Contrary to popular belief, those without health insurance are not flooding emergency rooms as a consequence of being cut off from routine and preventive care. Actually, frequent visitors to the local ER are far more likely to have insurance according to a new review of 25 studies on ER use published since 1990.
Frequent users account for about 8% of ED patients but 28% of visits. Although frequent …
Health reform won’t help the ER
by Marianne Mattera
President Obama is planning to appoint Don Berwick — the Harvard pediatrician, recognized health policy expert, and head of the Institute for Healthcare Improvement (IHI) — as the new head of CMS.
Berwick’s nomination has been heralded by many as a terrific choice.
Our own health policy columnist, David Nash, said that “Berwick’s global following is a powerful political force …
Don Berwick and whether he can change Medicare and Medicaid
by Marie Cooper
St. Vincent’s Medical Center in Greenwich Village was founded in 1849, making it the third oldest hospital in New York City. It has been an occasional scene of notoriety but mostly it has witnessed countless episodes of anonymous compassion and care. My two sons were born there. As a major teaching hospital, it has over 1000 affiliated physicians. It is where generations of …
St. Vincent’s Hospital closes, but who’s to blame?
The following op-ed was published on March 30th, 2010 in AOL News.
Health reform has passed, and the United States is poised to join the rest of the industrialized world in providing most of its citizens with affordable health coverage.
But having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, reports projected a shortfall of 40,000 primary care physicians over the …
Op-ed: Health insurance doesn’t mean doctors will be available
Across the country, state Medicaid health insurance programs serving low-income children and families, people with disabilities, and older adults are struggling in an environment of chronic underfunding.
Consider that, nationwide, at least one child in four relies on Medicaid for health coverage. Medicaid funds healthcare services for two out of every five births and fills in gaps in Medicare coverage for the elderly and disabled.
But inadequate payments and outmoded methods of …
Medicaid physician payment rates hurts primary care doctors
I congratulate President Obama and the Democrats on their historic health reform achievement.
Will this bill be able to win approval as it runs the parliamentary gauntlet? Is it an act of political suicide that will become manifest in November? Will it bankrupt the country because of lack of cost controls?
Regardless of where one stands, the bill is a political act of vast ambition and colossal risk.
Now may be a good …
Health reform winners and losers, and how it affects doctors
by Rick Bendinger, MD
I am a rural health provider in Abbeville, Alabama and have been here almost 30 years. I originally went to school on a public health scholarship and took the private practice option. This was a program that existed in the 1980s that paid for tuition and a stipend with the obligation to go either to a prison, rural area, or Indian reservation.
Sadly the program no longer exists. …
Rural medicine won’t be helped by health reform
by Joyce Frieden
Most patients who visit the emergency department (ED) four or more times a year have health insurance and a primary care physician, a review of the literature found.
“The uninsured represent only 15% of frequent users and are no more likely to be frequent users than they are to be occasional ED users (<4 visits/year),” Eduardo LaCalle, MD, MPH and Elaine Rabin, MD, of the Mount Sinai School of …
Patients who visit the emergency department have insurance
Beginning in the 1970s, the house call began a slow death. As the medical-industrial complex (MIC) burgeoned, with bigger hospitals and a surfeit of technology, it became incumbent on patients to come see us rather than us going to see you.
Yet there are pockets of house calls still left in the U.S.
For the geriatric age group, there has been growth in the care-at-home sector, especially for homebound elders. They can …
Can house calls be revived under health reform?
A guest column by the American Medical Association, exclusive to KevinMD.com.
by J. James Rohack, MD
As our country turns the corner on the historic path toward health system reform, many physicians are left with questions as to how this new law will affect them and their patients.
The AMA has been an active participant in the health reform debate since …
AMA: Health reform victories for physicians and what still needs to be done
While the health reform bill will have many effects, one of its most profound will be to unshackle the Centers for Medicare & Medicaid Services (CMS).
Under the legislation, CMS is now far freer to undertake a variety of pilot programs and demonstration projects designed to improve quality, safety and efficiency, and to convert the successful ones into policy. And, if that wasn’t enough for those who have long been praying …
Don Berwick to lead Medicare and Medicaid
Obamacare faces a shaky future because of its call for an individual mandate. This mandate requires people to buy insurance or face income tax penalties, which the IRS would presumably enforce.
As I write, attorney generals in 35 states are in the process of challenging the individual mandate as unconstitutional.
The individual mandate issue is important. Kill it, and you kill Obamacare.
Why? Because the individual mandate is the political mechanism for controlling …
The individual mandate may collapse health reform
As physicians progress through medical training and acquire new knowledge and skills, something interesting happens. They also develop a new and increasing awareness of not only how much they didn’t previously know but also how much they still don’t know. This process sounds paradoxical but has been consistent with my personal experience: The more I learn, the less I think I know.
Any seasoned clinician knows that in order for one …
Physicians should be involved in health care decisions
ADVERTISEMENT
In the Journal of the American Medical Association on May 15, 1991, in our first of many theme issues dedicated to “Caring for the uninsured and underinsured,” I wrote: “An aura of inevitability is upon us. It is no longer acceptable morally, ethically, or economically for so many of our people to be medically uninsured or seriously underinsured. We can solve this problem. We have the knowledge and the resources, …
Medicare for all may be next for healthcare reform
The health reform legislation was decidedly unpopular, with a variety of polls showing the majority disapproved of the bill.
What did the people want?
The ACP’s Bob Doherty linked to a post by Princeton’s Uwe Reinhardt, who observed 10 things that the public wants in health care reform:
1. Lets only patients and their own physicians determine how to respond clinically to a given medical condition, never an insurance clerk or, even …
How health reform can be popular with the American public
An excellent article appeared recently in the Washington Post, entitled, “Having health insurance doesn’t ensure it will be easy to find a doctor,” where a young, otherwise healthy and insured woman discusses her extreme difficulty in finding a doctor in Washington, DC who will see her.
“I was just 23, basically healthy and, most important, insured. So I pulled out my computer, looked up the UnitedHealthcare list of pre-approved doctors …
Primary care access isn’t guaranteed by health insurance
During President Obama’s final push for “universal health care” legislation, his biggest obstacle was not Republicans but rather anti-abortion Democrats let by Congressman Bart Stupak (D-Michigan).
Stupak eventually reached a last-minute deal with the White House on federal funding of abortion services. But no one should be surprised that under government-controlled health insurance, medical coverage decisions will be based on political considerations. Rather, the recent wrangling over abortion will be …
Government-controlled health insurance may politicize health
Let’s get one thing out of the way.
The health care reform bill that passed the House this past Sunday, and will be fixed via reconciliation in the Senate, is a moderate, relatively incremental approach to fixing our health care system.
Conservatives are up in arms, as they have been during the entire process, and are lining up lawsuits and trying to gather momentum to repeal the bill.
And I’m asking myself, …
Health reform should make conservatives very happy
by Robin Tang
Sunday, March 22, 2010, marked the passage of the Health Care and Education Affordability Reconciliation Act (H.R. 4872) by the House by a narrow 219-212 margin, with no Republicans voting in favor. Whether you think the bill is good, bad, sustainable, or even constitutional, we can agree this was a historic day.
Putting politics aside, I want to highlight two parts of the bill that aren’t getting enough …
Tax credits and new patient care models in health reform
Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
With the House and Senate now in basic agreement on healthcare reform and President Barack Obama about to sign the underlying bill into law, opponents are gearing up to challenge the legislation on a variety of fronts.
This effort was beginning even before Sunday’s House vote sent the Senate …
Healthcare reform will be challenged in states
Get free updates delivered free to your inbox.
