August 13th, 2011 by DrWes in Health Policy, Opinion
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You could see the frustration in his eyes as he spoke to his fellow resident.
“I had to fork over eight hundred and thirty five dollars,” he said slowly in a disgusted tone, “… and that doesn’t even include the $300 state license fee we have to pay later….”
So much for starting our EKG conference on time.
The comments continued. No one could understand why medical school licensure has become so expensive in the US. I thought I’d look into what medical students can expect to pay these days for licensure since it had been a while since I had gone through the gauntlet. Here’s what I found out: Read more »
*This blog post was originally published at Dr. Wes*
June 14th, 2011 by DavidHarlow in Health Policy, Opinion
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There has been a significant outcry against the proposed ACO regs: everything’s wrong and nothing’s right about them, or so some would have us believe. (The comment period is still open, and CMS is still soliciting input; much of the outcry is a form of posturing and negotiation … not that there’s anything wrong with that.)
Today’s “nattering nabobs of negativism” focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure incuded), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the premature pledging of allegiance to an idea only partly proven through the PGP demo, the likelihood of failure due to the whole endeavor’s being tied to FFS reimbursement, on the one hand, and due to exposure of ACOs to downside risk, on the other, the unreasonable reliance on dozens and dozens of quality measures . . . and the list goes on. For further detail, see, e.g., David Dranove’s recent post decrying unproven theories baked into the ACO program (with a link to info on the PGP demo’s results, and differing interpretations of those results; check out the lively discussion in the comments to Dranove’s post on The Health Care Blog), Jeff Goldsmith’s opposition to ACOs as conceived in the ACA (and alternative proposal discussed in the linked post), and Mark Browne’s search for a few good quality measures. (This has been a recurring theme for me as well; I would love to find six or eight meta-measures that predict all others; Mark links to the AHA’s comments on the ACO rule, which are worth a read). Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
June 12th, 2011 by GarySchwitzer in News
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Those who market heart scan services should be more careful about what they promote and to whom.
When ProPublica’s Marshall Allen got a telemarketing offer for heart scans for him and his wife, he followed up with a story, “Body Imaging Business Pushes Scans Many Don’t Need – Including Me.”
Reminding Allen about the deaths of figure skater Sergei Grinkov, baseball player Darryl Kile, newsman Tim Russert and actor Patrick Swayze, the salesman said:
“You never know when it could happen. … Boom, you’re dead!” he exclaimed, slapping a desk for emphasis.
But Allen tells another story – of complaints by patients and regulators about the business. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
June 11th, 2011 by Shadowfax in Opinion
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It’s ever so satisfying to be proven right. Well, maybe “proven” is too strong a word to use, but there is a bit of strong evidence that, as I have said in the past, the practice of defensive medicine is driven by powerful multifactorial incentives and is very unlikely to change even if the most often-asserted motivator, liability, is controlled. Today, Aaron Carroll guest blogs at Ezra Klein’s WaPo digs:
The argument goes that doctors, afraid of being sued, order lots of extra tests and procedures to protect themselves. This is known as defensive medicine. Tort reform assumes that if we put a cap on the damages plaintiffs can win, then filing cases will be less attractive, fewer claims will be made, insurance companies will save money, malpractice premiums will come down, doctors will feel safer and will practice less defensive medicine, and health-care spending will go way down.[...]
Health Affairs in December, estimated that medical liability system costs were about $55.6 billion in 2008 dollars, or about 2.4 percent of all U.S. health-care spending. Some of that was indemnity payments, and some of it was the cost of components like lawyers, judges, etc.; most of this, however, or about $47 billion, was defensive medicine. So yes, that is real money, and it theoretically could be reduced.
The question is, will tort reform do that? Read more »
*This blog post was originally published at Movin' Meat*
June 5th, 2011 by Edwin Leap, M.D. in Opinion
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This is my column in June’s EM News.
‘But you’re a rich doctor, right?’ Have you had that conversation? There’s a certain expectation of physicians, that we’re all just filthy rich, overflowing with boxes of cash tucked neatly away beneath our gilded beds.
When we were building our house, our builder talked with my wife: ‘Jan, I want you to meet me to look for counters and cabinets. Don’t bathe the kids. Put them in dirty play clothes and don’t wear anything nice. Don’t ever tell them your husband is a doctor.’ He’s a wise man. What he knew was that the word ‘doctor’ means ‘cash.’ Or at least, means ‘cash’ to the popular mind.
I wonder if this perception is the reason patients come to the emergency department and say things like this: ‘I don’t have any money to go to the dentist, so I came here.’ It’s the belief that we come to our jobs already in possession of large amounts of money. Granted, there are some physicians who come from wealthy families. The majority, however, do not. And no one does that to any other professional. ‘I’d like a house built to order, and I know you’re a rich contractor. I can’t pay you, so get to work! Or else I’ll sue!’
Nevertheless, from patients to insurers, real-estate agents to contractors, attorneys to government and hospital officials, the belief is straightforward. MD means ‘Mucho Denaro.’ Witness the hospital in Pennsylvania that recently began Read more »
*This blog post was originally published at edwinleap.com*
