Washington Watch: Health Policy

Physicians writing on KevinMD about federal health policy from 2017 to 2020: the Affordable Care Act and the proposals to replace it, Medicare for all argued for and against, hospital prices and what fair payment means, and why physicians should or should not get political. This archive is closed; policy posts since 2020 sit on the Health Policy category. Two maintained records draw on this archive: Prior authorization: what physicians say, in their own words, and Primary care: what physicians say, in their own words.

Primary care makes a difference for patients and the nation

Glen R. Stream, MD

Health Policy

October 2, 2017

This week is National Primary Care Week, an opportunity to engage medical students and healthcare stakeholders in a national discussion around the tremendous role that primary care plays in our health care system.

With so much debate about the high price of health care in the United States, too often one of the most effective methods of controlling costs is overlooked: primary care. A wealth of research continues to show that …

What’s the greatest threat to health reform?

Mark Kelley, MD

Health Policy

October 1, 2017

The main character in the popular film Groundhog Day is caught in a time loop where he must repeat the same day over and over again.

The U.S. Senate is now having its own Groundhog Day moment as it debates (yet again) a law to replace the Affordable Care Act. To add to the drama, Senator Bernie Sanders (I-Vt.) is promoting his single payer alternative popularly branded as “Medicare for All.” In a recent …

9 reasons you shouldn’t expect health care to change

Thomas D. Guastavino, MD

Health Policy

September 29, 2017

Although I am now working part time, I still get my academy’s monthly newsletter. I pretty much ignore the ads and any clinical studies that do not directly affect the work I am doing now, but I still find myself drawn to stories with a political bent. Namely, those stories that reflect the latest health reform controversy. The vast majority of these stories do not mention anything really new, just …

Physicians have the power to save our health care system

Timothy Barrett, DO

Health Policy

September 29, 2017

Health care is falling apart. We all know it, we can feel it, but it’s hard to say why it’s happening or even what is happening, we just know that it is true. And as bad as it is for patients, it’s even worse for providers. We know that there is something wrong. We want to help people. We are busy all day long seeing patients. Why doesn’t it feel …

A first-hand account of single-payer health care

Darrel Moellendorf

Patient

September 29, 2017

I am sitting in my hospital room in a bone marrow transplant unit in a European city. I am a patient who has recently received a stem cell transplant. I am U.S. citizen, but I am a resident of a country with a single-payer health system. The insurance system here covers 85 percent of the population. And participation is mandatory, although high earners can opt out by purchasing private insurance. …

So much for repealing and replacing Obamacare. What’s next?

Brian C. Joondeph, MD

Health Policy

September 26, 2017

So much for repealing and replacing Obamacare. The Graham-Cassidy Senate bill is on life support. Members of the Senate death panel have made their decision, leaving their patient on palliative care to spend the last few days of life on heavy pain meds but without lifesaving treatments.

Death is scheduled for the end of September when time runs out on the reconciliation rules which allow the Senate to pass legislation …

Bernie Sanders and the single-payer dream: Why we must take it seriously

Matthew Hahn, MD

Health Policy

September 25, 2017

After being out of the news for a few weeks, health care reform came back with a bang this week when Senator Bernie Sanders unleashed his Medicare for all, single-payer reform plan, now backed by sixteen Democratic senators. More than anything, to make progress on reform of our dying health care system, the nation needs to get to a place where it can engage in serious conversations about such proposals.

I …

If you cut payments to surgeons, don’t be surprised if they do more procedures

Peter Ubel, MD

Health Policy

September 25, 2017

Knee replacements are booming. Between 2005 and 2015, the number of knee replacement procedures in the U.S. doubled, to more than one million. Experts think the figure might rise another sixfold in the next couple of decades because of our aging population.

Since many people receiving knee replacements are elderly, Medicare picks up most of the cost of such procedures. It shouldn’t be surprising, then, that the program is experimenting …

Ranking the world’s health systems: These results may surprise you

Ashish Jha, MD, MPH

Health Policy

September 24, 2017

I was recently by the New York Times’ the Upshot to rank eight health care systems they had chosen: Australia, Canada, France, Germany, Singapore, Switzerland, the United Kingdom, and the United States. This forced me to think about a pretty fundamental question: what do we want from a health care system?

What does an ideal health care system look like?

