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 113

Health policy

Stop trying to copy health care systems from other countries

83

“It is immoral that the wealthiest nation on the planet does not provide affordable, high-quality health care to all of its citizens. Despite being the only global ‘superpower’ still standing, we trail much of the industrialized world in life expectancy,…

“It is immoral that the wealthiest nation on the planet does not provide affordable, high-quality health care to all of its citizens. Despite being the only global ‘superpower’ still standing, we trail much of the industrialized world in life expectancy, infant mortality, and countless other indicators of health. Until we fix our broken, prohibitively expensive delivery system, things will only get worse.”

I’m not sure if anyone has used those …

Read more…

Stop trying to copy health care systems from other countries

Health policy

There really is no war on doctors: There’s a war on patients.

66

So you think there is a war on doctors, don’t you? It certainly looks that way from your particular vantage point. The government is deftly intruding into your professional life with a computerized fifth column that is extracting information on…

So you think there is a war on doctors, don’t you? It certainly looks that way from your particular vantage point. The government is deftly intruding into your professional life with a computerized fifth column that is extracting information on your every move, and to add insult to injury, it forces you to actually collect the data which is to be used against you in the court of public opinion. …

Read more…

There really is no war on doctors: There’s a war on patients.

Health policy

It is wrong to subsidize rich, European nations

7

People have criticized the Affordable Care Act for amounting to a large transfer of wealth, from wealthy Americans to those not as well-off. But the real transfer of wealth has been from United States to other developed nations, whose health…

People have criticized the Affordable Care Act for amounting to a large transfer of wealth, from wealthy Americans to those not as well-off. But the real transfer of wealth has been from United States to other developed nations, whose health care costs we have subsidized for many years by paying so generously for many of our health care services. No better example of this comes to mind than the price …

Read more…

It is wrong to subsidize rich, European nations

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Health policy

5 controversies surrounding the Affordable Care Act

13

The continued implementation of the Affordable Care Act (ACA) in 2014 will be as controversial as in previous years. Here are five main areas of concern: 1. The individual mandate. By what right does the federal government “force” its citizens…

The continued implementation of the Affordable Care Act (ACA) in 2014 will be as controversial as in previous years.

Here are five main areas of concern:

1. The individual mandate.  By what right does the federal government “force” its citizens to buy a product they may not want? The Supreme Court upheld the mandate in 2012, but that does not end the matter. Partly — perhaps largely — because the ACA sets …

Read more…

5 controversies surrounding the Affordable Care Act

Health policy

Is medicine for the suits or the white coats?

24

“Get the suits out of medicine.” This refrain has become commonplace among physicians, who worry that patient care, the essence of medicine, is increasingly taking a backseat to bureaucratic demands on safety metrics and electronics health records as well as…

“Get the suits out of medicine.”

This refrain has become commonplace among physicians, who worry that patient care, the essence of medicine, is increasingly taking a backseat to bureaucratic demands on safety metrics and electronics health records as well as corporate measures of efficiency. Without physicians, after all, there is no health care system for administrators to administrate, they say. Not only do top-down regulations make patient care more cumbersome, they …

Read more…

Is medicine for the suits or the white coats?

Health policy

Walter White and the narrow networks of Obamacare

15

As we behold the continued wonders of Obamacare, we receive another reminder of the president’s empty promise: “If you like your doctor, you can keep your doctor.” The New York Times observed, “No matter what kind of health plan consumers…

As we behold the continued wonders of Obamacare, we receive another reminder of the president’s empty promise: “If you like your doctor, you can keep your doctor.”  The New York Times observed, “No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider …

Read more…

Walter White and the narrow networks of Obamacare

Health policy

4 ways to improve the Affordable Care Act

15

The fate of the Affordable Care Act (ACA) will be the big issue in the upcoming mid-term congressional elections, with Republicans and their allies continuing to press for repeal, believing that it is a winning issue with voters (or at…

The fate of the Affordable Care Act (ACA) will be the big issue in the upcoming mid-term congressional elections, with Republicans and their allies continuing to press for repeal, believing that it is a winning issue with voters (or at least the base voters who lean Republican). Opinion polls are not as clear-cut, though. Although more Americans continue to have a less favorable than more favorable view of the law, …

Read more…

4 ways to improve the Affordable Care Act

Health policy

The health insurance shell game reminds me of derivatives

4

I just realized what all these new insurance intermediaries, programs and organizations remind me of: derivatives. And we all remember how well that worked out for stocks a few years back. Let me explain. A few years back, a bunch…

I just realized what all these new insurance intermediaries, programs and organizations remind me of: derivatives. And we all remember how well that worked out for stocks a few years back.

