Health policy and public health

4,357 articles · Since 2004

Articles, page 120

Why health insurance for all obstructs lowering health care costs

November 2, 2013Nov 2, 201318

If you are like millions of Americans, at some point in your adult life, your doctor will order you to have a CT or MRI scan. Quick, easy, and painless, these invaluable imaging tests provide a vast amount and array…

However, the real pain usually begins when you receive the bill. It is not uncommon for the charges, including radiological interpretation, to …

Health policy

Is the death of the solo practitioner a bad thing?

Cedric Dark, MD, MPH

November 2, 2013Nov 2, 201356

In recent years, there has been a shift away from solo practice to group practice among physicians. The trend, which some say began in the early 2000s, appears to have accelerated with new incentives proscribed in legislation such as the Affordable Care Act. The push for accountable care organizations seems to be fostering the rapid reorganization of medicine from one based on …

Physician voices

Changing how doctors, patients and the media perceive prevention

Robert Pearl, MD

October 29, 2013Oct 29, 20135

Imagine two men in their early 60s. A year from now, both men will be dead. Changing how doctors, patients and the media perceive prevention could save lives and billions of health care dollars. Today, each is scheduled for an…

Imagine two men in their early 60s. A year from now, both men will be dead.

Changing how doctors, patients and the media perceive prevention could save lives and billions of health care dollars.

Today, each is scheduled for an initial consultation with an orthopedic surgeon and will undergo hip replacement surgery. Patient A will die on the operating table from a surgical complication. Patient B will undergo the procedure without incident. …

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Health policy

Should the health exchanges be shut down?

Robert Laszewski

October 29, 2013Oct 29, 201319

My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout. If they had developed the computer system in a transparent way, the marketplace would…

No one outside the inner circle at the Department of Health and Human Services has any idea what’s really going on behind …

Health policy

Why care must conform to patient values and cultural preferences

Margalit Gur-Arie

October 28, 2013Oct 28, 2013

On his campaign trails, Harry Truman used to call on citizens to go out and vote for themselves, in their own selfish interests. It may sound shallow and divisive, but Harry Truman believed that the individual interests of the people should trump the special interests of the powerful few, and that’s how Democracy should work. Those were simpler times, but the logic still applies today, although it’s becoming increasingly difficult …

Health policy

Should doctors encourage their patients to get health insurance?

Mara Gordon

October 26, 2013Oct 26, 201317

She was a stressed-out mother of six, working a grueling job as a kitchen manager that required her to wake up at 4am every day. She came to her doctor for her headaches: searing, throbbing pain that made her vomit. She slept fewer than five hours a night. She had tried every over-the-counter pain medication I had heard of, and she had maxed out all of those doses. I met …

Conditions and diseases

Obamacare covers screening colonoscopies, with a catch

Stephen C. Schimpff, MD

October 25, 2013Oct 25, 201333

“An ounce of prevention” we all know is good medicine. An example is colonoscopy. It was time for mine so after some lengthy procrastination I called and set up an appointment which I soon found a perfectly good reason to postpone for a few weeks. A common occurrence. The government wants me (and you) to not procrastinate, at least not because of the cost. The Affordable Care Act (or Obamacare) …

Physician voices

David and Goliath lessons for doctors and our health system

Davis Liu, MD

October 24, 2013Oct 24, 20132

October 1st was a special day. The Affordable Care Act (ACA) also commonly known as Obamacare became official. The federal government shut down because Republicans and Democrats disagreed around Obamacare funding. Most importantly, October 1st was when I could finally…

Gladwell ponders why do underdogs succeed when we least expect them to? Is it possible that advantages a Goliath has can be a disadvantage? …

Patient voices

Finding out the price of health care should be a realistic expectation

Jessie Gruman, PhD

October 23, 2013Oct 23, 20137

"Health care costs are sky-rocketing!" "The percentage of the U.S. GDP devoted to heath care costs is the highest in the world." "The cost of Medicare is unsustainable." For most of us, the cost of health care (i.e., the dollars…

“Health care costs are sky-rocketing!” “The percentage of the U.S. GDP devoted to heath care costs is the highest in the world.” “The cost of Medicare is unsustainable.”

For most of us, the cost of health care (i.e., the dollars required by the system to produce and deliver care) isn’t what brings us the most anxiety.

It’s when we’re patients or helping a loved one find care that so many of us are deeply …

Health policy

Emergency departments will remain a safety net for decades to come

Edwin Leap, MD

October 23, 2013Oct 23, 20136

Former South Carolina Senator, and current Heritage Foundation president, Jim DeMint recently angered supporters of the Affordable Care Act by stating that uninsured patients will "get better healthcare just going to the emergency room," than they will receive through Obamacare.…

Former South Carolina Senator, and current Heritage Foundation president, Jim DeMint recently angered supporters of the Affordable Care Act by stating that uninsured patients will “get better healthcare just going to the emergency room,” than they will receive through Obamacare.

