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Health policy and public health

4,357 articles · Since 2004

Articles, page 119

Health policy

You can now keep your plan: What does this mean for you?

4

The president, by his own admission, did “fumble the ball” on the rollout of the major elements of health reform implementation. Not only is Healthcare.gov not functioning as it should, but people in the individual market are having their health…

The president, by his own admission, did “fumble the ball” on the rollout of the major elements of health reform implementation. Not only is Healthcare.gov not functioning as it should, but people in the individual market are having their health insurance coverage cancelled–despite repeated assurances that if they liked their current coverage, they could keep it.

While that is absolutely a problem, it needs to be put into perspective. For …

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You can now keep your plan: What does this mean for you?

Health policy

What Healthcare.gov can learn from the Challenger shuttle disaster

3

By now, the Obamacare insurance exchange debacle is old news. Our attention spans are so short, we're on to the next disaster. So we sit before our TVs and enjoy the Humana ads with a smiling senior pointing to a…

By now, the Obamacare insurance exchange debacle is old news. Our attention spans are so short, we’re on to the next disaster.  So we sit before our TVs and enjoy the Humana ads with a smiling senior pointing to a whiteboards with their insurance plan name, or watch the news sponsored by UnitedHealthcare or Walmart’s pharmacy department. Everyone’s got a cheaper plan these days with more benefits than the other …

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What Healthcare.gov can learn from the Challenger shuttle disaster

Health policy

Is Obamacare paternalistic?

10

Dr. Bob Centor, author of the always provocative and thoughtful DB’s Medical Rants, suggests that the deep divide over the Affordable Care Act is based on “a major philosophic disagreement” over the respective roles of government and of individuals in…

Dr. Bob Centor, author of the always provocative and thoughtful DB’s Medical Rants, suggests that the deep divide over the Affordable Care Act is based on “a major philosophic disagreement” over the respective roles of government and of individuals in choosing what is best for them:

The administration and their supporters believe that government’s job is to protect citizens from their bad choices. They want to decide what the people need and

…

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Is Obamacare paternalistic?

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Health policy

California offers clues to the future of the Obamacare exchanges

8

Covered California, the state-run Obamacare health insurance exchange, announced recently that 59,000 people have so far signed up for health insurance. Given that California amounts to about 10% of the nation's population, this would suggest a smooth running federal exchange…

Covered California, the state-run Obamacare health insurance exchange, announced recently that 59,000 people have so far signed up for health insurance.

Given that California amounts to about 10% of the nation’s population, this would suggest a smooth running federal exchange might well have enabled the Obama administration to have met its national first month goal of 500,000 sign-ups.

But the California enrollment also points to the real challenge Obamacare faces.

In the first …

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California offers clues to the future of the Obamacare exchanges

Health policy

The unintended beneficial consequences of Obamacare

31

From the point of view of the rational humble classical liberal, Obamacare sucks. We rebel against the further intrusion of a narcissistic national government into our lives, as any sane person would who recognizes the value of liberty and the…

From the point of view of the rational humble classical liberal, Obamacare sucks.

We rebel against the further intrusion of a narcissistic national government into our lives, as any sane person would who recognizes the value of liberty and the repeatedly proven harm of collectivism.

Given that the national government constantly takes away liberty, and given that even the Constitution has been unable to defend our liberty against the onslaught of the …

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The unintended beneficial consequences of Obamacare

Health policy

A little known rule in the ACA could pose financial risk to doctors

38

A little known rule published by CMS to implement the Affordable Care Act (ACA) could pose a significant financial risk for doctors, hospitals and other healthcare providers. The rule requires health plans participating in the exchanges to provide individuals purchasing…

A little known rule published by CMS to implement the Affordable Care Act (ACA) could pose a significant financial risk for doctors, hospitals and other healthcare providers. The rule requires health plans participating in the exchanges to provide individuals purchasing insurance through the exchanges a grace period before terminating the coverage for non payment of the premiums. Doctors and other healthcare providers will continue to provide care during the grace …

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A little known rule in the ACA could pose financial risk to doctors

Health policy

Do you believe sick and disabled people deserve care?

150

The roll out of Healthcare.gov has given plenty of ammunition to opponents of health care reform, who style themselves as crusaders against incompetence. While many who oppose the program do so in good faith, some critics carry an ugly prejudice…

The roll out of Healthcare.gov has given plenty of ammunition to opponents of health care reform, who style themselves as crusaders against incompetence. While many who oppose the program do so in good faith, some critics carry an ugly prejudice against sick and disabled people.

