Health policy and public health

4,357 articles · Since 2004

Articles, page 104

Improving our health system requires a culture change. Can it happen?

May 20, 2016May 20, 201629

Most industrialized nations have long supported the idea that access to health care is a fundamental right, and have built centrally planned systems to accomplish that goal. The result has been universal coverage that delivers excellent-quality outcomes at lower costs…

In some countries, such as England and Canada, the government controls both financing and certain aspects of health care delivery, while in others, including Australia, Sweden, and …

Health policy

The state of health care in America: Smell the bacon

Anonymous

May 19, 2016May 19, 20167

I am forced to attend one of these mandatory continuing medical education (CME) events. My malpractice insurance provider has a deal with the state medical association. To get lower rates, I have to be a member of the association and…

I make it on time, despite the traffic.

As I walk into the lobby of this rather nice building, looking for …

Health policy

Why Obamacare is not economically realistic

Brian C. Joondeph, MD

May 18, 2016May 18, 201656

United Healthcare announced that it plans on exiting most of the Obamacare insurance plans by 2017. Not their traditional commercial insurance plans or Medicare supplements, but specifically the insurance plans offered through the state exchanges of Obamacare. Didn’t President Obama…

Didn’t President Obama tell Americans that if they liked their insurance plan, they would be able to keep it under Obamacare? Actually he did, at least 36 times. So what happened?

In …

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Health policy

What can physicians do to increase empathy about the health of populations?

Liang Chen, MD & Sandro Galea, MD, MPH, DPH

May 12, 2016May 12, 201634

As physicians, we are charged with extending empathy to our patients. In addition to a professional responsibility, empathy is also a mechanism for improving patient care and professional satisfaction. It has been associated with better patient satisfaction, clinical outcomes, fewer medical errors and lawsuits, as well as provider happiness. However, while physicians can be expected to pursue the ideal of empathy towards individual patients, that …

Health policy

To make big heath care changes, think small

Stephen Beeson, MD

May 9, 2016May 9, 20164

The changes to health care -- not just in policy, regulation, and payment but also the tectonic shifts in how we define, evaluate, report and are paid for care -- can make us all feel like we’re on a runaway…

The changes to health care — not just in policy, regulation, and payment but also the tectonic shifts in how we define, evaluate, report and are paid for care — can make us all feel like we’re on a runaway train.

Alongside the runaway train are the significant improvement opportunities in health care we must somehow address — less variance, improved patient engagement, coordination of care, adherence to evidence, waste reduction …

Physician voices

6 medical breakdowns in my mother’s care. And 1 close call.

Marion Mass, MD

April 17, 2016Apr 17, 2016

I dialed the number to return the call of the nursing home. The nurse who answered the phone was relieved to hear my voice on the other line: “Dr. Mass, thank God you called back! She has been pacing since she woke up, and she refuses to take her meds. We’ve kept her away from Catherine, so they don’t get into another fistfight. But we can’t handle her here anymore. …

Health policy

Improve health care services for our most vulnerable

Katie Bayne

April 13, 2016Apr 13, 2016

My dad was recently diagnosed with cancer. Overnight, he found himself faced with tough care decisions, small insurance crises, and the overwhelming bureaucracy of cancer. He was also about to become tasked with managing a daily care routine far outside…

Since his diagnosis, he has returned to the hospital twice with pneumonia. While many cancer patients become prone to bacterial infections due to a …

Health policy

A physician’s health policy advice to Donald Trump

Dr. Saurabh Jha

April 11, 2016Apr 11, 2016

It is possible that in a few months from now, only Nate Silver’s prediction models will stand between Donald Trump and the White House. I will leave it to future anthropologists to write about the significance of that moment. For now, the question, “What will President Trump be doing when he is not building a wall?” has assumed salience.

This is relatively easy to answer when it comes to health policy. …

Health policy

Physicians need to get involved or risk irrelevance

John Gonzalez, MD, MBA

April 1, 2016Apr 1, 20165

What is happening in medicine? How will these changes affect our patients? How will they affect how we deliver health care? These seem to be the questions asked most often amongst physicians across the country. I do not profess to have a crystal ball nor can I state with any certainty what the profession we chose to dedicate our lives to will look like in the near future. However, there …

Health policy

How employers can lead the way for health reform

Pradhan Bhat

April 1, 2016Apr 1, 20165

American businesses hold a solution to one of the most fundamental flaws of American health care: misalignment of incentives. We live in a nation where profit-seeking behavior can be more alluring than high-quality patient care. To date, major health care…

Status quo

Currently, the status quo is such that health insurance companies and health care providers act …

Health policy

Who do presidential candidates blame for high health costs?

