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.
The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed, “We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients, and they’re equal that we prioritize the commercial insured patients enough so … We can …
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The American Health Care Act isn’t perfect. It’s pragmatic.
Uncertainty surrounding health system reform and the future of the Affordable Care Act has left many physicians with questions about how current proposals will affect them and their patients. Stakes could not be greater for patients who may again face the stark, life-or-death choices arising from the possible loss of health insurance. As a longtime member of the American Medical Association’s Board of Trustees and a former president of the …
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Physicians must speak out on heath reform to make a difference for patients
At this point, much has been made of the health care bill the Republican administration has put forth to replace the ACA. We’ve heard the details of the bill, we’ve seen the numbers. We know that the U.S. Congressional Budget Office has forecast that 24 million more people will be uninsured by 2026 if House Representatives replace the ACA with the current bill proposed by the Trump administration. We know …
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Help me help you: I’m not a politician. I’m just a doctor.
As a doctor, I am guided by the code of medical ethics. The code is made of up of four principles: autonomy, justice, do good and do no harm. These principles guide me and my colleagues, including the fifteen doctors in Congress, as we care for others. In the debate over the fate of the Affordable Care Act, thirteen of the fifteen doctors in Congress have publicly stated that they …
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Why the American Health Care Act takes us in the wrong direction
As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017. Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues. Coincidentally, March 8 was also the day two House Committees began deliberations on …
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The fundamental problem with the American Health Care Act
I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons …
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The AMA’s letter on the American Health Care Act was too narrowly focused
Like they have a gun to their heads, congressional Republicans, led by Paul Ryan, are moving ahead at warp speed to pass a sweeping new health care bill to replace Obamacare. Despite an almost deafening roar of objections from the many people who would lose coverage or whose insurance costs might go up; from major medical groups; and even from within its own party, they continue onward with this health …
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The Republican health plan just doesn’t make sense
Pause with me for a moment and create an image in your mind of the quintessential healthy person. What do you see?
I picture someone who is slim and agile. They probably bike or walk to work and engage in daily exercise. They cook for themselves, use fresh vegetables and few processed foods. They find satisfaction in their career and home life, mange stress well and devote time to meaningful hobbies …
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Why Obamacare wouldn’t have worked anyway
Having graduated from medical school in 2008 and internal medicine residency in 2011, I am a physician-child of the Affordable Care Act (ACA) era. The belief that “health care is a human right” ran deep through my upbringing and life experiences, but training during a period of such intense debate over health care reform reinforced this ideal. My professional identity developed interwoven with a compelling national conversation about access and …
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Who if not me will make my patients whole?
In no other field is change received with so much resistance and skepticism than in medicine. The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy.
As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress. As the world is witnessing an unprecedented technological …
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We must challenge the health care status quo
A month into Donald Trump’s presidency, it is clear we are in for a wild and dizzying ride. As is typical in matters of opinion, post-mortem analyses on how we got here are frequent and varied.
However, I believe the Affordable Care Act was the iceberg which sunk Hillary Clinton’s ship. Sure, there were both real and fabricated scandals which dampened enthusiasm among potential Clinton voters. There were the emails. There …
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Obamacare cost Hillary the presidency
It won’t work.
Obamacare works for the poorest that have affordable health insurance because all of the program’s subsidies tilt in their favor.
Obamacare doesn’t work well for the working and middle class who get much less support — particularly those who earn more than 400 percent of the federal poverty level, who constitute 40 percent of the population and don’t get any help.
Because so many don’t do well under the law, …
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Obamacare was poorly constructed. The Republican plan is worse.
I can envision a comprehensive design for health care in the United States that will expand access and control costs while conforming to our shared national values of personal responsibility, care for thy neighbor and free enterprise.
After dozens of attempts to repeal, defund, delay or restrict Obamacare, the Republicans now have the opportunity to do all of the above. The problem is that it is not clear what should be …
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A comprehensive health care redesign for the United States
I’m a member of the 25,000-strong medical school graduating class of Obamacare.
We were pre-med college students during the debate over the Affordable Care Act (ACA) and began medical school during its implementation. We put ourselves into deep debt and studied late into the night with the promise that we would practice medicine in a system that promoted insurance coverage, reduced medical bankruptcy, and incentivized high-quality care.
Increasingly, we see that promise …
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The Obamacare generation of physicians is ready to fight for patients
America’s health care system is broken and no longer works. Many practicing physicians are unhappy with the way insurance companies control medicine. Most patients are unsatisfied with the benefits they receive from the health insurance companies and with the lack of choice they have in who cares for them. Patients are frustrated with the exorbitant cost of prescription medicine. They wonder why this system often doesn’t allow them to receive …
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12 steps to make America’s health care great again
I was raised in a family that hates taxes. Not hates taxes as in, “Gosh, it’s too bad such a high percentage of my paycheck goes to the government.” More like: “How dare the government steal my hard-earned money and give it to undeserving moochers?” (Is there such a thing as a deserving moocher? Sorry, I digress.)
The origins of this anti-tax sentiment are deeply ideological, steeped in a frothy mix …
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Who hates taxes? The answer isn’t what you think.
