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 we must temper our unregulated free-market philosophy in health care

Peter F. Nichol, MD, PhD

Health Policy

December 9, 2016

Quick, name the most watched, financially successful and competitive sports league in the United States?

The NFL. Right?

Now, name the most tightly regulated, transparent sports league, one that has a multilayered system of wealth redistribution and the one of the strongest unions of any profession in the United States? The NFL.

Surprised?

This is not a coincidence

Major problems with concussions and Roger Goodell’s persona and salary aside, the NFL offers a tremendous lesson …

This liberal physician wants to give Tom Price a chance. Here’s why.

Niran S. Al-Agba, MD

Health Policy

December 8, 2016

Recently, President-elect Trump selected Rep. Tom Price, MD to lead the Department of Health and Human Services. Suffice it to say, this signals Mr. Trumps’ resolve and commitment to definitively repealing and replacing. Dr. Price has already sunk his teeth into health care reform, having proposed alternative health care solutions in every Congressional session since 2009.

As a physician myself, I am delighted at the prospect of having another doctor at …

Endorsing Tom Price: Does the AMA owe us an explanation?

Eric Beam, MD

Health Policy

December 8, 2016

On Tuesday, November 29, President-elect Donald Trump named Dr. Tom Price, a former orthopedic surgeon, current Republican congressman, and chair of the House Budget Committee, as his pick for Secretary of Health and Human Services.

The same day, the American Medical Association issued a press release enthusiastically endorsing Price for the position.

The next day, Dr. Andrew Gurman, the president of the AMA, came to my …

We cannot ignore the dysfunctional systems at the heart of how we care

Peter Pronovost, MD, PhD

Health Policy

December 6, 2016

If we want to rein in the costs of the U.S. health care system — now equal to nearly 18 percent of the nation’s gross domestic product — we cannot ignore the fragmented technologies used to help heal and save lives.

At first glance, the devices, monitors, electronic health records and machines found in today’s hospitals might inspire awe. Look beyond the slick displays with blinking lights, however, and the picture …

Medical service based on socioeconomic status: That’s unacceptable

Linda Girgis, MD

Health Policy

December 6, 2016

The patient was in pain and had been for over a year. And it was getting worse, not better. Exhausting all avenues of treatment, I decided it was time to refer him to a pain management doctor. Because of the injury to his back, the patient lost his job and his health care coverage. With no alternative for health care coverage, he ended up covered by Medicaid. While health care …

I never want to be a government-employed physician. Here’s why.

Suneel Dhand, MD

Health Policy

December 6, 2016

Every health care system in the world is facing its fair share of challenges. Aging populations, the exponential increase in chronic diseases such as heart disease and diabetes, expensive new treatments—all at a time when most countries desperately need to curtail rising health care costs to save their economies. At the two extremes, we have fully public-funded (socialized) medicine versus entirely free-market (private) health care delivery systems. I’ve written previously …

How this physical therapist left her insurance nightmare behind

Kristi Anderson, PT

Health Policy

November 29, 2016

It is time for me to dig out from under the frustrating quagmire of paperwork imposed on me by my insurance contracts so I can reclaim my sanity and love of my work. I am terminating all of my in-network contracts, firing my billing service, and focusing my clinic time and energy entirely on patient care. Removing my practice from the control and limitations of health care insurance companies allows …

Why repealing Obamacare won’t be as bad as many people think

Brian C. Joondeph, MD

Health Policy

November 28, 2016

With Donald Trump’s promise to repeal and replace Obamacare on many Americans’ minds, there are numerous questions about how the health care system will work in the very near future. There are equally as many, if not more, outlandish speculations.

Donald Trump was elected a week ago and doesn’t assume office for two more months. Much of what will get changed and how is yet unknown. Yet the mainstream media has been quick …

Donald Trump keeping the pre-existing conditions protections isn’t new

Robert Laszewski

Health Policy

November 28, 2016

The Wall Street Journal, The Washington Post, CBS News and other news outlets have led with headlines touting the big news that Donald Trump is willing to keep parts of the Affordable Care Act — notably the pre-existing condition protections and the ability for children up to the age of 26 to stay on their parents policies.

Except this isn’t news.

