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The Battle Begins Between States And Feds Over Control Of Health Insurance

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The battle between the states and federal government begins.

Yesterday, Illinois Insurance Director Michael McRaith told an audience that state insurance regulation is “under attack,” but that the states will prevail because they “do it better.”

Following a line of reasoning I highlighted last week, McRaith suggested adding federal regulation onto the existing state system would be duplicative, burdensome and fraught with the potential for conflict.  McRaith said that insurance was such a uniquely local business that the states were best suited to regulate it. Read more »

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

Using ICD-9 Codes To Describe Your Morning

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PLACE OF OCCURRENCE, HOME ICD-E849.0

6:00 AM

Alarm goes off.  Hit snooze button. CIRCADIAN RHYTHM SLEEP D/O IRREG SLEEPWAKE TYPE ICD-327.33

6:30

  • Alarm goes off for third time.  Ready to hit snooze button, but knee in ribs from wife prevents more snooze button procrastination.  CONTUSION OF CHEST WALL ICD-922.1, ADULT MALTREATMENT UNSPECIFIED NEC ICD-995.8
  • Feeling tired, go to make a pot of coffee. CAFFEINE ADDICTION ICD-304.40
  • Fill bowl with Lucky Charms and start eating. UNSPECIFIED NUTRITIONAL DEFICIENCY ICD-269.9, HYPERGLYCEMIA ICD-790.29

6:45

  • Realize that coffee pot needs to be turned on for it to make coffee. ATTENTION DEFICIT DISORDER, ADULT ICD-314.00, LISTLESSNESS ICD-780.79
  • Read more »

*This blog post was originally published at Musings of a Distractible Mind*

No Good Answers At Healthcare Town Hall

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I am not as well educated in healthcare policy or politics as Dr Wes, Dr Val, KevinMD, Movin’ Meat, or Dr Sid Schwab.  I keep reading and listening, trying to understand and decide where I stand.  I seem to be more of a centrist (I think).

I was not able to attend any of the previous town hall meetings held in Little Rock on healthcare, but was able to attend the one today.  It was sponsored by the Americans for Prosperity.   The headline speaker was John Stossel.  I am happy to note it was a civil discourse though that may be due to most of them leaning the same way.

I didn’t come away any clearer than before.

I do tend to agree with Stossel that “when insurance is paying” (and not the individual) “it changes behavior.”  We aren’t as engaged in the decision making when someone else is paying.  However, it is very difficult to get straight answers or even estimates when it comes to healthcare.  It’s easy to say what an x-ray might cost.  It is difficult to estimate all the drugs, surgeries, care someone might need who has been involved in a major accident.  WSJ Health Blog provides links to sites that can help with cost questions. Read more »

*This blog post was originally published at Suture for a Living*

Ultrasound Isn’t All That Useful In The ER

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What Shari Welch Said.

Ultrasound is a neat toy, and I’m all about toys.  I found two opportunities to play with enhance patient care with our ultrasound today on my shift.  But it doesn’t have the bang for the buck that the enthusiasts think it does.   It has very narrow, but real, utility, and does nothing to generate revenue.  It does in some cases enhance patient turnaround, and it certainly enhances patient satisfaction (they love cool toys as much as we do — and extra face time with the doctor to boot!).  But that’s a small return on a machine costing tens of thousands of dollars. Read more »

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

Hospital Halloween Pumpkins

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… they can get creative with “pump-kin” decorating:

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

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