Health policy and public health

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Articles, page 165

Should reduced ER use be a measure of health reform?

September 23, 2010Sep 23, 20108

In making the case for health care reform, inappropriate utilization of emergency rooms is frequently cited as an example of our inefficient system and an important factor behind the staggering cost of U.S. health care. At first, the logic makes…

At first, the logic makes sense: emergency rooms have to treat people, so the uninsured often turn there for care, including primary care, which is very expensive to provide in an emergency room, and would be …

Health policy

A difficult time for health insurance companies in Massachusetts

Paul Levy

September 23, 2010Sep 23, 20102

This has to be a very difficult time for insurance companies in Massachusetts. Notwithstanding that they are non-profits, they are under a lot of scrutiny with regard to reserve margins and profitability. Much of this is unfair, but I think…

But the Massachusetts insurers have an additional problem. They have been …

Health policy

What motivates health care workers is needed to explain health care costs

angienadia, MD

September 21, 2010Sep 21, 201020

As part of the new health care legislation, the government has instituted Medicare's Physician Quality Reporting Initiative (PQRI) in an attempt to motivate health professionals to do the right thing. According to the legislation, PQRI asks physicians to report how…

As part of the new health care legislation, the government has instituted Medicare’s Physician Quality Reporting Initiative (PQRI) in an attempt to motivate health professionals to do the right thing.

According to the legislation, PQRI asks physicians to report how the care they furnish aligns with evidence-based clinical guidelines for a variety of medical conditions, such as diabetes or heart disease. In 2010, physicians who successfully report these measures will receive …

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Health reform vaults the USPSTF into prominence

Glenn Laffel, MD, PhD

September 20, 2010Sep 20, 201012

The most visible impact of Affordable Care Act is surely the expansion of health insurance coverage to 30 million uninsured Americans, but a lesser known provision in the overhaul will have far-reaching implications as well. The provision catapults the US…

The provision catapults the US Preventive Services Task Force (USPSTF) from an obscure agency that produced unenforceable guidelines about screening and preventive services into one whose recommendations directly impact reimbursement.

According to the terms of the new …

Health policy

Patient Protection and Affordable Care Act individual mandate controversy

Roger Collier

September 19, 2010Sep 19, 2010

The individual mandate is the single most controversial feature of the Patient Protection and Affordable Care Act. Everyone who can afford coverage—unless an undocumented immigrant or exempted on religious grounds—is required to have it or pay a penalty of $695…

The rationale is straightforward: without a mandate, many people would wait until they needed care before buying insurance, driving up premiums for those with ongoing coverage, …

Health policy

Emergency department utilization and its impact on health care reform

James P. Davison, DO

September 15, 2010Sep 15, 20104

by James P. Davison, DO Emergency department utilization and its impact on health care reform legislation has been a hot topic of conversation in healthcare journals and the blogosphere. It is a tenet of the currant legislation that ER visits…

by James P. Davison, DO

Emergency department utilization and its impact on health care reform legislation has been a hot topic of conversation in healthcare journals and the blogosphere. It is a tenet of the currant legislation that ER visits and cost growth will go down, contributing to a decreased health cost growth curve.

Opponents state the newly insured will flock to the nation’s emergency rooms. Proponents …

Health policy

Patients don’t believe the evidence, blame our healthcare system

Trisha Torrey

September 11, 2010Sep 11, 201020

Health Affairs reports on a study that finds Evidence That Consumers Are Skeptical About Evidence-Based Health Care. According to the abstract, We found many of these consumers’ beliefs, values, and knowledge to be at odds with what policy makers prescribe…

Health Affairs reports on a study that finds Evidence That Consumers Are Skeptical About Evidence-Based Health Care.

According to the abstract,

We found many of these consumers’ beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as “medical evidence” or “quality guidelines.” Most believed that more care meant higher-quality, better care. The gaps in

…

Health policy

Working with industry requires building a culture of trust

Thomas Sullivan

September 9, 2010Sep 9, 20109

Howard Brody, a family physician, recently wrote an article in the Annals of Family Medicine discussing, “Professional Medical Organizations and Commercial Conflicts of Interest: Ethical Issues.” The article focused on how AAFP has “recently been criticized for accepting a large…

Howard Brody, a family physician, recently wrote an article in the Annals of Family Medicine discussing, “Professional Medical Organizations and Commercial Conflicts of Interest: Ethical Issues.”

The article focused on how AAFP has “recently been criticized for accepting a large corporate donation from Coca-Cola to fund patient education and materials on obesity prevention,” and how this money has been called a “conflict of interest.” To that effect, Dr. Brody defines such …

Health policy

Why are most physicians writing their prescriptions by hand?

Bob Doherty

September 8, 2010Sep 8, 201034

Is the pen mightier than the PC? When it comes to prescribing, it appears so. A new report from the Center for Studying Health System Change finds that most physicians write their RX scripts by hand, despite financial incentives for…

Is the pen mightier than the PC?

When it comes to prescribing, it appears so. A new report from the Center for Studying Health System Change finds that most physicians write their RX scripts by hand, despite financial incentives for physicians to adopt electronic prescribing. Even those who have e-RX systems do not always use them, and when they do, they may not to use the features that were …

Health policy

Insurance companies affect patients with paperwork for tests

Jeoffry B. Gordon, MD, MPH

September 6, 2010Sep 6, 201017

by Jeoffry B. Gordon, MD, MPH I have always considered it to be my professional responsibility and ethical imperative to fight for my patients with the insurance companies to get approval for every test and medication that I think is…

by Jeoffry B. Gordon, MD, MPH

I have always considered it to be my professional responsibility and ethical imperative to fight for my patients with the insurance companies to get approval for every test and medication that I think is medically necessary.

