Health policy and public health

4,357 articles · Since 2004

Articles, page 159

How medical loss ratios impact mini-med policies

February 23, 2011Feb 23, 2011

It’s amazing how much trouble a couple of hundred inexpensive health insurance policies can cause. Up until recently, few people were aware of the existence of so-called mini-med policies. Marketed primarily by for-profit insurers Aetna and Cigna, they are designed…

It’s amazing how much trouble a couple of hundred inexpensive health insurance policies can cause.

Up until recently, few people were aware of the existence of so-called mini-med policies. Marketed primarily by for-profit insurers Aetna and Cigna, they are designed to provide bare-bones coverage to employees of low-wage low-margin service companies. Unlike other approaches to affordable insurance that emphasize catastrophic coverage, mini-meds typically keep premiums affordable (some as low as $15 …

Health policy

Why more primary care may not improve health care quality

Maggie Mahar

February 22, 2011Feb 22, 201115

The emphasis on primary care as the “key” to lifting the quality of U.S. healthcare may be exaggerated according to a report by Dartmouth’s Institute for Health Policy & Clinical Practice. "Primary care forms the bedrock of a well-functioning, effective…

The emphasis on primary care as the “key” to lifting the quality of U.S. healthcare may be exaggerated according to a report by Dartmouth’s Institute for Health Policy & Clinical Practice.

“Primary care forms the bedrock of a well-functioning, effective health care system,” the researchers observe. But– and this is an important caveat- “simply increasing access to primary care, either by boosting the number of primary care physicians in an area …

Physician voices

ACP: High value, cost conscious care

American College of Physicians

February 22, 2011Feb 22, 2011

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP There were two reports from the recent 2011 International Stroke Conference that got my attention. One report noted the sharp increase in…

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

by John Tooker, MD, MBA, MACP

There were two reports from the recent 2011 International Stroke Conference that got my attention.

One report noted the sharp increase in the incidence of strokes in children and young adults. The second, in the Los Angeles Times (“Mild strokes may be a target for clot-busting drug”), suggested that mild strokes, …

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ACP: High value, cost conscious care

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Health policy

Change of culture in a rapidly evolving health care environment

Kent Bottles, MD

February 19, 2011Feb 19, 201111

When a health system asked me to facilitate a Board discussion on physician alignment and integration on November 12, 2010, I was already committed to giving a keynote on the future of health care for the American Institute of CPAs in Las Vegas on November 11. Although I usually fly Delta or USAir where I have priority frequent flyer status, the only way I could get to the Board meeting …

Conditions and diseases

Treatment guidelines pros and cons

David Williams

February 17, 2011Feb 17, 20117

I was puzzled by a Health Affairs article showing the public finds arguments against treatment guidelines a lot more compelling than arguments in favor. But after reading the technical appendix, which contains the full text of the survey, I think…

I was puzzled by a Health Affairs article showing the public finds arguments against treatment guidelines a lot more compelling than arguments in favor. But after reading the technical appendix, which contains the full text of the survey, I think the problem is that the researchers framed the question poorly. In particular, the researchers portrayed guidelines as unrealistically rigid.

In A National Survey Reveals Public Skepticism About Research-Based Treatment …

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Treatment guidelines pros and cons

Health policy

Requiring an ultrasound and counselling before an abortion

Robert Luedecke, MD

February 17, 2011Feb 17, 201134

A bill given emergency status by Texas Governor Rick Perry is the largest invasion of the patient-physician relationship that I am aware of. Proposed by Senator Dan Patrick (R-Houston) and supported by Lt. Gov. David Dewhurst, the bill as originally written would require physicians to perform a ultrasound and explain the physical characteristics of the fetus to anyone contemplating an abortion.

