May 30th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
The development and use of an electronic medical record is extremely important for communication, rapid diagnosis and clinical decision making, increasing efficiency in working up patients, decreasing the cost of duplication of testing and time delays in medical care and treatment.
There are many other advantages of using a functional electronic medical records. A person could be anywhere in the world and have his medical information immediately available. The results of all testing should immediately be communicated to the treating physician. All imaging studies should be digital.
Patients’ physicians could immediately read and use them for their clinical decision making.
These are only a few of the advantages of the electronic medical record. Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 24th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
No Comments »
There is a widespread discrepancy between the opinions of organized medical group leaders in the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and practicing physicians. AMA, AAFP, and ACP are part of organized medicine.
These organizations supported the healthcare reform law in 2010 and continue to support the legislation. I believe they have taken this position because they want a seat at the table as implementation of the legislation moves forward. President Obama has not paid attention to them so far and there is little evidence that he will in the future.
In March of 2010, Speaker of the House Nancy Pelosi famously said, “We have to pass the [health care] bill so that you can find out what is in it.”
Most physicians are starting to realize the implications of President Obama’s Healthcare Reform Act (ACA) (Obamacare). They are terrified about the implications for the practice of medicine.
Organized medicine is still not disenchanted with President Obama’s Healthcare Reform Act. Charles Cutler, MD, chair of the ACP Board of Governors said recently, “The medical community recognizes that so much of the ACA is good.” Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 17th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
“The media is the message.” It does not matter if the policy has failed previously. All that is important is the effectiveness of the policy’s presentation and its ability to manipulate the polls.
The government’s purpose is to work for the people who elected it. It does not seem to be working that way at present. Bureaucrats create rules or regulations as they interpret the laws made by congress and the president. Regulations are controlled by the administration’s ideology. Many times the regulations in one area nullify the intended effect in another area.
Regulations and bureaucracy inhibit the use of common sense in policy making for the benefit of the people.
The people did not have an outlet to express their opinions or frustrations until blogging came into its own seven years ago.
Americans do not like President Obama’s healthcare reform act. They also do not like Dr. Don Berwick’s apparent disrespect for their intelligence and his infatuation with the British healthcare system.
“I am romantic about the NHS (British National Health Service); I love it. All I need to do to rediscover the romance is to look at health care in my own country.” Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 11th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
No Comments »
In an ideal world ACOs should work. There is no evidence that untested and complex organizational structure of ACOs developed by Dr. Don Berwick (head of CMS) will improve quality of care and reduce costs.
ACOs are supposed to provide financial incentives to health care organizations to reduce costs and improve quality. There are too many defects in the ACOs infrastructure to improve the financial and medical outcomes.
At a conceptual level, the incentive for ACOs would be to increase efficiency and avoid overuse and duplication of services, resources, and facilities. In this model, ACO members would share the savings resulting from the increased coordination of care.
I have said over and over again that excessive administrative fees and ineffective management of chronic disease is the main source of waste in the healthcare system. ACOs do not deal with these main drivers of costs.
The only stakeholders who can demand that this waste be eliminated are consumers/patients. Patients must control their healthcare dollars. They will make sure there are competitive prices and will not permit duplication of services. Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 3rd, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow.
Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost.
- Thousands of physicians have been confused by the concept of ACO.
- Many have felt ACOs are an attack on their freedom to practice medicine the best they can.
- Many have rejected the concept because they feel they will have to be salaried by hospital systems.
- Many physicians do not trust President Obama or Dr. Don Berwick.
- The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations.
The two core stated objectives for ACOs are:
(1) Reducing healthcare costs.
(2) Preserving and improving quality.
The stated objectives are laudable. The government regulations and controls are confusing. Read more »
*This blog post was originally published at Repairing the Healthcare System*