My batting average is close to 100% Lately, the insurance companies have been trying to draw the noose tighter and make the task of getting …

Health policy

Don Berwick is a patient centric, consumer oriented radical

Joseph Paduda

September 4, 2010Sep 4, 201067

The recess appointment of Dr. Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain's National Health Service. To support their claims, these politicians…

To support their claims, these politicians are using Berwick’s own words, in a way eerily reminiscent of the recent Shirley Sherrod debacle.

It started with Glenn Beck, master of the one-word quote, and then slipped over into more …

Health policy

Health care reform provides a chance that we can do the right thing

Joe Flower

September 3, 2010Sep 3, 20105

The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality. The reform act has not brought…

The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality.

The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, …

Drugs and prescribing

Mail order pharmacies have cheap prices, but also problems

WhiteCoat, MD

September 2, 2010Sep 2, 201020

After seeing Mrs. WhiteCoat argue on the phone with Medco representatives for 20 minutes about why one of her 80+ year old patients hadn’t received her medicine despite three lost faxes to Medco, I had to write this post to…

If you’re like most Americans, you want to try to save some money. One of the ways that …

Conditions and diseases

Preparing for gastric bypass surgery by eating more

Douglas Perednia, MD

September 2, 2010Sep 2, 201012

Thinking is hard work. This is why so few people bother. At least voluntarily. So whenever it seems like the threat of brainwork looms in modern American medicine, we can thank our lucky stars for the geniuses behind healthcare reform…

This comes up as a result of a conversation that I had with a patient the other day. A pleasant, obese gentleman. He had been struggling with …

Physician voices

Why pay for performance does not work and may impair patient care

Chris Rangel, MD

September 1, 2010Sep 1, 20108

In response to a recent article on the topic of economic motivation theory, Michael Kirsch sent me information about a very interesting study (May 2010 issue of the British Medical Journal) done to evaluate the effects of monetary incentives on…

In response to a recent article on the topic of economic motivation theory, Michael Kirsch sent me information about a very interesting study (May 2010 issue of the British Medical Journal) done to evaluate the effects of monetary incentives on clinic, physician, and staff work performance.

From 1999 to 2007, 35 medical facilities of Kaiser Permanente in NorthernCalifornia, were given financial incentives for ensuring that their patients got regular screening for …

Physician voices

Make your small private practice thrive in 4 steps

Susan Giurleo, PhD

September 1, 2010Sep 1, 20108

Health care is changing at lighting speed. If you don’t know this, or worse, don’t accept it you’re doomed. No. Really. It’s change or close shop. Whether you like it or not, health care reform is going to change the…

Many physicians are choosing to work for large group practices to buffer themselves from directly dealing with change. Mental health providers could do the same, …

Health policy

Health care reform controversy in both Europe and the United States

Anesthesioboist T., MD

August 31, 2010Aug 31, 201031

On my way onto the plane for my recent flight home from France I picked up a copy of Le Figaro thinking I might enjoy the article about actress Sophie Marceau, who was on the cover of everything while we…

On my way onto the plane for my recent flight home from France I picked up a copy of Le Figaro thinking I might enjoy the article about actress Sophie Marceau, who was on the cover of everything while we were in France in celebration of her turning 40.

I did enjoy catching up on Marceau – I still remembering watching La Boum in my high school French class – but …

Health policy

Southern states may block the government from delivering health care

Allen Perkins, MD

August 30, 2010Aug 30, 20107

I have lived on the Gulf Coast for all but 5 of my 50 years. I grew up in Baton Rouge, Louisiana and now live in Mobile Alabama. I was educated in the public schools during the height of the…

I have lived on the Gulf Coast for all but 5 of my 50 years. I grew up in Baton Rouge, Louisiana and now live in Mobile Alabama.

I was educated in the public schools during the height of the desegregation battles and my experiences were colored by those battles in a number of ways. I ran track in high school and was in the racial minority on that team (as …

Health policy

Why the sustainable growth rate formula (SGR) is here to stay

Jaan Sidorov, MD

August 29, 2010Aug 29, 20108

According to the Washington Post, it is highly unlikely that Congress will undo the planned "sustainable growth rate formula" (SGR) mandated Medicare fee schedule cuts. While there's an outside chance of a fix, the American Medical Association, as well as…

According to the Washington Post, it is highly unlikely that Congress will undo the planned “sustainable growth rate formula” (SGR) mandated Medicare fee schedule cuts. While there’s an outside chance of a fix, the American Medical Association, as well as other organized physician groups, can’t be happy about the constant threat of the 20% payment reductions.

Recall that the SGR was signed into law back in 1998. It was designed to …

Health policy

Checks and balances in health reform

Richard Reece, MD

August 26, 2010Aug 26, 20104

What follows are ten thoughts on checks and balances in health reform. I am writing from Oak Ridge, Tennessee, where I am attending a high school class reunion. My son Spencer, a nationally known poet and a candidate for the…

What follows are ten thoughts on checks and balances in health reform.

I am writing from Oak Ridge, Tennessee, where I am attending a high school class reunion. My son Spencer, a nationally known poet and a candidate for the Episcopal priesthood, is with me. He is checking on my past, and I am trying to provide balance so he can understand his father’s legacy.

There …

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Checks and balances in health reform

Health policy and public health

Articles, page 165

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