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.
If the Democrats capture the White House, keep the House, and take over the Senate, the Biden health care outline stands a good chance of being enacted.
The Biden health care proposal directly takes on the big things that haven’t worked in Obamacare.
Here are the things that are most broken in Obamacare:
- The individual health insurance premiums and deductibles are, and have from the beginning of the program, Read more…
Analyzing the Biden health plan. Will it work?
I can’t sleep, or maybe it’s that I got up too early. It’s 3 a.m. and a good 1 to 2 hours before I usually get up. California is literally burning. We have no rain in sight. Colorado is burning as well, although they may have snow soon. Do you remember last year when Australia was up in flames and koalas were dying? Did you wonder what the Australians were …
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It’s time to go all in on climate action
It’s winter in Oxford, and I’m biking to the John Radcliffe Hospital, the flagship medical center of England’s National Health Service. It’s raining, and the chain on my bike keeps slipping off the gear. “Figures — I shouldn’t have bought a bike from an antique shop.” Back in December, my school had offered to send me across the pond to immerse myself in the British health care system. Seeing as …
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What we can learn from England about universal health care
It is hard to envision that this is an election year. With a paucity of campaign ads and the presidential nominees locked up for quite a while, I didn’t even know that the Democratic convention was going on until I saw a report about it after the fact.
With election day now on the horizon, I reflect on the common mantra used almost every time an incumbent …
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The path to a healthy nation starts with the you, the voter
“No school today!” All of us can remember waking up to these words connected to whatever weather or current event thing and breathing a sigh of relief. A day without learning, without teachers nagging: a day to do whatever you wanted. What are today’s children feeling about this phrase?
The problem is that we aren’t really asking them. A quick internet search about children and COVID-19 brings up countless articles on …
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Let kids come to the table
Expectations, particularly when unmet, can be a source of disappointment. Anticipating something to happen a certain way and having it not come to fruition can leave us wanting, waiting, wondering. It can be particularly challenging when we feel responsible for a result but have incomplete, little, or even no control over it in the first place.
In medicine, there is a movement toward Read more…
Ownership of outcomes: Reuniting power and responsibility
After being kept up all night responding to pages, I was still half-asleep walking into Mr. Jenkins’ room for what I thought would be a routine early morning admission for new-onset seizures. From scanning through the electronic medical record, I was not expecting to encounter the unfortunate and complex array of social factors underlying his condition.
Mr. Jenkins was in his late 20s and had three children to take care of. …
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What happens if you are both too rich and too poor for health insurance?
Physician reimbursement increasingly depends upon measures of health care quality. Physicians who fall short on quality measures now face financial penalties.
The study involved a panel of people with expertise in evidence-based medicine. Panelists were asked to evaluate the validity of quality measures being used by either …
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Quality measures have gotten ahead of the science of quality measurement
Novel coronavirus (COVID-19) targets older ethnic and racial minorities with lethal precision, establishing irrefutable evidence that inequality kills. Nearly one-third of those who have died from COVID are Black, while Blacks represent about 14% of the population in the areas analyzed. In Chicago, 78.6% of COVID-related deaths were age 60 or more. While ethnic and racial minorities represent 59% of the population, they made up …
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COVID-19 adds a new health care gap: internet disparity
“I live and die by waveforms and not just a snippet. I need to see the entire waveform and what led to an event to determine an intervention or root cause.”
The intensive care specialist told me this with desperation in his voice. He’s the one who has to tell families that their loved one is gravely ill, that another cardiac event could happen at any time, without warning, or that …
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Health care, we have a problem
A recent report by Merritt Hawkins, the physician recruiting firm, includes two key revelations about the impact of the COVID-19 crisis on physicians: Merritt Hawkins’ searches on behalf of prospective employers have dropped by 30 percent since March 31, and up to 35 percent of practices in some markets might soon close because of their unsustainable financial losses.
As of late May, visits to physicians—both in-person and …
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Physicians of America, unite! You don’t have to work for hospitals.
As CNN and other outlets report, rates of COVID-19 have been overwhelming Imperial County, California, for the past two months. Bordered to the west by San Diego County, to the east by Arizona, and to the south by Mexico, the rate of new infections and deaths are higher here than anywhere else in California. Local hospitals have been flooded, and a federal field hospital continues to be at capacity. …
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A Southern California outbreak highlights failures of the American health care system
Earlier this summer, the Trump administration announced new rules that would eliminate asylum eligibility for people arriving from countries where COVID-19 is “prevalent,” even if they are fleeing for their lives. This is the latest in a string of anti-immigrant policies being pushed forward during the pandemic under the guise of public health. As physicians who care for migrants within and outside of the United States, …
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Stop using false public health claims to attack immigrants
Spoiler alert: If you are looking for the “right” answer as to whether or not your school should reopen for in-person teaching or if you should send your kid to school (versus virtual learning), you will not find that answer below. But you will find some factors to consider in making a decision for your family.
Given that I am in multiple Facebook physician groups and parenting/community groups, my Facebook feed …
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A physician-parent’s thoughts on reopening schools
Is it possible to have it all? Can you have a job that you love, helping people and using your brain and hands all at the same time; plus, a family, with a spouse and children, that you are always there for? Is it possible to have a balance between your work and your family live while working as a medical practitioner?
I would argue, it depends. About 15 years ago, …
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Our patients matter, but at what cost to our families?
With the news that nearly 6 million Americans have lost their employer-sponsored health due to COVID, it is finally time to ask ourselves: is the “American Model” of health care working?
The “American Model” is a system of fragmentation: one in which changing jobs can mean lapses in insurance, moving to a new state can mean losing Medicaid eligibility, and getting a raise can mean financial ruin …
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Is now the time for single payer?
