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Health policy and public health

4,357 articles · Since 2004

Articles, page 121

Health policy

Will the Affordable Care Act worsen physician burnout?

22

As the Affordable Care Act (ACA) is implemented, many physicians are beginning to take stock in their own professional and personal lives. The practice of medicine is a privilege but it is also an occupation that can consume nearly all…

As the Affordable Care Act (ACA) is implemented, many physicians are beginning to take stock in their own professional and personal lives.  The practice of medicine is a privilege but it is also an occupation that can consume nearly all aspects of a physician’s life.  In the past I have struggled with my own “work-life balance” and I have shared my thoughts on burnout in my previous blogs.

As a …

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Will the Affordable Care Act worsen physician burnout?

Health policy

Obamacare: There is risk for the American public to be worse off

19

With the implementation of health insurance exchanges in October 2013 and the beginning of the Affordable Care Act (ACA), also known as Obamacare, there is tremendous risk for the American public to be worse off. Certainly the millions of Americans…

With the implementation of health insurance exchanges in October 2013 and the beginning of the Affordable Care Act (ACA), also known as Obamacare, there is tremendous risk for the American public to be worse off. Certainly the millions of Americans who currently are uninsured because their employers do not offer insurance coverage and those with pre-existing conditions unable to purchase affordable individual coverage, will benefit. It is those with employer-based …

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Obamacare: There is risk for the American public to be worse off

Health policy

The great irony of health care reform

9

The great irony of health care reform is that really, nothing is new. Everything, it seems, remains cloaked in secrecy. Yes, there are things called exchanges now. And millions upon millions of dollars will be spent on Internet, social media,…

The great irony of health care reform is that really, nothing is new.  Everything, it seems, remains cloaked in secrecy.

Yes, there are things called exchanges now.  And millions upon millions of dollars will be spent on Internet, social media, TV, print, and radio advertising touting the law.  There will be counselors there to help people make an informed choice.

But there’s still a new complicated, unreadable law that promises much, but …

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The great irony of health care reform

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Health policy

I support the Affordable Care Act, but not Obamacare

15

More than three years after being signed into law, and more than a year after surviving a Supreme Court challenge, the Affordable Care Act, more commonly known as Obamacare, finally begins to fulfill its promise. Most of this country has…

More than three years after being signed into law, and more than a year after surviving a Supreme Court challenge, the Affordable Care Act, more commonly known as Obamacare, finally begins to fulfill its promise. Most of this country has long since taken sides, despite appalling gaps in popular understanding of what the law means, what it does, and what it doesn’t do.

Let me admit that I’ve never had particularly …

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I support the Affordable Care Act, but not Obamacare

Health policy

Why your premium may rise under Obamacare

15

The Affordable Care Act (ACA) will make insurers unable to exclude Americans with serious health problems from enrolling in insurance plans. This is among the most popular aspects of Obamacare. It is also the most likely explanation for huge premium…

The Affordable Care Act (ACA) will make insurers unable to exclude Americans with serious health problems from enrolling in insurance plans. This is among the most popular aspects of Obamacare. It is also the most likely explanation for huge premium increases in plans for individuals not on employer group policies.

Persons employed by companies with insurance plans for their employees, usually called group plans, routinely accept all eligible employees, regardless of …

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Why your premium may rise under Obamacare

Health policy

How the Obamacare exchanges will transform health care

6

When the next phase of the Affordable Care Act (ACA) kicks into gear January 1, 2014, each state will be required to offer its residents access to health care insurance through an online marketplace, often referred to as a “health…

When the next phase of the Affordable Care Act (ACA) kicks into gear January 1, 2014, each state will be required to offer its residents access to health care insurance through an online marketplace, often referred to as a “health insurance exchange.” These exchanges are now open for business on Oct. 1, 2013, allowing individuals to sign up online, by phone or in-person, with health insurance coverage starting next year.

Until now, buying health …

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How the Obamacare exchanges will transform health care

Health policy

The problem with Obamacare is that it doesn’t do enough

40

Obamacare is here. It’s really here. You might be wondering what’s been going on in the hospital or office -- the contact points where health care actually happens. The funny thing is: nothing seems any different. And this is the…

Obamacare is here. It’s really here.

