NEJM Blasts “Crusade,” Omits that Its Former Editor Launched It
By MICHAEL MILLENSON
A blistering attack by the national editor of the New England Journal of Medicine against the “less is more” movement in medicine omitted that the publication’s former editor-in-chief played a foundational role in popularizing the idea of widespread medical waste.
The commentary in late December by Dr. Lisa Rosenbaum, “The Less-Is-More Crusade – Are We Overmedicalizing or Oversimplifying?” has attracted intense attention. Rosenbaum berates a “missionary zeal” to reduce putative overtreatment that she says is putting dangerous pressure on physicians to abstain from recommending some he...
Source: The Health Care Blog - January 19, 2018 Category: Consumer Health News Authors: Matthew Holt Tags: Economics Physicians Michael L. Millenson NEJM Source Type: blogs
The Individual Mandate ’s Dead. What Happens Next?
By STEVEN FINDLAY
The demise of the ACA individual mandate, along with Trump’s and Republicans’ efforts to repeal Obamacare in 2017, will trigger in election year 2018 a new phase of the long-running, bitter battle over the fate of ACA, the insurance marketplaces, and the direction of health reform in general.
Surprisingly, the Democrats appear to have the upper hand for the moment. Republican efforts to repeal the ACA in 2017 were deeply unpopular—only about 20 percent of the U.S. population supported them. Independents and moderate Republicans, in Congress and among voters, were notably opposed. And in the Sen...
Source: The Health Care Blog - January 11, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACA Individual mandate Medicare For All Trump Source Type: blogs
Healthcare for the Uninsured Is Wasteful (For a Surprising Reason)
Shutterstock American physicians dole out lots of unnecessary medical care to their patients. They prescribe things like antibiotics for people with viral infections, order expensive CT scans for patients with transitory back pain, and obtain screening EKGs for people with … Continue reading →
The post Healthcare for the Uninsured Is Wasteful (For a Surprising Reason) appeared first on PeterUbel.com. (Source: blog.bioethics.net)
Source: blog.bioethics.net - January 10, 2018 Category: Medical Ethics Authors: Peter Ubel Tags: Health Care health insurance health policy Medicare Peter Ubel syndicated Uncategorized Source Type: blogs
Expanding coverage and cutting health care costs: ideas for 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 path toward universal coverage.
Despite its name, however, the ACA has not made health care “affordable” for the vast majority of Americans. While the individual marketplace has offered reasonable, comprehensive coverage to nearly ...
Source: Kevin, M.D. - Medical Weblog - January 8, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cedric-dark" rel="tag" > Cedric Dark, MD, MPH < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs
CHIPping away at the social contract
And then there were none
Long before the arrival of the Obama Administration with its explicit goal of expanding health insurance coverage to everyone, the country had achieved consensus on the need to insure all children. The Children’s Health Insurance Program (CHIP), first enacted in 1997, enables relatively low income families who don’t qualify for Medicaid to get low cost, high quality insurance for their kids.
Congress let funding for the program expire at the end of September. CMS and the states have been scrambling to shift other funds around to keep the program going. But time is now running out.
Alaba...
Source: Health Business Blog - December 20, 2017 Category: Health Management Authors: dewe67 Tags: Health plans Policy and politics CHIP Doug Jones Medicaid Source Type: blogs
On the Morality of Insurance Premiums
By ANISH KOKA, MD
As CVS-Aetna merger talks fill the air this Christmas season and experts weigh in on the impact this will have on the economy and consumers alike, I’m sitting at a little desk in a little office contemplating health insurance.
I run a little shop that’s about as far from CVS-Aetna as you can get in the health care space : a solo practice doctor with four full time employees and revenues a little south of $65 billion dollars. I shouldn’t feel too alone. Small businesses account for 99% of US firms and employ almost half of all private sector employees. But knowing my problem is one shared b...
Source: The Health Care Blog - December 11, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized ACA Anish Koka CVS-Aetna IRS Source Type: blogs
The hidden work of primary care
It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me for a minute, just to ask a quick question.” After many years working in community health, I know these types of requests are rarely “quick,” but, understanding our patients’ limited opportunities access to care, I obliged.
As soon ...
Source: Kevin, M.D. - Medical Weblog - December 11, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michelle-nall" rel="tag" > Michelle Nall, MPH, ANP-BC < /a > Tags: Policy Primary Care Source Type: blogs
The Future Of Telemedicine Doesn ’t Depend On Health Plans Anymore
For as long as I can remember, the growth of telemedicine depended largely on overcoming two obstacles: bandwidth and reimbursement. Now, both are on the verge of melting away.
