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Health policy and public health

4,357 articles · Since 2004

Articles, page 157

Physician voices

Why does society frown on doctors earning a reasonable living?

94

Recently, while jogging through my community, I had the pleasure of bumping into a former colleague and his brother who were out for their daily five mile walk. Dr. G. had attended a local medical school, finished near the top…

Recently, while jogging through my community, I had the pleasure of bumping into a former colleague and his brother who were out for their daily five mile walk.

Dr. G. had attended a local medical school, finished near the top of his class, and had gone on to do his internship and residency at the premier private hospital in Miami Beach, Florida. After completing his residency …

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Why does society frown on doctors earning a reasonable living?

Health policy

Controlling health care costs requires shared sacrifice

58

To understand how hard it is going to be to control health care costs, one merely has to consider the outrage surrounding TSA's recent roll-out of "enhanced security" measures - measures which include 'enhanced pat downs' and full body scans.…

To understand how hard it is going to be to control health care costs, one merely has to consider the outrage surrounding TSA’s recent roll-out of “enhanced security” measures – measures which include ‘enhanced pat downs’ and full body scans.

Videos of boys getting patted down personified the problem. But the upset and outrage and anger visible today will be nothing if …

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Controlling health care costs requires shared sacrifice

Health policy

Rationing and limitations are inevitable in any health system

8

Healthcare is a limited commodity. It’s limitations are defined by the numbers of professionals supplying it and their physical limitations on the number of patients they’re able to treat, on availability of biomedical equipment and technology, on availability of physical…

Healthcare is a limited commodity. It’s limitations are defined by the numbers of professionals supplying it and their physical limitations on the number of patients they’re able to treat, on availability of biomedical equipment and technology, on availability of physical space to safely provide medical care and, underlying all of these, on the funding for such.

And so, not …

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Rationing and limitations are inevitable in any health system

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Health policy

Direct primary care and medical loss ratio will impact health insurers

5

With my extensive health care background, many people have asked for my opinion during the health reform debate. My response has been that the only way to really "reform" the system is to blow it up and start over, which…

With my extensive health care background, many people have asked for my opinion during the health reform debate. My response has been that the only way to really “reform” the system is to blow it up and start over, which isn’t politically feasible.

After delving deeper into the current legislation, I believe that we are going to see something …

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Direct primary care and medical loss ratio will impact health insurers

Health policy

The Relative Value Scale Update Committee (or RUC) impact on health care

7

On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities. Her article extols the work of the 29 physician volunteers who, "at no…

On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities.

Her article extols the work of the 29 physician volunteers who, “at no cost to taxpayers … generously volunteer their time, supported by advisers and staff from more than 100 national medical specialty societies and health care professional organizations.”

She fails to mention that the …

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The Relative Value Scale Update Committee (or RUC) impact on health care

Health policy

After the ACO regulations: Accountable care organization answers

11

by Jeffrey L. Cohen Patient centeredness, fragmentation and value based purchasing are just a few of the terms that are peppered throughout the newly proposed regulations for accountable care organizations (ACOs). The healthcare reform law established the Medicare Shared Savings…

by Jeffrey L. Cohen

Patient centeredness, fragmentation and value based purchasing are just a few of the terms that are peppered throughout the newly proposed regulations for accountable care organizations (ACOs).

The healthcare reform law established the Medicare Shared Savings Program for …

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After the ACO regulations: Accountable care organization answers

Health policy

Can ACOs curb health costs and improve quality of care?

3

Accountable Care Organizations (ACOs) have received considerable attention recently, and are the new "hot topic" in healthcare delivery policy circles. They are the latest response to the need to do something to stem the runaway inflation of healthcare costs, while…

Accountable Care Organizations (ACOs) have received considerable attention recently, and are the new “hot topic” in healthcare delivery policy circles. They are the latest response to the need to do something to stem the runaway inflation of healthcare costs, while maintaining or improving measurable health care quality.

According to a …

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Can ACOs curb health costs and improve quality of care?

Health policy

Debt prevents health insurance from providing more health care access

I read an article in the New York Times that underscores my argument that health care insurance does not and never will equal health care access. Our federal and state governments are being crushed by debt. There are many reasons…

I read an article in the New York Times that underscores my argument that health care insurance does not and never will equal health care access.

Our federal and state governments are being crushed by debt. There are many reasons for that debt, and addressing the reasons for the debt are a necessary aspect of decreasing the debt. For example, if a family household had overdrawn its checking account by …

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Debt prevents health insurance from providing more health care access

Physician voices

Dangers of strict adherence to clinical guidelines

10

Medical guidelines are well on their way to becoming the Law of the Land. Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point. When a study published in the Journal of the American…

Medical guidelines are well on their way to becoming the Law of the Land.  Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point.

