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.

The bureaucratic myth harming American health care

Matthew Hahn, MD

Health Policy

March 3, 2018

There is an accepted storyline in American health care that is so ingrained in our culture that it is almost beyond question. It goes like this. The chief culprit underlying the high-cost, low-quality American health care system is the traditional fee-for-service payment model, which rewards physicians for the volume of services they provide with no consideration for the quality of care being delivered.

The answer, the story goes on to say, …

How to incentivize higher quality and lower cost in U.S. medical care

Samuel Falkson

Health Policy

February 28, 2018

U.S. health care costs are high – over $3 trillion annually and about 18 percent of our GDP. Estimates suggest that our costs are rising. Concomitantly, we are entering an era of extreme biomedical promise, where research breakthroughs are translating into unprecedented clinical benefit.

Luxturna from Spark therapeutics, for example, remarkably restores vision loss in patients with a specific eye disease. With amazing innovations, …

This is what’s missing from medical education today

Suhas Gondi

Medical Education

February 28, 2018

When my classmates and I returned to Boston to continue our first year of medical school early last month, we returned to a very different type, of course, called “Essentials of the Profession.” In it, we explored health policy, social medicine, ethics, and other topics outside the realm of traditional physiology and disease but just as important to our roles as physicians. In the health policy class, we learned about …

The patient-physician relationship is in critical condition

Ryan Enke, MD

Health Policy

February 25, 2018

The state of medicine in America is a highly discussed topic today. The reports are rarely positive. Politicians battle for control over their vision for health care and predict doom and gloom if the other side “wins.” The cost of health care continues to rise for employers and employees. Physician burnout and dissatisfaction are on the rise. We hear from politicians, media outlets, and others on how to fix the …

Here’s why health insurance is different from other insurance

Joseph Crisp

Health Policy

February 19, 2018

Anyone who has ever tried to buy health insurance in the open marketplace knows how difficult and expensive it can be. I spent years working at jobs that did not provide health insurance, and I remember the annual feeling of dread when I received notice of the new premium increase. The only way I could keep the cost affordable was by continually raising the deductible until eventually, I was paying …

Why is health care so expensive in the United States?

Scott Treutlein, MD

Health Policy

February 16, 2018

CNN recently posted an article online, asking this very question. It was posed in the guise of our leading mega-billionaires, Warren Buffet, Jeff Bezos, and Jamie Dimon, “fixing” our broken health care system. In actuality, these three industry giants announced plans to combine resources to create their own insurance system for their combined 850,000+ employees. A nice gesture, to be sure, but not really a panacea for a nation of …

Health equity is the missing value in value-based payments

Christopher J. Frank, MD, PhD

Health Policy

February 14, 2018

The way doctors and hospitals are paid is undergoing a quick and quiet revolution in an attempt to control costs and improve health outcomes. Federal payers are driving this change from fee-for-service payments to reimbursements based on quality outcomes and measurements of clinical processes. This focus on clinical outcomes does not account for the deep inequities that drive poor health outcomes in the United States. Without measuring and paying for …

The fire and fury of Trump’s diet

Shivam Joshi, MD

Physician

February 13, 2018

As a physician, I am totally disgusted by what President Donald Trump eats — and you should be too. His standing order on Trump Force One is reminiscent of a fast-food bacchanalia, comprised of “two Big Macs, two Filet-O-Fish, and a chocolate malted” according to the recently released book by his former campaign manager Corey Lewandowski and top aide David Bossie.

But it doesn’t stop there: Trump …

Read more…

The fire and fury of Trump’s diet

The psychology of Trumpism: scientific assessment versus relentless antagonism

David Kerr, MD

Physician

February 13, 2018

2017 has been open season on the psyche of the 45th president of the United States. Psychiatrists and psychologists have gone public to express their concerns about his perceived state of mind despite the established Goldwater rule that it is unethical for them to diagnose mental illness in a living public figure they haven’t examined and whose consent they have not obtained. The consensus seems to be the Donald J. …

Immigrant health care workers serve a vital function within the American health care system

Raymond Jean, MD

Physician

February 2, 2018

Early this month, it was reported that President Donald Trump, having grown frustrated from discussions regarding a bipartisan deal on immigration, asked why proposals continued to provide special protections for immigrants from the countries of El Salvador and Haiti, and the continent of Africa. He reportedly exclaimed, “Why are we having all these people from sh*thole countries come here?” The statement has been largely denounced both at home and abroad, and …

