November 12th, 2009 by Dr. Val Jones in Health Policy, Opinion
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There hasn’t been much discussion about serious tort reform in the current healthcare reform debate. That’s probably because most policy experts don’t believe it will make a significant dent in healthcare costs. I happen to believe that tort reform would be a huge boon for healthcare (just ask Ob/Gyns in Texas) and save a lot in defensive medicine practices and unnecessary testing, but even if I’m wrong and it wouldn’t result in cost-savings, there’s another issue at play: access to primary care physicians.
We all agree that we’re in the midst of a major shortage in primary care physicians. Many different solutions have been proposed – everything from “let the nurses do it” to forgiving medical school loans to physicians who choose primary care as a career. However, solving the PCP shortage isn’t just about recruitment, it’s about retention. And with up to a half of PCPs saying that practice conditions are so unbearable they’re planning to quit in the next 2 years – Houston, we have a problem. Read more »
November 11th, 2009 by Richard Cooper, M.D. in Better Health Network, Health Policy, Opinion
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The Institute of Medicine (IOM) has addressed seven key health care reform questions and offered answers that capture today’s consensus. No surprises, but good clear analyses. But what if the underlying conceptual framework is not an excessive use of services by wrongly incentivized providers but the tragic over-use of services by the poor? Here are seven “what ifs” plus an eighth question.
1. Is health care too expensive?
What if health care is the economy, the major source of jobs and the basis for America’s worker productivity? And what if the problem is an unfair insurance system and inequitable distribution of fiscal responsibility?
2. How much too expensive is it?
What if regional variation is not a manifestation of excessive spending but of income inequality and the intersection of wealth and poverty? And what if differences in price and economic development, rather than waste and inefficiency, differentiate costs among countries? Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 7th, 2009 by Toni Brayer, M.D. in Better Health Network, True Stories
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I took my son to the ER for a broken thumb. It was a minor injury but the thumb is the most important digit on the hand. The ER care was just fine…a quick look, an Xray and a small splint. We didn’t have to wait long and everyone was courteous.
Imagine my surprise to receive the bill from the hospital. Yes, I have insurance. My out of pocket expense was minimal but here is what the insurance company was charged:
- Hospital Misc.- $56.00 (could this be the splint?)
- Diagnostic Xray – $342.00
- Emergency Care- $952.00
- Surgery – $570.00
- Total $1920.00
Take a look…surgery? There was so surgery, no procedure. There was no break in the skin. The doctor component of the visit was about 7 minutes (mainly because I knew the doc and we chatted about politics)
This bill is unreal and is comprised of unreal health care costs. Read more »
*This blog post was originally published at EverythingHealth*
November 6th, 2009 by GruntDoc in Better Health Network, Opinion
1 Comment »
Kevin, MD linked to this, and I really must comment.
Here’s the abstract, and I hope you’ll read it all:
For years I’ve heard friends describe experiences of being caught in a web of excessive and unnecessary medical testing. Their doctors ordered test Z to investigate a seemingly incidental finding on test Y, which had come about because of a borderline abnormality on test X.
I often wondered why test X was done in the first place. As a primary care physician, I would have treated them for the likely diagnosis and done diagnostic tests — especially a series of diagnostic tests — only if they didn’t respond as expected…. Read more »
*This blog post was originally published at GruntDoc*
October 31st, 2009 by Shadowfax in Better Health Network, Opinion
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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*
