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.

This liberal physician wants to give Tom Price a chance. Here’s why.

Niran S. Al-Agba, MD

Health Policy

December 8, 2016

Recently, President-elect Trump selected Rep. Tom Price, MD to lead the Department of Health and Human Services. Suffice it to say, this signals Mr. Trumps’ resolve and commitment to definitively repealing and replacing. Dr. Price has already sunk his teeth into health care reform, having proposed alternative health care solutions in every Congressional session since 2009.

As a physician myself, I am delighted at the prospect of having another doctor at …

Until the gap between doctors and patients is fixed, the nation will suffer

Robert Pearl, MD

Physician

December 7, 2016

It’s widely acknowledged that the American health care system achieves relatively poor quality outcomes compared to most industrialized nations and at much higher cost. A new survey, conducted by Nielsen Strategic Health Perspectives and commissioned by the Council of Accountable Physician Practices (CAPP), provided important insights into why this could be the case — and more ominously, why the future may be no better.

CAPP is made up of …

We cannot ignore the dysfunctional systems at the heart of how we care

Peter Pronovost, MD, PhD

Health Policy

December 6, 2016

If we want to rein in the costs of the U.S. health care system — now equal to nearly 18 percent of the nation’s gross domestic product — we cannot ignore the fragmented technologies used to help heal and save lives.

At first glance, the devices, monitors, electronic health records and machines found in today’s hospitals might inspire awe. Look beyond the slick displays with blinking lights, however, and the picture …

Medical service based on socioeconomic status: That’s unacceptable

Linda Girgis, MD

Health Policy

December 6, 2016

The patient was in pain and had been for over a year. And it was getting worse, not better. Exhausting all avenues of treatment, I decided it was time to refer him to a pain management doctor. Because of the injury to his back, the patient lost his job and his health care coverage. With no alternative for health care coverage, he ended up covered by Medicaid. While health care …

I never want to be a government-employed physician. Here’s why.

Suneel Dhand, MD

Health Policy

December 6, 2016

Every health care system in the world is facing its fair share of challenges. Aging populations, the exponential increase in chronic diseases such as heart disease and diabetes, expensive new treatments—all at a time when most countries desperately need to curtail rising health care costs to save their economies. At the two extremes, we have fully public-funded (socialized) medicine versus entirely free-market (private) health care delivery systems. I’ve written previously …

Why repealing Obamacare won’t be as bad as many people think

Brian C. Joondeph, MD

Health Policy

November 28, 2016

With Donald Trump’s promise to repeal and replace Obamacare on many Americans’ minds, there are numerous questions about how the health care system will work in the very near future. There are equally as many, if not more, outlandish speculations.

Donald Trump was elected a week ago and doesn’t assume office for two more months. Much of what will get changed and how is yet unknown. Yet the mainstream media has been quick …

Donald Trump keeping the pre-existing conditions protections isn’t new

Robert Laszewski

Health Policy

November 28, 2016

The Wall Street Journal, The Washington Post, CBS News and other news outlets have led with headlines touting the big news that Donald Trump is willing to keep parts of the Affordable Care Act — notably the pre-existing condition protections and the ability for children up to the age of 26 to stay on their parents policies.

Except this isn’t news.

In May, Trump’s policy advisor told Healthline that …

Can a Trump revolution happen in health care?

Suneel Dhand, MD

Physician

November 27, 2016

The election result shook the world. As the vote counts started to come in, most of the country descended into a state of collective shock and disbelief — even Mr. Trump’s own supporters. Nobody seemed more surprised than the political pundits on all the cable news channels, who had for months incorrectly predicted the opposite result.

Let me take a step back for a moment before I sound like somebody who …

The good, bad, and the ugly of repealing the Affordable Care Act

Ilene Benator, MD

Health Policy

November 22, 2016

With the election of Trump and a Republican Congress, it looks like the ACA is doomed. Will it be repealed in whole or in part? Will something replace it? None of us, including the new administration, know exactly what will happen. But if it does get repealed, what exactly are the consequences?

