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.

An analysis of Barack Obama’s health care reform speech to Congress

Health Policy
September 11, 2009

by Emily P. Walker, Washington Correspondent, MedPage Today

In Wednesday’s address to Congress and the nation, President Barack Obama made a number of statements about healthcare reform, some involving issues that would directly affect medical practice. MedPage Today examined five of Obama’s statements to add context to the sound bytes.

medpage-today The Statement:

“I don’t believe malpractice reform is a silver bullet, …

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An analysis of Barack Obama’s health care reform speech to Congress

Rising health care costs and the tax preference for employer-based health insurance

Health Policy
September 8, 2009

by Robert Berry, MD

In his column, David Brooks of The New York Times effectively compares our rapidly rising health care costs to “a stampede of big ugly rhinos.” What he ignores, however, is the huge elephant in the room that is largely responsible for this rhino stampede – the tax preference for employer-based health insurance.

This tax preference – enjoyed primarily by employees of large businesses and government at …

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Rising health care costs and the tax preference for employer-based health insurance

10 things your insured patients need to know about health care reform

Health Policy
September 4, 2009

by Paula Hartman Cohen

My husband and I live in Massachusetts, a state that already has health care reform.

On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance.

They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This …

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10 things your insured patients need to know about health care reform

How hospitalists can provide high quality patient care at the lowest possible cost

Physician
September 3, 2009

Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless …

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How hospitalists can provide high quality patient care at the lowest possible cost

What can health reform in the United States learn from Africa?

Health Policy
September 2, 2009

As an outside observer of the American health reform debate, I cannot help but notice the disparity of views, the fractured arguments, the protectionism and desperation. My country is in a similar struggle for health care reform, with the main difference being America is a rich nation, and we are poor by comparison. In both debates, however, I have looked for the humanitarian argument, and in many cases found it …

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What can health reform in the United States learn from Africa?

Health care reform: The uncivil war dividing America

Health Policy
August 31, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

The unfettered debate about ideas that characterizes the democratic process in the United States operates best when there is a truthful presentation of the issues, and when the process is civil and respectful. Unfortunately, the debate about health care reform has evolved to the point that it …

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Health care reform: The uncivil war dividing America

Health care as a futures exchange

Health Policy
August 30, 2009

by Susan H

It seems that health insurers are serving as exchange and clearing firm for “health futures” traders. Traders of “health futures” are potential patients, and health care providers. Patients are synthetic buyers of futures on health care provision, doctors and providers of medical goods and services are short sellers of those futures. The exchange and clearing firm (health insurer) represents that it serves to stand as guarantor in the …

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Health care as a futures exchange

Will medical malpractice reform be included in the final health bill?

Physician
August 27, 2009

Believe it or not, some element of federal tort reform is not only possible, but likely.

Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the plaintiff’s bar strongly supports the Democratic Party. We know that Democrats have traditionally shied away from specific reforms, such as caps on pain on suffering. So, this would seem the worst …

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Will medical malpractice reform be included in the final health bill?

Is health care a public good?

Health Policy
August 24, 2009

by Jeoffry B. Gordon, MD, MPH

The public policy and current political action around changing the system overlooks two important technical fallacies:

(1) That health care is most efficiently distributed by a free market mechanism; and,
(2) That medical services are an ordinary commodity.

The commercial market model is a failing economic and public policy ideology used to rationalize and justify corporate control of the health care system to profit from the enterprise. …

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Is health care a public good?

What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Health Policy
August 21, 2009

Today’s health care communications lesson is brought to you courtesy of Whole Foods … I mean John Mackey.

John Mackey’s stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a …

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What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Is it fair to compare American health care with systems in Europe or Canada?

Health Policy
August 18, 2009

by Ralph Silverman, MD, FACS, FASCRS

I am tired of the comparisons people make between health care in the United States and other countries. For instance, there are those who think that we should have universal health care because some European countries and Canada do.

It is true that those countries do have universal health care, but is it a fair comparison?

Who does Canada rely on to defend its borders? When the …

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Is it fair to compare American health care with systems in Europe or Canada?

ACP: Putting effectiveness into the health care equation: Rational or rationing?

Health Policy
July 30, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

“Effectiveness” has become a buzzword these days in discussions about healthcare reform. It is often accompanied by different preceding modifiers, such as “cost” or “comparative,” each conjuring up different images in the minds of physicians, patients, insurers, and the pharmaceutical industry. Some say that cost effectiveness and comparative …

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ACP: Putting effectiveness into the health care equation: Rational or rationing?

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AMA working for reform that benefits patients and physicians

Health Policy
July 26, 2009

The following is part of a series of original guest columns by the American Medical Association.

by J. James Rohack, MD

Physicians know first-hand the frustrations of caring for patients in our broken system and also the joys of patient care that get us out of bed before the sun rises. The AMA is committed to getting health reform this year – so that the joys can again outnumber the …

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AMA working for reform that benefits patients and physicians

Will the lack of primary care doctors make universal coverage useless?

Physician
July 23, 2009

It appears that one source of agreement among health reformers is that there isn’t enough primary care doctors.

The New York Times wrote a front-page piece on this issue last month, which I had commented on.  Now, an article in the Washington Post re-iterates the same theme:

As the debate on overhauling the nation’s health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are …

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Will the lack of primary care doctors make universal coverage useless?

Should doctors support Congress’ health reform efforts?

Health Policy
July 20, 2009

The American Medical Association recently gave unqualified support to the House health reform bill, H.R. 3200, and that is drawing the ire of some of their supporters.

To be sure, H.R. 3200 is the most left-leaning of the proposals, and there is clear ideological opposition to the so-called “public plan,” which expands the government’s role in our health care system. It’s a tremendously sensitive topic, with some expressing their outrage …

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Should doctors support Congress’ health reform efforts?

Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Health Policy
July 20, 2009

Well, that was fun.

kevinmd This past Friday, I participated in Health Care Reform: Putting Patients First, an event put together by Better Health’s Dr. Val Jones. It was an impeccably organized gathering, and provided medical bloggers a valuable opportunity to discuss health care reform. Great timing too, given the fact that two major reform bills were introduced earlier …

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Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

Health Policy
July 17, 2009

The following are my prepared remarks at Health Care Reform: Putting Patients First, held at the National Press Club in Washington, DC, on July 17th, 2009.

President Obama recently declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.” And indeed, finding a way to provide universal health coverage to every American is one of the focal points in today’s health care debate. …

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Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

ACR: Reducing medical imaging costs requires a short term investment

Health Policy
July 9, 2009

The following is a guest post from the American College of Radiology.

by James H. Thrall, M.D.

Health care reform cannot be approached with a “one size fits all” cost-cutting mentality. Reducing costs in the long term often requires an investment in the short term — particularly, in regard to medical imaging.

Medical imaging saves lives. Imaging also saves dollars through earlier disease diagnosis, less invasive medical procedures, shorter hospital stays, and …

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ACR: Reducing medical imaging costs requires a short term investment

The AMA and Sermo break up, and how it’s getting ugly

Social Media in Medicine
July 3, 2009

When the online physician discussion site, Sermo, and the American Medical Association joined forces in 2007, it was heralded as a promising partnership for both entities.

In fact, as Sermo’s CEO Daniel Palestrant said back then, “As a company, we had to take a very rational perspective on that by saying we’re a small software company, not an advocacy organization. Who is the best entity to turn voice into action? …

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The AMA and Sermo break up, and how it’s getting ugly

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