One, the availability of broadband, has largely been addressed, though there are certainly areas of the US where broadband is harder to get than it should be. Having lived through a time when the very idea of widely available consumer broadband blew our minds, it’s amazing to say this, but we’ve largely solved the problem in the United States.
The other, the willingness of insurers to pay for telemedicine services, is still something of an issue...
Source: EMR and HIPAA - December 6, 2017 Category: Information Technology Authors: Anne Zieger Tags: Digital Health EHR Electronic Health Record Electronic Medical Record EMR Healthcare Healthcare Business HealthCare IT Healthcare Reimbursement Population Health Management Telemedicine Value Based Reimbursement Virtual Reality B Source Type: blogs
ACA Subsidies and Labor Market Participation
Since the passage of the Affordable Care Act (ACA) in 2010, many economists have predicted that the Act will cause a reduction in labor market participation and a recentNew York Timesarticle seemingly vindicates these expectations. The article recounts how the rapid increase in insurance premiums have led Anne Cornwell to cut her working hours, and thus her yearly income, by 30 percent in order to be eligible for health insurance subsidies. The $24,000 reduction in income allowed Ms. Cornwell and her husband to qualify for $27,000 in subsidies.Ms. Cornwell ’s reduced labor market participation supports economists’ pred...
Source: Cato-at-liberty - December 5, 2017 Category: American Health Authors: Peter Van Doren Source Type: blogs
How the Republican Tax Cuts Will Impact the Health Care System
Conclusion
The U.S. spends a whooping amount on health care—across the board. Its’ commitments in this area of the economy are huge. Health spending is forecast to rise at a rapid clip over the next decade. Without substantial changes in the way we pay for health care that leads to a reduction in the rate of increase, rising expenditures are unavoidable and become unsustainable if other societal needs are to be met.
Tax cuts and reforms that add to deficit spending and seek to reduce health care spending growth by (a) slashing budgets, (b) eliminating coverage or benefits and/or (c) shifting costs to consumers—withou...
Source: The Health Care Blog - November 29, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CBO Corporate Tax Rate Tax system Source Type: blogs
Purging Healthcare of Unnatural Acts
BY UWE REINHARDT
In tribute to Uwe we are re-running this instant classic from THCB’s archives. Originally published on Jan 31, 2017.
Everyone knows (or should know) that forcing a commercial health insurer to write for an individual a health insurance policy at a premium that falls short of the insurer’s best ex ante estimate of the cost of health care that individual will require is to force that insurer into what economists might call an unnatural act.
Remarkably, countries that rely on competing private health insurers to operate their universal, national health insurance systems all do just that. They allow...
Source: The Health Care Blog - November 21, 2017 Category: Consumer Health News Authors: John Irvine Tags: Repeal Replace Trending Uwe Reinhardt Source Type: blogs
Changes to 340B Program Reduces Hospital Reimbursement for Pharmaceutical Products by 28.5%
Recently, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period (CMS-1678-FC), which includes updates to the 2018 rates and quality provisions, and other policy changes. CMS adopted many policies that will support care delivery; reduce burdens for health care providers, especially in rural areas; lower beneficiary out of pocket drug costs for certain drugs; enhance the patient-doctor relationship; and promote flexibility in healthcare. This final rule p...
Source: Policy and Medicine - November 14, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
3 steps to a better health care system
A friend recently asked me, “Where do we go from here?” The friend was referring to our impasse with health care in America. The Democrats have failed to repair the Affordable Care Act, and the Republicans have failed to repeal or replace it.
With the status quo, I can understand our health care system providing lower quality care compared to its counterpart industrialized nations. I can even tolerate lack of access to health care to millions of uninsured Americans. However, what is not acceptable and a path toward disaster for our health system and for the national economy and even American supremacy in the world is...
Source: Kevin, M.D. - Medical Weblog - November 12, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/manoj-jain" rel="tag" > Manoj Jain, MD, MPH < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs
Practicing Medicine While Black
By KIP SULLIVAN, JD
The managed care movement thrives on misleading words and phrases. Perhaps the worst example is the incessant use of the word “quality” to characterize a problem that has multiple causes, only one of which might be inferior physician or hospital quality. [1] To illustrate with a non-medical analogy, no one would blame auto repair mechanics if 50 percent of their customers failed to bring their cars in for regular oil changes. We would attribute the underuse of mechanics’ services to forces far beyond the mechanic’s control and would not, therefore, refer to the problem as a “quality” problem...
Source: The Health Care Blog - November 9, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
