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Health policy and public health

4,357 articles · Since 2004

Articles, page 135

Health policy

A patient is not a dish off the menu

8

Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can…

Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can be easily paraphrased.

The Cheescake Factory, like other successful restaurant chains, has “brought chain production to complicated sit-down meals.” They’ve done it by far-reaching standardization of the best possible …

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A patient is not a dish off the menu

Health policy

Stop setting hospital benchmarks at the state average

Recently, I discovered the statewide report on quality of stroke care in Massachusetts. It’s a plain document, mostly in black and white, much of what you might expect from a state government report. Yet, this 4-page document is a reminder…

Recently, I discovered the statewide report on quality of stroke care in Massachusetts.  It’s a plain document, mostly in black and white, much of what you might expect from a state government report.  Yet, this 4-page document is a reminder of how we have come to accept mediocrity as the standard in our healthcare delivery system.

The report is about 1,082 men and women in Massachusetts unfortunate enough to have a stroke …

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Stop setting hospital benchmarks at the state average

Health policy

Align employers with doctors, hospitals and insurance companies

5

I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health…

I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health care reform law. But now I think differently.

Now I believe that emboldened employers in places like Memphis can use their clout. They can influence insurers and work directly with doctors …

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Align employers with doctors, hospitals and insurance companies

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Physician voices

Reform needs more than expanding health care coverage

Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s…

Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people.  There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care …

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Reform needs more than expanding health care coverage

Health policy

The cost of health care is different from its price

4

“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 …

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The cost of health care is different from its price

Physician voices

How America’s healthcare system will keep you sick

11

Have you ever worried about how you’re going to get healthy these days? Has your doctor recommended diet and exercise? Well, if you’re like millions who are struggling to find health, you’re going to need a lot more than just…

Have you ever worried about how you’re going to get healthy these days? Has your doctor recommended diet and exercise? Well, if you’re like millions who are struggling to find health, you’re going to need a lot more than just diet and exercise. You’re going to have to fight like crazy against a mind-set of disease that’s paradoxically disguised as health care.

America’s healthcare system – health insurance companies, government health …

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How America’s healthcare system will keep you sick

Health policy

Why health insurance is the problem and not the solution

13

Recently a neighbor backed into my car while I was leaving a food store. The damage was minimal, but she offered to have her insurance company pay for the repair. After contacting the company, I was offered several body shops,…

Recently a neighbor backed into my car while I was leaving a food store. The damage was minimal, but she offered to have her insurance company pay for the repair. After contacting the company, I was offered several body shops, and chose the one closest to my home.  The work was completed in only two days, and while it was in the shop, I decided to also have some dents …

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Why health insurance is the problem and not the solution

Health policy

The AAFP picks a fight with nurse practitioners

56

The American Academy of Family Physicians (AAFP) recently issued a new report describing its vision of primary care's future. Not surprisingly, the report talks about medical homes, with patient-centered, team-based care. More surprisingly, though, it makes a point to insist…

The American Academy of Family Physicians (AAFP) recently issued a new report describing its vision of primary care’s future. Not surprisingly, the report talks about medical homes, with patient-centered, team-based care.

More surprisingly, though, it makes a point to insist that physicians, not nurse practitioners, should lead primary care practices. The important questions are whether nurse practitioners are qualified to …

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The AAFP picks a fight with nurse practitioners

Health policy

Are Medicare vouchers a good idea for patients and their physicians?

4

Trying to figure out whether Medicare vouchers are a good idea for patients and their physicians? Then consider these two basic questions: 1. How much will the federal government contribute? 2. Who is at risk for health care cost increases?…

Trying to figure out whether Medicare vouchers are a good idea for patients and their physicians?  Then consider these two basic questions:

1.  How much will the federal government contribute?
2.  Who is at risk for health care cost increases?

How much will the government contribute?  The traditional Medicare program has no set limit on how much the federal government will contribute to a beneficiary’s health care, although there are limits on how …

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Are Medicare vouchers a good idea for patients and their physicians?

Physician voices

Can the airline industry teach customer service lessons to medicine?

4

"Your call is important to us. Please listen carefully because our options have changed." During your current or any prior lifetime, has any phone menu option ever changed? I have more than once experienced an option not offered on the…

“Your call is important to us.  Please listen carefully because our options have changed.”

During your current or any prior lifetime, has any phone menu option ever changed?

I have more than once experienced an option not offered on the robotic phone menu option choices – a dead phone line after a 30 minute wait.

Have you tried this customer plea as I have?  Could you pretty-please jot down my cell phone number in …

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Can the airline industry teach customer service lessons to medicine?

Health policy

To fix health care, we need to be screwed

5

“We need to be screwed!” Not altogether surprising words to spill out of a college student’s mouth. But this particular student was not talking about sex. She was discussing the U.S. healthcare system—more specifically what she thought it would take…

“We need to be screwed!”

Not altogether surprising words to spill out of a college student’s mouth. But this particular student was not talking about sex. She was discussing the U.S. healthcare system—more specifically what she thought it would take for our two political parties to come together to find a reasonable way to control our nation’s healthcare costs.