That’s a sweeping assertion. However, the ACA supporters offended by Sen. DeMint need to understand the supreme irony that without America’s emergency departments and their dedicated personnel, the ACA will fall …

Health policy

Getting health insurance is not about your ideology

Manoj Jain, MD, MPH

October 22, 2013Oct 22, 201311

Standing in the dimly-lit cave-like radiology reading room, I was looking at a CT scan which was done in the emergency room on a man in his 40s who had a testicular mass — likely a cancer — which had spread through out his body. It wasn’t that the man did not know the mass was present — earlier CT scans from the emergency room clearly showed the mass in …

Health policy

Emerging enterprises of health care management

Brian Klepper, PhD

October 20, 2013Oct 20, 20134

A new class of health care management organization is emerging that thrives by taking advantage of health care’s rampant and institutionalized waste. These firms mine the market dysfunction that has developed over decades, which will almost certainly yield enough fuel…

The founders of these organizations have deep health care experience, and they understand the mechanisms of excess. More important, the ones …

Health technology

Advice to the next national coordinator for health IT

John Halamka, MD

October 18, 2013Oct 18, 20136

Over the next few months, Jacob Reider will serve as the interim National Coordinator for Health Information Technology (ONC) while the search continues for Farzad Mostashari’s permanent replacement. What advice would I give to the next national coordinator? David Blumenthal…

What advice would I give to the next national coordinator?

David Blumenthal led the ONC during a period of remarkable regulatory change and expanding budgets. He was the right person for the “regulatory era.”

Farzad Mostashari led ONC during a period of implementation when resources peaked, grants were …

Health policy

Pay for performance: Not everything that can be counted counts

James Marroquin, MD

October 17, 2013Oct 17, 20136

There is a lot of talk these days about changing our health care system from “pay for volume” to “pay for value.” The idea is that we currently reimbursement doctors and hospitals according to the number of services delivered rather than how well they make us. This perverse system of incentives results in runaway health care spending that doesn’t necessarily result in a more healthy citizenry.

There is certainly truth in …

Health technology

Health IT will dictate how health is provided in the future

Margalit Gur-Arie

October 16, 2013Oct 16, 201310

Health IT is booming, or so they say. The hotly debated and highly politicized health care reform, a.k.a. Obamacare, has been shining bright lights on a segment of our economy that is quickly approaching $3 trillion per year, and is in dire need of improvement, or so they say. Depending on who you ask, some say that health care resources must be redistributed in a more equitable manner, while others …

Health policy

How Medicare can fix the shortage of primary care physicians

Stephen C. Schimpff, MD

October 15, 2013Oct 15, 201328

Primary care physicians (PCPs) have been marginalized by Medicare for decades with low reimbursement rates for routine office visits which has led to the 15-20 minute office visit with 10-12 minutes of actual “face time” and a panel of patients…

Is there a good solution to the Medicare cost and quality issues? Setting aside either the Democrats’ approach to basically enact price controls by ratcheting down reimbursements or …

Physician voices

Hostile dependency: The real reason for physician burnout

Wes Fisher, MD

October 14, 2013Oct 14, 201327

A piece recently appeared in the New York Times entitled "Who Will Heal the Doctors?" The piece is written by Donald Borstein and I encourage all to read it. Mr. Bornstein offers a solution to the doctor burnout problem in…

A piece recently appeared in the New York Times entitled “Who Will Heal the Doctors?”

The piece is written by Donald Borstein and I encourage all to read it. Mr. Bornstein offers a solution to the doctor burnout problem in health care, a course called “The Healers Art,” now being promoted in US medical schools that uses “mindfulness” as his means of creating compassionate, caring doctors as a way forward.

I should say …

Physician voices

Is it worth it? A question providers need to be asking

John Ly, MD

October 14, 2013Oct 14, 201313

“Will you charge me?” he asked quietly, between labored breaths. He sat in the hospital bed with his legs over the side in what is known as a “tripod” position -- his elbows resting on a nearby stool to prop…

“Will you charge me?” he asked quietly, between labored breaths. He sat in the hospital bed with his legs over the side in what is known as a “tripod” position — his elbows resting on a nearby stool to prop his chest up as much as possible. His head was hunched over, with his eyes pointed down; clearly he was in agony.

He had been admitted to the hospital two weeks …

Health policy

What the Apple Store can teach health exchanges

Carmine Gallo

October 12, 2013Oct 12, 20137

The Affordable Care Act is a hefty 2,000 page law that is extraordinarily complex. Actually, have you ever seen a 2,000 page anything that’s not complex? It should come as little surprise that just over half of U.S. adults struggle to explain any of the components of the law. The survey conducted by the American Institute of CPAs, also found 48 percent of younger …

Medical education

Medical students may find themselves without a job

Christy Duan

October 12, 2013Oct 12, 201364

“Well, if medicine doesn’t work out, you can always fall back on waiting tables,” I joked with my waiter, who, like me, happens to be a medical student. We were bonding over completing our first year of medical school — he, in Detroit, and myself, in the Bronx. He liked waiting tables and decided to work during his last summer of …

Health policy and public health

Articles, page 120

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