Bob Doherty

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

How physicians can fight obstructivism over Obamacare

Bob Doherty

Policy

September 18, 2013

Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it. The state marketplaces, created by the Affordable Care Act (Obamacare) will begin enrolling eligible people on October 1, and eligible persons will have until March 31 to sign up. The coverage and subsidies for those who sign up will start on …

Will delays pose a big problem for Obamacare?

Bob Doherty

Policy

August 27, 2013

“What, me worry?” could pretty much characterize how Obamacare supporters are reacting to the news that the administration is delaying or modifying the implementation of some of its requirements. Like Alfred E. Neuman, they are expressing a public confidence that there is no reason to worry, everything is fine, the announced delays aren’t really that important, and Obamacare will be up and running and ready to start enrolling people on October 1. No worries.

“The …

My health care wish list if I were king

Bob Doherty

Policy

August 9, 2013

I think we all have fantasies from time-to-time what we might do it we were made King for a day (only benevolent kings, of course—no despots need apply!) What decrees might we issue to make the world a better place? What changes would we order to make our politics better? What improvements would we institute to make health care better? Well, here’s my (health care) list:

1. I would decree that every …

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My health care wish list if I were king

Are doctors ethically obligated to sign patients up for Obamacare?

Bob Doherty

Policy

August 2, 2013

One of the most disheartening developments in the unrelenting political fight over the health reform law is the organized effort by its opponents to dissuade the public from signing up for coverage. Having failed in efforts to block Obamacare in the Supreme Court, or to elect a president or Senate that would work for its repeal, they are now working to kill the law by persuading people to not sign …

There should be no quarterbacks in health care

Bob Doherty

Policy

July 20, 2013

The seemingly irreconcilable conflict between the medical and nursing professions usually boils down to one question: who is in charge? Physicians often use a football analogy: they are the quarterbacks of the team, calling the plays that others on the gridiron must follow, because of their greater training and skills. Advanced practice nurses (APNs) respond: not so, we are also highly trained and qualified to call the plays and lead …

Health care price transparency should receive bipartisan support

Bob Doherty

Policy

July 12, 2013

Most Republicans hate Obamacare for what they consider to be government over-reach, most Democrats support it because they believe only a strong policy of government intervention can extend coverage to the millions of uninsured—and there are no signs that their ideological battle will abate anytime soon. But there may be one sweet spot that both parties could agree on: providing consumers (or patients, if you prefer) information on the prices …

Can Republicans and Democrats agree on an SGR fix?

Bob Doherty

Policy

June 20, 2013

Getting rid of Medicare’s SGR formula has been organized medicine’s Holy Grail. But medicine has gotten no closer to finding a solution to the SGR than the medieval knights did in their search. This year could be different, though. The House and Senate both are working on bipartisan plans to repeal the SGR and reform Medicare payments, plans that are being developed with the input of physicians.

Yes, you heard that …

Is it possible to improve clinical performance without measuring it?

Bob Doherty

Policy

May 22, 2013

Like it or not, measuring physician performance is now a key part of the conventional wisdom on improving our health care system. Borrowing from management guru Peter Drucker’s mantra “You can’t manage what you can’t measure” health care policy makers have embraced performance measurement as being central to managing our heretofore unmanageable health care system. But there is a small but seemingly growing group of Don Quixote-like dissenters who are …

4 hard truths about Obamacare

Bob Doherty

Policy

April 28, 2013

It was recently the Affordable Care Act’s third birthday, but you might have missed it for all of the (lack of) attention it received. Sure, there was the usual back and forth from the law’s supporters and opponents, but almost nothing that provided any new insights.

Supporters, such as the liberal New York Times editorial page, marked the ACA’s anniversary by touting the tens of millions already being helped …

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4 hard truths about Obamacare

Why physicians should sympathize with federal employees

Bob Doherty

Policy

April 5, 2013

“Physicians care more about their pocketbooks than taking care of patients. They are self-interested and overpaid. They want to control everything. They don’t know what life is like in the real world of patients.”

