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ACP News Highlights: Healthcare Reform And Primary Care Shortages

ACP Internist’s wrap-up of current events continues with ping-pong for health care reform, how the recession curbed health care spending and how legislation preventing patient-dumping can hurt the physicians required to provide treatment.

Health care reform
Ping pong project by mknowles via FlickrNegotiations for health care reform will avoid the formal conference procedure and instead negotiate directly. The “ping-pong” talks, which don’t have to be public, will send the bill back-and-forth between the House and Senate until both chambers agree. C-SPAN wants to televise the negotiations. The goal is to pass the legislation by a State of the Union speech scheduled for February. (Los Angeles Times, C-SPAN, Baltimore Sun)

The recession did what Congress has struggled to do–slow spending for health care. Spending on physicians and services rose by 4.4% in 2008 over the previous year, the slowest increase in 50 years of tracking by the Centers for Medicare and Medicaid Services. Still, spending totaled $2.3 trillion, or more than 16% of the entire economy. The credit freeze in the most recent recession may have dissuaded people from paying large deductibles. (AP, USA Today)

Toward more efficient spending, House and Senate legislation both test the waters on accountable care organizations. Such arrangements prompt primary care doctors, specialists and hospitals to work together and reimburse them based on that care. Health reform legislation would limit the experiment to Medicare. (NPR)

Primary care shortage
More doctors than ever have sought to practice in Wyoming, often through telemedicine. That’s not enough. Of the 301 doctors who received state licenses, 18% work full time in the state. And of Wyoming’s more than 2,800 licensed doctors, less than 40% practice full time. The paper’s editorial board is now calling for loan repayment programs to help rural health recruiting efforts. (Star-Tribune)

In case you missed it …
In Prescott, Ariz., local physicians consider the Emergency Medical Treatment & Active Labor Act as the “biggest, most voluminous constraint” on doctors in the community. The 1986 law prevents patient dumping, but while one doctor says it’s ethically and morally correct, it also punishes doctors and hospitals who see patients in emergency rooms. In Prescott, that may be as many as 20% of all patients. The issue plays out in the nation’s capital, too, where a vacation turned into a much longer stay for a legally visiting tourist who developed complications during her pregnancy and stayed through delivery. (The Daily Courier, Washington Post)

*This blog post was originally published at ACP Internist*

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