quick look at a newspaper will tell any doc just how important physician leadership has become, and increasingly so, in having a say in our economic futures. But our titular leaders are in a historically weak system complicated by being only one group of voices struggling to be heard in the rush to deal with national health care reform. There are many docs …

How can doctors make America a better place to live?

Richard Reece, MD

Health Policy

January 29, 2010

What can physicians do to make American a better place to live, die, afford, and receive care? What can we do to bring about practical reform? What can we contribute?

These may seem odd questions, After all, we deliver care. Care goes through us. But Medicare, Medicaid, and private third parties are big players. They dictate terms of engagement and payment. But the answers lie at the core of the physicians’ …

Nobody will be held accountable if healthcare reform fails

Edwin Leap, MD

Health Policy

January 28, 2010

I must admit I’m a little weary of the entire debate on health-care reform. But something still haunts me. And that something is accountability. Of course, over the almost twenty years that I have borne the title ‘MD,’ I’ve learned a few things about accountability.

I understand that, almost without fail, the buck stops with me. The nursing home director knows the elderly lady wasn’t seriously hurt in that fall, but …

How President Barack Obama’s State of the Union speech will impact healthcare reform

Kevin

Health Policy

January 27, 2010

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. …

10 ways United States health reform may fail

Richard Reece, MD

Health Policy

January 26, 2010

One, develop a plan that the presently privately insured Americans, estimated at 200 million, pay more in premiums, and to just make sure you succeed, immediately starting raising taxes by $400 billion over the next decade.

Two, alienate those over 65, the most dependable voting bloc, by promising to cut Medicare by $500 billion over the next ten years with the false promise, which you know you cannot …

Why the Mayo Clinic is refusing to see Medicare patients

Toni Brayer, MD

Health Policy

January 25, 2010

Medicare, the government insurance company for everyone over age 65 (and for the disabled), pays fees to primary care physicians that guarantee bankruptcy.

Additionally, 70 percent of hospitals in the United States lose money on Medicare patients. That’s right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for …

How ideology is shaping health care reform

Richard Reece, MD

Health Policy

January 21, 2010

I’m an ideological pragmatist. I believe in what works and what suits the temperament of American people, rather than what is politically correct or what passes some moral litmus test.

Whatever reform measure passes, it will be a public-private mix and will superimpose more government regulations on our private system. It will have uneven effects. It will cost more than the status quo. And it will expose the reality, that when …

Did Martha Coakley kill health reform, and what Senator Scott Brown means for healthcare

Kevin

Health Policy

January 20, 2010

In case you haven’t heard, in a stunning result in yesterday’s special election in Massachusetts, Republican Scott Brown won the Senate seat previously occupied by the late Edward Kennedy.

Needless to say, pundits are going crazy analyzing the results, and its implications on health reform. I’ll leave the political commentary to them, but I’ll comment on what this means for health reform’s future.

In essence, what turned into a 95% likelihood …

What doctors should expect with health care reform

David Harlow

Health Policy

January 14, 2010

What should health care providers be doing in anticipation of the likely passage of an historic health reform bill?

There are at least three possibilities: (1) Lament the passing of the good old days and oppose it; (2) Insist that it isn’t good enough because it is lacking some key provision (tort reform; SGR replacement; robust public option); or (3) Embrace it, because incrementalism works, and prepare for what’s coming down …

The history of Medicare and its influence on American health care

Kevin

Health Policy

January 13, 2010

Originally published on MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

As Congress stands poised to make the most sweeping change to the U.S. healthcare system since the creation of Medicare, a look back at the incremental growth in that program may serve as a harbinger for the progress of healthcare reform.

The program — which provides insurance for some 43 million …

The American College of Cardiology (ACC) sues Medicare over physician rate cuts

Kevin

Health Policy

January 11, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

The American College of Cardiology (ACC) has filed suit against U.S. Department of Health and Human Services Secretary Kathleen Sebelius charging that the 2010 Medicare Physician Fee Schedule was adopted unlawfully.

The complaint seeks an injunction that will prevent the cuts — which the association claims used a flawed survey for …

Op-ed: Ways to make primary care the key to health reform

Kevin

Health Policy

January 9, 2010

The following op-ed, co-written with Rahul Parikh, was published on December 16th, 2009 in CNN.com.

America is closer to meaningful health care reform than at any time in its history. As we have all witnessed, finding a way to both provide every American access to affordable health care while seeking to control health care costs has not been easy.

Many of the proposed solutions have led to sharp disagreements, with contention …

Will physician and hospital penalties improve patient care?

Kevin

Health Policy

January 5, 2010

Originally published in HCPLive.com

by Alan Berkenwald, MD

In 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.

Well, good news for physicians – that day has arrived!