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Health policy and public health

4,357 articles · Since 2004

Articles, page 152

Health policy

Staff who resist quality improvement efforts

4

Perhaps you are just beginning a quality improvement program or project. Perhaps you have several project improvement projects successfully completed at your healthcare site. No matter what your level of experience, you have encountered staff who are roadblocks to your…

Perhaps you are just beginning a quality improvement program or project.  Perhaps you have several project improvement projects successfully completed at your healthcare site.

No matter what your level of experience, you have encountered staff who are roadblocks to your efforts.  What are you to do?  Ignoring them or doing nothing will imperil your quality efforts eventually.  Let me share some ideas on what to do based upon my own …

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Staff who resist quality improvement efforts

Physician voices

The radiation delivered by CT scanners has gone largely unregulated

9

Although the medical profession has been harming unlucky patients for centuries, the patient safety movement didn’t take flight until 1999, when the Institute of Medicine published its seminal report, To Err is Human. And that report would have ended up…

Although the medical profession has been harming unlucky patients for centuries, the patient safety movement didn’t take flight until 1999, when the Institute of Medicine published its seminal report, To Err is Human. And that report would have ended up as just another doorstop if not for its estimate that 44,000-98,000 Americans each year die from medical mistakes, the equivalent of a jumbo jet crashing each …

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The radiation delivered by CT scanners has gone largely unregulated

Patient voices

Our health system defaults toward treatment rather than compassion

26

I believe knowledge is power. There is no more complex topic in the healthcare debate than end-of-life care. I have been a Registered Nurse for thirty years. I deal with this every day. All of us will confront this issue…

I believe knowledge is power. There is no more complex topic in the healthcare debate than end-of-life care. I have been a Registered Nurse for thirty years. I deal with this every day. All of us will confront this issue eventually. When it’s your turn, I hope the medical profession will guide you to the best options for you and your family.

Often I see patients who have prepared living …

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Our health system defaults toward treatment rather than compassion

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Health policy

Why the human brain seems to struggle with comprehending risk

6

There's a fascinating blog post over at the New York Times math blog that has the health policy program here at New America scratching our heads, sharpening our No. 2 pencils, and dusting off our calculators. Turns out, German mathematicians…

There’s a fascinating blog post over at the New York Times math blog that has the health policy program here at New America scratching our heads, sharpening our No. 2 pencils, and dusting off our calculators.

Turns out, German mathematicians have been studying how and why the human brain seems to struggle with comprehending risk. We find it difficult to translate the mathematical …

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Why the human brain seems to struggle with comprehending risk

Health policy

Consumer driven health care will only shift costs if implemented poorly

7

The creation of consumer-driven health plans (CDHPs), health insurance policies with high deductibles linked to a savings option and with more financial responsibility shouldered by patients and employees and less by employers, was completely inevitable. The American public likes to…

The creation of consumer-driven health plans (CDHPs), health insurance policies with high deductibles linked to a savings option and with more financial responsibility shouldered by patients and employees and less by employers, was completely inevitable.

The American public likes to have everything, whether consumer electronics or other services, as cheap as possible. With escalating health care expenses rising far more rapidly than wages or inflation, it’s not surprising employers …

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Consumer driven health care will only shift costs if implemented poorly

Health policy

Cost containment strategies for emergency care

4

It strikes me that in developing payment reform related, compensation driven cost-containment strategies aimed at constraining the cost of emergency care, policy makers, emergency physicians, and health insurers should adhere to certain principles. The American College of Emergency Physicians should…

It strikes me that in developing payment reform related, compensation driven cost-containment strategies aimed at constraining the cost of emergency care, policy makers, emergency physicians, and health insurers should adhere to certain principles.

The American College of Emergency Physicians should be at the forefront when it comes to establishing these principles, which I hope will be focused on protecting our patients first, and our specialty second.