When a study published in the Journal of the American Medical Association showed that nearly 23% of patients receiving implantable cardioverter-defibrillators (ICDs) received them under circumstances that did not match up with the recommended “guidelines” for doing so, this breach of …

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Dangers of strict adherence to clinical guidelines

Health policy

How primary care will play a central role with health care reform

4

by Jeffrey L. Cohen Healthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be…

by Jeffrey L. Cohen

Healthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be unconstitutional, the healthcare business community is unleashed. Change is afoot!

If you follow my naysaying on the …

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How primary care will play a central role with health care reform

Health policy

Why medical students should be passionate about health reform

10

Recently, I stood in the back of a boisterous, packed auditorium as each of our school’s fourth-years received their match letters and proudly announced in front of friends, family, and classmates where they would be headed for residency. As peers…

Recently, I stood in the back of a boisterous, packed auditorium as each of our school’s fourth-years received their match letters and proudly announced in front of friends, family, and classmates where they would be headed for residency.

As peers enthusiastically cheered each other, significant others breathed …

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Why medical students should be passionate about health reform

Health policy

Accountable Care Organizations and the need to innovate

6

There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA). An ACO is a network of health care providers and hospitals that collaboratively manage patient care and…

There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA).

An ACO is a network of health care providers and hospitals that collaboratively manage patient care and prospective budgets. Perhaps the biggest draw of ACOs is the potential to create innovative ways to improve quality and decrease costs. To …

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Accountable Care Organizations and the need to innovate

Physician voices

How physician practices can compete with retail clinics

23

A reader recently wrote to me: "Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?" We…

A reader recently wrote to me: “Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?”

We had along discussion. So I put together a summary of our conversation. Below is a rundown, more of less, of what I …

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How physician practices can compete with retail clinics

Medical education

Why medical education needs to be more affordable

12

I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs…

I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year.

And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their …

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Why medical education needs to be more affordable

Health policy

Reduce variations in cancer care that do not improve outcomes

Here are a few facts to enliven the next public discussion about death panels. An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care,…

Here are a few facts to enliven the next public discussion about death panels.

An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care, the most expensive form of end-of-life care and contrary to most patients’ wishes. Nearly half are not offered hospice …

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Reduce variations in cancer care that do not improve outcomes

Health policy

Expand health care systems in a way that is professionally satisfying

5

You try to do the right things to sustain your business. You set high standards for delivery of quality care, follow the basic tenets of marketing, align your organization so that everyone in your firm "gets it," avoid unnecessary expenses…

You try to do the right things to sustain your business. You set high standards for delivery of quality care, follow the basic tenets of marketing, align your organization so that everyone in your firm “gets it,” avoid unnecessary expenses but identify important growth opportunities and prudently invest so that you remain competitive and serve your patients well. But can you afford investing in the assets you require to become or …

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Expand health care systems in a way that is professionally satisfying

Conditions and diseases

Restricting nuclear cardiac stress testing in favor of stress echocardiography

3

Dr. William Follansbee is the chairman of the American College of Cardiology/American Society of Nuclear Cardiology (ACC/ASNC) task force on non-invasive cardiac imaging and the director of nuclear cardiology at the University of Pittsburgh Medical Center Cardiovascular Institute. He recently…

Dr. William Follansbee is the chairman of the American College of Cardiology/American Society of Nuclear Cardiology (ACC/ASNC) task force on non-invasive cardiac imaging and the director of nuclear cardiology at the University of Pittsburgh Medical Center Cardiovascular Institute.

He recently published an editorial in the Pittsburgh Post Gazette in which he criticized the local Blue Cross/Blue Shield carrier, Highmark, for restricting the use of nuclear cardiac stress testing in …

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Restricting nuclear cardiac stress testing in favor of stress echocardiography

Health policy

Accountable care organizations: The lost art of medicine?

11

It’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost,…

It’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost, and dread the concept of “cookbook medicine.”

And under the ACO model, physicians are going to, without …

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Accountable care organizations: The lost art of medicine?

Health policy

Concierge and primary care medical home hybrid model of care

12

As a consultant, I spend a lot of time on airplanes and subsequently get to meet a new "person in the next seat" almost every week. Once the small talk is over, the conversation is nearly the same every time.…

As a consultant, I spend a lot of time on airplanes and subsequently get to meet a new “person in the next seat” almost every week. Once the small talk is over, the conversation is nearly the same every time. “Oh, you work in healthcare! What do you think about all of this reform stuff anyway? Is there an answer?” I’m always very cautious how I frame my answer. As those …

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Concierge and primary care medical home hybrid model of care

Health policy

Huge holes exist in the health reform law

68

Huge holes exist in the health reform law you can drive an 18-Wheeler through. These holes are not "devils in the details." They are so obvious nobody talks about them. They are the proverbial elephants in the room. I suppose…

Huge holes exist in the health reform law you can drive an 18-Wheeler through. These holes are not “devils in the details.” They are so obvious nobody talks about them. They are the proverbial elephants in the room. I suppose this makes sense. It takes an 18-wheeler to transport …

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Huge holes exist in the health reform law

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