Health policy and public health

4,357 articles · Since 2004

Articles, page 154

What medical professionalism has to do with the federal debt

May 31, 2011May 31, 20117

In recent weeks, headline news has been reporting on the battle to curb the federal debt. What does this have to do with medical professionalism? The federal government must borrow forty cents of every dollar it spends. In health care,…

In recent weeks, headline news has been reporting on the battle to curb the federal debt. What does this have to do with medical professionalism?

The federal government must borrow forty cents of every dollar it spends. In health care, it needs to borrow from China and other lenders to reimburse doctors, hospitals and other providers who bill federal programs.

The government’s debt totals $14.3 trillion. It is …

Medical education

Would free medical school be enough to save primary care?

Kevin Pho, MD

May 31, 2011May 31, 201133

Medical school should be free. That's an argument made by physicians Peter B. Bach and Robert Kocher in the New York Times. This isn't a new concept. I've discussed whether medical school should be free for students who choose primary…

Medical school should be free.

That’s an argument made by physicians Peter B. Bach and Robert Kocher in the New York Times.

This isn’t a new concept. I’ve discussed whether medical school should be free for students who choose primary care. And, for some in the country, it’s already happening. Like at Case Western Reserve University, for instance. The Cleveland Clinic …

Health policy

The evolution of hospitals and the present state of health policy

Tom Glendinning

May 30, 2011May 30, 20114

My first exposure to KevinMD.com is reading Healthcare costs can be reduced with emerging business models by Joe Flower. While I am not informed about the medical business models to which he refers, I am experienced in business. I hail…

My first exposure to KevinMD.com is reading Healthcare costs can be reduced with emerging business models by Joe Flower.

While I am not informed about the medical business models to which he refers, I am experienced in business. I hail from a family of doctors and hospital owners. While I did lose touch with the industry for several years, I have noted several changes which do not make sense. …

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Health policy

Can ACOs reinvent the American health care system?

George Lundberg, MD

May 26, 2011May 26, 20118

The cost curve of American medicine continues to bend up. That is unsustainable. It must begin to bend downward. Two recent headlines focus the problem: New York Times, May 14, 2011: Health Insurers Making Record Profits as Many Postpone Care…

The cost curve of American medicine continues to bend up. That is unsustainable. It must begin to bend downward.

Two recent headlines focus the problem:

New York Times, May 14, 2011: Health Insurers Making Record Profits as Many Postpone Care

And, CNN Money, May 11, 2011 reports “Your family’s healthcare costs $19,393.” That is for a family of four, which has a median income of $75,700 — before taxes.

Opportunity …

Physician voices

Medical malpractice tort reform equals healthcare reform

Darrell E. White, MD

May 26, 2011May 26, 201143

I’m a big game theory guy. I think you can explain the actions of the participants in any structured activity or enterprise by looking at the rules of the game. When you look backwards in time you discover that the…

I’m a big game theory guy.

I think you can explain the actions of the participants in any structured activity or enterprise by looking at the rules of the game. When you look backwards in time you discover that the “players” almost always made choices that represented rational self-interest. This is especially true in games played using zero sum rules: someone wins only if someone else loses. How the game is …

Health policy

E-prescribe now, or risk a Medicare penalty

Rosemarie Nelson

May 25, 2011May 25, 20117

Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.…

The penalty will increase to 1.5% in 2013 for those who don’t e-prescribe for 25 Medicare patients during 2011.

Not yet e-prescribing?

Maybe your …

Health policy

ACP: How accountable care is a team sport

American College of Physicians

May 25, 2011May 25, 20116

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP On March 31, 2011, CMS issued a proposed rule to implement a section of the Patient Protection and Affordable Care Act (ACA)…

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

by John Tooker, MD, MBA, MACP

On March 31, 2011, CMS issued a proposed rule to implement a section of the Patient Protection and Affordable Care Act (ACA) that requires the HHS Secretary to establish a Medicare Shared Savings Program. Under the proposed rule, eligible providers and hospitals that create or join …

Physician voices

How basing physician pay on popularity marginalizes some patients

Jan Gurley, MD

May 24, 2011May 24, 201111

Part one of the three-part series, Let's Pay Popular People More! My patient only had 20 minutes to wait for the van headed to detox. The people who had worked to get him into a detox program already numbered in…

Part one of the three-part series, Let’s Pay Popular People More!

My patient only had 20 minutes to wait for the van headed to detox. The people who had worked to get him into a detox program already numbered in the double digits. Sam (not his real name) was the classic public inebriate — he woke on sidewalks with the shakes, vomited blood on a regular basis, had lost most of …

Health policy

The tension between physicians and health policy experts

Kevin Pho, MD

May 24, 2011May 24, 201153

There's an underlying tension between physicians and health policy experts. Health policy experts take subtle jibes against physicians in their analyses, with many feeling American doctors are overpaid, which exacerbates health costs. They tend to be politically progressive, and generally…

There’s an underlying tension between physicians and health policy experts.

Health policy experts take subtle jibes against physicians in their analyses, with many feeling American doctors are overpaid, which exacerbates health costs. They tend to be politically progressive, and generally dismiss the issues that most doctors care deeply about. Medical malpractice, tort reform and the cost of medical education, for instance.

