KevinMD.com: Social media’s leading physician voice
The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →
NEWExperts by KevinMDPhysicians and health care experts, by specialty.Shveta GuptaHematology physicianDevin ZarkowskyVascular surgeonKenneth RoInternistEmily WattersPsychiatristAleksandra FilipovicMedical oncologistReuben MathewMed-peds residentRobert MurryFamily physicianKayvan HaddadanPhysiatristPaul HainPediatricianBarbara SparacinoPsychiatristHussain Isma'eelCardiologistAnn LebeckFamily physicianLynn R. WebsterPain medicine physicianAngelika LuehrsConsultant psychiatristBobby DuboisInternistLaurel A. CoonsScientistNathaniel AranaHealth care CEOCraig HaubenHealth care CEOJessica ChalkPatient advocateBrowse experts

Health policy and public health

4,357 articles · Since 2004

Articles, page 111

Health policy

A business approach to controlling health care costs

14

Part of a series. Helping employees improve their health is right for the company’s bottom line and is doing right by our employees. Healthier employees are happier, demonstrate less absenteeism and presenteesism, and are more productive. This is a win…

Part of a series.

Helping employees improve their health is right for the company’s bottom line and is doing right by our employees.  Healthier employees are happier, demonstrate less absenteeism and presenteesism, and are more productive.  This is a win for everyone involved.  
– John Torinus, Jr., a retired CEO and current board chair of Serigraph, Inc., a mid-sized Wisconsin company with about 500 employees

In my earlier posts in this series …

Read more…

A business approach to controlling health care costs

Health policy

To those who admire the NHS: Empower primary care physicians

A recent report from the Commonwealth Fund, which placed U.S. last amongst developing nations in health care, analyzed Britain’s high score on the management of chronic conditions. The authors attributed care coordination to the widespread adoption of health information technology…

A recent report from the Commonwealth Fund, which placed U.S. last amongst developing nations in health care, analyzed Britain’s high score on the management of chronic conditions. The authors attributed care coordination to the widespread adoption of health information technology in the National Health Service (NHS).

That’s like someone saying Chinese food is tasty because chopsticks are widely used.

Like quants so fastidious about decimal points they’ve missed the overall point.

Where do …

Read more…

To those who admire the NHS: Empower primary care physicians

Health policy

Employer-sponsored insurance or Medicaid? An ideological debate.

8

The recent disagreement between Uwe Reinhardt and Sally Pipes in Forbes is a teachable moment. There’s a dearth of confrontational debates in health policy, and education is worse off for it. Crux of the issue is the more efficient system:…

The recent disagreement between Uwe Reinhardt and Sally Pipes in Forbes is a teachable moment. There’s a dearth of confrontational debates in health policy, and education is worse off for it.

Crux of the issue is the more efficient system: employer-sponsored insurance (ESI) or Medicaid. Sally Pipes, president of the market-leaning Pacific Research Institute, believes it is ESI. Employers spend 60% less than the government, per person: $3,430 versus $9,130, …

Read more…

Employer-sponsored insurance or Medicaid? An ideological debate.

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Physician voices

An American doctor’s experience with the NHS

47

You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital. Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind…

You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital.

Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind outside of Westminster Abbey. He was complaining enough to let me flip his eyelid and irrigate his eye on the square in front of Big Ben. (I’m sure several people thought …

Read more…

An American doctor’s experience with the NHS

Health policy

Confessions of a rebound doctor: The impact of narrow networks

8

“We lost our regular doctor with Obamacare, so now we have to see you.” I routinely ask my new patients how they heard about our pediatric office, and this is the answer I dread most. My pediatric practice is a…

“We lost our regular doctor with Obamacare, so now we have to see you.”

I routinely ask my new patients how they heard about our pediatric office, and this is the answer I dread most. My pediatric practice is a very nice and modern private office, and in my opinion, full of excellent physicians. I entrust my own children’s care to my partners. But none of that matters when you’re the rebound doctor, the …

Read more…

Confessions of a rebound doctor: The impact of narrow networks

Health policy

Go ahead, let’s just make poverty a disease

85

In a previous post, I described how the American health care system is morphing into a system designed to service impoverished populations, and concluded that the transition “will take time, thoughtful planning, lots of innovation and a carefully cultivated disdain…

In a previous post, I described how the American health care system is morphing into a system designed to service impoverished populations, and concluded that the transition “will take time, thoughtful planning, lots of innovation and a carefully cultivated disdain for human life.”

