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Are Most ER Visits Unnecessary?

Much of the ongoing healthcare reform debate has focused on unnecessary healthcare expenses—specifically, medical bills that rack up without demonstrably improving people’s health. According to Peter Orszag, the director of the Federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud.

At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors’ offices. If we could only convince patients to take their stubbed toes to urgent care clinics or primary care offices instead of ERs, the thinking goes we could save a load and help fix this whole healthcare fiasco. But there are a few problems with this logic. See:

Are most emergency room visits really unnecessary? – By Zachary F. Meisel and Jesse M. Pines, Slate Magazine

It’s a short, well-written article. It makes some good points and being an EM doctor I happen to agree with most of them, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit. The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles (that includes me.) 

*This blog post was originally published at GruntDoc*

What Primary Care Physicians Need To Know About Healthcare Reform

DrRich is obviously far more intelligent than those wayward Democrat Congresspersons, whose last-minute “yes” votes Speaker Pelosi is seducing with her winning smile, and with her double-super-hope-to-die promise that the Senate will surely agree with the reconciliation package the House has finally assembled.

Unlike Pelosi’s reluctant Blue Dogs, DrRich understands that once the House has deemed the Senate bill to have been passed, and the President signs it into law, and the confetti drops and the champagne pops and the press goes into raptures and the work begins to revise Mt.Rushmore, the odds immediately become vanishingly small that the President, the Senate, or even the 200 House Democrats who really like the new law, will actually then embark on a new, prolonged, contentious spectacle of a reconciliation fight in the Senate.

Rather, once healthcare reform becomes law, political expediency dictates that we in the teeming masses never hear another word about healthcare until after the November elections. We will be distracted by more pressing matters, from which there will be many to choose — gasoline prices, Iranian nuclear weapons, economic collapses in the PIIGs, etc.

Now, DrRich does not have the stamina to study the new law all at once as a whole. He must bite off little pieces. And the first thing he sought in embarking on his study of our new healthcare system was evidence of how the new law would rescue the Primary Care Physician (PCP). Read more »

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

How Does Healthcare Reform Affect People with Diabetes?

I can haz a question?The healthcare reform bill “doesn’t fix everything that’s wrong with our health care system, but it moves us decisively forward,” said the President.  Insurance companies will be under government regulations, coverage can’t be denied based on pre-existing conditions, and the bill is signed.

Wait…coverage can’t be denied based on pre-existing conditions?  

According to this New York Times editorial, “The biggest difference for Americans who have employer-based insurance is the security of knowing that, starting in 2014, if they lose their job and have to buy their own policy, they cannot be denied coverage or charged high rates because of pre-existing conditions. Before then, the chronically ill could gain temporary coverage from enhanced high-risk pools and chronically ill children are guaranteed coverage.”  

I’ve always wanted to take that leap and run my own business. I enjoy working in new media and healthcare, I like working hard, but what kept me from making a bold move was pure and unadulterated fear. Read more »

*This blog post was originally published at Six Until Me.*

6 Reactions To The Healthcare Reform Plan

Since the 2000 Presidential election, and most especially since the world-changing events of October 17, 2004, I’ve known this: Don’t assume anything is over until it’s over. Still, I’m going to bed so I’m going to give you my six quick reactions to the healthcare reform plan, based on the assumption it’s about to get voted in:

UPDATE: I stayed up and it passed.

1.  It’s Historic. It is, but mostly because people keep saying that it is.  I mean the President of the United States has gambled most of what he’s got on this, so it’s one for the history books in that sense.  Still, a health care program that was truly historic would be something like taking all of the uninsured and just enrolling them immediately in Medicare.  This plan doesn’t come anywhere close to doing that.  Much of what is meant to deal with the serious problem of the uninsured doesn’t start for years, and is going to be handled through a complicated mechanism that may not even work.  I suspect the history-making part of this will have to do more with the political fortunes of the Democrats and President than American health care. Read more »

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

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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