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Healthcare Reform Law Is Gaining Public Support

GOP hardliners soon to be in control of the House have made repeal of the detested healthcare reform law a cornerstone of their agenda, despite the impossibility of actually being able to repeal it, politically, at least until an election or two has passed, and despite the fact that their ascent to power had more to do with the terrible economy and high unemployment than any mandate to repeal the law.

It seems that, finally, there may be movement towards increased public support for the law. A new McClatchy poll shows a majority of Americans now in favor of the law:

A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll.

The post-election survey showed that 51 percent of registered voters want to keep the law or change it to do more, while 44 percent want to change it to do less or repeal it altogether.

Driving support for the law: Voters by margins of 2-1 or greater want to keep some of its best-known benefits, such as barring insurers from denying coverage for pre-existing conditions. One thing they don’t like: the mandate that everyone must buy insurance.

Of course, it is the mandate that makes the whole thing hang together. And it’s hardly news that people like the individual provisions and protections found within the law. Read more »

*This blog post was originally published at Movin' Meat*

Where’s My Government-Provided Healthcare?

Freshman Republican Congressman Andy Harris, who was elected on a promise to repeal the Patient Protection and Affordable Care Act (PPACA), is outraged that he’s going to go a whole month before his government-provided health insurance kicks in. From Politico:

A conservative Maryland physician elected to Congress on an anti-Obamacare platform surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in.

Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1st –- 28 days after his Jan. 3rd swearing-in.

“He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” said a congressional staffer who saw the exchange. The benefits session, held behind closed doors, drew about 250 freshman members, staffers and family members to the Capitol Visitors Center auditorium late Monday morning.”

All the more embarassing because he’s a doctor, for Pete’s sake. You’d think he’d have a better idea of how insurance works. Guess the dude’s never heard of COBRA. Also, it’s pretty standard that this is how enrollment happens. And it’s idiots like this that want to repeal the PPACA. Read more »

*This blog post was originally published at Movin' Meat*

Drug Seekers And A New Threat

I wish I could say that every patient encounter worked out well, that all my patients went home happy and satisfied. It would be nice, but unfortunately that is not true at all.

There are many patients who present with unrealistic expectations or an agenda which is non-therapeutic, and I am relatively straightforward and unapologetic about correcting patient’s misconceptions about the care that is or is not appropriate in the ED. Unsurprisingly, this often though not always involves narcotic medications.

Which is not to say that I am a jerk. I try to be compassionate, and I try to find alternative solutions, and I have been told that I can turn away a drug seeker more nicely than any other doctor in the department. But when it is time to say “no,” I say “no” firmly and without evasions or excuses. People don’t like to hear that, and all the more so in this “the consumer is king” environment of customer-service culture we foster in the medical industry these days.

So when I do say “no,” as nice as I try to be, some people get upset. Sometimes they escalate. They hurl insults, spit, throw themselves on the floor and throw a fit or feign unconsciousness. Read more »

*This blog post was originally published at Movin' Meat*

Light Shed On The Corruption Of The RUC

Interesting [recent] front-page article in the Wall Street Journal (WSJ) about the American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC). From the WSJ:

Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.

The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement. […]

The RUC, as it is known, has stoked a debate over whether doctors have too much control over the flow of taxpayer dollars in the $500 billion Medicare program. Its critics fault the committee for contributing to a system that spends too much money on sophisticated procedures, while shorting the type of nuts-and-bolts primary care that could keep patients healthier from the start — and save money.

I’m glad to see the RUC getting some much-needed scrutiny, and skeptical scrutiny at that. But they miss the point with the “fox watching the henhouse” angle, or at least they paint with too broad a brush. Read more »

*This blog post was originally published at Movin' Meat*

Accountable Care Organizations: The Gathering Storm?

Those of you who’ve read this blog for any length of time know that I have been a pretty strong advocate for healthcare reform. This has been primarily motivated by my passion for universal coverage, but also with my frustration with the cost of the current healthcare system, the generally crummy outcomes, and the overall level of fragmentation in the whole affair.

Even today, I had to repeat blood tests on a cancer patient who came to the ER. He had had blood tests at the cancer center ACROSS THE STREET before presenting, but, so sorry, our computers don’t talk to theirs and it’s after 5pm now, so forget about getting those results. 

So it’s with a mixture of enthusiasm and dread that I consider the coming onslaught of accountable care organizations (ACOs). What are ACOs? They’re the buzzword of the day, that’s for sure. Everybody knows they’re the next big thing. They’re coming. We’ll all be in an ACO by next Tuesday for sure. It’ll be nirvana. Right? Read more »

*This blog post was originally published at Movin' Meat*

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