Doctors must take a stand and force the government to cancel MACRA

Matthew Hahn, MD

Health Policy

February 1, 2018

The most profound health care legislation enacted since the Affordable Care Act, The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a huge mistake. It adds another vast layer of bureaucracy to a health care system already overburdened by such things, and penalizes physicians who take care of the most complicated patients. The head of the Centers for Medicare and Medicaid Services (CMS), who administer the program, admits …

Exploring 2 roads to universal health coverage

Cody Mullens

Health Policy

January 30, 2018

“Of all forms of inequality, injustice in health care is the most shocking and inhumane.”
– Martin Luther King, Jr.

I am very strongly of the opinion that equal access to quality health care should not be regarded as a privilege but rather ought to be viewed as one of the most basic right afforded to all. Much of the industrialized world agrees with this notion based on the infrastructure of health …

If politicians really want to address the problems in health care, this is what they should do

Linda Girgis, MD

Health Policy

January 20, 2018

Americans witnessed the many failed attempts of our elected officials to reform our broken health care system over the past year. Some call for repealing and replacing the Affordable Care Act (ACA) while others think it is the cure-all for what ails our system. The simple fact that politicians fail to consider is the fact that having health care coverage does equate to actually receiving health care services.

In fact, the …

Should medical school encourage political thought?

Faiz Kidwai

Health Policy

January 15, 2018

Many medical schools don’t encourage political thought in their students, far less nurture it. That’s a shame because it squanders an opportunity to equip future thought leaders to deal with serious concerns facing the U.S. population, many of which have their tentacles in politics.

In “Experiencing Politics,” a memoir about his 12-year stint in the …

Expanding coverage and cutting health care costs: ideas for 2018

Cedric Dark, MD, MPH

Health Policy

January 8, 2018

The controversy over health care reform often boils down to two issues: coverage and cost. The Affordable Care Act (ACA) made significant impact on the coverage issue, dropping the uninsured rate below 10 percent for the first time in the recorded history of the United States, covering 20+ million Americans in the 8 years since it was passed, and putting the United States on a reasonable …

An argument in favor of single-payer health care

David Penner

Health Policy

January 5, 2018

It is the year 2018, and patients don’t always receive good care and doctors questions their career choice. How have we arrived at this tragic state of affairs? The answer is that our for-profit health care system is the principal cause — not only of poor patient care but physician burnout. Only a single-payer system, which is anchored in the idea that good health care is an inalienable right and …

Doctors: It is never too late to step up and fulfill the true potential of your voice

Charlene Gaw

Medical Education

January 4, 2018

I entered medical school with an intense desire to take care of others. A naturally — sometimes overbearingly — caring person with a penchant for science, becoming a physician was my dream since middle school.

My naiveté was quickly slapped by reality when I realized people enter medicine for many other reasons: prestige, job stability, income or a genius fascination of science that sometimes overlooks the suffering human. This crushed my …

Do physicians make the best politicians?

Anonymous

Physician

January 4, 2018

Even though we have probably 20 years of work remaining as physicians, like a lot of you, I like to think about how we will spend our retirement years. After all, in twenty years we will still only be in our early fifties, hopefully with no dependents and a lot of financial security. Of course, my wife and I are interested in traveling, spending time with grandchildren (hopefully), gardening and …

Why do people hate Obamacare?

Julie Rovner

Health Policy

December 26, 2017

The Affordable Care Act, a.k.a. “Obamacare,” has roiled America since the day it was signed into law in 2010. From the start, the public was almost evenly divided between those who supported it and those who opposed it.

They still are. The November monthly tracking poll from the Kaiser Family Foundation found that 50 percent of those polled had a favorable view of the health law, while 46 …

Read more…

Why do people hate Obamacare?

Should President Trump be tested for degenerative brain disease?

Ford Vox, MD

Physician

December 23, 2017

When President Trump slurred his words during a news conference this week, some Trump watchers speculated that he was having a stroke. I watched the clip and, as a physician who specializes in brain function and disability, I don’t think a stroke was behind the slurred words. But having evaluated the chief executive’s remarkable behavior through my …

Washington Watch: Health Policy

Washington Watch: Health Policy

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