And …

Health policy

Direct primary care and the Marcus Welby vision of primary care

Dave Chase

May 18, 2011May 18, 20118

The insurance middleman has taken a toll on the family doctor. New practice models plan to change that. Physicians in Seattle, Silicon Valley and Boston are proving what the rest of the world already knows. When you have a high…

Before House, M.D., …

Health policy

Practice variation from the perspective of an e-patient

Dave deBronkart

May 18, 2011May 18, 201110

One of our purposes e-Patients.net is to help people develop e-patient skills, so they can be more effectively engaged in their care. One aspect is shared decision making. A related topic, is understanding the challenges of pathology and diagnosis. Both…

I’ve recently learned of an another topic, which I’m sure many …

Physician voices

Emergency medicine, we can do better

angienadia, MD

May 18, 2011May 18, 201115

When someone gets sick, what are their options? They can try to make an urgent appointment that day, but how many of your doctors actually offer that? Most people will have to wait for weeks, if not months, for a…

When someone gets sick, what are their options?

They can try to make an urgent appointment that day, but how many of your doctors actually offer that? Most people will have to wait for weeks, if not months, for a regular appointment. Even if you go to a walk-in clinic, the wait will likely be hours, and you’re not sure if clinics can take care of everything, so you head to …

Read more…

Emergency medicine, we can do better

Health policy

The myth of undocumented immigrants using American health care

Brad Wright, PhD

May 17, 2011May 17, 201111

I hear it all the time: "All these illegals are coming over here and they don't pay taxes, but they get all these government handouts and they're clogging up our health care system ..." I often point out that many…

I hear it all the time: “All these illegals are coming over here and they don’t pay taxes, but they get all these government handouts and they’re clogging up our health care system …”

I often point out that many undocumented immigrants actually do obtain a taxpayer identification number for the express purpose of paying taxes in hopes that if a path to …

Health policy

Predictions on the future of medicine after health care reform

Wes Fisher, MD

May 16, 2011May 16, 201112

Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled "ObamaCare Is Already Damaging Health Care." While I'm not sure I'm ready to concede that Obamacare has already damaged health care in America,…

Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled “ObamaCare Is Already Damaging Health Care.”

While I’m not sure I’m ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, …

Health policy

How an ACO will affect the relationship between a doctor and a patient

Randall S. Bock, MD

May 16, 2011May 16, 201115

At the heart of medicine is the relationship between a doctor and a patient. The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could…

At the heart of medicine is the relationship between a doctor and a patient.

The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files — I can vouch that knowing …

Health policy

The problem with global, or capitated, payments to doctors and hospitals

Paul Levy

May 15, 2011May 15, 201121

One aspect of religious dogma that has entered the medical world is that fee-for-service pricing of medical services is bad and should be replaced by a capitated, or global, arrangement that establishes an annual budget for care for different risk…

Like other religious beliefs, this is often offered without rigorous analytic support. Some insurance companies are particularly pleased …

Health policy

How ACOs creatively destroy fee for service medicine

David K. Cundiff, MD

May 13, 2011May 13, 201138

The U.S. Department of Health and Human Services (HHS) advocates the "creative destruction" of the traditional system of U.S. physicians practicing solo or in small groups operating as small businesses. Republicans and Democrats approve of ACOs in concept. The Affordable…

The U.S. Department of Health and Human Services (HHS) advocates the “creative destruction” of the traditional system of U.S. physicians practicing solo or in small groups operating as small businesses.

Republicans and Democrats approve of ACOs in concept. The Affordable Care Act of 2010 calls for shifting from fragmented care …

Health policy

AMA: Individual responsibility for health insurance helps America’s patients, pocketbooks

American Medical Association & Cecil B. Wilson, MD

May 12, 2011May 12, 201126

A guest column by the American Medical Association, exclusive to KevinMD.com. A wise physician once said, "Health is not valued til sickness comes." The same can certainly be said about health insurance. This concept is at the heart of our…

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

A wise physician once said, “Health is not valued til sickness comes.” The same can certainly be said about health insurance.

This concept is at the heart of our current debate about individual responsibility for health insurance coverage. While we hope never to need surgery or chemotherapy or to have an unexpected accident or illness, it’s certain that many of …

Drugs and prescribing

One in four children in the United States are on chronic medications

Maggie Kozel, MD

May 10, 2011May 10, 201121

The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication. IMS Health is a firm that provides "marketing intelligence" to pharmaceutical…

The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication.

IMS Health is a firm that provides “marketing intelligence” to pharmaceutical companies. The firm’s job is to keep the $800 billion per year global pharmaceutical industry on a continued pattern of growth. Hopefully these consultants accomplished something quite different this week. Hopefully they …

Health policy

Excited about the future of healthcare in the emergency department

William Schumacher, MD

May 10, 2011May 10, 20115

Am I the only one excited about the future of healthcare? With all the prevailing pessimism about America’s "dysfunctional" health" system, optimists (and I am one) sometimes feel stranded on our own lonely islands. It’s not that we don’t know…

Am I the only one excited about the future of healthcare?

With all the prevailing pessimism about America’s “dysfunctional” health” system, optimists (and I am one) sometimes feel stranded on our own lonely islands.

It’s not that we don’t know what the challenges are. I have been practicing emergency medicine for over 30 years, and there is no better …

Health policy and public health

Articles, page 154

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