Health Policy and Public Health

Physicians writing on KevinMD about policy as it reaches the exam room: prior authorization and the state and federal rules now written for it, scope of practice laws state by state, the CDC opioid guideline and what forced tapers did to patients, and public health from vaccination to the pandemic. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Opioids: what physicians and pain patients say, in their own words, and Vaccines: what physicians say, in their own words.

What the United States health care system can learn from Mexico

Kevin

Health Policy

October 2, 2009

by Esther Buddenhagen, MSW

I write as a lay person concerned about the gap between what many people should receive and what they actually receive. The question of good medical care for ordinary people is being buried not only by insurance issues but by failure to come to terms with what primary care should be about.

Even Atul Gawande, who is particularly good at making distinctions between good and …

A formula to help Congress with health care costs

Kevin

Health Policy

September 30, 2009

by Gary R. Gibson, MD, FACP

In his 2007 book Critical, Tom Daschle said lawmakers were “flummoxed” when attempting to craft specific reform legislation. They seem flummoxed again as they fail to recognize the primacy of the patient-physician covenant and try to analyze a complex problem without a suitable conceptual model.

The formula below represents a valid conceptual model describing health care costs.

“E” is expressed in monetary units …

What doctors can learn from patients in the health care reform debate

Wendy S. Harpham, MD

Health Policy

September 30, 2009

Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope?

I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of …

Will there really be an impending shortage of cardiologists?

Larry Husten, PhD

Health Policy

September 28, 2009

There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people.

However, that doesn’t mean that the message conveyed …

Should letting a premature infant die be considered health care rationing?

Kevin

Conditions and Diseases

September 27, 2009

by an anonymous NICU nurse

There is a medical controversy brewing over in England that is threatening to invade the United States. Ms. Capewell, a 23-year old British mother, is claiming English doctors let her 21 5/7 week infant die, only because they were following national perinatal guidelines.

If only he was born at 22 weeks, she insists, they would have tried everything to save him and admitted him to the …

What does socialism have to do with the health care reform debate?

Kevin

Health Policy

September 24, 2009

by David Alway, MD

In thinking about socialism and medicine in the United States let’s adopt socialist point of view and ponder some logical conclusions.

Injustice Exists

The socialist notices that some people are starving, don’t have adequate shelter, or are relatively uneducated. He also observes that others are very well off, having access to the finest meals, enough money to buy grand homes and are well-educated. This state of affairs, …

Should soft drinks be taxed and be called a public health hazard?

Kevin

Health Policy

September 24, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Soft drinks and other beverages loaded with sugar should be taxed as a public health hazard, much as cigarettes are, a group of prominent medical researchers says.

Since extensive evidence ties sugary drinks to an epidemic of obesity and related health problems, such as heart disease and diabetes, they …

Health care reform protests and how fears and beliefs are exploited

Kevin

Health Policy

September 21, 2009

by Abraham Verghese, MD

The unfortunate politicians who have braved town hall meetings to talk about health reform seem to have been taken by surprise by the vitriol and volume of the push back. Yes, I know the audiences were marshaled and recruited to shout down the speakers but still the passion on display was genuine and not in the least surprising to me. What the President and our politicians should …

How eliminating waste and taking fewer steps can improve patient care

Donald Tex Bryant

Patient

September 21, 2009

Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.

I often find myself counting steps during my daily activities as I know that the fewer physical steps it …

Medical malpractice reform by President Obama and the White House

Emily P. Walker

Physician

September 19, 2009

by Emily P. Walker, Washington Correspondent, MedPage Today

The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases.

In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians …

Is the public plan option supported by doctors?

Emily P. Walker

Health Policy

September 18, 2009

by Emily P. Walker, Washington Correspondent, MedPage Today

A solid majority of physicians favor creating a new public insurance option that would operate alongside existing private plans, according to a survey published online in the New England Journal of Medicine.

About 63% of doctors, across a smattering of specialties and in various geographic regions, support a public insurance option. That …

Analysis of the Max Baucus health care reform plan

MedPage Today

Health Policy

September 17, 2009

by Peggy Peck, Executive Editor, MedPage Today

In an important step toward moving healthcare reform legislation through Congress, Sen. Max Baucus (D-Mont.) introduced his much-awaited bill today after months of working to gain bipartisan support.

The chairman of the powerful Senate Finance Committee released a summary of legislation that would not create a public insurance option and would cost $856 …

Citizens, not lobbyists, must reform health care in the United States

Kevin

Health Policy

September 16, 2009

by Gary R. Gibson, MD, FACP

We can deliver better health care to every U.S. citizen at less than one-half of 2.1 trillion dollars per year with constructive reform, a system wherein people receiving and providing care would feel greater satisfaction and dignity. Through courage and perseverance, we must identify and minimize waste, eliminate corruption and modernize our system. In a competitive world economy, we must reform health care …

Cutting health care costs means reducing utilization

Kevin

Health Policy

September 15, 2009

by Mark Coyne

The core of the health care debate revolves around the perceived spiraling cost of health care in America. There are many quotes in the media, and from politicians, that health care costs are increasing by more than 10 percent a year, and consistently increasing by more than wage growth – which is unsustainable in the long term. The basic point being made is correct, the overall …

Why price transparency won’t affect health care costs

Kevin

Health Policy

September 15, 2009

by Kumud B. Jindal, MD, MPH

Many patients and self-appointed health care experts view medical services as commodities, and openly express frustration with seemingly opaque pricing for a visit to the doctor’s office. “Doctors should publish their fees so we know what we’re paying!” The idea that this matters significantly with regard to health care costs is a terrible myth, one that deserves much closer scrutiny.

The health insurance industry and …

Dean Ornish injects himself in the health reform debate

Rahul K. Parikh, MD

Health Policy

September 14, 2009

It looks like The Huffington Post’s honorary Medical Editor, Dr. Dean Ornish, walked into the same trap that Whole Foods CEO John Mackey did.

Mackey got a lot of flack when he wrote an op-ed in the Wall Street Journal on health care reform, one in which he emphasized the need for personal responsibility for our health.

Ornish, in an effort to inject himself into the current debate, blogged, Don’t Tread on …

Op-ed: Why the doctor won’t see you now

Kevin

Health Policy

September 12, 2009

The following op-ed was published on August 20th, 2009 in CNN.com.

When President Obama recently cited the number of Americans without health insurance, he declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.”

Uninsured patients often delay preventive care, waiting to seek medical attention only when their conditions worsen. This leads to more intensive treatment, often in the emergency department or hospital where …

Read more…

Op-ed: Why the doctor won’t see you now

Advice for President Obama’s health care reform plan

Arthur Chernoff, MD

Health Policy

September 11, 2009

Prior to President Obama’s address to Congress on health reform, I asked myself, “What would I tell the President?”

First and foremost: go for it. All of it. Health care in America is too important, both economically and morally, to be left adrift in its current state. Its focus is wrong. It costs too much. And not everyone who needs it is able to have it.

Two rules that have served me …

Why health care savings accounts should play a larger role in reform

Kevin

Health Policy

September 11, 2009

by Charles W. Patterson, MD

Health care reform has long been one of my main interests and currently, it seems to be everyone else’s. The President said he thought a single-payer system would be best, but submitted a proposal he thought could be passed. The outcome is in doubt.

Actually, the single-payer system is the second best possible solution. The government would hold the money but would remain vulnerable to political manipulation, …

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