However, a new blog post from Dr. Peter Ubel makes me think that it may not take that much time after all. It seems that Dr. Ubel …

Read more…

Go ahead, let’s just make poverty a disease

Health policy

Will the attacks on Obamacare lead to a single-payer system?

32

The unrelenting opposition by American conservatives to Obamacare may have the unintended consequence of leading the United States to a single-payer system like Canada’s. How’s that, you say? Isn’t the whole point of conservative opposition to Obamacare to drive home…

The unrelenting opposition by American conservatives to Obamacare may have the unintended consequence of leading the United States to a single-payer system like Canada’s.

How’s that, you say? Isn’t the whole point of conservative opposition to Obamacare to drive home the point that the government is incapable of managing people’s health care?  Yes.  And aren’t conservatives effective in driving home that point? Yes, polls show that confidence in government is at …

Read more…

Will the attacks on Obamacare lead to a single-payer system?

Health policy

The Affordable Care Act will face many more Halbigs

5

“Then you should say what you mean,” the March Hare went on. “I do,” Alice hastily replied; “at least–at least I mean what I say–that’s the same thing, you know.” “Not the same thing a bit!” said the Hatter. “You…

“Then you should say what you mean,” the March Hare went on.

“I do,” Alice hastily replied; “at least–at least I mean what I say–that’s the same thing, you know.”

“Not the same thing a bit!” said the Hatter. “You might just as well say that “I see what I eat” is the same thing as “I eat what I see!”

The brilliant Lewis Carroll had a field day with logical fallacies in …

Read more…

The Affordable Care Act will face many more Halbigs

Health policy

Quality measures benefit from quality improvement

5

I am a long-time proponent of measuring provider performance and aligning it with payment as an effective means for improving the quality of care and with it, patient outcomes. Because of this, I welcomed the value-based purchasing concepts and quality…

I am a long-time proponent of measuring provider performance and aligning it with payment as an effective means for improving the quality of care and with it, patient outcomes.

Because of this, I welcomed the value-based purchasing concepts and quality improvement initiatives that are fundamental to the Affordable Care Act (ACA).

But, as in so many things, the devil is in the details and, despite their best efforts, measure designers can’t always …

Read more…

Quality measures benefit from quality improvement

Physician finance

Are American doctors paid too much or too little?

119

USA Today on July 2, 2014. There are some who think that I’m overpaid as a physician, and that my salary fuels rising health costs. I can understand their point: A May 2014 survey released by the Medical Group Management…

A version of column was published in USA Today on July 2, 2014.

There are some who think that I’m overpaid as a physician, and that my salary fuels rising health costs.  I can understand their point: A May 2014 survey released by the Medical Group Management Association found that internal medicine doctors like myself have a starting median annual salary of $190,000, …

Read more…

Are American doctors paid too much or too little?

Health policy

The 7% plan to fix primary care

8

This is a simple plan that would empower patients, improve the lot of primary care physicians and likely hold down medical costs while improving quality in the health care system. I would first like to present the plan, then elaborate…

This is a simple plan that would empower patients, improve the lot of primary care physicians and likely hold down medical costs while improving quality in the health care system. I would first like to present the plan, then elaborate on how it could accomplish the above objectives.

The first part of the plan would set aside a portion of each person’s health care dollars (i.e., insurance premiums) and place it …

Read more…

The 7% plan to fix primary care

Health policy

Obamacare isn’t a train wreck. Here’s why.

34

For years, critics of Obamacare (Affordable Care Act), have predicted that it would turn out to be a “train wreck” -- or something worse. But now we know that by every objective measure, the ACA is working out pretty darn…

For years, critics of Obamacare (Affordable Care Act), have predicted that it would turn out to be a “train wreck” — or something worse.  But now we know that by every objective measure, the ACA is working out pretty darn well.  Let’s run through the “train wreck” predictions, and what we now know to actually be the case:

Train wreck prediction #1: “Obamacare will lead to skyrocketing health care cost increases and …

Read more…

Obamacare isn’t a train wreck. Here’s why.

Health policy

After Halbig: What’s next for Obamacare?

8

After more than 40 attempts to pass legislation calling for repeal or significant changes to the health law, opponents of the Affordable Care Act have moved their focus from the House floor to the courthouse. Currently at least four lawsuits…

After more than 40 attempts to pass legislation calling for repeal or significant changes to the health law, opponents of the Affordable Care Act have moved their focus from the House floor to the courthouse. Currently at least four lawsuits are working their way through state and district court — and one case awaits a nod from the Supreme Court — that would make it illegal for the federal government …

Read more…

After Halbig: What’s next for Obamacare?

