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So you know that survey you get in the mail after a hospital stay or an outpatient diagnostic test? The one that ask you questions like, "Were you treated politely?" and "Were snacks available without having to ask for them?" Due to requirements in the new Obamacare federal health regulations, Medicare money for hospitals will to some degree be tied to patient satisfaction scores -- most of which will come from those post-encounter surveys. Check out this nice video from msnbc.
Showing posts with label federal health reform. Show all posts
Showing posts with label federal health reform. Show all posts
Sunday, November 27, 2011
Tuesday, May 10, 2011
Doctor in the House: an interview with author Congressman Michael Burgess, M.D.
When Dr. Michael Burgess gave up delivering babies in favor of kissing them, most physicians thought he was crazy.
After reliving the September 11th World Trade Center nightmare in his head for weeks, the successful obstetrician decided to run for Congress in his Republican district of North Texas against the well-funded and well-named son of then Majority Leader Dick Armey.
Not only did Burgess win, but he has quickly become the thought leader of American medicine in the United States Congress.
In his new best-selling book, Congressman Dr. Burgess retells the story of his first years in the House of Representatives where another nightmare unfolded: the Democratic creation of Obamacare.
His work is entitled Doctor In The House and it contains the prescription necessary to heal the ills of American health care.
In this blog we engage in a spirited discussion with Dr. Burgess. Let us know what you think.
Tuesday, February 22, 2011
Re-bamacare: Is health care reform now a problem for Republicans?
The public relations nightmare for the Obama administration's health care plan last year now seems to be a problem for the Republicans.
Republican lawmakers have long wanted more intense reforms of insurance laws that purport to stream line the system, lower cost, and cut out redundancy.
Of course the concern for patients is that the only sure fire way to lower health care costs is to restrict access and therefore lower utilization.
Patient advocates have long been skeptical of Republican promoted health care (read: insurance reforms) because below the surface the bills seem to be reminiscent of old war style cronyism: pandering to the insurance companies and corporate medicine.
True or not, that's not the purpose of my discussion today. This is more about the table turning anti-Obamacare public sentiment that is now being carefully redirected toward these Republican proposals.
Particularly in state legislatures where lawmakers are now struggling to balance state budges with escalating deficits, every possible revenue source or cost cutting move is being critically examined.
On the surface many of these ideas seem plausible -- directly employee physicians so that their prescribing and ordering habits can be controlled.
Given that the most expensive piece of medical equipment in America right now is the pen, this would seem to be on target.
Limit tests or procedures, force the use of quality guidelines and metrics, cross share lab to prevent redundancy, and put physicians smack in the middle of a care management team to increase quality and value for patients.
And to make more money for the corporate entities involved.
The problem is not whether something like these rules need to be implemented -- they do -- the problem is that absent proper oversight and restraint the slippery slope of profits and revenue would suggest that patients might get the short end of the stick.
Just imagine if your physician was told to use a certain drug, a certain provider for a procedure or diagnostic test, a particular institution for your surgery -- your choice would be gone as would that of the physician.
Now certainly we are all going to have give up some health care decision freedom as we move to limit the exponential rise in health care expenditures.
But patients and physicians need the opportunity for some autonomy in the doctor-patient relationship.
Whether it is contractural protections against wrongful termination, protections against adverse hospital decisions, prohibitions against forced admissions, or whistleblower protections, physicians need to maintain some degree of separation from the unintended consequences of corporate America.
Patients need this as well.
What's been fascinating to watch is that in multiple states where Republicans are using the budget shortfall as a steam roller to clear a path for any proposal that seems to save money, the health care changes related to employment and insurance reform seem to be hitting a snag.
Dubbed "____-bamacare" depending on the lawmaker in question, use of this phrase immediately conjures up negative sentiment not only among the public but also among fellow Republicans who might not be so forward educated on the benefits at stake.
This is particularly evident in Texas where Lieutenant Governor David Dewhurst is seeing push back on his proposals to expand corporate control of health care.
From visiting with hundreds of patients its clear that monkeying with anything to do with a patient's health care choices, particularly now in this post-Obamacare sensitivity, is a risky move.
It is likely that good proposals will also potentially fall on the sword with our President's plan.
Patients seem to be tired of government intervention in health care. They recognize the need for changes in the cost, but they are still not convinced that government or big business is in the best position to make these decisions.