Peter Ubel, MD

March 16, 2016Mar 16, 2016158

The United States far outspends peer countries on health care. When American politicians complain about these high health care costs, they often vilify pharmaceutical and insurance companies for profiting at the expense of the general public. As I wrote earlier, such vilification is misguided, pushing too much of the blame on individual actors rather than on the system that incentivizes individuals to act those ways.

So what it is …

Health policy

Explaining the physician anxiety behind performance measures

Bob Doherty

March 1, 2016Mar 1, 201621

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…

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, …

Physician voices

Fix high-deductible health insurance. But it won’t be easy.

Michael Kirsch, MD

February 25, 2016Feb 25, 201643

May I whine for a few sentences, please? My staff and I have a high-deductible medical insurance plan. As the costs of coverage increased each year, we had to find a product that we could afford for our small private practice. As any small business owner knows, margins are tight, revenue is declining and expenses inexorably rise. And physicians, unlike other retailers, cannot raise our fees. Would you want to …

Conditions and diseases

Slow health costs with grade-appropriate body education

Barbara Berkeley, MD

February 5, 2016Feb 5, 201610

We physicians live in the shadow of rising health care costs. Hospitals want us to cut length of stays and somehow become more efficient. Insurance companies ask us to accept less money for patient visits, forcing us to see more people in fewer hours. The government wants us to check a slew of electronic boxes to prove that we’ve performed what they deem to be best practices, even though there is …

Health policy

The straight face test of our health care system

Hans Duvefelt, MD

January 27, 2016Jan 27, 20167

Health care in America is fracturing right down the middle, and doctors are going to have to figure out if or how long they can straddle the divide between what patients want and what the government and corporate America want…

Up until this point, the momentum has been with the payers, Medicare, and the insurance industry. But the more heavy-handed they become, the more inevitable the public backlash …

Conditions and diseases

Meaningful use is dead. Is it time to celebrate?

Margalit Gur-Arie

January 14, 2016Jan 14, 201695

At the J.P. Morgan Healthcare Conference in San Francisco, Mr. Andrew Slavitt, acting administrator at the Centers for Medicare & Medicaid Services (CMS), announced on January 11th that, “The meaningful use program as it has existed will now effectively be over, and replaced with something better,” and later clarified on Twitter that, “In 2016, MU as it has existed– with MACRA– will now be effectively over and replaced with something …

Health policy

Want to help fix health care? First you have to care about costs.

Chris Trimble, MBA

January 11, 2016Jan 11, 2016115

An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time. I’ve studied lots of industries. In general, cost and quality compete on equal terms. Some companies emphasize cost, others quality, but both are always in the…

An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time.

I’ve studied lots of industries. In general, cost and quality compete on equal terms. Some companies emphasize cost, others quality, but both are always in the picture.

And then there is health care. Uniquely among industries, health care has evolved with minimal attention to cost. Forces of cost constraint have historically been so weak as …

Health policy

These are the reasons why health insurers have to change

Robert Pearl, MD

January 8, 2016Jan 8, 20165

Consumers spend 16 times as long choosing a computer as they do selecting a health plan for themselves and their family. And it should not be a big surprise. For decades, nearly all insurance companies offered similar choices of in-network…

Consumers spend 16 times as long choosing a computer as they do selecting a health plan for themselves and their family. And it should not be a big surprise.

For decades, nearly all insurance companies offered similar choices of in-network physicians and hospitals. And as a result, plans differed only minimally in clinical quality, access and service. And even when clinical outcomes varied, consumers had no easy way to access comparative data.

So …

Health policy

Innovation in health care delivery can be boiled down to these 4 ideas

Chris Trimble, MBA

December 29, 2015Dec 29, 201528

An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time. In 2011, Shreya Kangovi hired her first two community health workers, or CHWs, at the University of Pennsylvania Health System. Their role was to develop partnerships…

An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time.

In 2011, Shreya Kangovi hired her first two community health workers, or CHWs, at the University of Pennsylvania Health System. Their role was to develop partnerships with low-income hospitalized patients who were at high risk of readmission. The CHWs ensured that the patients understood their discharge instructions, bridged communication gaps between the patients and …

Health policy

How we can move to value-based health care delivery

Robert Rowley, MD

December 22, 2015Dec 22, 201525

A recent study of health care organizations showed that most are not prepared to deliver standardized longitudinal care across multiple provider systems. Shared care plans will be the centerpiece of coordinated care delivery, incentivized by the move from fee-for-service to value-based care. In 2015, Medicare unveiled its plan to transition to quality-based payments via the Merit-Based Incentive Payment System (MIPS), which will sunset and subsume earlier quality-encouraging programs, and …

Health policy and public health

Articles, page 104

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