The concept and practice of …

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Cost containment strategies for emergency care

Health policy

Cost of care is related to the advancements in medicine

25

Much is being written about the ever increasing cost of health care in the US, especially compared to the rest of the developed world. As a nation, we spend nearly 16% of our GDP on health care. All estimates predict…

Much is being written about the ever increasing cost of health care in the US, especially compared to the rest of the developed world.

As a nation, we spend nearly 16% of our GDP on health care.  All estimates predict that this amount will continue increasing unless costs can be controlled now.  Hence the passage of the Affordable Care Act.  Not only was it designed to extend coverage to more …

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Cost of care is related to the advancements in medicine

Health policy

Reverse our attitudes and values to control health costs

10

by John Kaegi We all complain about the cost of health care and health insurance. Ours is by far the most expensive health care system in the world. And for the money, our health isn’t so hot either. On the…

by John Kaegi

We all complain about the cost of health care and health insurance.  Ours is by far the most expensive health care system in the world.  And for the money, our health isn’t so hot either.  On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization.  America …

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Reverse our attitudes and values to control health costs

Health policy

The challenge of pre-authorization for an elective procedure

7

It was supposed to be a routine office visit for my patient. Unexpectedly, it turned into a real-world health economics lesson for me, the treating physician. The old adage "listen to your patients; they will always give you the answer"…

It was supposed to be a routine office visit for my patient.

Unexpectedly, it turned into a real-world health economics lesson for me, the treating physician. The old adage “listen to your patients; they will always give you the answer” became exceedingly true in this case, even when it dealt with an issue beyond a medical diagnosis, such as lack of transparency regarding insurance coverage …

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The challenge of pre-authorization for an elective procedure

Health policy

Team based care in health reform needs patient involvement

23

The following op-ed was published on June 7, 2011 in USA Today. More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, "How will reform affect me?" It's a…

The following op-ed was published on June 7, 2011 in USA Today.

More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, “How will reform affect me?” It’s a complicated question, with a different answer for each patient. But as the law’s full effects unfold, one of the more significant changes will be in how patients interact with their …

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Team based care in health reform needs patient involvement

Health policy

Physician consolidation places health reformers in an ironic dilemma

7

One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota's Mayo Clinic or California's Kaiser Permanente. According to health reformers, these integrated systems…

One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota’s Mayo Clinic or California’s Kaiser Permanente.

According to health reformers, these integrated systems can reduce variation in care, which improves quality, and potentially reduces costs.

There’s been a major effort to re-organize hospitals and physicians under guises of Patient Centered Medical Homes and  …

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Physician consolidation places health reformers in an ironic dilemma

Health policy

ACP: ACOs – On to the final rule

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP Recently, I commented on cost saving, quality, and care coordination requirements in the proposed rule that physician practices will likely need to…

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

by John Tooker, MD, MBA, MACP

Recently, I commented on cost saving, quality, and care coordination requirements in the proposed rule that physician practices will likely need to meet to be eligible for additional Medicare payments.

The public comment period on the proposed rule for the creation of ACOs has ended. CMS has pledged it will …

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ACP: ACOs – On to the final rule

Health policy

2 changes to cut Federal health care expenditures

8

If we're serious about cutting Federal health care expenditures over the long term, here are two changes that will do just that. 1. Requiring HHS to negotiate with pharma for Part D drug costs would reduce annual expenditures by over…

If we’re serious about cutting Federal health care expenditures over the long term, here are two changes that will do just that.

1. Requiring HHS to negotiate with pharma for Part D drug costs would reduce annual expenditures by over $20 billion.

As I’ve noted repeatedly(but unfortunately few in the mass media have), Part D’s perhaps the biggest deficit problem we have – the ultimate unfunded liability is now over $20 trillion. …

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2 changes to cut Federal health care expenditures

Health policy

A new organization for primary care

19

Recently, the Board of the American Academy of Family Physicians (AAFP) announced that, for now, it would continue participating in the Relative Value Scale Update Committee (RUC), the secretive American Medical Association committee that, through a longstanding relationship with the…

Recently, the Board of the American Academy of Family Physicians (AAFP) announced that, for now, it would continue participating in the Relative Value Scale Update Committee (RUC), the secretive American Medical Association committee that, through a longstanding relationship with the Centers for Medicare and Medicaid Services (CMS), has heavily influenced physician reimbursement.

