Health policy and public health

4,357 articles · Since 2004

Articles, page 163

Why moral hazard fails in health care

November 11, 2010Nov 11, 201010

I’m going to take the time to review a topic that is one my pet peeves, one you hear bandied about all the time in discussions of more consumer directed health care. It’s a topic I came back to repeatedly…

Basically, the moral hazard is the idea that people insulated from risk behave differently than people exposed to risk. For instance, …

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Why moral hazard fails in health care

Health policy

Medical malpractice reform in exchange for paying doctors less

Kevin Pho, MD

November 11, 2010Nov 11, 201036

The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country's debt. Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal…

The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country’s debt.

Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal of the Sustainable Growth Rate formula — the flawed method by which Medicare, and subsequently private insurers, pays doctors.

According to this method, physicians are due for a pay cut of …

Medical education

How medical students can improve our health system

Aaron J. Stupple, MD

November 11, 2010Nov 11, 20102

Many fellow medical students are eager to improve "the system." However, an overeager attitude offers both promise and peril -- promise that budding physicians are inspired to improve the inner workings of their chosen field, peril in that our naiveté…

Many fellow medical students are eager to improve “the system.”

However, an overeager attitude offers both promise and peril — promise that budding physicians are inspired to improve the inner workings of their chosen field, peril in that our naiveté may simply clutter the very complexities we seek to improve.

How do we strike a balance between getting involved and getting in the way?

I found guidance in law professors Raustiala’s and Sprigman’s …

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Health policy

Will the new Congress allow the physician Medicare cuts to pass?

Dan McCoy, MD

November 10, 2010Nov 10, 201012

Well it's that time of year again. No, not Thanksgiving or Christmas, or even the venerable Interim Meeting of the AMA. It's the time that physicians nationwide anticipate another mandatory cut in Medicare reimbursement rates. This time the recurrent temporary…

Well it’s that time of year again.

No, not Thanksgiving or Christmas, or even the venerable Interim Meeting of the AMA. It’s the time that physicians nationwide anticipate another mandatory cut in Medicare reimbursement rates.

This time the recurrent temporary fix will result in a cut of 23.6 percent on December 1st. Assuming political gridlock the rate will fall another fraction of 6.5 percent on …

Health policy

Uninsured Americans cannot afford many medications

Brad Wright, PhD

November 9, 2010Nov 9, 201031

I went to the doctor recently and got a new prescription. The doctor was kind enough to give me some free samples, and a voucher that I could redeem to fill the prescription once at no cost. In the future,…

I went to the doctor recently and got a new prescription.

The doctor was kind enough to give me some free samples, and a voucher that I could redeem to fill the prescription once at no cost. In the future, it will cost me $50 if I decide to refill it. If I didn’t have pharmaceutical benefits through my insurance coverage, the medication would set me back about $500 for a …

Physician voices

Primary care private practice will die, will patients benefit?

Kevin Pho, MD

November 8, 2010Nov 8, 201017

Having more primary care physicians doesn't necessarily improve the quality of care. That may come as a surprise to regular readers of this blog, but that's one of the findings that came from a recent analysis of the Dartmouth Atlas.…

Having more primary care physicians doesn’t necessarily improve the quality of care.

That may come as a surprise to regular readers of this blog, but that’s one of the findings that came from a recent analysis of the Dartmouth Atlas.

As reported by the WSJ’s Health Blog,

having regular primary-care visits isn’t a guarantee of receiving recommended care. There was “no relationship” between rates of breast cancer screening for women age 67-69

…

Health policy

Why public support for health care reform is falling

Roger Collier

November 4, 2010Nov 4, 201012

The latest Kaiser Family Foundation poll, conducted in August, shows public support for health care reform falling. After two monthly polls in which reform was viewed increasingly favorably, the new poll shows a sharp decline in public backing for the…

Kaiser polls in the first couple of months after enactment of Patient Protection and Affordable Care Act (PPACA) showed more confusion than clear support or opposition, but by June favorable …

Physician voices

Doctors are quietly opting out of medicine

Nancy Pando, LICSW

November 3, 2010Nov 3, 201041

Dr. Ryan Flesher was working his usual shift in the emergency department that night in July of 2006. The hospital was short-staffed, per usual, and patients continued streaming through the revolving doors. Neither the people at the front desk nor…

The following is a true story that occurred well before healthcare …

Health policy

If health care reform is killed, what happens?

Maggie Mahar

November 2, 2010Nov 2, 201045

If conservatives manage to kill health care reform legislation, what will happen next? I really don’t want to go there. First, I’m convinced that conservatives won’t be able to repeal the Affordable Care Act (ACA). Democrats will hold onto the…

If conservatives manage to kill health care reform legislation, what will happen next?

I really don’t want to go there.

First, I’m convinced that conservatives won’t be able to repeal the Affordable Care Act (ACA). Democrats will hold onto the Senate, and President Obama still has a veto. If necessary, he will use it to protect the bill. Meanwhile, the majority of the public either favors the legislation or want to “wait …

Health policy

Covering the uninsured and the costs to society

Lucas Restrepo, MD

November 2, 2010Nov 2, 201013

Recently, the fire department of a small town in Tennessee called South Fulton ignored the call of a man who needed help quelling a fire near his house. The firefighters declined lending a hand because the caller neglected to pay…

Recently, the fire department of a small town in Tennessee called South Fulton ignored the call of a man who needed help quelling a fire near his house.

