Health policy and public health

4,357 articles · Since 2004

Articles, page 129

Providers who want the authority of doctors: Let them have it

March 4, 2013Mar 4, 201368

California doesn’t have enough doctors to provide healthcare to newly insured patients. California state senator Ed Hernandez asks, "What good is it if they are going to have a health insurance card but no access to doctors?" Wait. Health care…

California doesn’t have enough doctors to provide healthcare to newly insured patients.

California state senator Ed Hernandez asks, “What good is it if they [state citizens] are going to have a health insurance card but no access to doctors?”

Wait. Health care insurance doesn’t mean that patients will have access to health care? Where have I heard that being said for more than 3 years?

The government is going to …

Physician voices

The solo family doc isn’t extinct: I’m proof of that

Pamela Wible, MD

February 27, 2013Feb 27, 201311

An excerpt from Pet Goats and Pap Smears. My dad is eighty-eight years old. He finally retired from medicine at eighty-six. I call to check on him. “What are you up to, Dad?” “I just returned from synagogue a few…

An excerpt from Pet Goats and Pap Smears.

My dad is eighty-eight years old. He finally retired from medicine at eighty-six. I call to check on him. “What are you up to, Dad?”

“I just returned from synagogue a few hours ago. Right now I’m catching up on my reading. I’m finishing up the fiftieth anniversary issue of Medical Economics.

That’s Dad living it up on a Saturday night.

“It …

Physician voices

Destroying the family physician: An AAFP member responds

LaDona Schmidt, MD

February 27, 2013Feb 27, 201325

A response to The creative destruction of the American family physician. Dr. Brooks' column shines a bright light on the misconception that some subspecialists have about the core of primary medical care and family medicine. As a former nurse practitioner…

A response to The creative destruction of the American family physician.

Dr. Brooks’ column shines a bright light on the misconception that some subspecialists have about the core of primary medical care and family medicine. As a former nurse practitioner and current family physician, I’d like to point out the flaws of his argument.

At a time when the health care community is working to end the fragmentation, duplication and gross …

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Health policy

Expanding Medicaid and cost sharing: A recipe for disaster?

Brad Wright, PhD

February 25, 2013Feb 25, 20137

From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and deductibles that people had to pay, and then they observed their use of the health care system. As you might expect, those who had to pay more out of their …

Health policy

Look to Oregon to see if Obamacare will succeed

Sreedhar Potarazu, MD, MBA

February 23, 2013Feb 23, 2013

Over the past several months, the state of Oregon has been pursuing an aggressive approach to solving the healthcare crisis that many states are dealing with. A couple of years ago Oregon was facing a $2 billion deficit in their…

Over the past several months, the state of Oregon has been pursuing an aggressive approach to solving the healthcare crisis that many states are dealing with.

A couple of years ago Oregon was facing a $2 billion deficit in their Medicaid program, with few solutions to repair the situation. The governor was reluctant to take the obvious step of cutting doctors’ pay for …

Medical education

Medical education: Reform the investment of tuition and time

Kevin R. Campbell, MD

February 21, 2013Feb 21, 20132

When I was in medical school in the 1990s, students were given a bleak picture of the life of a subspecialist. We were told that there would be few job opportunities and that the only way to ensure a job was to pursue a career in primary care. Many of my classmates did go into primary care but the majority of us accepted residency positions in surgery, neurosurgery and other …

Patient voices

Can you really choose a hospital based on the best price?

Trudy Lieberman

February 21, 2013Feb 21, 201321

Consumerism in health care is coming to mean patients must shop around for the best price — for a doctor’s visit, Cipro, health insurance and maybe even your next operation. The marketplace gurus are telling us we can buy health…

But can you really choose a place for surgery based on the …

Health policy

The path to data driven public policy: Ask the right questions first

David L. Katz, MD

February 21, 2013Feb 21, 20133

Should marijuana be legal, for either medical or recreational use? I think the best initial answer to this is: It's a crummy question! We are good at those. It's a crummy question, because it calls for answers based on unsubstantiated…

Should marijuana be legal, for either medical or recreational use? I think the best initial answer to this is: It’s a crummy question! We are good at those.