In May, Trump’s policy advisor told Healthline that …

The good, bad, and the ugly of repealing the Affordable Care Act

Ilene Benator, MD

Health Policy

November 22, 2016

With the election of Trump and a Republican Congress, it looks like the ACA is doomed. Will it be repealed in whole or in part? Will something replace it? None of us, including the new administration, know exactly what will happen. But if it does get repealed, what exactly are the consequences?

The ACA was never a full health care overhaul. It was a form of insurance reform that used subsidies …

Why physicians need to organize

Andres Barkil-Oteo, MD

Health Policy

November 19, 2016

In my previous post, “Have physicians finally joined the working class,” I discussed the changes in the health care system regarding physicians roles in these systems. In this post, I propose two strategies that could help physicians regain some influence over their work and to participate fully not just in the execution of strategy from management but also have an input in creating it.

Building unions

There has …

Read more…

Why physicians need to organize

Don’t like the election outcome? Here’s what you can do from now on.

Morgan Leafe, MD

Health Policy

November 15, 2016

Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election. Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality. What does the future hold? What will the consequences be for my gay, minority, and Muslim friends, family, and patients? How will this affect the vulnerable children that I care for every day?

As I began to process …

Is it fair to reward Medicaid patients for routine health care?

Peter Ubel, MD

Health Policy

November 14, 2016

My son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over-caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing drugs and engaging in unprotected sex. You should be rewarding me for being such a good kid.”

“Reward you for not being bad?!,” I replied incredulously. That made no sense to …

What will Trumpcare bring?

Niran S. Al-Agba, MD

Health Policy

November 14, 2016

The world is not going to end. We witnessed a revolution earlier recently. The people have spoken, and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo. We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for health care. Here is what we do know. Mr. Trump is a successful entrepreneur. Forbes describes the entrepreneurship pathway as having no …

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What will Trumpcare bring?

What does the Trump victory mean for health care?

Linda Girgis, MD

Health Policy

November 14, 2016

While health care was a hot topic during previous presidential races, not much attention was paid to it in our current one. For the most part, many people think that Obamacare cannot continue as is: It costs too much, only a few insurances are now participating eliminating the market competition and laden with poor coverage with high deductibles. The world watched with bated breath as Donald Trump surprisingly won the …

Instead of repealing the Affordable Care Act, strengthen it

Kenneth Lin, MD

Health Policy

November 12, 2016

On the election day that made Donald Trump the next president of the United States, I traveled to Lancaster, Pennsylvania to give a lecture. Long a conservative political stronghold, Lancaster County was dotted with “Make America Great Again” campaign signs, forecasting Trump’s comfortable 47,000 vote margin there, which ended up being more than two-thirds of his 68,000 victory margin in Pennsylvania, one of the states that effectively decided …

If you’re obeying the law, you’re contributing to CEOs’ astronomical salaries

Justin Reno, MD

Health Policy

November 10, 2016

Guess what America? If you pay for health insurance, you’re giving billions upon billions to health insurance CEOs, hospital administrators, pharmaceutical company CEOs. So, if you’re obeying the law, you’re contributing to their astronomical salaries.

In fact, Cigna’s CEO made around $49 million this past year, if you read the various reports on the Internet. The CEO at a non-profit hospital in New Jersey (Morristown Medical Center) made some $5 million …

What does hugging have to do with physician pay?

Peter Ubel, MD

Health Policy

November 8, 2016

According to recent research, a hug a day could keep the doctor away. According to another study, Twitter can predict the chance that people will experience heart attacks. A normal blogger would look at these two findings and tell a story about the relationship between stress and health. I’m not normal. I looked at these two studies and came to a different conclusion — that we …

The broken dreams of Obamacare

Richard Young, MD

Health Policy

November 8, 2016

I have written before about predictions of the actual costs of Obamacare and the probable death spiral of increasing costs and decreasing participants. Several recent reports have brought more clarity to the cost realities.

Recently regulators across the country approved rate hike requests by Obamacare insurance companies even greater than they originally asked for. For example, Pennsylvania regulators approved rate hikes of 33 percent, which was …

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The broken dreams of Obamacare

Our health system is in dire straits with no good plans for reform

Linda Girgis, MD

Health Policy

November 7, 2016

In her home country, everything is free. However, there is a catch — certain services are only available to those who pay for private insurance. Those who are on the “free plan” sometimes must wait months for procedures. My patient said she knew many people who died on the list waiting for procedures. So, which is better: Free rationed care where people may suffer consequences waiting in line or overpriced care …

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