Physicians would be required to inform women about alternatives to …

Health policy

Clinical guidelines in healthcare reform

Richard N. Fogoros, MD

February 17, 2011Feb 17, 201111

While DrRich is a conservative American, and has made plain the difficulties he has with the Progressive program in general and with Progressive healthcare reform in particular, at times he is forced to admit that, on occasion, the Progressive way of looking at the world has certain merits. And as DrRich contemplates a question that has been bothering him lately, a question that no doubt plagues many American physicians who …

Health policy

Insurance status when arranging follow-up from the ED

Katherine Fullerton, MD

February 15, 2011Feb 15, 2011

As a pediatric emergency physician in Northern Virginia, I have the good fortune to work with an amazing staff in a busy pediatric emergency department (ED) that sees a wide range of patients with both minor and life-threatening illnesses. Of note, we have a wonderful electronic medical record (EMR) that allows us to see past visits, lab tests, and medical problems.

My last shift was an overnight during which I …

Physician voices

Shared decision making to determine implantable defibrillator need

Shannon Brownlee

February 15, 2011Feb 15, 2011

Implantable defibrillators are truly life saving devices that have prevented sudden death in thousands of patients. No bigger than an iPod nano, the device can sense when the heart is beating irregularly and deliver an electrical jolt that kicks it back into proper rhythm. But like so many of medicine’s miracles, defibrillators are not always used on the right patients. According to a study published recently in the …

Health policy

Our health is worsening at a time when medicine has never been better

David Gratzer, MD

February 14, 2011Feb 14, 201120

With little notice, UnitedHealth released a major paper recently considering diabetes in America. First the bad news: a large portion of our population either has the disease or is pre-diabetic. Now, the really bad news: diabetes and pre-diabetes rates are…

With little notice, UnitedHealth released a major paper recently considering diabetes in America.

First the bad news: a large portion of our population either has the disease or is pre-diabetic.

Now, the really bad news: diabetes and pre-diabetes rates are going to soar in the coming decade, according to the analysis, in part driven by the obesity crisis.

I’ll return back to the study in a moment, but it underscores a …

Health policy

Onsite clinics within a competitive health care marketplace

Brian Klepper, PhD

February 13, 2011Feb 13, 2011

The recent explosion of interest in onsite clinics – not just by employers, but by health plans, hospital systems, public health programs, and others – is anything but just another health care fad. At once, clinics’ growing popularity signals purchasers’ weariness with an intransigent, self-interested health system, as well as their guarded optimism about a better way.

Today’s best clinics are single-mindedly focused on what works best for the patient and …

Health policy

What physicians should believe about Accountable Care Organizations

Jeffrey L. Cohen, Esq

February 13, 2011Feb 13, 20119

by Jeffrey L. Cohen In the 90s, physicians were told “The sky is falling. You have to find a tree to stand under or you will be crushed.” The “trees” were things like IPAs and PHOs. The future outlook was…

by Jeffrey L. Cohen

In the 90s, physicians were told “The sky is falling. You have to find a tree to stand under or you will be crushed.” The “trees” were things like IPAs and PHOs. The future outlook was bleak. All patients were going to be part of some system with which the physician would have no input or control. Decisions would be made on purely …

Health policy

Physicians’ voices heard through AMA advocacy activities in Washington, DC

American Medical Association & Ardis D. Hoven, MD

February 10, 2011Feb 10, 20113

A guest column by the American Medical Association, exclusive to KevinMD.com. by Ardis Dee Hoven, MD This week, hundreds of physicians and medical students converged in Washington, D.C., for the AMA’s annual National Advocacy Conference. The current and future physicians…

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

by Ardis Dee Hoven, MD

This week, hundreds of physicians and medical students converged in Washington, D.C., for the AMA’s annual National Advocacy Conference. The current and future physicians learned about and discussed key legislative issues, including how new policy will impact physician practices, and heard from officials including CMS Administrator Donald Berwick, M.D., MPP. The participants also visited elected leaders …

Medical education

How to check your scientific paper for plagiarism

George Lundberg, MD

February 8, 2011Feb 8, 20113

We were taught in grammar school that plagiarism is wrong. It is stealing someone else's property. Imagine in high school asking your mother to buy you "Cliff Notes" so you can copy it word for word. Mother would not have…

We were taught in grammar school that plagiarism is wrong. It is stealing someone else’s property.

