Bob Doherty

Bob Doherty is senior vice-president, governmental affairs and public policy, American College of Physicians and blogs at the ACP Advocate Blog.

Don’t underestimate the appeal of a Trump “health plan”

Bob Doherty

Policy

September 28, 2019

As the Democratic candidates for president continue to beat up each other on how best to achieve universal coverage (Medicare for all, a public option, closing the ACA’s coverage gaps), health care journalists keep wondering when President Trump will release his long-promised “phenomenal” plan to position the GOP as “the party of health care” for the 2020 election.

Skepticism is warranted over when or even if …

5 health care lessons from the mid-term elections

Bob Doherty

Policy

November 26, 2018

This seems to be the big take-home message from voters the mid-term elections, which bodes well for preserving gains from the Affordable Care Act and expanding coverage. Health care was the number 1 issue for voters according to several exit polls, beating out immigration, the economy, and gun violence, among others, with voters strongly favoring Democrats as the party more likely to protect patients with …

Medicare’s historic proposal to change how it pays physicians

Bob Doherty

Policy

July 22, 2018

The word “historic” is often used by PR professionals to hype something that is, well, pretty run-of-the-mill. They figure that no one is going to read a news release that announces “[Name of organization] proposes small change that really won’t make much of a difference.” The problem is that when something is done that really measures up to being historic, the recipient is less likely to believe it, kind of …

Are physicians ready for single-payer health care?

Bob Doherty

Policy

March 14, 2018

Single payer health care is enjoying a boomlet in public opinion.

A Pew Research Center poll released in June 2017 found that, “Overall, 33 percent of the public now favors such a ‘single payer’ approach to health insurance, up 5 percentage points since January and 12 points since 2014.” 58 percent of those surveyed by Pew said that the government has a responsibility to ensure health for all, with a third …

The ACP leads the charge against the Better Care Reconciliation Act

Bob Doherty

Policy

June 24, 2017

President Trump told a group of Republican Senators that the House-based American Health Care Act is “mean” — and on this he surely called it right!

How else would one describe a bill that would take health insurance away from 23 million people, allow states to waive rules requiring insurers to cover people with preexisting conditions at no extra charge, and raise premiums and deductibles to the oldest and …

Why the American Health Care Act must be stopped. Now.

Bob Doherty

Policy

March 24, 2017

When I tweeted this on Monday morning about the House GOP bill to “repeal and replace” the Affordable Care Act, I had no idea that it would result in me appearing on MSNBC’s Last Word with Lawrence O’Donnell or that it and my other tweets would be referenced by NBC News, a New York Times editorial, or for that matter, a retweet from singer-songwriter John Legend!

I mention …

50 ways to lose your coverage if Obamacare is repealed

Bob Doherty

Policy

January 5, 2017

The Republican congressional leadership appears to be determined to move forward with a high-risk “repeal, delay and replace” plan, very early in the new 115th Congress to repeal (at least on paper) the Affordable Care Act’s key coverage provisions—Medicaid expansion, subsidies to make private insurance sold through the exchanges affordable, the individual and employer mandates, and the taxes to pay for coverage—by a simple majority vote, while delaying when the …

Direct primary care: An evidence-based dialogue is needed

Bob Doherty

Policy

November 3, 2016

One thing I’ve learned is that physicians who have gone into direct primary care (DPC) practices are passionate about their decision: they not only believe that DPC is better for their patients and their own professional and career satisfaction, many assert it is the answer to just about everything ailing primary care. There is an evangelical fervor among some DPC advocates to spread the word and convert …

Government-run health care isn’t going away

Bob Doherty

Policy

August 25, 2016

We all want this sometimes, don’t we? We want the things in our daily lives that bug us the most, like long lines at the DMV, to just go away. But how often does that really happen?

As the senior staff person for ACP’s governmental affairs team in Washington, DC, I often hear from exasperated physicians who want ACP to just make things they don’t like go away, whether it’s MACRA …

Don’t rant about MACRA. Propose solutions instead.

Bob Doherty

Policy

July 20, 2016

Recently, ACP offered practical solutions to physicians’ concerns about Medicare’s proposal to implement the new payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA).

