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Obstruction to Cancer Drug Price Rationality

June 6, 2016

I’ve complained about CMS/Medicare many times in previous posts, but this time they deserve praise. HHS Secretary Sylvia Burwell floated a proposal to allow Medicare to change how it pays for cancer drugs. According to an aritcle in the New York Times, ALL members of the Senate Finance Committee signed a letter...
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Opioids and Chronic Pain – Ignorant Physicians or Ignorant Politicians?

May 14, 2016

Prescription opioid abuse is on the political radar. “Painkillers” are a recognized cause of thousands of deaths a year. But what to do about it? A FDA Panel recently recommended mandatory training for physicians who prescribe opioids. Congress passed a bill calling for more education, presumably physicians as a prime target....
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MedPAC Calls for More Primary Care Support — Again

April 25, 2016

The Medicare Payment Advisory Committee (MedPAC) just released its annual report on Medicare expenditures. Congress technically votes on the fees that Medicare pays, but it created MedPAC to serve as its primary advisor. If MedPAC sounds familiar to some, it may be because of reports in the past of the American...
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Retail Clinics Increase Costs

March 13, 2016

A study in the latest Health Affairs took a snapshot of utilization and costs associated with retail clinics. These are the small clinics located in Wal-Mart, CVS, Walgreen’s and the like. They were touted by proponents as low-cost options for primary care. They are usually staffed by nurse practitioners or physician assistants....
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PCMH and Prevention Spin Using Simplistic Quality Measures

February 29, 2016

Two recent reports extoll the virtues of the Patient-Centered Medical Home (PCMH) and direct primary/concierge care. One is the annual report of the Patient-Centered Primary Care Collaborative. The other is a study of a network called MD-Value in Prevention (MDVIP). Before I continue, let me be clear that there are positives...
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What Should We Fear? – The Healthcare System

February 14, 2016
What Should We Fear? – The Healthcare System

In the most recent Democratic debate, Hilary Clinton said, “Americans haven’t had a raise in 15 years.” I’ll talk more about that in a second. Other candidates of both parties are getting votes and dominating polls by playing on our current national fears. For some, it is security fears; for others it’s...
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Problems with Hospital Mortality Data

January 10, 2016

Another recent study has exposed the limitations of the current quality indicators used by Medicare and many insurance companies. This time it’s for in-hospital patient deaths. Researchers looked at the mortality rate for patients admitted for pneumonia to 303 California hospitals. Hospitals were lumped into groups of performance using the standard quality measures....
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Medicare Penalizes Hospitals that Care for Vulnerable Populations

December 31, 2015

All of us who care for the poor, the illiterate, the poorly educated, the immigrant, the frail, and the abused know this: caring for them involves many challenges that aren’t picked up by Medicare computers or big data. Simplistic calculations about quality metrics such as hospital readmission rates have been way...
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The High Cost of Healthcare Reduces American Jobs

December 9, 2015

The Congressional Budget Office just released a report estimating that the total workforce will lose 2 million jobs over the next 10 years as result of the new coverage expansions under Obamacare, with its mandates and changes in tax rates. This reduction could be from several factors. Some people might choose...
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High Deductibles – A Silver Lining for Family Medicine

November 23, 2015

Many say high deductibles make their health law insurance all but useless — so reads the headline of a recent piece in the New York Times. The article points out that while supporters of the new insurance exchanges talk about low premiums, the deductibles are so high that it , “…...
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