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Will Insurance Cover A Mole Removal?

In years gone by, I spent far too much time removing small skin bumps in the office. At the time, I was sharing space with another doctor who was profiting by any service I provided. His staff scheduled me with tons of things that simply made me no money. [Meanwhile his stuff diverted some of my better business into his schedule as opposed to mine.]

The facts of life are that medicine is a business and when I am paying a huge chunk of change to overhead, I need to make that back or I operate at a loss.

Patients frequently don’t understand why I cannot remove their moles for what their insurance pays and make a profit. Well, Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Even With Health Care Reform, Many Will Still Encounter Problems

Trudy LiebermanA 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*

Fixing Healthcare: Bring Shared Decision Making To A New Level

Last week the New York Times reported that some health insurers have applied to regulatory agencies to push premiums sharply higher – usually double-digit increases, while citizens are suffering.  This falls on top of the 11 year history reported last year by the Kaiser Family Foundation: wages and inflation are up ~40%, while health costs and worker contributions were up 138% and 159%:

Kaiser Family Foundation slide on care costs

No wonder we feel squeezed. (Last week’s announcement comes on top of this history.)

This has enormous human impact. Read more »

*This blog post was originally published at e-Patients.net*

Medicare Initiative Hopes To Support And Sustain Primary Care

Last week, Medicare’s Center for Medicare and Medicaid Innovation announced a Comprehensive Primary Care (CPC) Initiative, which asks private payers and state Medicaid programs to join with Medicare to “help doctors work with patients to ensure they:

1. Manage Care for Patients with High Health Care Needs;
2. Ensure Access to Care;
3. Deliver Preventive Care;
4. Engage Patients and Caregivers; and,
5. Coordinate Care Across the Medical Neighborhood,”

according to an email from CMS’s press office. The initiative will provide qualified practices with risk-adjusted, per patient per month care managements payments, in addition to traditional fee-for-service payments, along with the opportunity to share in savings achieved at the community level.

I believe that the Initiative is a potential game-changer in helping to support and sustain primary care in the United States. But Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Insurance Company Begins New Ad Campaign In The Face Of Health Reform

Trudy Lieberman Cigna launched a $25 million “GO YOU” national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014.   That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage.  If those uninsured folks don’t get coverage, they will have tax penalties to pay.

No insurer wants to be left behind in this expanding marketplace, so Cigna, by being first out of the gate, hopes to build brand awareness that will ring bells in 2014 when consumers must buy insurance.  It’s a smart strategy.  One industry consultant says “most insurers have not built enough brand equity with consumers.”

Cigna’s ad campaign positions health insurance as Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

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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