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Healthcare Repeal: How Would It Affect Coverage And Cost?

[Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) – lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did.

But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit?

In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiums for many:

– Deficit: repeal of the ACA would increase the deficit by $145 billion from 2012-2019, by another $80 to $90 billion over the 2020-21 period, and by an amount “that is in the broad range of one-half percent of the GDP” in the decade after 2019* — or about a trillion dollars. Read more »

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

Repealing Healthcare Reform To Gain Campaign Ammunition

Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate.

But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal.

Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. House Speaker John Boehner said, “I don’t think anyone in this town believes that repealing Obamacare is going to increase the deficit,” although Republicans have already exempted a repeal of the healthcare law from new rules prohibiting legislation from adding to the federal debt. (Politico, Kansas City Star, [Aurora, Ill.] Beacon-News, USA Today, CNN)

*This blog post was originally published at ACP Internist*

Patient-Centered Outcomes Research: Will Patients Be Involved?

A year ago Gangadhar Sulkunte shared his story here about how he and his wife became e-patients of necessity, and succeeded, resolving a significant issue through empowered, engaged research. As today’s guest post shows, he’s now actively engaged in thinking about healthcare at the level of national policy, as well – and he calls for all patients to speak up about this new issue. – Dave

I recently came across a Pauline Chen piece in the New York Times, “Listening to Patients Living With Illness.” It refers to a paper by Dr. Wu et al, ”Adding The Patient Perspective To Comparative Effectiveness Research.” According to the paper and the NY Times article, Dr. Wu and his co-authors propose:

  1. Making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection.
  2. In some cases requiring the information for reimbursement.

Patient-Centered Outcomes is outcomes from medical care that are important to patients. The medical community/research focuses on the standard metrics related to survival and physiological outcomes (how well is the part of the body being treated?). In the patient-centered outcomes research, they will also focus on outcomes important to patients such as quality of life. In other words, the care experience will be viewed through the eyes of the patients and their support groups to ensure that their concerns are also addressed. Read more »

*This blog post was originally published at*

Physician-Owned Hospitals: Preventive Medicine Instead?

With the new healthcare reform bill signed into law, the fate of physician-owned hospitals was sealed:

The bill Congress passed in March includes a ban on new physician-owned hospitals and freezes those already in business at their present size. Doctors hold a one-third interest in Avera Heart, which opened in 2001, so the bill President Obama signed would prevent that facility from ever growing.

The law change, in effect, leaves expansion of treatment of cardiovascular disease open for Sanford to dominate locally in coming years — if in fact that field of medicine grows. Avera Heart says such growth is not a given, because people are living healthier and have less need for emergency care. (Argus Leader)

While it’s easy to point to the potential conflict of interest inherent to physician-owned medical facilities, it’s not so easy to demonstrate that non-physician-owned hospitals don’t have similar conflicts with generating profits. After all, continuing to build large $78 million expansions requires hospitals of any kind to achieve a return on their investment in order to continue operations. Read more »

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

Some Good Things About Healthcare Reform

The large healthcare bill has some very good elements in it that should help the average American.

One is a provision that will kick in in 2011 that says all health insurers will need to spend 85 percent of the premium dollar on actually providing care. This means people may actually receive benefits they pay for. What a concept! Read more »

*This blog post was originally published at EverythingHealth*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

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

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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