The College’s detailed recommendations, summarized here in a press statement that is linked to the comment letter itself, would replace CMS’s proposed and unnecessarily complex quality scoring system with a much simpler and understandable approach as developed by the College.

We challenge CMS to completely …

Why doctors shouldn’t worry about MACRA

Bob Doherty

Policy

June 19, 2016

I’ve had the chance to present the changes being brought by the Medicare Access and CHIP Reauthorization Act (MACRA) to audiences of hundreds of physicians — at ACP’s Leadership Day on Capitol Hill, ACP’s Board of Governors and Board of Regents meetings, several educational sessions and a news briefing at the College’s Internal Medicine 2016 Scientific Meeting, and to the California Medical Association’s Leadership Academy. I’ve also had chats with …

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Why doctors shouldn’t worry about MACRA

Explaining the physician anxiety behind performance measures

Bob Doherty

Policy

March 1, 2016

Just as the U.S. health care system is about to make performance measurement a central feature of … well, just about everything doctors do … some prominent and highly influential physicians are asking for a pause and reassessment.

Writing for the New York Times, Dr. Bob Watcher argues that, “Two of our most vital industries, health care, and education, have become increasingly subjected to metrics and measurements. Of course, …

7 new Medicare codes primary care doctors can use to increase payments

Bob Doherty

Policy

December 14, 2015

The fact that primary care is undervalued by Medicare and other payers has been long understood to be driving the precipitous decline in the numbers of new physicians choosing primary care internal medicine or family practice, and a growing exodus of established primary care physicians.

Efforts to address this undervaluation have traditionally been to, 1) bump up the payments (relative value units) for the office visit codes traditionally billed by primary …

How Medicare benefits doctors: A complicated history

Bob Doherty

Policy

August 11, 2015

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Fifty years ago, President Lyndon Baines Johnson signed Medicare (and Medicaid) into law. Medicare’s relationship with physicians since then can best be described as a complicated one.

First, recall that Medicare became law notwithstanding the American Medical Association’s fierce opposition to it. Three years prior to its enactment, AMA President Ed Annis warned that, “We doctors fear that the American …

Do doctors really hate Obamacare?

Bob Doherty

Policy

July 19, 2015

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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 …

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Do doctors really hate Obamacare?

The best places for a doctor to practice: It’s more than money

Bob Doherty

Physician

June 30, 2015

I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make. Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider …

SGR repeal and MACRA: Here’s why it’s remarkable

Bob Doherty

Policy

April 16, 2015

The 92-8 vote in the United States Senate to join the House in passing the Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2, represents a remarkable milestone for the Medicare program, and for ACP advocacy on behalf of internists and patients.

It is remarkable not only because it eliminates the failed Medicare SGR — how often does Congress admit it made a mistake, and then correct it? — but because it …

Stop calling SGR repeal the doc fix. It’s about fixing Medicare.

Bob Doherty

Policy

March 21, 2015

Members of Congress and the news media have a bad habit of referring to efforts to stop Medicare from arbitrarily cutting payments to physicians for taking care of their patients as the “doc fix.” Typical is this story from CNN — “Bipartisan Love: Boehner, Pelosi strike deal to kick doc fix” — that reported on the release yesterday of an agreement between the two leaders on a bill to repeal …

Physicians need to be ready for the end of fee-for-service

Bob Doherty

Policy

February 25, 2015

For years, policy experts have been predicting the end of fee-for-service. Yet it can be said of fee-for-service that, like Mark Twain’s alleged demise, reports of its death have been greatly exaggerated. (Actually, this is an often-used misrepresentation of what Twain actually said. After the New York Herald incorrectly reported that he was “grievously ill and possibly dying,” an “amused” Mark Twain wrote that “the report of my death has been …

Will the psychologists involved in torture be held accountable?

Bob Doherty

Policy

December 30, 2014

Whatever happened to “first, do no harm?”

One of the findings included in a Senate investigative committee’s report on the U.S. government’s post-9/11 torture program was that it was designed by two psychologists. They were paid “$80 million to develop torture tactics that were used against suspected terrorists in the wake of the September 11 attacks on the Pentagon and the World Trade Center” — including “waterboarding and mock burial on some of the …

Bob Doherty

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