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Latest Posts

Priority Problems: The Failure Of Government Aid

I recently saw a teenage boy with headaches.  His father, wringing his hands, said that the headaches had been present for two years; but that the child had never been evaluated for them.  No imaging, no neurologist.  No insurance, of course.

A family friend, another child, had been diagnosed with a brain tumor.  The family of my patient was terrified.  Where to turn?  They were, reasonably, concerned about cost.

Contrast that with the woman I saw on state assistance. Read more »

*This blog post was originally published at edwinleap.com*

Hospitalist Recommends A Way Out Of Medicare And Medicaid

Ask yourself this question:  Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care?  I would.  That’s  what one hospital system in Massachusetts is offering to provide.  It is, essentially, a concierge hospital plan.   You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.

What a great idea.  In fact, it’s an idea I have thought about previously for Happy’s hospital.  Why shouldn’t Happy’s hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing?  I’d sign up.  My health insurance premiums cost over $12,000 a year.  In the eight years of my practice, I’ve probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.

It’s a concept who’s time has come.  In fact, direct concierge hospital plans also offer patients and their employers the opportunity for tiered pricing for special amenities  (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking,  door-to-door service, and 24 hour special access to their physicians and nursing staff).

No more worries about Read more »

*This blog post was originally published at The Happy Hospitalist*

The Plight Of The Uninsured

This is depressing:

A 24-year-old Cincinnati father died from a tooth infection this week because he couldn’t afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.

According to NBC affiliate WLWT, Kyle Willis’ wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn’t afford both, so he chose the pain medications.

The tooth infection spread, causing his brain to swell. He died Tuesday.

It can’t be denied that his poor decision-making was the proximate cause of this guy’s death (and many times I’ve gotten the maddening call from the pharmacy, “Doctor, the patient only wants the narcotics”). The underlying cause, however, was the fact that he was uninsured. Read more »

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

Coverage Fact Labels For Various Medical Services: Will They Be Useful

It’s official now.  The government has proposed that descriptions of health insurance policies will resemble those nutritional labels on canned and packaged foods—the ones you look at to find out how much sodium there is in Birds Eye peas versus the A&P brand.  Instead of getting the scoop on salt or sugar, shoppers will learn what they have to pay out-of-pocket for various medical services.  They’ll also get some general information, like what services are not covered, and how much they’ll have to pay for maternity and diabetes care and breast cancer treatment, all organized in a standard format designed for easy comparison shopping.  Insurers will have to translate common insurance jargon into plain English.

The health reform law requires these “Coverage Fact Label” disclosures, and tasked the National Association of Insurance Commissioners (NAIC) with creating them.   The NAIC released some samples a few weeks ago.  Theoretically, consumers armed with this information will choose wisely, and as free-market advocates say, their choices will regulate prices that insurers will charge.   If consumers choose the low-cost plans, Read more »

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

What The Healthcare System Really Needs: A Change Of Heart

I think a lot about the slow, certain dissolution of medicine as we know it.  Mental health issues crowd emergency departments, as few mental health clinics are available.  Psychiatrists are in short supply.  Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills.

Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly.  Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else.

The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away.  Politicians, eager to be re-elected, eager to be loved, promise Read more »

*This blog post was originally published at edwinleap.com*

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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