Originally published in MedPage Today
After a year-long struggle and often-raucous partisan debate, the House of Representatives passed an historic health care reform package late Sunday night.
The vote on the last of the two bills in the package was 220-211. All 178 Republicans, along with 33 Democrats, voted against the measure. The margin was similar on the other measure; both …
Health care reform passes the House in a historic vote
Heading into the final weekend of Mr. Toad’s Wild Ride, who could have guessed that in a year that brought us Death Panels, Pickup Trucks, “You Lie”, The Cornhusker Compromise, Bart Stupak (boy, that must have been a tough name to grow up with), and the Senate Parliamentarian-as-Rock-Star, we would be on the cusp of passing a perfectly …
Healthcare reform is an achievement but isn’t perfect
Originally published in MedPage Today
by John Gever
This meditation was evoked by the prospect that my basement could be filled with E. coli-laden mud next week.
I live within a few yards of Wheeling Creek, a tributary of the Ohio River that drains about 250 square miles of northern West Virginia and southwestern Pennsylvania. This week has brought temperatures near 70 degrees, …
Flood insurance by the government, but no public option
If there is anything about economics that has been proven over and over, it is that price controls do not work. The unintended consequences are usually worse than the problem that led to the solution in the first place.
Massachusetts legislators, feeling the frustration of higher insurance premiums, are now considering a bill to limit doctor and hospital reimbursement payments to 110% of Medicare rates, or perhaps some other percentage …
Medicare rates and capping payments to hospitals
If you are a physician, therapist or any other helping professional whose business model relies on third party manged care reimbursement you are engaged in the world’s worst business model.
Let me start with a story to set the stage.
Imagine you are a bright, idealistic college student. You’re good at academics, want to make a difference in the world and have hundreds of career options in front of you.
After lots of …
Business model woes traps doctors and impedes health care
A 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform.
In fact, I remember being invited to talk about healthcare reform on a panel for medical students this past fall. As part of my remarks, I mentioned the 21% pending cut in physician payment and recall the questions and …
Medicare doc fix questions and answers
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Nearly a third of children with special healthcare needs are underinsured, and where a child lives strongly influences whether he or she will have adequate healthcare coverage, a new study found.
The unadjusted proportion of underinsured special-needs children varied strongly by state, ranging from 24% in Hawaii (standard error=1.75) to 38% …
Children with special healthcare needs are underinsured
The following is part of a series of original guest columns by the American Medical Association.
by J. James Rohack, MD
Physicians in nearly every area of the country face a David and Goliath scenario when negotiating with entrenched health insurance companies. This is clearly illustrated by a new AMA study showing that competition in the health …
AMA: Health insurance consolidation can undermine physicians
There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand (like supporting a candidate that has no chance of winning).
Supporting health care reform is probably a little of both.
Even if any of the currently proposed health care reform plans pass, …
Health care reform needs to pass now, and here’s why
I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen.
One insurer even told him (the owner of the business) to just “make the sessions shorter and don’t give as much care.”
Clearly the insurance …
Primary care needs to be valued first before it can be saved
As the health reform debate rages on, the central issue of how to improve care while reducing costs remains unaddressed.
Fee-for-service has reduced doctors to assembly line pieceworkers, paid by the office visit and procedure rather than by effectiveness of treatment. The result is an inefficient, costly and dangerous system. It is not unusual for a five minute office visit, which excludes clinical examination or note taking. Many patients/consumers can be …
Health reform needs to end fee for service medicine
Originally published in MedPage Today
by Michael Smith
OK, don’t take this the wrong way, but ….
Chill. Relax. Give the other guy the benefit of the doubt. Don’t jump to conclusions. And most of all, think before you speak, blog, natter, comment, or otherwise pontificate on issues of the day.
And when I say ‘think,’ I don’t mean trying to find the …
The Danny Williams surgery shouldn’t be controversial
Doctors will soon be wagging the reform dog.
Look at it this way. Expansion of insurance coverage to the 31 million more Americans, as envisioned in the current reform bill, will require more doctors to care for them. The starting entry of 78 million baby boomers in the Medicare pool, starting in 2011, will also take more doctors.
As everybody knows, coverage does not equal access. This is most vividly illustrated in …
Medicare cuts will strengthen doctors’ negotiating position
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Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following quote from a “healthcare expert.”
“I’m not at all sympathetic with the cardiologists,” said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a …
Does your cardiologist deserve his salary?
by David Allen, MD
Should health care be controlled or provided by the government?
I believe that years of answering ‘yes’ to this question has been at the root of most of the problems in the American health care system. Let’s explore a few of these ‘yes’ answers:
Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. …
Why Medicare and health care should be deregulated
by Ernesto Gutierrez, MD
There is a lot of discussion about what Obama did right and wrong in managing the politics of passing health insurance reform. What strikes me as the most obvious is the failure to engage physicians. Sure there was support from the AMA, ACP, and AAFP, but the support was lukewarm at best. The position letters sent out to society members outlining their support seemed forced …
Why is President Obama ignoring the doctors when it comes to health reform?
Originally published in MedPage Today
by Charles Bankhead
Recently, I learned that members of Congress have their very own medical clinic. I guess I shouldn’t have been surprised. Being a member of Congress is a tough job, filled with stress and posturing and righteous indignation. I know that if I had to decide whether to spend tax money on a Bridge to Nowhere or a pet airport that has flights to …
What should free health care to members of Congress be called?
The following is part of a series of original guest columns by the American Medical Association.
by J. James Rohack, MD
Prominently displayed at the top of the AMA’s Web site this week is a “countdown clock” to this year’s 21 percent Medicare physician payment cut, which will hurt physicians ability to care for all Medicare and …
AMA: Why patients should care about fixing the Medicare physician payment cut
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Raising seniors’ copayments for ambulatory care to offset increasing healthcare costs may backfire on insurers, researchers asserted.
Seniors enrolled in Medicare plans that increased copayments had significantly fewer outpatient visits but spent more time in the hospital than patients in plans that left copayments untouched, according to Amal Trivedi, MD, …
Increasing copays will increase costs for health insurance companies in the long run
by Deborah Maggart
It’s a very exciting time to be a part of the health care world.
The U.S. Senate and House were in deep negotiations attempting to reform health care in America by reconciling their separate visions into a single bill and – just as reform was deemed imminent – a special election in Massachusetts complicated matters by ending the Democrats’ filibuster-proof “supermajority” and with it the possibility of strictly partisan …
Differences between the Senate and House approach to health insurance exchanges
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