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.

Supporters of Obamacare should consider this Trump proposal

Robert Laszewski

Health Policy

February 28, 2020

Readers of my articles know that no one has been more critical of Obamacare’s flaws––particularly over the impact the program has had on middle-class consumers in the individual health insurance market.

And, readers already know that no one has been more supportive of the Medicaid expansion from the very beginning.

Now, the Trump administration wants to give states the option to abolish the open-ended federal funding of Medicaid via fixed block grants …

Urgent care is emblematic of problems in our health system

Rosalind Kaplan, MD

Health Policy

February 23, 2020

Working in urgent care, I’ve started supervising some of the other providers at sites other than my own — 19 sites in all in Pennsylvania and Delaware — so I hear about a lot of patient situations.

The urgent care site where I work is in an affluent area. Most of our patients are employed or retired and have health insurance, though I have certainly encountered a number of patients …

The impact of economic inequality on the incidence of mass shootings

Niran S. Al-Agba, MD

Health Policy

February 20, 2020

Gun violence has become a public health epidemic. Despite countless deaths in mass shootings over the last two decades, the Dickey Amendment—a provision inserted into the 1996 spending bill which blocked federal funding for research on gun violence—remains on the books. While every politician, media pundit, and policy expert “know” the solution, the answers are not that simple.

In reality, the factors which have fueled the rise in gun violence across …

What is the application process for physician long-term disability insurance?

Bob Bhayani, MBA

Health Policy

February 20, 2020

Protecting your lifestyle starts with protecting your income. Disability insurance provides a solid foundation for your financial future by providing you income when you’re unable to work due to an illness or injury. When most people hear the word “disability,” they immediately think of accidents. But the reality is that 90 percent of disabilities are actually caused by illnesses.

Disability insurance is more complex than other types of insurance. We recommend …

5 disruptive trends transforming health care

Richard S. Isaacs, MD and Chris Grant

Health Policy

February 19, 2020

Spiraling costs, poor quality outcomes, and inequities in access to care are driving significant and long overdue changes to the way health care is administered and managed in the United States.

And while the U.S. spends more on health care per person than other wealthy countries, its health outcomes are no better than those in other developed countries. In fact, it performs worse in several health metrics, including life expectancy, infant …

Legislators, please stay out of our exam rooms. Especially when it comes to children and gender.

Amy Potter, MD

Health Policy

February 19, 2020

Legislators have found a new way to insert themselves into the physician-patient relationship. In October and November 2019, news stories regarding a parental dispute over the treatment of a transgender child prompted legislators in Texas, Kentucky, and Georgia to announce plans to introduce bills that would prohibit medical and surgical treatment of transgender children under age 18.

Since then, Read more…

Legislators, please stay out of our exam rooms. Especially when it comes to children and gender.

Medical error is not the third leading cause of death

Skeptical Scalpel, MD

Health Policy

February 17, 2020

Ever since the publication of the infamous 2016 BMJ opinion piece claiming medical error should be considered the third leading cause of death in the U.S., the debate on the true incidence of deaths caused by medical error has been raging. Many, including me, felt the estimate of 251,000 deaths per year from medical error was grossly inflated. For example, the paper extrapolated the number of deaths from …

What do hospital discounts really mean?

Robert S. Berry, MD

Health Policy

February 16, 2020

Our local newspaper recently ran an article on the top of its front page, stating that our monopoly health system is now “expanding health care cost discounts.” The article was actually a press release – free advertising on the front page. As a primary care physician who refers patients to this health system, I wanted to know what these discounts really meant.

So, I asked the newspaper in an editorial, “what …

Read more…

What do hospital discounts really mean?

Margaret Mead was right about health care

Peggy A. Rothbaum, PhD

Health Policy

February 9, 2020

One of my graduate school professors proclaimed that what is wrong with our society is that most people have not reached formal operations or have not been in psychotherapy.

Formal operations is the stage of development, described by French researcher Jean Piaget, where we learn to take the perspectives of others, to disagree while maintaining a relationship, and to understand that we are not the center of the universe.

Psychotherapy is where …

How health care is like a convoluted financial investment scheme

Smart Money, MD

Health Policy

February 8, 2020

The business of medicine is unlike any other type of standard “business” in that health insurance and hospitals confound what would appear to be a simple exchange of services for a set price. You know that the confusion is bad when neither doctors nor the patients fully understand how the insurance system works. I have seen patients going into surgery for a lap chole being quoted a price that ended …

Improve mental health by improving how we finance health care

Steven Siegel, MD, PhD

Health Policy

February 3, 2020

It takes an average of 10 years between symptom onset for mental health conditions to be accurately diagnosed and therefore treated. In addition to general misunderstandings about mental health, the nationwide shortage of mental health providers is one unignorable cause for this devastating delay. But why is there a shortage? Well, the bottom line is … the bottom line.

