Anti-Obamacare critics often claim that “every” physician they know hates Obamacare. For instance, pediatric neurosurgeon and GOP Presidential candidate Dr. Ben Carson told Fox News that “he’s spoken to hundreds of doctors throughout the country about the Affordable Care Act, and not one of them ‘liked’ President Barack Obama’s signature health care law.”
Doctors hate Obamacare, it’s alleged, because it …
Do doctors really hate Obamacare?
Congress is infected with the budget-cutting bug, and building an effective immune system requires political savvy. Sometimes, it’s simple (“We bomb terrorists” or “We process Social Security checks”), but sometimes an agency struggles. Case in point: AHRQ.
A House subcommittee recently voted to eliminate the Agency for Healthcare Research and Quality (AHRQ) as of Oct. 1, 2015, the start of fiscal 2016. If you hadn’t heard the news or aren’t …
Do these 3 things to save the AHRQ from extinction
In contrast to the expected shortage of tens of thousands of physicians, there appears to be an abundance of health care administrators, at least judging by graph above.
The originators of the graph — economists and physician-activists at Physicians for a National Health Program (PNHP) — invoke the administrative bloat as reason to promote a single payer system. With a single …
Will single-payer really reduce administrative waste?
The feminization of health care is fundamentally changing care delivery in the United States and it is doing so in ways that will accelerate the pursuit of improved quality and affordability.
Historically, health care providers and health care leaders have been selected for and nurtured traits that are traditionally seen as “masculine” — traits such as heroism, independence, and competition. Yet it …
The feminization of health care is here. And that’s a good thing.
We must be “brave, brave, brave,” as we exhaust and challenge ourselves to reconcile the disparities that exist in our country. These words, delivered by keynote speaker Bryan Stevenson at the 2013 Teaching and Leadership Development Summit, inspire me as I continue on my mission to help break down barriers that give rise to health challenges in our nation. Towards this end, I strongly believe we need to build a …
We need to build a robust army of physician advocates
In the past, physicians were responsible for both the business and practice of medicine. While administrative personnel played an important and complementary role in practice and hospital management, physicians were the cornerstone. In comparison, today the leadership structure in medicine is now an entirely foreign landscape. Administrators dominate medical practices today and, according to the New York Times, …
Rise of the administrators: Hasta la vista, docs
Let’s get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government.
But, that said, we have to face the fact that our massive privatization of what once were government functions has been a failure. There are some public services that get really loused up when done privately and for profit.
This is a classic mismatch …
Have we gone too far down the road of privatization?
Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer — but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for the treatment of leukemia, but not for the stunningly rare kind of sarcoma with which Manny has been diagnosed. Nothing is …
There are only 3 ways to allocate health care resources
California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how health care consumers, otherwise known as …
Can reference pricing be the answer to soaring health costs?
Recently, health insurance companies across the nation have petitioned to increase premium rates for customers covered under the Affordable Care Act (ACA). In North Carolina, Blue Cross Blue Shield (BCBS) has proposed a 25.7 percent raise in premiums; in New Mexico, BCBS requested a 56.1 percent raise; and, in Georgia, Alliant Health Plans has submitted a proposal for a hike as high as 85 …
Putting the increases in health premiums in perspective
Mergers and acquisitions aren’t two words that usually find their way into medical lexicon, but that is rapidly changing. However, health care, like many industries, is experiencing a new round of mergers and acquisitions that is reshaping local and national markets, as well as impacting the availability and affordability of health care services for millions of patients. According to many industry and Wall Street experts, we are on the front …
Should there be FTC scrutiny of health industry mergers?
The Medscape Physician Compensation Report puts primary care physicians at the bottom of the heap, with a median earning of less than $200,000 per year in 2014. What if the largest insurer of older Americans took those numbers to heart and decided to give primary care a pay raise of 25 percent, in recognition of and better support …
Medicare is paying for chronic care management! Here’s what you need to know.
In many communities around the country, hospitals are one of — if not the — largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that. It’s about the health care consequences, and by extension, the health consequences that might arise in a community when a hospital closes its doors.
The logic is fairly straightforward: If a …
If your hospital closes, does patient care suffer?
ADVERTISEMENT
Imagine you were seeking major surgery, and the hospital’s consent form contained this surprise statement, which you were asked to initial: “I understand that this surgeon and hospital have not performed this procedure in the last 12 months. As such, I accept the greater risk of complications and even death.”
It’s hard to believe that you would sign the form and move …
Can hospitals restrain themselves from doing low-volume surgeries?
There is a scene from the movie Dr. Zhivago that, no matter how often I see it, sends chills down my spine. Yuri returns home from World War I after the communist revolution in Russia and runs into his half brother. Yuri finds that not only has his house has been taken over, but being a doctor, he has been “assigned” …
The future of physicians: Dr. Zhivago offers clues
The Affordable Care Act (ACA) has changed Medicare for the better, and produced higher quality of care for patients. But whether the new shifts in Medicare policy will lower the total cost of health care, remains unclear. And that could present the program with a major problem in the future.
For the first 40 years of Medicare, most enrollees opted for the traditional fee-for-service Medicare program. The main reason for doing so was …
Will Medicare changes be enough to rein in health costs?
Paying someone to mow your lawn is a pretty straightforward affair. Ryan the lawn guy will look at the lawn size and maybe the hilliness of your yard, and you’ll settle on a price for mowing and trimming it. When you decide to contract for Ryan’s services on a more regular basis, payment might get a little more complicated. If you pay Ryan every time he mows your lawn he …
Paying for health care is hard. Just take a look at bundled payments.
I am going to make a bold statement here. Are you ready for it? There is nothing wrong with health care providers thinking like businessmen.
I know what you’re thinking, but I feel the word “business” gets a bad reputation in medicine. We immediately associate the term with profit-hungry, egocentric individuals, a preconceived notion probably rooted in their unfair depiction in popular …
4 reasons why business and medicine go together
Co-management agreements are growing in popularity as health care shifts to outcomes-based reimbursement models. Physicians and hospitals contract with one another in quality-oriented pay-for-performance arrangements, in which physicians oversee and manage service lines (most commonly orthopedics, oncology, and cardiology).
The overarching goal of these agreements is quality improvement, which benefits all parties involved — especially the patient. The hospital benefits financially in part from reducing costs and physicians receive a base …
Co-management agreements have risks. Beware.
This is one of those columns that will risk the respect and friendship of some of my closest colleagues in the health care world. In addition to disagreeing with me, they may argue that I am giving aid and ammunition to “the enemy,” where the enemy might be viewed as those forces in the health care world who really don’t want …
The triple aim has been hijacked by powerful political forces
Get free updates delivered free to your inbox.
