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.

Analysis of the Max Baucus health care reform plan

Health Policy
September 17, 2009

by Peggy Peck, Executive Editor, MedPage Today

In an important step toward moving healthcare reform legislation through Congress, Sen. Max Baucus (D-Mont.) introduced his much-awaited bill today after months of working to gain bipartisan support.

medpage-today The chairman of the powerful Senate Finance Committee released a summary of legislation that would not create a public insurance option and would cost $856 …

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Analysis of the Max Baucus health care reform plan

Citizens, not lobbyists, must reform health care in the United States

Health Policy
September 16, 2009

by Gary R. Gibson, MD, FACP

We can deliver better health care to every U.S. citizen at less than one-half of 2.1 trillion dollars per year with constructive reform, a system wherein people receiving and providing care would feel greater satisfaction and dignity. Through courage and perseverance, we must identify and minimize waste, eliminate corruption and modernize our system. In a competitive world economy, we must reform health care …

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Citizens, not lobbyists, must reform health care in the United States

Cutting health care costs means reducing utilization

Health Policy
September 15, 2009

by Mark Coyne

The core of the health care debate revolves around the perceived spiraling cost of health care in America. There are many quotes in the media, and from politicians, that health care costs are increasing by more than 10 percent a year, and consistently increasing by more than wage growth – which is unsustainable in the long term. The basic point being made is correct, the overall …

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Cutting health care costs means reducing utilization

Why price transparency won’t affect health care costs

Health Policy
September 15, 2009

by Kumud B. Jindal, MD, MPH

Many patients and self-appointed health care experts view medical services as commodities, and openly express frustration with seemingly opaque pricing for a visit to the doctor’s office. “Doctors should publish their fees so we know what we’re paying!” The idea that this matters significantly with regard to health care costs is a terrible myth, one that deserves much closer scrutiny.

The health insurance industry and …

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Why price transparency won’t affect health care costs

Dean Ornish injects himself in the health reform debate

Health Policy
September 14, 2009

It looks like The Huffington Post’s honorary Medical Editor, Dr. Dean Ornish, walked into the same trap that Whole Foods CEO John Mackey did.

Mackey got a lot of flack when he wrote an op-ed in the Wall Street Journal on health care reform, one in which he emphasized the need for personal responsibility for our health.

Ornish, in an effort to inject himself into the current debate, blogged, Don’t Tread on …

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Dean Ornish injects himself in the health reform debate

Op-ed: Why the doctor won’t see you now

Health Policy
September 12, 2009

The following op-ed was published on August 20th, 2009 in CNN.com.

When President Obama recently cited the number of Americans without health insurance, he declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.”

Uninsured patients often delay preventive care, waiting to seek medical attention only when their conditions worsen. This leads to more intensive treatment, often in the emergency department or hospital where …

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Op-ed: Why the doctor won’t see you now

Advice for President Obama’s health care reform plan

Health Policy
September 11, 2009

Prior to President Obama’s address to Congress on health reform, I asked myself, “What would I tell the President?”

First and foremost: go for it. All of it. Health care in America is too important, both economically and morally, to be left adrift in its current state. Its focus is wrong. It costs too much. And not everyone who needs it is able to have it.

Two rules that have served me …

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Advice for President Obama’s health care reform plan

Why health care savings accounts should play a larger role in reform

Health Policy
September 11, 2009

by Charles W. Patterson, MD

Health care reform has long been one of my main interests and currently, it seems to be everyone else’s. The President said he thought a single-payer system would be best, but submitted a proposal he thought could be passed. The outcome is in doubt.