In simple terms, insurance companies do not pay enough for mental health …

Why we need revolutionary medicine now

Seiji Yamada, MD, MPH, Arcelita Imasa, MD, and Gregory Maskarinec, PhD

Health Policy

February 2, 2020

Health care professionals, medical students, and students of public health are increasingly aware of the “social determinants of health.”

Everyone has begun to realize that poverty is the most important cause of illness. Too often, however, the analysis stops there, instead of asking what the root cause of poverty is, the question is: what causes those “social determinants”?

Why do resources remain unequally distributed, why cannot everyone access the same quality of …

Read more…

Why we need revolutionary medicine now

The primary care solution is obvious, but don’t expect policymakers to jump on board

Robert Pearl, MD

Health Policy

January 31, 2020

In a shocking development that could transform the medical profession, the International Journal of Health Services published the findings of a study titled, “Primary care, specialty care, and life chances.”

Using multiple regression analysis, the researchers concluded that “primary care is by far the most significant variable related to better health status,” correlating with lower mortality, fewer deaths from heart disease and cancer, and a host of other beneficial health outcomes. By contrast, …

What is “fair” payment for medical services?

Neal Biron

Health Policy

January 29, 2020

I write this hoping to appeal to common sense. When are we going to stop putting the cart before the horse? 99 percent of the rhetoric surrounding health care costs centers on a “fair” way to pay for it, “fair” reimbursement levels, and who should pay this “fair” level of payment, when the real issue is the amount being charged in the first place. What exactly is “fair”?

The real central, …

One person’s wasteful medical spending is another person’s income

Edward Hoffer, MD

Health Policy

January 29, 2020

In a New York Times article, “The Huge Waste in the U.S. Health System,” it stated that the estimated waste is at least $760 billion per year: “That’s comparable to government spending on Medicare and exceeds national military spending, as well as total primary and secondary education spending.”

Why is waste so prevalent? There are many sources. The biggest one, and the one that should most concern …

Making America great again with harm reduction

Mark Leeds, DO

Health Policy

January 28, 2020

I recently discovered a fact about the United States of America that should be a source of embarrassment for all Americans. What I found out is this: There is not a single safe injection site anywhere in the entire country. Safe injection sites save the lives of people addicted to opioids, such as heroin and fentanyl. These sites exist in countries around the world, and they are working every day …

Why this physician supports Medicare for all

Thad Salmon, MD

Health Policy

January 24, 2020

Alexa Karsdan’s medical bill for a sore throat reached over $28,000. NPR told her story recently, but I want you to know why I am actually glad this happened. Why is it good news that her charges were so exorbitant, and that her insurance paid over twenty-five thousand dollars for one laboratory test? This story is a brilliant illustration of fundamental flaws in our health care …

Does socialized medical care provide higher quality than private care?

Peter Ubel, MD

Health Policy

January 22, 2020

Americans are not fans of socialized medicine. Sure, some people want socialized health care payment, including many people who are fans of Medicare for all. But even most Bernie Sanders supporters probably aren’t in favor of socializing the entire U.S. health care system, thereby making hospitals and medical clinics into government property. Americans are proud of the high quality of care offered by non-government providers, from their local community …

Your grocery cart on WIC

Hanna Saltzman

Health Policy

January 20, 2020

Karen smiled nervously, her swollen belly peeking out from under her stretched silver tank top. Six months pregnant with her first child, the eighteen-year-old had come to the WIC (Women, Infants, and Children) office for help with getting enough to eat. As a medical student with a background in nutrition advocacy and a future in pediatrics, I had asked to observe the WIC enrollment process.

Karen and …

Read more…

Your grocery cart on WIC

Only Biden, Bloomberg, and Buttigieg have health plans that have a realistic chance of becoming law

Robert Laszewski

Health Policy

January 19, 2020

In an earlier post, I pointed out that there is no better chance of passing a Medicare for all health care plan through Congress in the coming years than there was in 1977, or 1993, or 2009.

Then Elizabeth Warren showed us just how politically unrealistic single-payer health care is when she released her funding plan and then quickly backtracked to the public option …

Health Policy

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts