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.

Obamacare isn’t a disaster. Failing to improve upon it would be.

Cedric Dark, MD, MPH

Health Policy

May 3, 2017

Congress has returned to DC in the wake of the defeat of Paul Ryan’s American Health Care Act. And while shouting “repeal and replace” might win elections, this debacle proves that the American people will not tolerate their families, friends, and neighbors losing healthcare coverage just so rich people can get tax cuts.

Yet, Congress will certainly revisit health reform again. With the Republican caucus fractured, Paul Ryan should seek out …

Students are the future of health policy: Let’s start treating them like it

Junaid Nabi, MD

Health Policy

May 1, 2017

The media is quick to point out the important role of American Medical Association (AMA) and other professional bodies in shaping the future of health policy in the United States. While these organizations have a certain responsibility, it is becoming increasing clear that medical and public health students will shape the future of post-Obama health care landscape. Recognizing their role is pertinent.

While physician members from AMA are the practitioners of …

Physicians ceded control of health care. It’s time to take it back.

Anonymous

Physician

April 21, 2017

In the not-to-distant past, American health care was the gold standard. It offered job satisfaction and autonomy, was financially rewarding and was considered by many to be the most honorable profession. But as we all know, over the last two decades, increasing health care costs and demands and increasing competition for insurance contracts have changed the face of medicine. Metrics ranging from quality and safety (which are needed and were …

To fix health care, we need to examine our shared values

Thomas Birch, MD

Health Policy

April 21, 2017

When the political process is not working, one option is to examine the shared values of most Americans. Values are learned, clarified and even negotiated. They are the algebraic axioms from which the formulas of public policy are derived.

Examples include:

Society should care for the sick, written into the EMTALA law that prohibits turning patients away from emergency rooms.

Free enterprise is the engine of material prosperity.

The government must correct the dangers …

Is health care a right or a privilege? Why can’t the answer be both?

Brian C. Joondeph, MD

Health Policy

April 18, 2017

Election Day 2016 should have been Christmas morning for Republicans. Long awaited control of the White House and both houses of Congress. A chance to deliver on an every two-year election cycle promise to repeal and replace Obamacare. In 2010 Republicans needed the House. They got it. In 2014, it was the Senate. Delivered. But we still need the White House they said. Asked and answered with President Donald Trump.

So, …

How Trump counties should instruct health reform

Suhas Gondi, Evan Beiter, and Vishal Khetpal

Health Policy

April 17, 2017

A few weeks ago, before the demise of the American Health Care Act, President Trump sat down for an interview with Tucker Carlson at Fox News. Citing an article from Bloomberg, Carlson informed the president that the counties which voted for him “would do far less well under the bill than counties that voted for Hillary,” were it to pass. Whether intentional or not, Trump agreed with his assessment, noting …

Why did the GOP health plan fail? Maybe because of medical Darwinism.

Michael L. Millenson

Health Policy

April 13, 2017

“We are now contemplating, Heaven save the mark, a bill that would tax the well for the benefit of the ill.”

Although that quote reads like it could be part of the Republican repeal-and-replace assault against the Affordable Care Act (ACA), it’s actually from a 1949 editorial in The New York State Journal of Medicine denouncing health insurance itself.

Indeed, the …

Politicians must consult front-line physicians for health reform

Niran S. Al-Agba, MD

Health Policy

April 11, 2017

Recently, the AHCA was pulled from the House floor after not enough votes could be secured in favor of its passage. A Washington Post article reported President Trump’s thoughts on the matter: “We couldn’t get one Democrat vote, not one. They [Democrats] own Obamacare. So when it explodes … we make one beautiful deal for the people.”

Journalist Robert Costa asserted “there was little evidence that either Trump or House Republicans …

Why politics and patients don’t mix

Mark Lopatin, MD

Health Policy

April 10, 2017

So the American Health Care Act was rejected. And I want to scream! Not because it failed, but instead because of the way the whole thing was handled. While both parties will argue that they were trying to do what is best for the American public, I disagree. As a physician, what I see are two forces who are more intent on winning a battle than in helping the public. …

Read more…

Why politics and patients don’t mix

Maybe mothers saved the Affordable Care Act

Claudia M. Gold, MD

Health Policy

April 8, 2017

In striking contrast to the happenings in the U.S. Congress, Kate Middleton, future queen of England, spoke these words at London’s Royal College of Obstetricians and Gynecologists on the occasion of a launch of educational films dealing with maternal mental health:

Nothing can really prepare you for you the sheer overwhelming experience of what it means to become a mother, It is full of complex emotions …

Read more…

Maybe mothers saved the Affordable Care Act

Health reform is dead. So what can we do now?

Matthew Hahn, MD

Health Policy

April 7, 2017

Health care reform as it is typically discussed in America is dead for now. By “as it is typically discussed,” I mean broad “big picture” health care reform, which deals primarily with how we organize payments: government vs. free market, multi-payer vs. single payer, profit-based vs. not-for-profit. The Democrats tried. Obamacare’s shortcomings stem largely from the fact that neither President Obama nor the larger Democratic Party had the political power …

We want a federal budget where the trade-offs support life, not death

Edward C. Halperin, MD

Physician

April 5, 2017

When I entered college, I took a course in introductory economics. Human wants are unlimited, I learned, but resources are limited. Therefore, we have to make choices about what we spend money on. That, I was told, was what economics was all about — how we make choices and allocate resources.

My economics textbook illustrated the point by quoting from Nazi Germany’s Propaganda Minister Joseph Goebbels who said: “We can do …

We should teach medical residents health policy. Here’s why.

Sneha Tella, MD

Medical Education

April 4, 2017

When the U.S. health care system began, physicians were largely autonomous in selection of medical treatments and their delivery. Patients were treated under a fee for service model. However, over time we began to notice an alarming incline in medical spending which ultimately lead to the development of health maintenance organizations (HMOs). At their inception, HMOs were intended to standardize medical treatment, reduce unnecessary use of resources, and encourage the …

The problem with too many health insurance options

Tenessa MacKenzie, MD

Health Policy

April 2, 2017

Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control.

In my current position as a primary care physician at an …

The need to marry socioeconomics, public health, and medical care is long overdue

Cory Michael, MD

Health Policy

March 30, 2017

I was recently invited to speak at a conference in what is likely the nicest hotel I have ever set foot in. Partially hidden by an array of palm trees and adjacent to a golf course, I could easily see why the conference rate was $350 per night. Before making my way to the conference room, I paused in the dining area to go over my slides one last time …

Health care cannot be sustainably fixed in broad political strokes

Margalit Gur-Arie

Health Policy

March 30, 2017

President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican “thought leaders” in Congress were quick to supply him with their stale and superficial “plans” to repeal and replace Obamacare, which were written in protest to President Obama’s policies and were never meant to be implemented. When scrutinized by the …

How social media powers physician advocacy

Marion Mass, MD

Physician

March 28, 2017

This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.

Dr. Marion Mass is a pediatrician in Philadelphia and a board member of a physician advocacy group, a large physicians-only network that started as a group on …

3 myths about a single-payer system and why it’s doomed to fail

Robert Pearl, MD

Health Policy

March 27, 2017

It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork.

The problem is that it won’t work.

For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now …

Meet the doctor who started a physician advocacy group

Kim Jackson, MD

Physician

March 27, 2017

Dr. Kim Jackson founded a large network of physicians and future physicians that started as a group on Facebook. As patients lamented increasing costs in health coverage …

How politicians mislead their constituents on health care

Charles Ornstein

Health Policy

March 26, 2017

When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic.

“Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Landing Pages Choices Commissioner’ to determine …

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