Imagine in high school asking your mother to buy you “Cliff Notes” so you can copy it word for word. Mother would not have liked that, and it wouldn’t have been right.

To write an essay today, you’ll probably start with a search engine. Instantly, Mr. Google delivers many intelligent commentaries on anything, probably better than …

Health technology

Online tools to help shop for the most affordable health care

Ray Carlson

February 8, 2011Feb 8, 20112

Two recent articles posted here at KevinMD.com regarding the inclusion of discussions about the cost of health care services between doctor and patient highlighted the growing emphasis on not only the quality of care but the cost of that care…

Two recent articles posted here at KevinMD.com regarding the inclusion of discussions about the cost of health care services between doctor and patient highlighted the growing emphasis on not only the quality of care but the cost of that care to the patient as well. The first article was written by Dr. Leslie Ramirez, who advocated for a more proactive stance by doctors regarding the subject …

Health policy

Integrating doctors and hospitals may worsen cost control in health reform

Kevin Pho, MD

February 8, 2011Feb 8, 201135

Health reformers propose the proliferation of integrated health systems, like the Mayo Clinic or Kaiser Permanente, which, according to the Dartmouth Atlas, lead to better patient care and improved cost control. To that end, Accountable Care Organizations have been a…

To that end, Accountable Care Organizations have been a major part of health reform, changing the way health care is delivered.

Never mind that patients may not be receptive to the new model, but the creation of these large, integrated physician-hospital …

Medical education

If you’re in medicine, you’re in politics

Nick Rohrhoff, MD

February 7, 2011Feb 7, 201112

Each generation of physicians has no choice but to take on the responsibility of learning the science of medicine - how best to care for patients. But current circumstances dictate that we must also bear the burden of developing policy…

Each generation of physicians has no choice but to take on the responsibility of learning the science of medicine – how best to care for patients. But current circumstances dictate that we must also bear the burden of developing policy that creates the best system in which to provide that care.

Creation of a 21st century American healthcare system will require engagement and effort from everyone. …

Conditions and diseases

Finding out the cost of lab tests is a real challenge for patients

Brad Wright, PhD

February 4, 2011Feb 4, 201148

In the spring of 2005, the sinus infection returned. I awoke severely congested with a pounding forehead and pain around my eyes that grew worse when I bent to tie my shoes. The feeling was familiar. Two years earlier, I had similar symptoms, but was uninsured and endured a miserable week with nothing but over-the-counter medication. Now they were back.

Fortunately, when I started graduate school, my father insisted that I …

Health policy

Can President Obama and the GOP agree on improving health reform?

Bob Doherty

February 2, 2011Feb 2, 201118

Everything seems to be pointing toward two years of partisan and ideological confrontations over health reform. The leadership of an emboldened Republican party has made it clear that it will use its newfound House majority to seek to “repeal and replace” the Affordable Care Act (ACA), and if that doesn’t work, to “defund” it. Huge GOP gains in statehouses make it likely that more states will resist implementation. Meanwhile, President …

Health policy

Ethics of the individual mandate

Raymond Raad, MD, MPH

February 2, 2011Feb 2, 201159

There is a remarkable inconsistency between the ethics of medical practice and the discussion about the health care reform law passed this past March, especially the individual mandate. In medicine, it is considered unethical to force a patient to do…

There is a remarkable inconsistency between the ethics of medical practice and the discussion about the health care reform law passed this past March, especially the individual mandate.

In medicine, it is considered unethical to force a patient to do something against his will. Patients are allowed to disagree with their doctors and to decide for themselves whether they want to heed their advice. Patients are even allowed to refuse medical …

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Ethics of the individual mandate

Health policy and public health

Articles, page 159

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