It’s a crummy question, because it calls for answers based on unsubstantiated opinion. Answering it does not invoke or even encourage any relevant evidence, or precedent. So what would a better question be? How about: On what basis should any particular substance be …

Health policy

Reform is suffocating private practice by design

Michael Kirsch, MD

February 19, 2013Feb 19, 201310

Cleveland and northeast Ohio are not hospitable to private practice medicine. I should know. I’m one of them. Private practice is fading as health care reform suffocates it by design. When this occurs, the public will have lost physicians who,…

Keep in mind that the first half of my professional career was spent as …

Health policy

The RUC survives and now our health system is worse off

Brian Klepper, PhD

February 14, 2013Feb 14, 201328

On January 7, 2013, a federal appeals court rejected six Georgia primary care physicians’ (PCPs) challenge to the Centers for Medicare and Medicaid Services’ (CMS) 20-year, sole-source relationship with the secretive, specialist-dominated federal advisory committee that determines the relative value of medical services. The American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC) is, in the court’s view, not subject to …

AMA: Join physicians and medical students in advocating on key issues

Jeremy Lazarus, MD

February 13, 2013Feb 13, 20134

This week, hundreds of our fellow physicians and medical students gathered in Washington, D.C., for the AMA’s National Advocacy Conference, which is held in the capital city each February. Attendees heard from members of Congress, top administration officials including HHS…

Physician voices

ACP: Medicine up in the air inflates patient expectations

American College of Physicians & Yul Ejnes, MD

February 13, 2013Feb 13, 20132

KevinMD.com. Medicine is big business. If you don't believe me, the next time that you travel by plane, pick up the airline magazine in the seat pocket and read the ads. If the advertising is a reflection of the air…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Medicine is big business. If you don’t believe me, the next time that you travel by plane, pick up the airline magazine in the seat pocket and read the ads. If the advertising is a reflection of the air traveling public, the typical flyer is bald, tired, and has …

Physician voices

Doctors are the canaries in the coal mine of medicine

Dike Drummond, MD

February 12, 2013Feb 12, 201323

Back in the day, coal miners always carried a canary with them in a small cage whenever they would go down in the mine. The canary is a very talkative bird, always singing and tweeting in a constant background noise.…

When there is bad air in the mine, the canary’s sensitive lungs will cause …

Physician voices

The creative destruction of the American family physician

Mitchell Brooks, MD

February 11, 2013Feb 11, 2013132

Medical knowledge, technology and rapid clinical advances in related scientific fields are expanding in an almost exponential manner. It is thus impossible for any individual or any medical specialty to absorb and implement these strides. Consequentially we physicians and other caregivers not only tend to specialize in medicine today, we are essentially ordained to subspecialize as a result of this knowledge explosion.

The …

Health policy

Should we expect patients to think about costs?

Skeptical Scalpel, MD

February 9, 2013Feb 9, 201317

Not long ago, I blogged about a plastic surgeon who aggressively pursues patients who refuse to pay her bills. The state is suing her to make her stop and also considering lifting her medical license. The central theme is that she makes patients who she sees in the ED to sign a form stating that they will pay her. It is unlikely that the patients are aware of …

Health policy

How pushing the Triple Aim ignores doctors and their patients

Margalit Gur-Arie

February 9, 2013Feb 9, 20137

Better Care for Individuals, Better Health for Populations, and Lower Per Capita Costs -ihi.org If you stop to think about the holy grail of health care reform, also known as the Triple Aim, it sounds like a grand challenge involving…

Better Care for Individuals, Better Health for Populations, and Lower Per Capita Costs
–ihi.org

If you stop to think about the holy grail of health care reform, also known as the Triple Aim, it sounds like a grand challenge involving wizardry or wishful thinking or worse, propaganda for the masses, particularly the last part. It’s like attempting to build a better driving machine, with better fuel efficiency at lower cost. …

Health policy

Do we really know what is going on with health care spending?

Bob Doherty

February 5, 2013Feb 5, 20139

Trying to figure out what is going on with health care costs is like Alice’s adventures in Wonderland, things are just getting curiouser and curiouser. To illustrate: which of the following statements do you think are correct? 1. It’s been…

1. It’s been 50 years since health care costs increased this slowly.
2. The U.S. spends more on healthcare than any other country but our health is …

Health policy

What is observation care? Clearing up common misperceptions

Robbin Dick, MD

February 4, 2013Feb 4, 20133

To treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions -- as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month --…

To treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions — as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month — is to take a short-sighted approach to a complex health issue.

Observation care in fact aims to address several of healthcare’s thorniest challenges head on. In the process, …

Medical education

Reform medical education to fix the primary care shortage

Kevin R. Campbell, MD

February 2, 2013Feb 2, 201311

Health policy

Is consolidation the answer to healthcare’s fragmentation problem?

Margalit Gur-Arie

January 29, 2013Jan 29, 201318

Adam Smith would disagree, Karl Marx would be appalled, and heck even Milton Friedman and Ayn Rand would be raising objections. But for some peculiar reason, there are enough contemporary lesser economic minds scattered throughout the entire philosophical spectrum, that are advocating for, and enabling the execution of, a government induced transition of our health care system to an oligopoly model …

Health policy and public health

Articles, page 129

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