I would argue that most people want a health …

We have the same end-goals, but disagree on how to reach them

Abigail Schildcrout, MD

Health Policy

September 24, 2017

Early yesterday morning, a 16-year-old child went missing. Early yesterday morning, a woman, in desperate anguish, put out a Facebook post with pictures of her child and asked for help. By late this morning, through the power of social media, the child was found safe.

Two days ago, a Big Ten university football team played a national military academy’s football team. There was an amazing pre-game military tribute, and the half-time …

Health care reform: America really is different from most other countries

Suneel Dhand, MD

Health Policy

September 24, 2017

The debate about the future of health care rages stronger than ever. As someone who grew up and trained in a country with probably the most centrally controlled medical system in the world—the United Kingdom with her NHS—my views have admittedly done a 180 over the last decade. I am no longer as strong a believer in socialized health care as I once was, and actually believe the future for …

Rising premiums, high deductibles, and gaps in coverage before the ACA

Yul Ejnes, MD

Health Policy

September 23, 2017

A guest column by the American College of Physicians, exclusive to KevinMD.com.

By the time you read this, Congress will be in session and hopefully not engaged in another watermelon spitting contest on health care (I’d use a urological metaphor, but there may be children in the room). If our Representatives and Senators choose to …

Here’s how a glucometer turned this doctor against Medicaid for all

Seiji Yamada, MD, MPH

Health Policy

September 22, 2017

In a recent Vox interview, Senator Brian Schatz (D-Hawaii) announced his plans to allow individuals without insurance to buy Medicaid coverage. As a family doctor caring for patients on Medicaid in Senator Schatz’s home state, I cannot support such a plan.

Medicare continues to be run by the federal government. In contrast, Medicaid programs are run by states. The trend in recent decades is for …

The next legislative battle for children’s health

Shetal Shah, MD and Heather L. Brumberg, MD, MPH

Health Policy

September 21, 2017

Twenty years ago, Congress made a commitment to its children when it created the Children’s Health Insurance Program, recognizing working parents who earned too much to qualify for Medicaid still couldn’t afford health insurance for their kids. For pediatricians who remember, the practice landscape was a great deal different then. So many children were uninsured that pediatric emergency rooms were filled with children who needed routine school physicals and regular …

Patients have more power than they may realize

Catherine Cheng, MD

Physician

September 21, 2017

A pediatrician husband recently wrote here in KevinMD about the stark differences in assumptions about work-life balance for men and women, in “What does your husband think of you being a surgeon?” Then I came across another article on Medscape by a male cardiologist, whose wife is also a physician, entitled, “The gender gap in cardiology is embarrassing.” Both men’s wives delayed their medical training, …

Is Medicare for all the future? Only the public can decide that.

Mark Kelley, MD

Health Policy

September 18, 2017

As Congress returns from its summer recess, the health care debate is sure to heat up … again. And over the past few months, the debate has had a significant impact on public opinion.

A recent report describes how Americans currently view the ACA. According to national polls, over 90 percent of Americans would change the current law. Most Democrats would expand ACA coverage while most Republicans …

What does it mean to be a progressive doctor?

Surafel Tsega, MD

Health Policy

September 15, 2017

A curious post popped up on my Facebook feed recently: “Another doctor running for office!” A picture of an attractive family was nestled below that exclamation, asking to show your support (in the form of dollars) for this doctor running as a Democrat for the House of Representatives. It had that sense of enthusiasm that implied I was obligated to be excited, but instead came off more like Jeb Bush’s …

Use your voice to change health care

Michael Weiss, MD

Health Policy

September 15, 2017

I’m pleasantly surprised to see how a growing number of physicians are finally starting to percolate openly with their extreme dissatisfaction about a just how broken our medical system is. I admire and am proud of these brave vanguards who are a minority but have seemed to pick up steam. I still don’t hear their fearless voices carried in major media outlets (shame on these outlets!), but they are more …

Read more…

Use your voice to change health care

Health care reform: A free-market solution works in other countries

Kent Holtorf, MD

Health Policy

September 13, 2017

Repealing and replacing the Affordable Care Act is on indefinite life support. The political consensus was that President Trump needed to pass health care reform to be able to move forward with his legislative agenda. While this may be true, the passing of any repeal and replacement bill without fundamental reforms has little chance of long-term success, likely defining Trump’s presidency as a failure no matter how successful he is …

When we talk about quality, what exactly do we mean?

John Corsino, DPT

Health Policy

September 12, 2017

It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in …

Washington Watch: Health Policy

Washington Watch: Health Policy

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