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Is The Healthcare Industry Calling The Shots?

Why has health care reform run into so much trouble?

Well, it could be because people think reform plans will affect them in ways they aren’t going to like.  Or because people don’t believe politicians in Washington who say that spending huge amounts of money will actually save money.  Or because confusing mixed messages and ever-shifting sales pitches create a lot of anxiety about what’s really going on.  It could be all of those things.

Or, it could be something more….sinister…. Read more »

*This blog post was originally published at See First Blog*

Why Price Controls Will Make Healthcare Worse

Massachusetts Governor Deval Patrick announced this week he has had enough of rising health care costs.

So he is proposing a novel solution: make them illegal.

Well, it’s not fair to call this idea “novel.”  Governments have tried price controls for 40 centuries.  And even though they don’t work, they keep trying.  The explanation isn’t complicated.  It’s an easy way for a politician to seem to do something about rising prices.  In this case, it won’t do much about the underlying problem, but it is a terrific way for a governor to look like a man of action. Read more »

*This blog post was originally published at See First Blog*

The US Is Number One…

… in national health care expenditures, that is. This, of course, is nothing new: spending on health care in the U.S. has long out-paced any other industrialized country. What is noteworthy is “the largest one-year increase in [health care's] GDP share since the federal government began keeping track in 1960″ blogs Chris Fleming, of Health Affairs. He writes that a new study shows that health care spending increased by an estimated 5.7 percent since 2008 despite a projected decline in the gross domestic product (GDP) in the same period.

The recession is having a big impact on respective roles of the public and private sectors. “Health spending by public payers is expected to have grown much faster in 2009 (8.7 percent growth, to $1.2 trillion) than that of private payers (3.0 percent growth, to $1.3 trillion)” Fleming writes, which is attributable to an increase in “projected growth in Medicaid enrollment (6.5 percent) and spending (9.9 percent) as a result of increasing unemployment related to the recession. Conversely, enrollment in private insurance is expected to have declined 1.2 percent in 2009, despite federal subsidies for Americans who have lost their jobs to extend their private insurance coverage via the Consolidated Omnibus Budget Reconciliation Act (COBRA) that increased participation in these plans.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Government Spending On Healthcare Outpaces Other Sources

Much of the debate about the health reform has been on whether or not it will lead to government-run health care. But the fact is that the government’s share of health care spending already is growing at a faster rate than private spending, a trend accelerated by the recent economic recession.

A new report from Medicare’s actuaries, published in the journal Health Affairs, found that “Federal government spending for health services and supplies increased 10.4 percent in 2008 . . . and accounted for almost 36 percent of federal receipts, up considerably from 28 percent in 2007. By comparison, spending for health care by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance premiums paid for by employers” while “health care spending by households grew 4.3 percent in 2008, a deceleration from 5.9 percent growth in 2007″ but still more than the adjusted personal income growth of 2.7%.

The current economic recession, the authors say, had two major impacts on health spending: Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

When Cardiologists Sue The Government

It’s sad that cardiologists have had to sue as their last resort to save their practices:

“Heart specialists on Monday filed suit against Secretary of Health and Human Services Kathleen Sebelius in an effort to stave off steep Medicare fee cuts for routine office-based procedures such as nuclear stress tests and echocardiograms.

The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government’s planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures.

Perhaps other professional organizations will be forthcoming with similar suits as private doctors and their patients pay dearly for the reform efforts underway. Read more »

*This blog post was originally published at Dr. Wes*

Electronic Medical Records: An Analogy For Meaningful Use

Fricking Brilliant.via Neil Versel

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

Threat Of Medical Malpractice Is The Only Force Opposing Healthcare Rationing

DrRich’s conviction that covert rationing is the engine that drives many (if not most) of the bizarre behaviors we see in the American healthcare system leads him to take positions on certain contentious issues that do not endear him to either his progressive or his conservative friends.

One of these issues is malpractice liability reform.