That prejudice is “just deserts” — the idea that people get what they deserve. Rich people deserve their luxury. Poor people deserve their poverty. Sick and …

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Do you believe sick and disabled people deserve care?

Health policy

How can we judge the ideal health system of the future?

12

Over the last couple of years, we have been witnessing the start of a seismic shift in healthcare philosophy. For far too long, the system has been totally focused on rewarding quantity: The more patients seen, tests performed, procedures completed…

Over the last couple of years, we have been witnessing the start of a seismic shift in healthcare philosophy. For far too long, the system has been totally focused on rewarding quantity: The more patients seen, tests performed, procedures completed — the higher the incentives.

Now, instead of rewarding healthcare providers for quantity in the “fee-for-service” model, we are moving towards a system that rightly focuses on the quality of care …

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How can we judge the ideal health system of the future?

Health policy

3 reasons to be against Obamacare

58

If you are a staunch conservative who believes that free markets should solve health care, or that poor people should work harder and have more skin in the game, or that governments should stick to building armies, you don’t need…

If you are a staunch conservative who believes that free markets should solve health care, or that poor people should work harder and have more skin in the game, or that governments should stick to building armies, you don’t need to read this post, unless of course you enjoy being aggravated by liberals.

If you are one of the talking heads posing as a progressive, while repeating the slogans of Obamacare …

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3 reasons to be against Obamacare

Health policy

A meeting with Kathleen Sebelius about Obamacare

17

Recently, I was among a dozen people who sat privately to talk about the Affordable Care Act (ACA), aka Obamacare, with the embattled Health and Human Services Secretary, Kathleen Sebelius. Dressed in a light green blazer, sitting alongside Memphis Mayor…

Recently, I was among a dozen people who sat privately to talk about the Affordable Care Act (ACA), aka Obamacare, with the embattled Health and Human Services Secretary, Kathleen Sebelius. Dressed in a light green blazer, sitting alongside Memphis Mayor AC Wharton and Congressman Steve Cohen, who had nudged her to visit Memphis, Secretary Sebelius listened to our feedback and shared her insights.

First and foremost, addressing the issue of the …

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A meeting with Kathleen Sebelius about Obamacare

Health policy

Analyzing the bipartisan plan to repeal the SGR

10

Recently, the chairs and ranking members of the Senate Finance and House Ways and Means committees released a bipartisan, bicameral plan to repeal the Medicare SGR and reform physician payments. And this time, it looks like the effort could actually…

Recently, the chairs and ranking members of the Senate Finance and House Ways and Means committees released a bipartisan, bicameral plan to repeal the Medicare SGR and reform physician payments.  And this time, it looks like the effort could actually succeed: never before has there been agreement between the House and Senate, Republicans and Democrats, on a plan to repeal the SGR, never mind on what they would replace it …

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Analyzing the bipartisan plan to repeal the SGR

Health policy

Is it too soon to declare the Affordable Care Act a failure?

31

It is hardly an understatement to characterize the health insurance exchange rollout as a big disappointment. A botched website poses a serious problem and threatens to dampen enthusiasm for the new law -- especially among the coveted “young invulnerables” who…

It is hardly an understatement to characterize the health insurance exchange rollout as a big disappointment. A botched website poses a serious problem and threatens to dampen enthusiasm for the new law — especially among the coveted “young invulnerables” who need to sign up for coverage to keep premiums affordable for all. In the short term, the website troubles put the Obama administration firmly back on the defensive, scrambling to …

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Is it too soon to declare the Affordable Care Act a failure?

Health policy

Do we really need greater numbers of lesser trained physicians?

6

My Swedish medical school curriculum was 5 1/2 years, but I remember during a third-year class trip to the Soviet Union hearing that some doctors over there had a much shorter education. My classmates and I were at first surprised…

My Swedish medical school curriculum was 5 1/2 years, but I remember during a third-year class trip to the Soviet Union hearing that some doctors over there had a much shorter education. My classmates and I were at first surprised to see physicians staffing ill equipped ambulances, riding the streets of Moscow with critically ill patients and no equipment to deliver care. We concluded that physician labor was cheap and …

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Do we really need greater numbers of lesser trained physicians?