You might be wondering what’s been going on in the hospital or office — the contact points where health care actually happens.

The funny thing is: nothing seems any different.

And this is the problem with Obamacare. It hasn’t, won’t, or perhaps couldn’t, change the fundamental problem with US health care. Namely, that it is too big, too disruptive, and too devoid of nuance. In this way, health care …

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The problem with Obamacare is that it doesn’t do enough

Health technology

Why physicians will never learn to like EMRs

43

EMRs are not designed for patient care. Is there anyone working in health IT who can honestly say that he or she never heard this statement being made hundreds or thousands of times? Is there any clinician actually working with…

EMRs are not designed for patient care. Is there anyone working in health IT who can honestly say that he or she never heard this statement being made hundreds or thousands of times? Is there any clinician actually working with patients and EMRs who can state that such thought never crossed his or her mind? This includes health IT evangelists and physicians spearheading IT initiatives at the most excellent of …

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Why physicians will never learn to like EMRs

Health policy

What Obamacare means to my family

67

The anticipated and dreaded letter from my health insurance company arrived yesterday. Dear Member: We are writing to let you know about some important changes to your individual health insurance coverage ... Your health insurance plan will no longer be…

The anticipated and dreaded letter from my health insurance company arrived yesterday.

Dear Member:

We are writing to let you know about some important changes to your individual health insurance coverage … Your health insurance plan will no longer be available after December 31, 2013.

We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different

…

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What Obamacare means to my family

Physician voices

With the patient hemorrhaging, doctors are backed into a corner

3

We were pretty damn lucky that she was young and healthy. The surgery had been technically successful. I watched as the resident finished with the last sutures. Although the attending had already left the room, I looked on with the…

We were pretty damn lucky that she was young and healthy.

The surgery had been technically successful.  I watched as the resident finished with the last sutures.  Although the attending had already left the room, I looked on with the eagerness of a third year student.  Orders were written, and the patient was transferred to recovery.

It was a routine hysterectomy.  None of the pizazz and flare of a gynecology-oncology surgery, but …

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With the patient hemorrhaging, doctors are backed into a corner

Physician voices

Who will pressure physicians to join the 21st century?

16

A Bank of America ATM can figure out who you are and how much money is in your account in seconds. It can spit out cash in virtually any currency from nearly any spot in the world -- even if…

A Bank of America ATM can figure out who you are and how much money is in your account in seconds. It can spit out cash in virtually any currency from nearly any spot in the world — even if you’re a Chase customer. It’s a technological convenience we’ve all come to expect.

Hospitals and doctors’ offices are starting to replace hard copy patient records with computerized heath systems. Some U.S. …

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Who will pressure physicians to join the 21st century?

Health policy

How physicians can fight obstructivism over Obamacare

23

Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it. The state marketplaces, created by the Affordable Care Act (Obamacare) will…

Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it.  The state marketplaces, created by the Affordable Care Act (Obamacare) will begin enrolling eligible people on October 1, and eligible persons will have until March 31 to sign up.   The coverage and subsidies for those who sign up will start on …

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How physicians can fight obstructivism over Obamacare

Health policy

Who gets left out of Obamacare?

25

The main purpose of health reform, said the president at a recent press conference, was to provide health insurance to people at affordable rates. He meant the nub of Obamacare -- the state shopping exchanges with their smorgasbord of insurance…

The main purpose of health reform, said the president at a recent press conference, was to provide health insurance to people at affordable rates. He meant the nub of Obamacare — the state shopping exchanges with their smorgasbord of insurance policies — would give coverage to millions of Americans who did not have insurance.

Whether that coverage will be affordable or comprehensive for families remains to be seen. What is crystal …

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Who gets left out of Obamacare?

Health policy

The Affordable Care Act ignores simple issues of human nature

58

The Affordable Care Act (ACA), aka Obamacare, is law. And its implementation is moving along slowly, but steadily. You have to give credit to the folks who believed in it, whether grass-roots supporters or highly placed politicians. They rammed it…

The Affordable Care Act (ACA), aka Obamacare, is law.  And its implementation is moving along slowly, but steadily.

