August 20th, 2011 by BobDoherty in Health Policy, Research
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If you ask internists and their patients what makes them bonkers about the U.S. health care system, paperwork will top the list. Many will point to the federal government as the culprit, citing the many forms, RAC audits, pre-and post-payment reviews, documentation and coding guidelines, HIPAA privacy rules, quality measurement and reporting, Part D drug formularies, and HIT meaningful use requirements imposed by Medicare and other federal programs. (Some put more of the blame on private insurers and pharmacy benefit managers.)
But if paperwork is associated with the degree of government involvement in health care, then Canada–a single payer system–should have more of it than the United States, right? Think again.
A new Health Affairs survey of U.S. physicians and practice administrators found that U.S. physicians spend Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
August 9th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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I have discussed Medicare Part B and Part F in recent blogs. A reader asked about Medicare Part D:
Dr. Feld
“Please discuss Medicare Part D, the drug benefit plan available to seniors. It is very complicated and completely confusing to me.
My physician gave me a prescription for Levequin 500 mg once a day for 10 days. The pharmacist told me it would cost me $330 dollars. Medicare Part D would pay an additional $110 dollars for a total of $440 dollars.
I asked the pharmacist if there was a generic equivalent. The answer was yes. It cost $10 dollars.
This is unconscionable. It is highway robbery.
Sincerely
a.g.”
Several issues are presented in this readers note. It is essential to understand these issues. The issues are an indictment against government “controlled” programs. Read more »
*This blog post was originally published at Repairing the Healthcare System*
July 27th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of healthcare costs in the population.
The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases.
U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year.
This is a result of a combination of factors. Chief among them is the increasing incidence of obesity.
Who spends the money? Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 17th, 2011 by John Di Saia, M.D. in Opinion
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In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.
Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/
While I have not specifically “refused to treat” obese patients, I have in a few cases recommended against surgery or recommended weight loss and re-evaluation later. Than again I am not in primary care and do understand what these OB/GYNs are saying. Obese patients do represent more risk when it comes to surgery and that would of course cover pregnancy and child bearing.
Take into account that Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
December 12th, 2010 by John Mandrola, M.D. in Better Health Network, Opinion, True Stories
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The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls.
Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified.
The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in December many years ago when I did five “urgent” pacemakers — and neither will the pacemaker rep. Read more »
*This blog post was originally published at Dr John M*
