Health policy and public health

4,357 articles · Since 2004

Articles, page 134

Why health care is a civil right

October 31, 2012Oct 31, 201251

I want to clear up a misunderstanding often voiced in the healthcare blog universe: namely, whether health care is a right or a service. Our answer to this question will affect how we approach healthcare reform in the next Congress,…

Civil rights are what we call those claims necessary to secure free and equal citizenship, secondary to basic rights. For …

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Why health care is a civil right

Health policy

Patients and doctors interpret fee for service differently

Bob Doherty

October 29, 2012Oct 29, 20122

The debate over fee-for-service physician payment often is misunderstood to be about the technicalities and relative merits of the RUC, relative value units, P4P and the SGR. It isn’t—instead, it’s what the fee itself represents (and who decides), and what…

Let me explain. Analysts across the political spectrum agree that the health care system needs to move …

Health policy

Walmart’s Center of Excellence program is another innovation

Brian Klepper, PhD

October 28, 2012Oct 28, 20123

Walmart's sheer size makes almost any of their initiatives newsworthy. That said, despite being a lightning rod for criticism on employee benefits and health care, they have introduced initiatives with far-reaching impacts. Their generic drug program began in September 2006…

Walmart’s sheer size makes almost any of their initiatives newsworthy. That said, despite being a lightning rod for criticism on employee benefits and health care, they have introduced initiatives with far-reaching impacts. Their generic drug program began in September 2006 – more than 300 prescription drugs for $4/month or $10 for a 90-day supply – and was widely emulated, disrupting retail drug markets and generating immense social benefit. Imagine the …

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Medical education

Rural medicine in India: What American health care can learn

Roheet Kakaday

October 27, 2012Oct 27, 20122

Many premeds take time during their undergraduate careers to volunteer abroad. Popular destinations include Mexico, various Central and Southern American countries, and Africa. These are great opportunities to discover more about underserved care and, more importantly, what you are made of. I just thought I would share my reflections on volunteering abroad during college. Hopefully, you can glean something from them.

In the backcountry of India, in the state of Maharashtra, …

Health policy

The iron triangle of health care is not law, but an observation

Davis Liu, MD

October 26, 2012Oct 26, 201216

A recent commentary in the Journal of the American Medical Association titled, "The Iron Triangle of Health Care: Access, Cost, and Quality" reflected that any health care system can only optimize two of the three elements - quality, access, cost.…

A recent commentary in the Journal of the American Medical Association titled, “The Iron Triangle of Health Care: Access, Cost, and Quality” reflected that any health care system can only optimize two of the three elements – quality, access, cost. A health care system which provides the finest quality and best access cannot do so without raising costs to unaffordable levels. An inexpensive health care system available to …

Health policy

Why healthcare is a boon for private equity

Kiran Raj Pandey, MD

October 25, 2012Oct 25, 20127

The New York Times recently did an expose on hospital overbilling by a group of cardiologists at some hospitals owned by the Hospital Corporation of America (HCA). Immediately after a few days, a rather gloating article about how HCA had…

The New York Times recently did an expose on hospital overbilling by a group of cardiologists at some hospitals owned by the Hospital Corporation of America (HCA). Immediately after a few days, a rather gloating article about how HCA had become the poster boy of Wall Street with its double digit growth strategy appeared. If the first story had not raised enough doubt about the …

Health policy

Hospitals need evidence based design

Joe Flower

October 25, 2012Oct 25, 20123

It was some doctor show on cable: Nurse McCarthy bustles into the hospital room, says “Good morning!” brightly, and crosses the brilliantly polished linoleum floor to the window. Humming to herself, she sweeps open the curtains to the view of the brick wall across the airshaft, then goes to the patient on the right and checks his dressing, clucking and offering encouragement. After a few moments she does the same …

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Hospitals need evidence based design

Health policy

Understanding the patients who are the most expensive to care for

Ishani Ganguli, MD

October 23, 2012Oct 23, 2012

We’ve known for decades that a small fraction of Americans incurs the bulk of health care costs. A report released last month by the National Institute for Health Care Management (NIHCM) analyzes 2009 data to shed light on the patients we should worry about most. Their findings take on special relevance in the wake of Massachusetts lawmakers passing an ambitious health care cost control bill.

As …

Physician voices

Should standardization end when the exam room door closes?

Suzanne Koven, MD

October 22, 2012Oct 22, 2012

The Pap smear, in which a clinician gently scrapes and brushes cells from a woman's cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to…

The Pap smear, in which a clinician gently scrapes and brushes cells from a woman’s cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to determine if the cells show pre-cancerous or cancerous changes caused by the sexually transmitted human papilloma virus (HPV), is a pretty simple procedure that takes less than a minute to …

Health policy

National reporting isn’t the answer to reduce medical errors

Kevin R. Campbell, MD

October 21, 2012Oct 21, 20123

Two articles recently addressed medical errors. In the Wall Street Journal, surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship,…

Two articles recently addressed medical errors.

In the Wall Street Journal, surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship, young doctors are not given the opportunity or security to report shortcomings of their superiors.