Health policy

Financial incentives are the wrong way to compensate physicians

Everyone agrees that the US healthcare system is too costly. The challenge of public policy is deliver higher value by improving quality while reducing costs by eliminating waste and increasing efficiency. Historically physician compensation has been tied to productivity, which…

Everyone agrees that the US healthcare system is too costly.  The challenge of public policy is deliver higher value by improving quality while reducing costs by eliminating waste and increasing efficiency. Historically physician compensation has been tied to productivity, which encourages procedures and over-utilization.

How can we motivate physicians to provide preventive, cost effective and quality care without incentive programs? Alfie Kohn in 1993 published ”Incentive Plans Cannot Work.” Clearly, poorly …

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Financial incentives are the wrong way to compensate physicians

Physician voices

Doctor dinosaur: Physicians may not be exempt from extinction

4

I grew up in a solidly middle class family. Our home was safe, loving, and we never wanted for anything. My parents believed in hard work and instilled in me the importance of a college education. I was the first…

I grew up in a solidly middle class family.  Our home was safe, loving, and we never wanted for anything.  My parents believed in hard work and instilled in me the importance of a college education.  I was the first kid on the block to have a computer.  That Radio Shack TRS-80 was a marvel of modern technology and made me the envy of my friends.  Today, a TRS-80 is …

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Doctor dinosaur: Physicians may not be exempt from extinction

Health policy

Physicians are the biggest driver of health costs

30

There are many reasons to be dismayed by the error-filled and managerially incompetent rollout of the federal health insurance exchanges that are in many ways the linchpin of President Obama's Affordable Care Act. I sympathize with commentators who have called…

There are many reasons to be dismayed by the error-filled and managerially incompetent rollout of the federal health insurance exchanges that are in many ways the linchpin of President Obama’s Affordable Care Act. I sympathize with commentators who have called for the resignation of Department of Health and Human Services Secretary Kathleen Sebelius. It’s hard to imagine Franklin Roosevelt not firing someone in his cabinet had social security stumbled this …

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Physicians are the biggest driver of health costs

Health policy

5 recommendations to achieving a grand bargain in Medicare

5

There are just a few key reasons why Medicare has become inordinately expensive. There is no end in sight for cost escalation. But there are some obvious solutions and they all begin with chronic illnesses. Chronic illnesses -- diabetes, heart…

There are just a few key reasons why Medicare has become inordinately expensive. There is no end in sight for cost escalation. But there are some obvious solutions and they all begin with chronic illnesses.

Chronic illnesses — diabetes, heart failure, cancer, chronic lung disease, etc. — are increasing at exponential rates; are caused largely by lifestyle behaviors; and consume 70-85% of all claims paid. Medicare enrollees tend to have chronic …

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5 recommendations to achieving a grand bargain in Medicare

Health policy

Obamacare’s effect on small business: An unintended consequence?

17

For employers, the Affordable Care Act takes two distinct approaches. First, for small employers (those with 50 or fewer full-time employees), the ACA does not penalize, but rather incentives the purchase of insurance with subsidies available through the Small Business…

For employers, the Affordable Care Act takes two distinct approaches.

First, for small employers (those with 50 or fewer full-time employees), the ACA does not penalize, but rather incentives the purchase of insurance with subsidies available through the Small Business Health Options Program (SHOP). Second, for large employers (those with 51 or more full-time employees), the ACA does very little. Recognizing that the overwhelming majority of these large employers already offer …

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Obamacare’s effect on small business: An unintended consequence?

Health policy

Should smokers pay higher health insurance premiums?

56

While the Affordable Care Act ends the era of denying people with pre-existing conditions access to health care, it allows insurance companies to charge tobacco users up to 50% more for their monthly premiums. Tobacco use for this purpose is…

While the Affordable Care Act ends the era of denying people with pre-existing conditions access to health care, it allows insurance companies to charge tobacco users up to 50% more for their monthly premiums. Tobacco use for this purpose is defined as any self-reported tobacco use four or more times a week within the past six months. There are excellent intentions behind this policy — smoking is the number one …

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Should smokers pay higher health insurance premiums?

Health policy

Why insurance is the wrong model for health care

78

Insurance, in its traditional form, is the wrong model for health care financing. It is the wrong commodity to be bought and sold. We don’t need health insurance, and I will tell you why. I will also tell you what…

Insurance, in its traditional form, is the wrong model for health care financing. It is the wrong commodity to be bought and sold. We don’t need health insurance, and I will tell you why. I will also tell you what we do need.

Insurance is something you buy, and then hope you never have to use. It is a hedging of your bets against bad outcomes. Term life insurance is the …

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Why insurance is the wrong model for health care

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