DrRich wrote about this some time ago (here and here), and as a result managed to alienate more than a few of his readers, especially the ones who are doctors. So if he were smart, DrRich would leave it alone. (After all, a lot of readers have long since forgotten precisely why they do not like DrRich, and merely harbor toward him a vague sense of unease and distrust. This, DrRich finds, he can live with.)

But a couple of things prompt DrRich to take up this topic once again.  Read more »

*This blog post was originally published at The Covert Rationing Blog*

Will Spending More Federal Money On Healthcare Improve Outcomes?

One need only look at the experience with education.

*This blog post was originally published at A Happy Hospitalist*

Red Tape Alert: New FDA Rule Puts Allergan In A Double Bind

I was reading my daily MedPage Today news, when I came across this amusing example of regulatory unintended consequences. As we all know, pharmaceutical companies are not allowed to promote off-label uses of their medications - doing so is punishable with billions of dollars in fines (just ask Pfizer). But a new set of rules created by the FDA’s Risk Evaluation and Mitigation Strategies (REMS) program essentially requires Allergan to provide safety information about off-label uses of the drug — uses that are illegal for them to discuss.

So Allergan has to file a law suit to resolve the issue of being required (by the government) to do something the government considers criminal.

And the winner is?

Lawyers!

Disability Determinations & How Social Security Workers Make More Than Physicians/Hour

This week, like many doctors in primary care, I was sent a request by the Social Security to provide “medical evidence” that one of my patients was disabled so they could collect Social Security benefits. As part of that request, I was asked to provide evidence since June 6th, 2007, that my patient qualified for disability on the basis of “alleged” diagnosis of “Heart Disease.”

I was asked to send “copies of records or a narrative report including diagnosis, medical history, laboratory findings, treatment and response to treatment.” Beyond this, I also had to include physical and emotional impairment assessments and a functional assessment of their ability to sit, stand, walk, lift carry, handle objects, hear, speak, travel, and wash their car, view films, and eat bon bons (well, kind of).

And for this copying, writing, mailing, collating what might I see from the government to compensate my time? Well, if I attach this invoice that requires a Federal Employee Identification Number filed through form W-9 available at www.irs.gov (yes, Virginia, this compensation is taxed), I might receive…

…drum roll, please…

… twenty dollars.

Now looking up the lowest paygrade of Social Security worker’s annual compensation of $29,726 and accounting for the 13 vacation days, 13 paid sick leave days, and 10 federal holidays they get paid, I estimate the least expensive Social Security employee makes a bit more than $16.50 an hour.

If we assume that the paperwork they just asked for takes about 2 hours collectively of office staff and doctor time, I think it’s clear that doctors’ payment for this service provided on behalf of our patients is substantially less than what the Social Security administration pays their own staff.

I wonder what else the government has in store for us.

-Wes

*This blog post was originally published at Dr. Wes*

Latest Interviews

Dr. Val Reports Live From HIMSS To ABC News

httpv www.youtube.com watch v KDGYwm ty…

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How Much Does Technology Improve Health?

Watch CBS News Videos Online Last week’s CDC report Health United States confirms that Americans are increasingly turning to medications scans and procedures to improve their health. Exercising eating right and weight loss not so much. Don’t get me wrong. I love technology as much as the next guy. Maybe…

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Latest Cartoon

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Latest Book Reviews

Saved By Dance: One Doctor’s Story Of Burnout And Recovery

By Susan Biali M.D. Ten years ago I was an emergency medicine resident and wanted to die. Today I’m a general practitioner in part-time practice and in love with life. What made the difference I signed up for a dance class. Reports on physician burnout list the personality traits that…

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Genius On The Edge - The Life Story Of Dr. William Stewart Halsted

I am one who loves medical history and Genius On The Edge the bizarre double life of Dr. William Stewart Halsted was a captivating read. For those who don t know Dr. Halsted is known as the Father of Surgery and practiced medicine after the civil war. Written by author…

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Book Review: Genius On The Edge

I received a free copy of the book Genius on the Edge The Bizarre Double Life of Dr. William Stewart Halsted by Gerald Imber MD a week ago. I have enjoyed reading it. The book is the biography of Dr Halsted but also gives you a glimpse into the life…

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