Let me explain.

A few years back, a bunch of Wall Street financiers came up with a bunch of new ways to package various stocks and securities that were intended to be too convoluted for anyone to figure out that they were nothing …

Read more…

The health insurance shell game reminds me of derivatives

Health policy

Rwanda: The little country that could

An excerpt from Pharmacy on a Bicycle. One of the more impressive success stories in health improvement in a low-income country is Rwanda. This small landlocked country of 11.37 million was devastated by genocide in 1994 that left 800,000 people…

An excerpt from Pharmacy on a Bicycle.

One of the more impressive success stories in health improvement in a low-income country is Rwanda. This small landlocked country of 11.37 million was devastated by genocide in 1994 that left 800,000 people dead, affecting everyone in the country. The tragedy occurred over a month, leaving hundreds of thousands of orphans, broken families, raped women infected with HIV, and …

Read more…

Rwanda: The little country that could

Health policy

The salaries of health executives: What can doctors do?

60

Health care reform is a reality. The ACA and its associated mandates have forever changed the landscape of medicine in the U.S. today. The Obama administration touts the goals of reform as providing affordable, cost effective, high quality care for…

Health care reform is a reality.  The ACA and its associated mandates have forever changed the landscape of medicine in the U.S. today.  The Obama administration touts the goals of reform as providing affordable, cost effective, high quality care for all Americans.  Certainly these are noble and lofty goals: But have we completely missed the mark?

Today, many remain uninsured and the majority that have signed up for the exchanges are simply …

Read more…

The salaries of health executives: What can doctors do?

Health policy

Demonizing doctors won’t solve our problems

9

The process of becoming an excellent physician is one of mastery. The passion of the child is replaced by the studiousness of the teenager, and the bottomless energy of the young adult. The leap from decision to clinician takes decades.…

The process of becoming an excellent physician is one of mastery.  The passion of the child is replaced by the studiousness of the teenager, and the bottomless energy of the young adult.  The leap from decision to clinician takes decades.  Forged in the steel of experience, trampled by pain and tortuous repetition, ability accrues.

The apprentice guards his knowledge closely.  He bows …

Read more…

Demonizing doctors won’t solve our problems

Health policy

Health care shouldn’t be a political issue

23

This post deserves a caveat — health care shouldn’t be a political issue. When someone comes into my office because they have chest pain, I don’t ask them, “What’s your political leaning?” before administering care. And now after reading about…

This post deserves a caveat — health care shouldn’t be a political issue. When someone comes into my office because they have chest pain, I don’t ask them, “What’s your political leaning?” before administering care. And now after reading about the recent delay of ICD-10 in Congress, I realized that my choice in practicing direct care was the most political and least political thing I could have done.

According to …

Read more…

Health care shouldn’t be a political issue

Health policy

Health insurance shouldn’t be tied to employment

16

If my car insurance isn’t linked to my employer, should my health insurance? A recent projection by S&P Capital IQ, a research firm in the financial industry, estimated that 90% of Americans will receive health insurance from government exchanges by…

If my car insurance isn’t linked to my employer, should my health insurance? A recent projection by S&P Capital IQ, a research firm in the financial industry, estimated that 90% of Americans will receive health insurance from government exchanges by 2020. If this estimate were to come to fruition, it would represent a monumental shift in the structure of the American health care system. For over half a century, employer-sponsored …

Read more…

Health insurance shouldn’t be tied to employment

Patient voices

Balancing individual care with systemic health fixes

"All patients are alike. This one complains about the same things that the last one did." "Every patient is unique. We can never find a way to make each one of them happy." Remember that 1980s public health paradox: Do…

“All patients are alike. This one complains about the same things that the last one did.”