Physician voices

My oasis of care is being threatened

21

I am a solo, independent family physician and my practice is not a silo. It is not a cold, stagnant, immobile, potentially dangerous storage facility where data to be used by insurance companies and statisticians is held until it is…

I am a solo, independent family physician and my practice is not a silo. It is not a cold, stagnant, immobile, potentially dangerous storage facility where data to be used by insurance companies and statisticians is held until it is finally purged. No, my office is a visually and emotionally comforting, innovative, healing environment where information is shared and confidence is enhanced. It is an oasis.

My practice is embedded in …

Read more…

My oasis of care is being threatened

Health policy

What the Uber of health care will look like

2

For a very long time, one of the most valuable business assets in New York City was a yellow cab taxi medallion. With recent value in the $1 million dollar range, ownership of the medallion was a virtual cash annuity,…

For a very long time, one of the most valuable business assets in New York City was a yellow cab taxi medallion. With recent value in the $1 million dollar range, ownership of the medallion was a virtual cash annuity, combined with equity growth (in 2004 medallion prices were in the mid $200,000 range and have increased in value 15% year over year in the 9 years since). As one …

Read more…

What the Uber of health care will look like

Health policy

Why government cannot cure our health care

17

There are few things more important than our health and our health care. Solving health care for everyone is critical to becoming a healthy, vibrant society. Because our government has controlled our health care for two generations, election realities and…

There are few things more important than our health and our health care. Solving health care for everyone is critical to becoming a healthy, vibrant society. Because our government has controlled our health care for two generations, election realities and political rancor obscures our ability to collectively solve the problem. Allow me to use a fictitious government program, “Foodaid,” to defray the noise and illustrate how government-control of our health …

Read more…

Why government cannot cure our health care

Health policy

Health care at half the cost: What will that actually look like?

21

Health care costs far too much. We can do it better for half the cost. But if we did cut the cost in half, we would cut the jobs in half, wipe out 9% of the economy and plunge the…

Health care costs far too much. We can do it better for half the cost. But if we did cut the cost in half, we would cut the jobs in half, wipe out 9% of the economy and plunge the country into a depression.

Really? It’s that simple? Half the cost equals half the jobs? So we’re doomed either way?

Actually, no. It’s not that simple. We cannot of course forecast with …

Read more…

Health care at half the cost: What will that actually look like?

Health policy

Correcting the physician shortage isn’t an easy solution

8

There is no doubt that Affordable Care Act has changed the landscape of medicine in the U.S. Now, private practice is becoming a thing of the past. Financial pressures, increasing regulatory requirements, electronic medical records and outrageously complex coding systems…

There is no doubt that Affordable Care Act has changed the landscape of medicine in the U.S.  Now, private practice is becoming a thing of the past. Financial pressures, increasing regulatory requirements, electronic medical records and outrageously complex coding systems are forcing long time private physicians to enter into agreements with academic centers and large hospital systems in order to survive.

As a result, medicine today is more about increasing patient …

Read more…

Correcting the physician shortage isn’t an easy solution

Health policy

Health care efficiency can mean different things

2

Whether you’ve praised or vilified Obamacare, see it as an amazing achievement or an existential threat, it is the law of the land. The price transparency created by online exchanges, a vital part of the law, stands to make cost…

Whether you’ve praised or vilified Obamacare, see it as an amazing achievement or an existential threat, it is the law of the land.  The price transparency created by online exchanges, a vital part of the law, stands to make cost the biggest driver of choice. This, along with cuts in government health spending, will disrupt the economics of health care in dramatic new ways.

Our first response to this brave new …

Read more…

Health care efficiency can mean different things

Health policy

Hypoliquidemia has now come to health care

13

The venerable University of Texas MD Anderson Cancer Center in Houston will accept patients with traditional Texas Medicaid health insurance, and some patients in Medicaid managed care plans. Memorial Hermann, another large health system in Houston, will accept traditional Medicaid…

The venerable University of Texas MD Anderson Cancer Center in Houston will accept patients with traditional Texas Medicaid health insurance, and some patients in Medicaid managed care plans. Memorial Hermann, another large health system in Houston, will accept traditional Medicaid patients and also those in Medicaid managed care plans. Neither institution will accept the Blue Cross Blue Shield HMO silver plan sold on the Affordable Care marketplace, according to  …

Read more…

Hypoliquidemia has now come to health care

179
pages