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Health policy and public health

4,357 articles · Since 2004

Articles, page 118

Health policy

What leaders can learn from the failure of Healthcare.gov

3

It’s lonely at the top. The buck stops here. I take full responsibility. Noble sentiments. But the idea that one person, at the top, or elsewhere in an organization, is solely to blame for a complex failure in novel territory…

It’s lonely at the top. The buck stops here. I take full responsibility.

Noble sentiments. But the idea that one person, at the top, or elsewhere in an organization, is solely to blame for a complex failure in novel territory is as unhelpful as it is limited. In fact, the blame game is less useful today than ever before. Consider Healthcare.gov.

The idea that a project as complex, new, and large as the Healthcare.gov website …

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What leaders can learn from the failure of Healthcare.gov

Health policy

Health care transparency as more than an amenity

3

Would you purchase a new phone without knowing its data plan? For almost everybody, the answer is an obvious “no.” We simply cannot make a good choice if we don’t know how much coverage the phone will offer, or how…

Would you purchase a new phone without knowing its data plan? For almost everybody, the answer is an obvious “no.” We simply cannot make a good choice if we don’t know how much coverage the phone will offer, or how much money it will end up costing us.

Unfortunately, this type of blind decision is exactly the sort that many could face when purchasing a plan in the new health insurance …

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Health care transparency as more than an amenity

Health policy

Direct pay primary care and the ACA still don’t mix

36

Lately I've gotten hooked on watching the reality TV show, the Deadliest Catch. It's astounding to me what these guys go through to catch crab in the Bering Sea. One of the recurring themes on the show is the new…

Lately I’ve gotten hooked on watching the reality TV show, the Deadliest Catch.  It’s astounding to me what these guys go through to catch crab in the Bering Sea.

One of the recurring themes on the show is the new crop of “greenhorns” — new recruits to the profession of working crab boats — that try to show they can hack “the world’s most dangerous job” each year.  They often come with …

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Direct pay primary care and the ACA still don’t mix

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Physician voices

Change will happen when millennial doctors step into leadership roles

8

I recently stumbled across a blog post by Dr. Jay Parkinson, an entrepreneur and founder of Sherpaa, who reflected on a recent private breakfast with New Yorker and best selling author Dr. Atul Gawande. The question posed by Gawande: Can…

I recently stumbled across a blog post by Dr. Jay Parkinson, an entrepreneur and founder of Sherpaa, who reflected on a recent private breakfast with New Yorker and best selling author Dr. Atul Gawande.

The question posed by Gawande: Can technology be a change agent for health care?

The inevitable answer is yes, with one important caveat. It’s not the technology that will change the practice of medicine, it’s the doctors who

…

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Change will happen when millennial doctors step into leadership roles

Health policy

Healthcare.gov is fixed, or is it?

3

From 27,000 enrollments in October to a reported 100,000 enrollments in November, the Affordable Care Act’s website is apparently working better and getting more people signed up. But is it fixed well enough to handle the expected wave of at…

From 27,000 enrollments in October to a reported 100,000 enrollments in November, the Affordable Care Act’s website is apparently working better and getting more people signed up.

But is it fixed well enough to handle the expected wave of at least many hundreds of thousands of people eager to get guarantee issue health insurance for the first time or replace a canceled policy by January 1?

Here are some of the press …

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Healthcare.gov is fixed, or is it?

Health policy

A doctor quits the AMA and his state medical society

24

Everywhere in the news these days, you read of stories where physicians are being cancelled from insurance plans, and groups like the American Medical Association, and state based medical societies fighting to reverse these decisions. Does anyone think these actions…

Everywhere in the news these days, you read of stories where physicians are being cancelled from insurance plans, and groups like the American Medical Association, and state based medical societies fighting to reverse these decisions. Does anyone think these actions will really make a difference? I certainly don’t.

