Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel. He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together.
Lebron James makes over $19 million per year playing basketball for the Miami Heat. Not surprisingly, this salary is peanuts compared his endorsement earnings, which in 2012 topped $42 million. Although perhaps peanuts is the wrong word to use when discussing James outside earnings, which to my knowledge have not involved foods anywhere near as healthy as peanuts. Instead, according to …
It is pretty easy to be against Obamacare these days.
The federal government can’t come up with a working website to help people buy health insurance. The president misled people about whether they could hold onto their old insurance plans. And come next tax day, the least popular provision of the Affordable Care Act — the individual mandate — will be implemented for the first time.
Lost amidst all this controversy is …
In an earlier post, I presented some data on which kind of physicians in the United States are most and least likely to see new patients who receive Medicaid, the state/federal program to pay healthcare costs for low income people. Now a recent study lays out some reasons why many physicians are so reluctant to see such patients.
Not surprisingly, it starts with low reimbursement rates. Medicaid pays about 61% …
Ask physicians if our messed up malpractice system causes them to practice “defensive medicine,” and most will probably say yes — hard not to be paranoid with so many lawsuits affecting so many physicians. Some experts even contend that major reforms of our malpractice system could go a long way towards controlling spiraling healthcare costs. On the other hand, if you ask physicians whether they ever order unnecessary tests …
To almost every claim that the American healthcare system is overpriced, defenders of the United States can point to the comparison problem — it is not fair to compare American surgeons, or hospitals, to our peers in Europe when American surgeons and hospitals are not the same as in those other countries. Our surgeons are better trained, the defenders retort, and our hospitals offer higher quality care. When quality measures …
In the wake of the horrific floods that struck Colorado recently, many people have debated whether global warming is to blame. The same goes for wildfires that hit that state this summer and for the massive tornado that struck in Oklahoma this spring. In the wake of that tornado, for instance, Senator Sheldon Whitehouse from Rhode Island claimed that Republican opposition to climate change legislation was at fault, for trying …
Healthcare markets are complex and confusing places. But one fact is simple and straightforward: all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics. Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics.
Bewildering until now. Shreya Kangovi and colleagues at the University of Pennsylvania interviewed low income patients and discovered some fascinating reasons why they aren’t …
The urologist broke the news: “Out of 12 cores, three were positive for cancer, so you have a small amount of cancer.”
He would soon explain the treatment choices — surgery, radiation, or active surveillance (watching the cancer closely with blood tests and biopsies). He described each option in elaborate detail, because he knew that the “right choice” would depend on what his 70-year-old patient thought about the pros and cons …
In 2008, the state legislature of Washington passed what was called the Death with Dignity Act, a law that legalized physician assisted suicide. Under the law, terminally ill patients (predicted to have less than six months to live) can request prescriptions for lethal medications from their physicians, under a series of safeguards: multiple requests for example, determination of competency, and the like. Then, if the patients so choose, they can ingest …
With its expansion of Medicaid eligibility, the Affordable Care Act (a.k.a. Obamacare) was supposed to go a long way towards providing healthcare coverage to millions of uninsured Americans. That accomplishment was dealt a large blow by the Supreme Court, when it forbade the federal government from requiring states to expand Medicaid coverage. Nevertheless, many states plan to offer Medicaid to anyone with incomes at or below 138% of the Federal …
Ten years ago, my tennis partner suffered a stroke. He was a sixty-year-old at the time, working to move up into the top ten players in his age group. In the country! You could not have found a healthier sixty-year-old. He played tennis three-plus hours a day, scampering across the court like a hyperactive adolescent. In other words, he was not …
I am very fortunate to have never been sued. That is not necessarily because of my amazing ability as a physician. I always practiced in Veterans Affairs medical centers, where my status as a federal employee meant I would not get sued by my patients. I also had an incredibly appreciative patient population.
But I know that most of my physician peers have been sued, successfully or unsuccessfully, at least once …
The importance of sleep is perhaps most realized when we become sick. When we are hospitalized and most in need of every ounce of health, though, hospital care practically guarantees that we won’t get good sleep. Fortunately, two approaches hold promise to improve sleep for patients: one organizational, and the other a common trick of the trade among those of us working in behavioral economics.
Recently I was all-too-miserably reminded of …
I have been thinking a lot about C. Everett Koop lately, ever since his death on February 25 at the ripe old age of 96 and more recently with the announcement that our current Surgeon General, Regina Benjamin, is planning to step down from that post. In particular, I have been pondering what made Koop such an effective Surgeon General, and what …
Recently, the makers of the Oncotype DX prostate cancer test presented results of a large study demonstrating that their test can help men decide whether their prostate cancer carries a low enough risk of progression to forgo surgical or radiation therapy, two treatments that typically eradicate prostate cancers but also cause most men to experience impotence and incontinence.
Lacking such a test, many men have felt compelled to …
Getting your appendix out can cost between $2,000 and $180,000. Hip replacements run from $10,000 to more than $100,000. Hospitals, we have also learned, frequently mark up the price of cotton swabs and routine X-rays by 300 or 400 percent, with most patients oblivious to the reason their health care bills are so large.
As a response to the hidden variability in health care prices, an increasing number of states have …
If you have been paying attention to US healthcare policy debates lately, you know that hospitals have a price problem. Walk across the street from one hospital to a competitor hospital, and you could easily find yourself facing a $30,000 increase in your medical bills. At one extreme for instance recent information shows that replacing your hip with a surgical implant might cost anywhere from $5000 to …
On April 14, The United States Preventive Services Task Force concluded that women with an elevated risk of breast cancer – who have never been diagnosed with breast cancer but whose family history and other medical factors increase their odds of developing the disease–should consider taking one of two pills that cut that risk in half. The Task Force is an independent panel of medical experts who …
Now that states have decided what they are going to do about health insurance exchanges—those new shopping carts created by Obamacare to help consumers find health insurance who do not get it through their employers—the really tough part begins. State and federal governments need to make sure that consumers understand their health insurance choices.
You probably thought that the tough part was behind us. You see, states had a difficult decision …
Think of the last few times you watched a popular movie that involved any kind of sex scene? Not as in pornographic sex, but as in two characters ended up in bed together and had, ahem, conjugal relations.
In how many of those scenes did either participant make mention of a condom before the act?
We face a public health crisis of sexually transmitted …
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