The firefighters declined lending a hand because the caller neglected to pay a $75 bill, the prerequisite for deserving assistance. The caller tried to put down the fire with a garden hose, but after two …

Health policy

Providing Medicare to everybody increases continuity of coverage

Aldebra Schroll, MD

October 31, 2010Oct 31, 201018

At a recent staff meeting, a colleague mentioned her client was at an "awkward age". I thought she was referring to a teenager, but she quickly clarified herself. She was referring to the age before someone is old enough for…

At a recent staff meeting, a colleague mentioned her client was at an “awkward age”.

I thought she was referring to a teenager, but she quickly clarified herself. She was referring to the age before someone is old enough for Medicare at sixty five, an awkward time indeed. Many people between the ages of fifty to sixty four find that relatively minor health problems make health insurance unaffordable. For those with …

Health policy

Deceptive marketing is widespread in health care

Roy Poses, MD

October 29, 2010Oct 29, 20103

Recently, reports about deceptive marketing and other questionable practices used by the growing for-profit higher education industry in the US appeared in the news. For example, per Bloomberg: Recruiters at U.S. for-profit colleges lied to entice students and encouraged them…

Recently, reports about deceptive marketing and other questionable practices used by the growing for-profit higher education industry in the US appeared in the news. For example, per Bloomberg:

Recruiters at U.S. for-profit colleges lied to entice students and encouraged them to commit fraud to qualify for aid, a report by the Government Accountability Office found.

Recruiters at all 15 colleges studied by the GAO, Congress’s investigational arm, misled potential students about the

…

Physician voices

Comparative effectiveness research needs to be taught to doctors and patients

David Williams

October 28, 2010Oct 28, 2010

Oncology is the area where the health care cost conundrum is coming into sharpest focus. Theoretically, who wouldn’t spend whatever it takes to cure a life-threatening disease? And yet practically the costs of new treatments are so high, and the improvements usually modest enough, that when it comes right down to it costs are becoming a real issue for patients and doctors.

An interesting article in the Journal of Clinical Oncology …

Health policy

Unintended consequences from healthcare reform

David B. Nash, MD, MBA

October 27, 2010Oct 27, 201012

In early October, the New York Times published two articles that addressed a pervasive problem from slightly different perspectives. Boiled down to its essence, the problem is the unintended consequences of some provisions of the new healthcare reform legislation. In…

In early October, the New York Times published two articles that addressed a pervasive problem from slightly different perspectives. Boiled down to its essence, the problem is the unintended consequences of some provisions of the new healthcare reform legislation.

In his well crafted article, entitled “Health Care’s Uneven Road to a New Era,” David Leonhardt explored the impact caused by the introduction of new regulations into a “status quo” system.

So-called “mini-med” …

Physician finance

Specialist and primary care pay per hour

Kevin Pho, MD

October 26, 2010Oct 26, 20109

Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists. As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how…

Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists.

As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make.

I think this is a good approach, since annual salary figures do not account for the number of hours doctors work — and in the case of primary …

Physician voices

ACP: Doctors as leaders – the value of civility

American College of Physicians

October 25, 2010Oct 25, 20104

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP The campaigning for the mid-term elections reminds us once again of the state of civility – or lack of civility - in…

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

by John Tooker, MD, MBA, MACP

The campaigning for the mid-term elections reminds us once again of the state of civility – or lack of civility – in American politics. By civility, I mean showing regard for others. We are beset by campaign attack ads that are often factually wrong and designed to …

Health policy

Will the accountable care organization (ACO) be a durable part of reform?

Jim Sabin, MD

October 25, 2010Oct 25, 20103

Magic bullets come and go in the world of health policy, but the accountable care organization (ACO) is likely to be a durable reform. Except for group practices like Geisinger, Harvard Vanguard, Kaiser Permanente, systems like the VA, and local communities in which independent practitioners have established cooperative collaborations, health care has been grotesquely uncoordinated in the U.S. ACOs speak to that structural lesion.

Title III of the Patient Protection and …

Health policy

Why the Florida Medical Association (FMA) is angry with the AMA

Brian Klepper, PhD & David C. Kibbe, MD, MBA

October 24, 2010Oct 24, 201011

At an Orlando meeting recently, Florida Medical Association (FMA) members fumed that their parent, the AMA, isn’t adequately representing Florida’s private practice doctors. After talk of secession and forming a new group, they settled for writing a stern letter urging…

The FMA dustup began with a resolution written by Douglas Stevens MD, a Fort Myers cosmetic surgeon – you can’t make this stuff up – complaining …

Physician voices

How can doctors successfully engage their patients?

Thomas Goetz

October 21, 2010Oct 21, 201011

by Thomas Goetz Enough about patients: What is a doctor to do? In the past few months, since The Decision Tree book came out, I’ve had the privilege to talk with many doctors about the opportunity and challenge of engaging…

by Thomas Goetz

Enough about patients: What is a doctor to do?

In the past few months, since The Decision Tree book came out, I’ve had the privilege to talk with many doctors about the opportunity and challenge of engaging patients in their own health. Some physicians, not surprisingly, have been suspicious, and even hostile to the idea that patients have a …

Health policy

How the Affordable Care Act helps Medicare

Bob Doherty

October 19, 2010Oct 19, 201010

One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong. Effective, in that it has been widely reported that seniors are more likely to express…

One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong.

Effective, in that it has been widely reported that seniors are more likely to express negative views of the ACA than other age groups. (Although the Kaiser Family Foundation’s Drew Altman, citing the group’s most recent tracking polls, writes that seniors’ opposition to …

Health policy and public health

Articles, page 163

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