Since this is the start of December, this is the time of year where I look at certain expenses and wonder if they are …

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A doctor quits the AMA and his state medical society

Physician voices

An anesthesia practice is sold, and a warning to young doctors

27

We were startled to learn recently that Sheridan Healthcare Inc., a physician services company based in Florida, has bought one of the largest private anesthesiology group practices in California, the Medical Anesthesia Consultants Medical Group Inc. (MAC) of San Ramon.…

We were startled to learn recently that Sheridan Healthcare Inc., a physician services company based in Florida, has bought one of the largest private anesthesiology group practices in California, the Medical Anesthesia Consultants Medical Group Inc. (MAC) of San Ramon.

The deal, which closed November 14, is Sheridan’s first in California, and “provides a platform that will accelerate our expansion in the California …

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An anesthesia practice is sold, and a warning to young doctors

Physician voices

What happened to doctors serving as advocates for their patients?

18

The Hippocratic Oath. Most medical students in America recite some version of this oath at their medical school graduation. Its text implies a sacred and overriding respect (ethic if you will) for the individual. Doctors are currently witnessing the profession…

The Hippocratic Oath. Most medical students in America recite some version of this oath at their medical school graduation. Its text implies a sacred and overriding respect (ethic if you will) for the individual.

Doctors are currently witnessing the profession of medicine moving from the ethic of the individual to the ethic of the collective. The passage of the Affordable Care Act has solidified this treatment ethic and, as a consequence, …

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What happened to doctors serving as advocates for their patients?

Health policy

How Obamacare will creatively destroy primary care as we know it

31

As Obamacare is winding its way through a hellish bureaucratic labyrinth of its own creation, accompanied by cheers and boos from the blood thirsty spectator crowds, confusion, fear, trepidation, despair and exhilaration, are gripping America’s doctors all at once, because…

As Obamacare is winding its way through a hellish bureaucratic labyrinth of its own creation, accompanied by cheers and boos from the blood thirsty spectator crowds, confusion, fear, trepidation, despair and exhilaration, are gripping America’s doctors all at once, because whatever else is accomplished in the next decade, medicine will never be the same.

At the confluence of cutting edge technology, great poverty and unimaginable fortunes, a new vision for the practice of …

Read more…

How Obamacare will creatively destroy primary care as we know it

Health policy

Where Obamacare is working well

38

Obamacare is working quite well, in some places, for quite a large number of people. But you wouldn’t know that from the constant media drumbeat about the problems with the healthcare.gov enrollment portal and the relatively small (fewer than 6%)…

Obamacare is working quite well, in some places, for quite a large number of people.  But you wouldn’t know that from the constant media drumbeat about the problems with the healthcare.gov enrollment portal and the relatively small (fewer than 6%) of the population whose individual insurance policies have to be replaced because they don’t meet the law’s benefits and ratings standards.

Now, before I get a rash of comments about how I can …

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Where Obamacare is working well

Health policy

Health reform will close hospitals: Why that may not be a bad idea

17

What first comes to mind when you hear the word “hospital”? Your reaction may depend on your past experiences. You may feel gratitude for the birth of a child or the treatment of acute appendicitis. You may feel sorrow, remembering…

What first comes to mind when you hear the word “hospital”?

Your reaction may depend on your past experiences. You may feel gratitude for the birth of a child or the treatment of acute appendicitis. You may feel sorrow, remembering a loved one who passed away on a hospital bed.

Regardless of our experiences, many of us assume the closer our hospital is to where we live, the safer and better off …

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Health reform will close hospitals: Why that may not be a bad idea

Health policy

Do safety net hospitals get penalized under new payment models?

2

The most commonly heard comment in healthcare these days is that we have to move from paying for volume to paying for value. While it may sound trite, it also turns out to be pretty true. Right now, most healthcare…

The most commonly heard comment in healthcare these days is that we have to move from paying for volume to paying for value.  While it may sound trite, it also turns out to be pretty true.  Right now, most healthcare services are paid for on a fee-for-service basis — with little regard for the quality of that service.  We clearly need to move towards value-based payments (sometimes referred to as …

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Do safety net hospitals get penalized under new payment models?