By now, I am sure that physician readers of this blog can feel their blood boiling, for good reason. Why would I, as the principal staff advocate for internal medicine physicians, put such pernicious, unfair, inaccurate quotes …

Is this the year Congress repeals the SGR?

Bob Doherty

Policy

March 13, 2013

An elderly doctor passes away, and he find himself standing before the Pearly Gates. The Almighty greets him and says, “In recognition of your stellar life of service to your patients, family and community, I welcome you to paradise. And because I know that doctors have a great sense of curiosity about all things, you can now ask me any question—any—and I will answer it.” The doctor ponders for a …

Stop blaming patients for not doing enough to stay healthy

Bob Doherty

Physician

February 20, 2013

“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.

“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …

Do we really know what is going on with health care spending?

Bob Doherty

Policy

February 5, 2013

alice-in-wonderland_3

Trying to figure out what is going on with health care costs is like Alice’s adventures in Wonderland, things are just getting curiouser and curiouser. To illustrate: which of the following statements do you think are correct?

1. It’s been 50 years since health care costs increased this slowly.
2. The U.S. spends more on healthcare than any other country but our health is …

What Lincoln can teach us about health reform

Bob Doherty

Policy

January 2, 2013

“Passed by corruption, aided and abetted by the purest man in America” is how anti-slavery Congressman Thaddeus Stevens described President Lincoln’s successful effort to enact the 13th amendment, banning slavery. This historically accurate quote, which runs counter to the public image of “Honest Abe” Lincoln, is among the many fascinating stories recounted in the Steven Spielberg’s masterpiece “Lincoln” playing …

Are the healing professions doing enough to curb gun violence?

Bob Doherty

Physician

December 19, 2012

Is the medical profession doing enough about gun violence?

Are any of us? This is the question that we all must ask ourselves, in the wake of the incalculably sad massacre of little school children in Newtown, Connecticut.

I have struggled for days now to find the right words—how can I, or anyone else for that matter, find the words to describe the indescribable shared grief we have about the indescribable horror …

Enough with government interference in the patient-doctor relationship

Bob Doherty

Policy

November 21, 2012

Worried about a government takeover of health care?

You should be, but it isn’t the bureaucrats and politicians in Washington that you should be most concerned about. Instead, it is the growing propensity of state legislators to dictate to physicians what they can and can’t say to their patients, what tests they must provide, and what advice they must give to them—the patient’s wishes, the medical evidence, and the physician’s clinical …

The micro level of health reform cannot be ignored

Bob Doherty

Policy

November 5, 2012

Much of what passes for debate on health care during this election year is focused on the macro side, on big issues like how do we cover the uninsured or restructure Medicare and Medicaid financing. But for all of the talk about vouchers and block grants and insurance mandates, the candidates are missing the micro issues that really matter most to doctors and their patients, which is how health care …

Patients and doctors interpret fee for service differently

Bob Doherty

Policy

October 29, 2012

The debate over fee-for-service physician payment often is misunderstood to be about the technicalities and relative merits of the RUC, relative value units, P4P and the SGR. It isn’t—instead, it’s what the fee itself represents (and who decides), and what the service being provided actually is (and how it’s described).

Let me explain. Analysts across the political spectrum agree that the health care system needs to move …

What Republicans and Democrats can agree on about Medicare

Bob Doherty

Policy

October 12, 2012

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors.

“If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we know it,’ then both parties have embraced that goal, writes former OMB Budget Director Alice Rivlin in a Daily Beast commentary.

“Paying providers on a fee-for-service basis offers incentives to …

Are Medicare vouchers a good idea for patients and their physicians?

Bob Doherty

Policy

October 4, 2012

Trying to figure out whether Medicare vouchers are a good idea for patients and their physicians? Then consider these two basic questions:

1. How much will the federal government contribute?
2. Who is at risk for health care cost increases?

How much will the government contribute? The traditional Medicare program has no set limit on how much the federal government will contribute to a beneficiary’s health care, although there are limits on how …

Bob Doherty

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