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Healthcare Bill Signed: Just How Many Pens Did Obama Use?

Count the pens. News reports said that the president signed healthcare reform into law with either 20 (The New York Times) or 22 pens (Everyone else). The White House posted the ceremony on YouTube so you can count for yourself, starting at 25 minutes into the 27-minute ceremony, when Mr. Obama quips: “This is going to take a little while.”

The pens hits the page 22 times. But there’s only 11 letters in “Barack Obama” (add seven more for his middle name), so he’s clearly having to sign partial letters.

There’s a long history to this practice, which creates historical artifacts and gifts. President Kennedy used his middle name and flourishes to stretch things out. President Lyndon Johnson used 75 pens to sign the Civil Rights Act, with one of the first going to Martin Luther King, Jr., and then key legislators. Here’s a list of who’ll get the 22 pens. (New York Times, Los Angeles Times, TIME, Washington Post)

*This blog post was originally published at ACP Internist*

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

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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