The ACA was never a full health care overhaul. It was a form of insurance reform that used subsidies …

A post-election physician’s letter to his patients

Gregory B. Dodell, MD

Physician

November 22, 2016

To my dear patients,

This has been a difficult time to be an American. I will never forget my walk through Central Park on the morning after the election; I have never felt New York so flat and somber. This election has brought out the worst in many. I have seen its ramifications in people’s health and fear that it may continue to have an impact. I want to express my …

After the election: I am frustrated with how people have been expressing themselves

Anonymous

Physician

November 15, 2016

I have a memory of feeling overwhelming anger and animosity as a 10 year old. I was holding my father’s spot in the checkout line at Walmart in rural Illinois as he ran to grab the paper towels he had forgotten. He quickly darted back in line into the spot that I had saved him as he knew leaving me surrounded by candy for longer than a couple of minutes …

Don’t like the election outcome? Here’s what you can do from now on.

Morgan Leafe, MD

Health Policy

November 15, 2016

Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election. Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality. What does the future hold? What will the consequences be for my gay, minority, and Muslim friends, family, and patients? How will this affect the vulnerable children that I care for every day?

As I began to process …

What will Trumpcare bring?

Niran S. Al-Agba, MD

Health Policy

November 14, 2016

The world is not going to end. We witnessed a revolution earlier recently. The people have spoken, and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo. We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for health care. Here is what we do know. Mr. Trump is a successful entrepreneur. Forbes describes the entrepreneurship pathway as having no …

Read more…

What will Trumpcare bring?

What does the Trump victory mean for health care?

Linda Girgis, MD

Health Policy

November 14, 2016

While health care was a hot topic during previous presidential races, not much attention was paid to it in our current one. For the most part, many people think that Obamacare cannot continue as is: It costs too much, only a few insurances are now participating eliminating the market competition and laden with poor coverage with high deductibles. The world watched with bated breath as Donald Trump surprisingly won the …

Instead of repealing the Affordable Care Act, strengthen it

Kenneth Lin, MD

Health Policy

November 12, 2016

On the election day that made Donald Trump the next president of the United States, I traveled to Lancaster, Pennsylvania to give a lecture. Long a conservative political stronghold, Lancaster County was dotted with “Make America Great Again” campaign signs, forecasting Trump’s comfortable 47,000 vote margin there, which ended up being more than two-thirds of his 68,000 victory margin in Pennsylvania, one of the states that effectively decided …

What does hugging have to do with physician pay?

Peter Ubel, MD

Health Policy

November 8, 2016

According to recent research, a hug a day could keep the doctor away. According to another study, Twitter can predict the chance that people will experience heart attacks. A normal blogger would look at these two findings and tell a story about the relationship between stress and health. I’m not normal. I looked at these two studies and came to a different conclusion — that we …

The broken dreams of Obamacare

Richard Young, MD

Health Policy

November 8, 2016

I have written before about predictions of the actual costs of Obamacare and the probable death spiral of increasing costs and decreasing participants. Several recent reports have brought more clarity to the cost realities.

Recently regulators across the country approved rate hike requests by Obamacare insurance companies even greater than they originally asked for. For example, Pennsylvania regulators approved rate hikes of 33 percent, which was …

Read more…

The broken dreams of Obamacare

Our health system is in dire straits with no good plans for reform

Linda Girgis, MD

Health Policy

November 7, 2016

In her home country, everything is free. However, there is a catch — certain services are only available to those who pay for private insurance. Those who are on the “free plan” sometimes must wait months for procedures. My patient said she knew many people who died on the list waiting for procedures. So, which is better: Free rationed care where people may suffer consequences waiting in line or overpriced care …

The government tried to fix primary care and failed. Here’s why.

Peter Ubel, MD

Health Policy

October 25, 2016

Americans spend more per capita on medical care than just about any other country and, yet they often have little to show for it. Americans have worse access to care than people in other countries, and are often less likely to receive primary care services, like preventive therapies and screening tests. Determined to address these problems, Medicare leaders have been testing out new models of primary care, hoping to find …

Medical speculation of Trump and Clinton leaves this doctor aghast

Linda Girgis, MD

Physician

October 25, 2016

As with most everyone else, I am watching the presidential race with something akin to amusement and horror alike. And as with many people, I feel that the U.S., as a nation, failed to find a suitable candidate for this presidential election. While there does need to be some test for fitness for office, I remain aghast at the medical speculations and facts being leaked about the presidential candidates. Reading this …

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