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Emergency Care’s Ambiguity In The Affordable Care Act

There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:

Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.

The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.

The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.

This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »

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

A Transparent Healthcare System: What’s More Clear?

Congressional democrats want more transparency in healthcare, believing it would further drive down the cost of care, reports Politico.

Hoping to drive competition, some lawmakers are grumbling to force doctors to reveal business negotiations between them and drug and device makers. Opponents worry that manipulating economics would backfire. If everyone knows their competitor’s business, why bother negotiating lower prices?

But transparency worked for Wisconsin’s hospitals, not in business dealings but in reporting outcomes, reports The Fiscal Times. By voluntarily revealing clinical outcomes on the Web, the Wisconsin Collaborative for Healthcare Quality was able to spur low-performing hospitals to improve, high-performing facilities to eliminate tests that didn’t improve outcomes, and create an informed healthcare consumer with choices where to receive care.

*This blog post was originally published at ACP Hospitalist*

Cutting Healthcare Costs Means Saying “No” To Patients

Let’s face it, the best way to cut healthcare costs is to say “no.” That means denying unnecessary tests that most patients in the United States are accustomed to having.

The New York Times‘ David Leonhardt has the best take on this issue that I’ve read. He acknowledges the difficulty of telling the American public “no,” and cites examples ranging from the breast cancer screening controversy to the managed care backlash in the 1990s:

This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans. Read more »

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

Health And Life Insurance Companies Invested In Fast Food

A new article published in the American Journal of Public Health shows that U.S., Canadian, and European insurance firms hold $1.88 billion of investments in fast food companies like Jack in the Box, McDonald’s, Burger King and Wendy’s/Arby’s Groups. Both health insurers and life insurers have substantial holdings in these companies.

A person just needs to read “Fast Food Nation” or watch the documentary “Food, Inc.” to understand the negative impact of processed foods on the health of our country.

The evidence is so compelling that the new health reform legislation is requiring fast food and chain restaurants to disclose calorie counts on their menus. Ironically, the new legislation will also add millions of customers to the health insurers. Read more »

*This blog post was originally published at EverythingHealth*

Most People Aren’t Angry About Healthcare Reform

I just got back from a wonderful week in Toronto, Canada. No, I wasn’t up there to take tips on how to impose socialized medicine on an unsuspecting public, notwithstanding what some of you may incorrectly-surmise about my political leanings.

Rather, I was there to attend ACP’s annual scientific meeting, during which I had the opportunity to serve as faculty for three separate scientific sessions that discussed the impact of the new Patient Protection and Affordable Care Act (PPACPA) of 2010 on internists and their patients. Several hundred ACP members attended these sessions.

And guess what? Rather than encountering doctors who were angry at the new law and ACP’s support for it, I instead found an engaged and curious group of internists who are looking at health reform in a reasoned, measured and open-minded way. Read more »

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

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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