April 28th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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A recent post on Kevin MD by Joseph Biundo, a rheumatologist, challenged my assertion that primary care doctors can save money:
(In reference to my claim…) That may be true in theory, but I see patients in my rheumatology office every day who have been “worked up” by primary care physicians and come in with piles of lab tests and X-ray and MRI reports, but are diagnosed in my office by a simple history and physical exam.
Prior to that, an article in the New York Times along with a post by Kevin Pho noted the fact that more solo practitioners are leaving private practice and joining hospital systems. Why are they doing this? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
April 11th, 2010 by DrWes in Better Health Network, Health Policy, News, Opinion
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Is the need for cookbook medicine being used as a ploy to bar cardiologists from practicing at competing hospital systems in Colorado? An excerpt from the Reporter Herald:
Banner Health, the owner of McKee Medical Center in Loveland and the operator of North Colorado Medical Center in Greeley, soon will bar cardiologists who are not on the Banner payroll from practicing at the Greeley hospital. The denial of hospital privileges to cardiologists outside the Phoenix-based Banner system is the latest step in carving up the heart of the Northern Colorado health care market, where two dominant hospital groups — Banner and Poudre Valley Health System — vie for shares. Read more »
*This blog post was originally published at Dr. Wes*
April 5th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
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We learn from the healthcare reform bill that the federal government will help subsidize Medicaid funding for all the new patients who qualify, but they will only do it for two years. After that, the states are on their own. Medicaid unfunded liabilities will crush state governments everywhere.
Why is Medicaid so expensive and going bankrupt? I’ll give you one example why. This is played out day after day, night after night in communities all across our country. And the only ones paying for it are you and me. The ones spending all the money have no incentive to stop.
I’m in the ER the other day when I see a chief complaint fly by on the radar. What is that chief complaint, you ask? Let me tell you a story.
Refused By Detox
The patient was so drunk even the community detox center refused him. So how did this play out? The patient was taken by ambulance from his home to a small-town community ER for altered mental status. There he was checked into the ER and seen by a small-town community ER physician, family practice resident, or PA or NP.
Diagnosis: Acute alcohol intoxication. Plan: Discharge to community detox center. Read more »
*This blog post was originally published at The Happy Hospitalist*
March 29th, 2010 by DrWes in Better Health Network, Health Policy, Opinion, Quackery Exposed, True Stories
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When hospitals mandate where patients are treated, it can lead to conspiracy and racketeering charges. Here’s an excerpt from a letter from the Chairman of the Board of Citizens Medical Center to one of the cardiologists filing suit:
“While it is certainly your right to exercise your medical judgement as you see fit, likewise, it is the responsibility of the Board of Directors at Citizens Medical Center to exercise their judgement as to what is in the interest of the business of Citizens Medical Center and its patients and Medical Staff. It is the Board’s firm belief that it is in the best interest of Citizens Medical Center for patients who are capable of being treated at Citizens Medical Center to be treated at Citizens Medical Center and not be transferred elsewhere.”
Business interests before doctor-patient interests? Ouch.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
March 23rd, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion
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The final House “Manager’s Amendment to Reconcilliation“ provides $400M for hospitals located in counties in the lowest quartile of Medicare spending, adjusted for age, sex and race — but not income. Coupled with annual cuts of $10B in DSH and $1.5B for re-admissions, this is bad news for the poor and the hospitals that care for them. Mayo Clinic wins!
Note that adjustments cannot be based on counties. Urban counties are too big and economically varied. When the extremes of wealth and poverty are averaged, mean household income is 128% of average in Washington DC, 113% in LA, and 108% in Chicago (Cook County), all with dense and costly poverty ghettos. Without any poverty, mean household income in Olmsted County (home to Mayo Clinic) is the same as in LA. Very few truly poor counties will qualify for such payments. This is another example of the truism that “Poverty is the Problem; Wealth is the Solution.”
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*