As discussed in the article, all of us have a memory of a particular surgeon …

Health policy

Democrats versus Republicans: Two different approaches to Medicare

Stephen C. Schimpff, MD

October 21, 2012Oct 21, 20125

The two party’s approaches are quite different. Politicians realize that Medicare will not be able to continue on its current track. Something has to change since the country will simply not be able to afford the inexorable growth and expenditures. But politicians do not like to take away entitlements so proposals generally are couched in vague terms and often with positions that are unrealistic.

The Democrats’ plans are contained generally in …

Physician voices

Why upcoding isn’t necessarily fraud

Juliet K. Mavromatis, MD

October 19, 2012Oct 19, 20125

Over the past several decades medical costs in the United States have escalated rapidly, exceeding the pace of inflation and threatening bankrupt to Medicare. As we heard in last week’s presidential debate, different solutions have been proposed on how to slow Medicare’s growth and reduce cost. President Obama highlighted his administration’s success in tackling fraud and waste within the system. This strategy appears to be supported across party lines. On …

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Why upcoding isn’t necessarily fraud

Physician voices

Having our own doctor treat us in the hospital is a thing of the past

John Schumann, MD

October 19, 2012Oct 19, 20123

Health care reform is a locomotive barreling down America's tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance. Political beliefs aside, it would seem that…

Health care reform is a locomotive barreling down America’s tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance. Political beliefs aside, it would seem that supplying insurance to protect the health of more people is a societal good. Though the costs of reform will be debated for years to come, one major question remains that …

Drugs and prescribing

Why clinical decision making in psychiatry is difficult

Julia Frank, MD

October 17, 2012Oct 17, 2012

“All psychiatrists do is push drugs!” I have heard this repeatedly, from students, wary patients, even family members who don’t pick up on a carefully worded hint that they just might benefit from getting help. For some reason, no one…

“All psychiatrists do is push drugs!”

I have heard this repeatedly, from students, wary patients, even family members who don’t pick up on a carefully worded hint that they just might benefit from getting help. For some reason, no one makes the same complaint about infectious disease specialists, or oncologists, though I wager that the success rates of our drug treatments are roughly equivalent.

As a psychiatrist, I try to treat people …

Health policy

AMA: Prescription for the future of medicine

American Medical Association & Jeremy Lazarus, MD

October 17, 2012Oct 17, 20124

A guest column by the American Medical Association, exclusive to KevinMD.com. As our nation’s health care system undergoes historic reforms, the American Medical Association (AMA) has embarked on a long-term strategic plan that seeks a better future for medicine –…

A guest column by the American Medical Association, exclusive to KevinMD.com.

As our nation’s health care system undergoes historic reforms, the American Medical Association (AMA) has embarked on a long-term strategic plan that seeks a better future for medicine – both for the physicians who make it their profession and the patients who count on us for care. Our focus is anchored in the belief that there is a national imperative …

Health policy

Will Medicare as we know it persist or will it change?

Stephen C. Schimpff, MD

October 16, 2012Oct 16, 2012

Since the nomination of Congressman Paul Ryan as the vice presidential candidate of the Republican Party, Medicare has become front and center in the political discussions. To understand the dialogue requires an understanding of Medicare, how it works, where the…

Medicare was designed in 1965 to serve as “major medical” …

Physician voices

Doctors need to be part of the digital revolution

Margaret Polaneczky, MD

October 15, 2012Oct 15, 20123

There’s a big discussion going on in the health tech community about a controversial keynote speech given by Vinod Khosla at the Health Innovation Summit (HIS), in which he stated that 80% of what doctors do could be replaced by…

If you’re a doc like me who has no idea who the heck Vinod Khosla is (he’s a venture capitalist and co-founder of Sun Microsystems), why he’d be a keynote speaker at a …

Health policy

Reduce health waste through deregulation and free market principles

WhiteCoat, MD

October 14, 2012Oct 14, 20125

Emergency Physicians Monthly has an important debate between ACEP President David Seaberg and EP Monthly founder Mark Plaster about the “Choosing Wisely” program. Choosing Wisely is being pushed by the ABIM Foundation as a way to get specialty societies to…

Emergency Physicians Monthly has an important debate between ACEP President David Seaberg and EP Monthly founder Mark Plaster about the “Choosing Wisely” program.

Choosing Wisely is being pushed by the ABIM Foundation as a way to get specialty societies to label certain tests as “unnecessary” or of questionable benefit.

I side with Dr. Seaberg in this argument.

I disagree with the concept some people advance …

Health policy

What Republicans and Democrats can agree on about Medicare

Bob Doherty

October 12, 2012Oct 12, 2012

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors. “If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we…

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors.

“If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we know it,’ then both parties have embraced that goal, writes former OMB Budget Director Alice Rivlin in a Daily Beast commentary.

“Paying providers on a fee-for-service basis offers incentives to …

Health policy

Why hospital pricing practices concern me

Peter Ubel, MD

October 12, 2012Oct 12, 2012

The gynecologist made several incisions and inserted the laparoscope. With the help of her surgical team of nurses, students and anesthesiologists, she removed the patient’s uterus, which had been bleeding uncontrollably for the past six months despite aggressive medical therapy.…

Meanwhile in a nearby hospital, another gynecologist removes another woman’s uterus, in a procedure no more complicated or time consuming than the first …

Health policy and public health

Articles, page 134

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