Actually, the single-payer system is the second best possible solution. The government would hold the money but would remain vulnerable to political manipulation, …

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Why health care savings accounts should play a larger role in reform

An analysis of Barack Obama’s health care reform speech to Congress

Health Policy
September 11, 2009

by Emily P. Walker, Washington Correspondent, MedPage Today

In Wednesday’s address to Congress and the nation, President Barack Obama made a number of statements about healthcare reform, some involving issues that would directly affect medical practice. MedPage Today examined five of Obama’s statements to add context to the sound bytes.

medpage-today The Statement:

“I don’t believe malpractice reform is a silver bullet, …

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An analysis of Barack Obama’s health care reform speech to Congress

Rising health care costs and the tax preference for employer-based health insurance

Health Policy
September 8, 2009

by Robert Berry, MD

In his column, David Brooks of The New York Times effectively compares our rapidly rising health care costs to “a stampede of big ugly rhinos.” What he ignores, however, is the huge elephant in the room that is largely responsible for this rhino stampede – the tax preference for employer-based health insurance.

This tax preference – enjoyed primarily by employees of large businesses and government at …

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Rising health care costs and the tax preference for employer-based health insurance

10 things your insured patients need to know about health care reform

Health Policy
September 4, 2009

by Paula Hartman Cohen

My husband and I live in Massachusetts, a state that already has health care reform.

On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance.

They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This …

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10 things your insured patients need to know about health care reform

What can health reform in the United States learn from Africa?

Health Policy
September 2, 2009

As an outside observer of the American health reform debate, I cannot help but notice the disparity of views, the fractured arguments, the protectionism and desperation. My country is in a similar struggle for health care reform, with the main difference being America is a rich nation, and we are poor by comparison. In both debates, however, I have looked for the humanitarian argument, and in many cases found it …

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What can health reform in the United States learn from Africa?

Health care reform: The uncivil war dividing America

Health Policy
August 31, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

The unfettered debate about ideas that characterizes the democratic process in the United States operates best when there is a truthful presentation of the issues, and when the process is civil and respectful. Unfortunately, the debate about health care reform has evolved to the point that it …

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Health care reform: The uncivil war dividing America

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Health care as a futures exchange

Health Policy
August 30, 2009

by Susan H

It seems that health insurers are serving as exchange and clearing firm for “health futures” traders. Traders of “health futures” are potential patients, and health care providers. Patients are synthetic buyers of futures on health care provision, doctors and providers of medical goods and services are short sellers of those futures. The exchange and clearing firm (health insurer) represents that it serves to stand as guarantor in the …

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Health care as a futures exchange

Is health care a public good?

Health Policy
August 24, 2009

by Jeoffry B. Gordon, MD, MPH

The public policy and current political action around changing the system overlooks two important technical fallacies:

(1) That health care is most efficiently distributed by a free market mechanism; and,
(2) That medical services are an ordinary commodity.

The commercial market model is a failing economic and public policy ideology used to rationalize and justify corporate control of the health care system to profit from the enterprise. …

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Is health care a public good?

What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Health Policy
August 21, 2009

Today’s health care communications lesson is brought to you courtesy of Whole Foods … I mean John Mackey.

John Mackey’s stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a …

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What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Is it fair to compare American health care with systems in Europe or Canada?

Health Policy
August 18, 2009

by Ralph Silverman, MD, FACS, FASCRS

I am tired of the comparisons people make between health care in the United States and other countries. For instance, there are those who think that we should have universal health care because some European countries and Canada do.

It is true that those countries do have universal health care, but is it a fair comparison?

Who does Canada rely on to defend its borders? When the …

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Is it fair to compare American health care with systems in Europe or Canada?

ACP: Putting effectiveness into the health care equation: Rational or rationing?

Health Policy
July 30, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

“Effectiveness” has become a buzzword these days in discussions about healthcare reform. It is often accompanied by different preceding modifiers, such as “cost” or “comparative,” each conjuring up different images in the minds of physicians, patients, insurers, and the pharmaceutical industry. Some say that cost effectiveness and comparative …

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ACP: Putting effectiveness into the health care equation: Rational or rationing?

AMA working for reform that benefits patients and physicians

Health Policy
July 26, 2009

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

by J. James Rohack, MD

Physicians know first-hand the frustrations of caring for patients in our broken system and also the joys of patient care that get us out of bed before the sun rises. The AMA is committed to getting health reform this year – so that the joys can again outnumber the …

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AMA working for reform that benefits patients and physicians

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