You have to give credit to the folks who believed in it, whether grass-roots supporters or highly placed politicians.  They rammed it down the American gullet like a lead ball down the muzzle of a Hawken rifle.  The problem is, once it goes off, the whole thing is going to explode.

The reasons are …

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The Affordable Care Act ignores simple issues of human nature

Health policy

The Triple Aim is vital to our collective health

21

In 2008, a couple of years before the Affordable Care Act became the law of the land, Donald M. Berwick, MD, and his colleagues at the Institute for Healthcare Improvement (IHI) introduced the Triple Aim concept and set to work…

In 2008, a couple of years before the Affordable Care Act became the law of the land, Donald M. Berwick, MD, and his colleagues at the Institute for Healthcare Improvement (IHI) introduced the Triple Aim concept and set to work on ways to (1) improve population health, (2) increase patient satisfaction and (3) reduce per capita healthcare costs.

In pursuit of these goals, IHI encouraged the exploration of a variety of …

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The Triple Aim is vital to our collective health

Physician voices

The role of physicians is set to evolve again

3

Talking with an insurance doctor, who denied a vertebroplasty for my patient with a spontaneous compression fracture, I started thinking about the dilemma of defining what a doctor-patient relationship is. A couple of years ago a local doctor with a…

Talking with an insurance doctor, who denied a vertebroplasty for my patient with a spontaneous compression fracture, I started thinking about the dilemma of defining what a doctor-patient relationship is.

A couple of years ago a local doctor with a dwindling private practice joined an Internet medical site that promoted drugs like Viagra and offered online consultations with physicians who prescribed the medications when they felt it was appropriate. The state …

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The role of physicians is set to evolve again

Health policy

Can American doctors get off the hamster wheel?

15

What follows are not complaints. These are just the facts. Here’s a recent exchange from an enlightened physician leader, one who has yet to give up: “My colleagues are discouraged and frustrated every day, leaving the office defeated and fatigued.…

What follows are not complaints. These are just the facts.

Here’s a recent exchange from an enlightened physician leader, one who has yet to give up: “My colleagues are discouraged and frustrated every day, leaving the office defeated and fatigued. There are other ways to practice.”

High health care costs get most of the attention, but there’s a more important crisis coming your way.

First a review, then to the looming crisis.

When Americans travel …

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Can American doctors get off the hamster wheel?

Health policy

Use the Internet to create a competitive medical marketplace

3

An enemy intent on ruining the U.S. economy and sabotaging our public health could do no better than burden us with our current system of health care. The crushing costs of our health expenditures almost double per person those of…

An enemy intent on ruining the U.S. economy and sabotaging our public health could do no better than burden us with our current system of health care. The crushing costs of our health expenditures almost double per person those of other developed countries, with health outcomes that fall somewhere between mediocre and lousy.

There is no single cause for our medical fiasco and no single cure — especially since all solutions …

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Use the Internet to create a competitive medical marketplace

Health policy

Our dysfunctional system: Both doctors and patients are at fault

6

I do not argue with my patients. Rather, I teach, outline options and explain my point of view, as each person must choose their path. However, the other day, Audrey and I got in a tiff when she was in…

I do not argue with my patients.  Rather, I teach, outline options and explain my point of view, as each person must choose their path.  However, the other day, Audrey and I got in a tiff when she was in the office to discuss her breast cancer.  We had an enthusiastic discussion not of chemotherapy, x-rays or surgical options.  Nope, we disagreed about what is wrong with healthcare.

It seems to …

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Our dysfunctional system: Both doctors and patients are at fault

Health policy

What health care in the United States can learn from Nepal

10

In the US, many health care woes are blamed on the federal or state government. Whether there is too little oversight and lack of transparency or too much interference and regulation, it seems that policy and politics often end up…

In the US, many health care woes are blamed on the federal or state government. Whether there is too little oversight and lack of transparency or too much interference and regulation, it seems that policy and politics often end up getting blamed for health care system troubles. But what happens when one lives in a country with no functioning …

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What health care in the United States can learn from Nepal

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