Health policy

Is health care a right or a business? It’s time to make a choice

187

The recent health care discussion in the media has centered around the implementation of the Affordable Care Act, now no longer a lengthy, inert document but rather a living, breathing manifestation of what should be a collective, unambiguous vision for…

The recent health care discussion in the media has centered around the implementation of the Affordable Care Act, now no longer a lengthy, inert document but rather a living, breathing manifestation of what should be a collective, unambiguous vision for the delivery of care in the United States. It is, however, anything but comprehensive in scope, and the coverage has primarily focused on crashing websites, politics, calls for resignations, and …

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Is health care a right or a business? It’s time to make a choice

Health policy

The key to saving primary care

17

Despite the current outcry over Healthcare.gov, Obamacare will soon bring 30 million Americans healthcare coverage. But if the website to signup may have lacked adequate planning, is our infrastructure for primary care ready? With some estimating a current shortage of…

Despite the current outcry over Healthcare.gov, Obamacare will soon bring 30 million Americans healthcare coverage. But if the website to signup may have lacked adequate planning, is our infrastructure for primary care ready? With some estimating a current shortage of 20,000 doctors, legions of new patients will add stress to an already crippled system. As a junior medical resident managing my own panel of outpatients at our local VA hospital, …

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The key to saving primary care

Health policy

Health and wellness: We need to broaden our perspective

How do we keep the well people well while managing the devil out of the 1%? This is one of our most complex and challenging questions, and there is no simple answer -- but we needn't look far to see…

How do we keep the well people well while managing the devil out of the 1%?

This is one of our most complex and challenging questions, and there is no simple answer — but we needn’t look far to see that progress is being made.

Judging from the unprecedented groundswell of interest in health and wellness — and the corresponding emergence of a “wellbeing economy” — I think it’s fair to say …

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Health and wellness: We need to broaden our perspective

Health policy

The difficult transition from substandard to standardized coverage

21

Some years ago, driving through an end of town where pawn shops and boarded up homes are common, I saw a small placard sign nailed on a telephone pole. "Buy Health Insurance," it touted with premiums as low as $25…

Some years ago, driving through an end of town where pawn shops and boarded up homes are common, I saw a small placard sign nailed on a telephone pole. “Buy Health Insurance,” it touted with premiums as low as $25 a month. I was tempted.

Health insurance, for me and for most Americans, is a necessary part of life, similar to home rent or mortgage, grocery bills and gasoline. Insurance is …

Read more…

The difficult transition from substandard to standardized coverage

Health policy

AAFP: The right care by the right provider is more important than ever

2

For several weeks, the bumpy rollout of the federal health insurance marketplaces has overshadowed almost all other health care topics. But after reviewing the timely Health Affairs issue dedicated to the health care work force, it is clear we must…

For several weeks, the bumpy rollout of the federal health insurance marketplaces has overshadowed almost all other health care topics. But after reviewing the timely Health Affairs issue dedicated to the health care work force, it is clear we must maintain our focus on building a primary care system of the highest quality and value. Within that increasingly complex system, primary care physicians are the first, most critical line of …

Read more…

AAFP: The right care by the right provider is more important than ever

Health policy

We really need 3 health care systems

3

I was reading a blog about health policy and the failings of the ACA rollout posted on CNN. The author spends time talking about how much we want to change our health care system. And how, since change is hard,…

I was reading a blog about health policy and the failings of the ACA rollout posted on CNN.  The author spends time talking about how much we want to change our health care system.  And how, since change is hard, no one should be surprised by the pains accompanying this change, particularly in terms of individuals loosing their current insurance policies due to the rollout of the ACA …

Read more…

We really need 3 health care systems

Health policy

Bringing low income patients into the health care conversation

2

As we mark significant milestones in our changing healthcare landscape, much of the dialogue continues to focus on the goals of payers and providers. Yet the goals of a third group are just as important. In order to truly transform…

As we mark significant milestones in our changing healthcare landscape, much of the dialogue continues to focus on the goals of payers and providers. Yet the goals of a third group are just as important. In order to truly transform care delivery in coming years, our efforts must include patients — their needs, interests, and engagement — at every step.

For the first time, the Affordable Care Act (ACA) will give …

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Bringing low income patients into the health care conversation

Health policy

Why physicians are hesitant to take Medicaid patients

48

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.…

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% …

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Why physicians are hesitant to take Medicaid patients

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