They are probably right.
- Posted using BlogPress from my iPad
Republican lawmakers have long wanted more intense reforms of insurance laws that purport to stream line the system, lower cost, and cut out redundancy.
Of course the concern for patients is that the only sure fire way to lower health care costs is to restrict access and therefore lower utilization.
Patient advocates have long been skeptical of Republican promoted health care (read: insurance reforms) because below the surface the bills seem to be reminiscent of old war style cronyism: pandering to the insurance companies and corporate medicine.
True or not, that's not the purpose of my discussion today. This is more about the table turning anti-Obamacare public sentiment that is now being carefully redirected toward these Republican proposals.
Particularly in state legislatures where lawmakers are now struggling to balance state budges with escalating deficits, every possible revenue source or cost cutting move is being critically examined.
On the surface many of these ideas seem plausible -- directly employee physicians so that their prescribing and ordering habits can be controlled.
Given that the most expensive piece of medical equipment in America right now is the pen, this would seem to be on target.
Limit tests or procedures, force the use of quality guidelines and metrics, cross share lab to prevent redundancy, and put physicians smack in the middle of a care management team to increase quality and value for patients.
And to make more money for the corporate entities involved.
The problem is not whether something like these rules need to be implemented -- they do -- the problem is that absent proper oversight and restraint the slippery slope of profits and revenue would suggest that patients might get the short end of the stick.
Just imagine if your physician was told to use a certain drug, a certain provider for a procedure or diagnostic test, a particular institution for your surgery -- your choice would be gone as would that of the physician.
Now certainly we are all going to have give up some health care decision freedom as we move to limit the exponential rise in health care expenditures.
But patients and physicians need the opportunity for some autonomy in the doctor-patient relationship.
Whether it is contractural protections against wrongful termination, protections against adverse hospital decisions, prohibitions against forced admissions, or whistleblower protections, physicians need to maintain some degree of separation from the unintended consequences of corporate America.
Patients need this as well.
What's been fascinating to watch is that in multiple states where Republicans are using the budget shortfall as a steam roller to clear a path for any proposal that seems to save money, the health care changes related to employment and insurance reform seem to be hitting a snag.
Dubbed "____-bamacare" depending on the lawmaker in question, use of this phrase immediately conjures up negative sentiment not only among the public but also among fellow Republicans who might not be so forward educated on the benefits at stake.
This is particularly evident in Texas where Lieutenant Governor David Dewhurst is seeing push back on his proposals to expand corporate control of health care.
From visiting with hundreds of patients its clear that monkeying with anything to do with a patient's health care choices, particularly now in this post-Obamacare sensitivity, is a risky move.
It is likely that good proposals will also potentially fall on the sword with our President's plan.
Patients seem to be tired of government intervention in health care. They recognize the need for changes in the cost, but they are still not convinced that government or big business is in the best position to make these decisions.
They are probably right.
- Posted using BlogPress from my iPad
Location:Jacksonville, Florida
Thursday, February 17, 2011
Stark Contrast: How the Democrats are missing again on healthcare
Recently Pete Stark told a group that the Republicans were trying to shove a massive bill to repeal the Obamacare Bill down the throats of the Democrats.
The Republicans two-page bill stands in sharp contrast to the 2000-plus page bill pushed through by the Democrats last spring. So Mr. Stark, what's different now?
I had the pleasure of spending an hour with Congressman Stark last March right before the historic vote that changed the way healthcare is financed and delivered in this country. He was adamant at that time that he would never "support" the Senate version of the healthcare bill.
Well he did.
Now this isn't the first time or probably the last that a member of Congress has changed their mind.
But fundamentally the reason he voted for the bill as did most of the Democrats was political: legislation had to be passed regardless if it was good or not. Nancy Pelosi's health care chief told me in a meeting the same day that "we know its not a good bill but we can always fix it later."
The Republicans have taken the position that repeal is the best choice, followed by not funding key elements of the legislation, and probably hoping that the Supreme Court will rule that the Democrats overstepped their interpretation of the commerce clause. The latter is the ruse that allowed them to pass the bill in the first place.
So now the Democrats believe they have to defend the bill they created. And reforming the legislation would be tantamount to failure.
The American Medical Association adopted a recent slogan from their Texan brethren when they started preaching the "Keep what's good. Fix what's broken" mantra. But this lobby tactic would assume that either side would want to fix anything in the first place.