“Every patient is unique. We can never find a way to make each one of them happy.”

Remember that 1980s public health paradox: Do you focus on intensive interventions that might produce significant improvements in outcomes for a defined, high-risk group or do you direct energy to system-level changes that may achieve more …

Read more…

Balancing individual care with systemic health fixes

Health policy

Protocol-driven observational units can reduce ER crowding

“If you insure them, they will come.” Those words might as well be the mantra of hospitals across the country, because they can expect an onslaught of customers thanks to the expansion of health insurance under Obamacare. A recent study…

“If you insure them, they will come.”

Those words might as well be the mantra of hospitals across the country, because they can expect an onslaught of customers thanks to the expansion of health insurance under Obamacare. A recent study published in Science showed increased emergency room use among people in Oregon who became eligible for Medicaid, compared to others who, literally by the luck of the draw, were not chosen to …

Read more…

Protocol-driven observational units can reduce ER crowding

Health policy

Applying the lessons learned in other industries to health care

40

While grappling with the costs and imperfections of our health care system in recent years, a multitude of experts in the field found it useful and enlightening to compare health care to a variety of more familiar industries, and to…

While grappling with the costs and imperfections of our health care system in recent years, a multitude of experts in the field found it useful and enlightening to compare health care to a variety of more familiar industries, and to suggest that health care should adopt operational models that have been shown to work well in those other industries.

From the financial industry, we learned that health care must be computerized. …

Read more…

Applying the lessons learned in other industries to health care

Health policy

Why the VA scandal is a red flag for single-payer advocates

42

"I will not stand for it.” That’s what President Obama said about the deepening VA health care crisis. It’s also a lightening rod for how partisans want to frame the ongoing health debate. Some are eager to link the VA…

“I will not stand for it.”

That’s what President Obama said about the deepening VA health care crisis.  It’s also a lightening rod for how partisans want to frame the ongoing health debate.

Some are eager to link the VA scandal to Obamacare, and more broadly, government-run health care.

Others extol the virtues of the VA, holding it …

Read more…

Why the VA scandal is a red flag for single-payer advocates

Health policy

Obamacare is up for grabs: Who wins in November?

5

House Energy and Commerce Committee Republicans seemed surprised recently when representatives of the insurance industry reported that they didn't have enough data yet to forecast prices for next year's health insurance exchanges, the market was not about to blow up,…

House Energy and Commerce Committee Republicans seemed surprised recently when representatives of the insurance industry reported that they didn’t have enough data yet to forecast prices for next year’s health insurance exchanges, the market was not about to blow up, and that so far at least 80% of consumers have paid for the health insurance policies they purchased on the exchanges. The executives also reported there are still …

Read more…

Obamacare is up for grabs: Who wins in November?

Health policy

Predicting Medicaid enrollment numbers under the Affordable Care Act

2

The Affordable Care Act expanded Medicaid eligibility this year in those states which decided to follow its provisions. That means lots of people are now newly eligible for Medicaid. However, the number of people signing up for Medicaid in the…

The Affordable Care Act expanded Medicaid eligibility this year in those states which decided to follow its provisions. That means lots of people are now newly eligible for Medicaid. However, the number of people signing up for Medicaid in the states has been underwhelming. Which raises a question: How much can we expect enrollment numbers to increase over the next few years?

To begin to answer that question, a group of …

Read more…

Predicting Medicaid enrollment numbers under the Affordable Care Act

Health policy

The United States takes the spoiled rich kid approach to health care

59

Currently, the United States spends approximately 3 trillion dollars on health care, which is roughly 18% of our gross domestic product (GDP). Not only is this more than every other country in the world, but it’s also more than the…

Currently, the United States spends approximately 3 trillion dollars on health care, which is roughly 18% of our gross domestic product (GDP).  Not only is this more than every other country in the world, but it’s also more than the next 10 largest spenders combined.  Looking backwards, health care spending rose steadily from about 9% of our GDP in 1980 to about 16% in 2008.  Looking ahead, by 2020, health …

Read more…

The United States takes the spoiled rich kid approach to health care

179
pages