At nearly the same time, Medicare announced that it will go broke in 2024, a decade sooner …

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A new organization for primary care

Health policy

5 strategic tools to solve our healthcare woes

4

It’s getting scary. We are facing, before the end of this decade, a bifurcated future. The way things are going now—with the economy wheezing, doctors bailing, chronic disease rising fast, boomers sliding out of the Viagra years into the Depends…

It’s getting scary.

We are facing, before the end of this decade, a bifurcated future. The way things are going now—with the economy wheezing, doctors bailing, chronic disease rising fast, boomers sliding out of the Viagra years into the Depends years, reimbursements getting squeezed ever tighter, Medicaid sputtering on fumes, and 30 million or more new people soon swarming our doors with insurance cards—if we don’t pull a rabbit out …

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5 strategic tools to solve our healthcare woes

Physician voices

Medical practice career choices commonly become medical business failures

15

Never in the history of medicine have doctors faced such a ruthless gauntlet of threats, financial debts, and practice restrictions than they do today. These factors, among others just as crucial, don’t begin to tell the story about why 40%…

Never in the history of medicine have doctors faced such a ruthless gauntlet of threats, financial debts, and practice restrictions than they do today.  These factors, among others just as crucial, don’t begin to tell the story about why 40% of medical doctors readily admit to intense frustration in their practices, in addition to the percentage of doctors quitting medical practice completely.

They’re not retiring.  They’re adapting.  Extended hours to see …

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Medical practice career choices commonly become medical business failures

Health policy

Why the AMA is in decline, and should doctors care?

46

The American Medical Association recently released its membership numbers, and they're declining. According to MedPage Today, the AMA "saw another steep drop in its membership in 2010 -- this time losing about 12,000 members or 5% of its total membership."…

The American Medical Association recently released its membership numbers, and they’re declining.

According to MedPage Today, the AMA “saw another steep drop in its membership in 2010 — this time losing about 12,000 members or 5% of its total membership.”

It’s been well publicized that the AMA only represents a minority percentage of physicians, depending on what you read, it’s between 20 and 30%.  But it seems many physicians have little …

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Why the AMA is in decline, and should doctors care?

Health policy

How Medicaid is under political attack

4

by Rishi Manchanda, MD, MPH Mr. M walked into the community clinic where I work with a portable oxygen tank in tow. At 62, he's gaunt and winded, battling a disease that is progressively scarring his lungs. Every breath is…

by Rishi Manchanda, MD, MPH

Mr. M walked into the community clinic where I work with a portable oxygen tank in tow. At 62, he’s gaunt and winded, battling a disease that is progressively scarring his lungs. Every breath is a fight. Instead of the clear flow of air, I hear the sound of velcro ripping when I place my stethoscope on his chest. In medicine, his …

Read more…

How Medicaid is under political attack

Physician voices

How physicians not adhering to clinical guidelines may be punished

13

The Justice Department decided to weigh in on the topic of clinical guidelines. As if to underscore Dr. Rich’s assertion that “guidelines are no longer guidelines," the Federal government has raised the prospect of fining your doctor and/or sending her…

The Justice Department decided to weigh in on the topic of clinical guidelines.

As if to underscore Dr. Rich’s assertion that “guidelines are no longer guidelines,” the Federal government has raised the prospect of fining your doctor and/or sending her to prison for the crime of not strictly following guidelines of care.

As reported by MedPage Today:

“Federal prosecutors are looking into physicians’ prescribing practices relating to implantable cardioverter defibrillators

…

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How physicians not adhering to clinical guidelines may be punished

Health policy

Considering a single payer model for health reform

82

The Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain. Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an…

The Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain.

Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an estimated 400 billion in taxpayer money to subsidize the purchase of these plans. Is this the best way to spend our money?

Many of us in the health field remain skeptical …

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Considering a single payer model for health reform

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