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The Government’s Rising Stake In Healthcare Costs

The federal government may be stalled on health care reform legislation, but the executive branch has been expanding its stake in paying for care.

Yesterday, QD reported that federal and state governments will pay for more than half of the health care purchased in the U.S. by 2012, and likely even sooner. Today, Medicare’s actuaries announced that growth in national health expenditures (NHE) outpaced growth in the Gross Domestic Product (GDP) last year. The recession, H1N1 programs and federal subsidies for COBRA benefits all contributed to the largest one-year increase in history, from 16.2% of GDP in 2008 to 17.3% of GDP last year.

In 2010, NHE growth will decelerate to 3.9% while GDP is anticipated to rebound to 4% growth. But, and this is a big caveat, much of the projected slowdown in NHE growth is attributed to the 21.3% slashing of Medicare physician payment rates called for under current law’s Sustainable Growth Rate provisions. Read more »

*This blog post was originally published at ACP Internist*

Who Will Pay For Healthcare?

A couple of recent news stories reminded me of the dirty little secret about healthcare that no one wants to talk about, the proverbial elephant in the room. All those pills, surgeries, x-rays, medical care? It costs money!

Yes, Virginia, quality medical is not a right, not guaranteed in the Constitution, not something good-hearted corporations and companies, whether for-profit or not, are obliged to hand out like candy corn at Halloween. It costs money. Billions of dollars a day.

This appears to be something we all forgot in the warm fuzzy moments of watching military transport planes fly critically ill people out of Haiti to Florida hospitals. Who was going to pay for all this medical care? For the months of hospitalizations and rehabilitation these people were going to require? When the state of Florida, rightly so, asked the same question, prompting the halting of those military convoys, it ended up on the receiving end of a world-wide outpouring of boos and hisses. Read more »

*This blog post was originally published at Debra Gordon's Musings on Medicine and Health Care*

Medical Ethics Smack Down Part 3: The ACP Responds

A few days ago Mr. Doherty (who is also the ACP’s Senior Vice President of Governmental Affairs and Public Policy), graciously agreed to engage in this discussion, and promised to do so after consulting with the ACP’s Committee on Ethics, Professionalism, and Human Rights.

DrRich had hoped that Mr. Doherty would reply with a post on his ACP blog, which (since it likely has a vastly greater readership than the CRB), would more effectively give this topic some much-needed airing – and in particular, might engage some of the ACP’s membership (specialists in internal medicine) in this important discussion. DrRich was disappointed, then, when the reply came today in the form of a comment, which was tacked on to a long queue of reader’s comments at the end of DrRich’s posting.

DrRich was also very disappointed by the content of the reply which, fundamentally, was: This is a non-issue, and even if it was an issue, it’s now a settled issue. (So go away.) Read more »

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

The Japanese Healthcare System: Same Crisis, Different Country

Japan is completely different from the United States.  But it’s exactly the same.

I’m talking about health care, of course.

Japan is a country of about 130 million people, and one of the richest countries on Earth.  They enjoy a system of universal health care coverage, and some of the best doctors in the world.  But there are problems.

The country is is straining under the twin burdens of an aging population and rising health care costs.  At some point in the next two decades, retirees will outnumber active workers.   Medical expenses per person have almost doubled since the 1990s and continue to rise.   In a country with little immigration and low birth rates, it’s a bad combination. Read more »

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

Unintended Consequences: When Hospitalists Become Too Popular, Costs Rise

It’s the fastest growing “specialty” service in medicine: hospitalist medicine. These are the doctors who limit their practice to the care and management of patients admitted to the hospital. It has been wildly popular because it adds a shift-like work schedule to medical care for physicians while supposedly preserving their personal life. It also moves patients through the hospital faster, shortening length of stays. As one of our more esteemed hospitalist bloggers likes to boast: it’s a “WIN-WIN!”

At least until the hospitalist service gets too busy. Read more »

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

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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