December 9th, 2011 by DrWes in Health Policy, Opinion
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With the announcement that the Center for Medicare and Medicaid Services (CMS) will begin auditing 100% of expensive cardiovascular and orthopedic procedures in certain states earlier this week, we see their final transformation from the beneficent health care funding bosom for seniors to health care rationer:
The Center for Medicare and Medicaid Services will require pre-payment audits on hospital stays for cardiac care, joint replacements and spinal fusion procedures, according to the American College of Cardiology in a letter to members. Shares in both industries fell with Tenet Healthcare Corp., the Dallas- based hospital operator, plunging 11 percent to $4.18, the most among Standard & Poor’s 500 stocks. Medtronic Inc., the largest U.S. maker of heart devices, dropped 6 percent to $34.61.
The program means hospitals won’t receive payment for stays that involve cardiac care or orthopedic treatment until auditors have examined the patient records and confirmed that the care was appropriate, Jerold Saef, the reimbursement chair for the Florida chapter of the American College of Cardiology, wrote in a Nov. 21 letter to members. The review process is expected to take 30 days to 60 days, beginning January 1, Saef said.
This is not at all unexpected. In fact, Read more »
*This blog post was originally published at Dr. Wes*
December 4th, 2011 by DrWes in News, Opinion
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A sure-to-be controversial article appears in the Chicago Tribune earlier this asking the sensitive question of ‘Health care at any age, any cost?:’
“If you want to save all lives, you’re in trouble,” said Callahan, co-founder of The Hastings Center, a bioethics research institute in New York, and a faculty member at Harvard Medical School, in an interview. “And if you want to save all lives at any cost, you’re really in trouble.”
Callahan and co-author Nuland, a retired professor of surgery at Yale School of Medicine who wrote the best-selling “How We Die,” were both 80 when the article was published.
“We need to stop thinking of medicine as an all-out war against death, because death always wins,” said Callahan.
The article goes on the make some bold demands of doctors: Read more »
*This blog post was originally published at Dr. Wes*
November 6th, 2011 by DrWes in Health Policy, Opinion
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Like Christmas season advertising, the holiday crunch for procedural medicine is coming earlier every year.
Perhaps that’s why the posting on this blog as suffered: we’re busier than ever.
Why is this?
I suspect it’s because of a variety of forces that are coming together to create the great procedural “perfect storm” this time of year.
Perhaps the most important contributor to the holiday rush is the patients themselves. Patients are Read more »
*This blog post was originally published at Dr. Wes*
October 23rd, 2011 by DrWes in Health Policy, Opinion
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As Occupy Wall Street spread across the nation, I can’t help but wonder if the same movement could occupy health care. After all, the basic tenants of the movement involve protesting against social and economic inequality, corporate greed, and the influence of corporate money and lobbyists on government. In the “Occupy” movement, there is a feeling there’s an inside game and the game is rigged.
It would seem, then, that our new health care law, written by corporate interests and heavily influenced by lobbyists, could become a ripe target for the movement. We are beginning to see Read more »
*This blog post was originally published at Dr. Wes*
October 20th, 2011 by PreparedPatient in Health Policy, True Stories
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A couple weeks ago I walked the streets of Lincoln, Nebraska, talking to men and women about whether they thought Washington was listening to their economic concerns. Jeff Melichar manages his family’s Phillips 66 gas station on the city’s main street, and one of his big financial problems happens to be health insurance. The more we talked, the more I realized what a jam he could be in down the road because of a loophole in the health reform law, which has received almost no press coverage or public discussion: If you have health insurance from your employer, you may have to keep it whether or not it’s adequate or affordable. Buying less expensive or better coverage from one of the state “exchanges” or shopping services will be off limits. So despite all that talk about consumer choice, for many like the Melichars, there may be no choice.
Melichar’s wife is eligible for health insurance from the optical company where she works. But the family waited until this fall to enroll when the firm offered coverage they finally could afford. Their premium is Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*