It was the last day of the semester, the last class discussion in …

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To fix health care, we need to be screwed

Health policy

How the surplus of patients will impact primary care

9

I believe the projected shortage of physicians caused by the Affordable Care Act will drive primary care into two opposite tracks. Each is a distinct and logical response to the patient overload and each points out gaping holes in our…

I believe the projected shortage of physicians caused by  the Affordable Care Act will drive primary care into two opposite tracks. Each is a distinct and logical response to the patient overload and each points out gaping holes in our medical education that must be addressed.

The Association of American Medical Colleges  estimates that there will be a shortage of 63,000 doctors by 2015 and 130,600 by 2025 in the wake …

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How the surplus of patients will impact primary care

Health policy

What happens if Medicaid expansion is undermined

3

He was a "frequent flyer" -- a patient with multiple health problems who gets admitted to the hospital repeatedly. It was usually because he hadn't taken his medicine correctly, if at all. When he left the hospital 10 days earlier,…

He was a “frequent flyer” — a patient with multiple health problems who gets admitted to the hospital repeatedly. It was usually because he hadn’t taken his medicine correctly, if at all. When he left the hospital 10 days earlier, he told his physician that he wouldn’t have problems filling his prescriptions, because he had Medicaid. But when he arrived at his local drug store, it wasn’t so easy.

“I was …

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What happens if Medicaid expansion is undermined

Health policy

The Accountable Care Organization: Think opportunity, not threat

8

Accountable care is here – both as a way of doing business and an approach to providing high quality health care. With accountable care, the potential for reducing overall health care costs, realigning incentives and focusing clinical resources on prevention…

Accountable care is here – both as a way of doing business and an approach to providing high quality health care.  With accountable care, the potential for reducing overall health care costs, realigning incentives and focusing clinical resources on prevention and disease management is now a real opportunity. Physicians who aren’t ready to transition their practices to operate in a manner required under accountable care models will increasingly find themselves …

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The Accountable Care Organization: Think opportunity, not threat

Health policy

Why is there a primary care shortage?

39

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, provided neither the Supreme Court nor a…

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, provided neither the Supreme Court nor a new president overturns the law. 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 …

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Why is there a primary care shortage?

Health policy

Are insurance companies responsible for increasing health costs?

8

The insurance system for healthcare is perverse. The individual is not the customer of the healthcare company; in most cases it is the employer or the government (i.e., Medicare, Medicaid). They physician works for the insurer who determines for what…

The insurance system for healthcare is perverse. The individual is not the customer of the healthcare company; in most cases it is the employer or the government (i.e., Medicare, Medicaid). They physician works for the insurer who determines for what and for how much the doctor is paid. But are the insurance companies the blame that is often placed on them for our current state of affairs?

This system abrogates the …

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Are insurance companies responsible for increasing health costs?

Physician voices

Can the AMA be fixed?

9

There is nothing more powerful than an idea whose time has come. There is nothing less powerful than an idea whose time has come and gone. In 1846, and for more than 100 years after that, the American Medical Association…

There is nothing more powerful than an idea whose time has come. There is nothing less powerful than an idea whose time has come and gone.

In 1846, and for more than 100 years after that, the American Medical Association as a nationwide organization for all physicians was a powerful idea whose time had come. It worked well for many things and OK for many more.

Then, in the 1970s, 80s, 90s, …

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Can the AMA be fixed?

Health policy

Both sides are spewing nonsense when they talk Medicare

2

Medicare has suddenly become a centerpiece issue in the 2012 election—but not in a good way. Instead of an informed debate about Medicare’s present and future place in our health care system, the politicians have subjected us to a daily…

Medicare has suddenly become a centerpiece issue in the 2012 election—but not in a good way.  Instead of an informed debate about Medicare’s present and future place in our health care system, the politicians have subjected us to a daily assault of nonsense over substance:

Let’s start with the nonsense accusation by Governor Romney that “There’s only one president that I know of in history that robbed Medicare, $716 billion to …

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Both sides are spewing nonsense when they talk Medicare

Health policy

Physicians need to embrace change to fix health care

12

Several interesting facts crossed my computer screen recently. The first was a Tweet by American Medical News that the first CT scan was performed on August 25th 1973. The second focused on the large number of practicing physicians who suffer…

Several interesting facts crossed my computer screen recently.  The first was a Tweet by American Medical News that the first CT scan was performed on August 25th 1973.  The second focused on the large number of practicing physicians who suffer from burnout, and the third was an article, which cited a talk given by Vinod Khosia in which he is quoted as saying “80 percent of doctors could …

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Physicians need to embrace change to fix health care

Health policy

What can we learn about health care from Europe?

6

May I tiptoe onto a ledge for a moment? Some (just-back-from-Europe) thoughts on health care policy, perhaps? One of the many differences between the European Society of Cardiology (ESC) Congress and a typical American cardiology meeting was the scarcity of…

May I tiptoe onto a ledge for a moment?

Some (just-back-from-Europe) thoughts on health care policy, perhaps?

One of the many differences between the European Society of Cardiology (ESC) Congress and a typical American cardiology meeting was the scarcity of healthcare policy sessions at the ESC. That’s hard to explain; perhaps European countries are settled on their own systems and do not wish to — or can’t — influence their neighbors.

It goes …

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What can we learn about health care from Europe?

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