Neither the Democrats nor the Republicans are really motivated to reform the legislation. These polar opposite positions place American patients right in the middle of a stand off -- most likely to be killed by "friendly" fire.
Democrats are missing the boat here by not learning from prior mistakes and following the advice that we talked with Pete Stark about a year ago. Give patients some protections from preexisting illness and right of recision rules from the insurance companies and allow them to keep their doctor.
That's really what patients and taxpayers want.
And, tank the rest of the 2000 pages of the bill.
The 18 thousand new IRS agents, the Independent Medicare Advisory Panel, the criminalization of billing issues, the mandate on individual coverage, the expansion of a broken Medicaid system -- all of this needs to go away. None of it will improve the health of America.
But sadly it is doubtful that anything good will happen in Congress this term related to healthcare.
Yes, the House can refuse to fund key elements of the legislation...they can vote to repeal the bill. But the Democratically controlled Senate and the sitting President will not allow the bill go away.
In the meantime Washington bureaucrats will be turning out millions of pages of rules and regulations that will immortalize Obamacare for millions of patients.
- Posted using BlogPress from my iPad
The Republicans two-page bill stands in sharp contrast to the 2000-plus page bill pushed through by the Democrats last spring. So Mr. Stark, what's different now?
I had the pleasure of spending an hour with Congressman Stark last March right before the historic vote that changed the way healthcare is financed and delivered in this country. He was adamant at that time that he would never "support" the Senate version of the healthcare bill.
Well he did.
Now this isn't the first time or probably the last that a member of Congress has changed their mind.
But fundamentally the reason he voted for the bill as did most of the Democrats was political: legislation had to be passed regardless if it was good or not. Nancy Pelosi's health care chief told me in a meeting the same day that "we know its not a good bill but we can always fix it later."
The Republicans have taken the position that repeal is the best choice, followed by not funding key elements of the legislation, and probably hoping that the Supreme Court will rule that the Democrats overstepped their interpretation of the commerce clause. The latter is the ruse that allowed them to pass the bill in the first place.
So now the Democrats believe they have to defend the bill they created. And reforming the legislation would be tantamount to failure.
The American Medical Association adopted a recent slogan from their Texan brethren when they started preaching the "Keep what's good. Fix what's broken" mantra. But this lobby tactic would assume that either side would want to fix anything in the first place.
Neither the Democrats nor the Republicans are really motivated to reform the legislation. These polar opposite positions place American patients right in the middle of a stand off -- most likely to be killed by "friendly" fire.
Democrats are missing the boat here by not learning from prior mistakes and following the advice that we talked with Pete Stark about a year ago. Give patients some protections from preexisting illness and right of recision rules from the insurance companies and allow them to keep their doctor.
That's really what patients and taxpayers want.
And, tank the rest of the 2000 pages of the bill.
The 18 thousand new IRS agents, the Independent Medicare Advisory Panel, the criminalization of billing issues, the mandate on individual coverage, the expansion of a broken Medicaid system -- all of this needs to go away. None of it will improve the health of America.
But sadly it is doubtful that anything good will happen in Congress this term related to healthcare.
Yes, the House can refuse to fund key elements of the legislation...they can vote to repeal the bill. But the Democratically controlled Senate and the sitting President will not allow the bill go away.
In the meantime Washington bureaucrats will be turning out millions of pages of rules and regulations that will immortalize Obamacare for millions of patients.
- Posted using BlogPress from my iPad
Monday, December 20, 2010
Conversation with a Health Care Leader: the past and future of health reform with Dr. Susan Rudd Bailey
Today we talked with Susan Rudd Bailey, MD who is the President of the nation's largest state medical society about the genesis of federal health reform and what she expects for the future. This nationally known leader of the Texas Medical Association is candid in her discussion of the role that physicians and patients play in determining the ultimate outcome of the recent federal health regulation. She also discusses the implications of the flawed funding mechanism for Medicare -- the so called "SGR".
Thursday, December 16, 2010
Is Obamacare unconstitutional?
Is Obamacare unconstitutional? That's the question we address today on docdano.com. Darren Whitehurst and Dan Finch from the Texas Medical Association join us today to discuss the Virginia federal judge ruling that the health reform bill is unconstitutional. What does it mean? And what effect is it going to have on the upcoming session of Congress?
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