Health Reform Hub Issues

Issues :: Health Care Delivery

Doctor Drain Turns to Gain: Physicians Move North
Tom Blackwell

National Post, 9/9/10

For years, an exodus of doctors to the United States helped fuel Canada’s growing shortage of medical staff, and gave emotional ammunition to opponents of Canadian-style health-care reform in the States. But medical recruiters and migration statistics suggest a surprising new trend has emerged over the past few years: a net movement of physicians from the United States to Canada. Read more...

Conservative Group Forecasts Medicare Doctor Access Problem
Marilyn Werber Serafini

Kaiser Health News, 9/8/10

Getting a doctor appointment may become increasingly difficult for seniors and the disabled over the next decade unless Congress changes the new health law, according to a report that the conservative National Center for Policy Analysis plans to release today. Due to scheduled “draconian" changes in payments to doctors and hospitals serving Medicare beneficiaries, the NCPA says, seniors may soon face the same access issues that sometimes send poor Medicaid recipients to community health centers and safety net hospitals. Read more...

Health Reform: Last Call for Competitive Markets?
Alice M. Rivlin

The Brookings Institution, 9/7/10

The new health care exchanges to be implemented in health care reform offer competitive market advocates a tremendous opportunity. If the exchanges work well, they will prove that market forces and consumer choice can improve quality and slow the growth of health care spending. If the exchanges fail, however, the next round of health reform will likely move away from market solutions toward a heavier government hand. Read more...

Researchers Peg Malpractice Costs at Over $55 billion
Jennifer Lubell

Modern Healthcare, 9/7/10

Medical malpractice costs average about $55.6 billion annually, or 2.4% of annual healthcare spending, according to a new Health Affairs analysis. The estimate includes defensive-medicine activities, such as ordering tests or treatments physicians in order to avoid lawsuits, which alone costs an estimated $45.6 billion per year, the study found. The real cost of medical liability has been widely debated, said the study, published in the September issue of Health Affairs. Some studies have shown that on one hand, healthcare “is rife with errors and avoidable injury to patients. On the other, doctors and hospitals fear frivolous lawsuits and resent high malpractice insurance premiums,” according to the findings. Read more...

In Defense of Physician Autonomy
Saul Greenfield

Wall Street Journal, 9/7/10

The auditorium was filled with young, newly minted physicians sitting nervously in white jackets. When the chairman of surgery mounted the stage to address me and my fellow surgical interns, we immediately hushed and gave him our attention. I don't now recall most of what he said, but one remark has stayed with me through my 25 years of surgical practice: "You can't practice medicine by committee." Read more...

Trapped in the Medicaid Ghetto
Ben Domenech

The Washington Examiner, 9/7/10

During the legislative battle over President Barack Obama’s health care law, there were many stories left untold about the true ramifications of the measure. We learned recently that allies of the White House have been circulating a presentation advising supporters to stop claiming the law will lower costs or reduce the deficit — now they tell us! But perhaps the most disturbing of the untold stories is how the new law’s expansion of Medicaid will burden African-Americans. Read more...

Patients' Choices May Narrow as Insurers Adjust Standards for Doctors, Hospitals
Bruce Japsen

Chicago Tribune, 9/4/10

The new federal health care law is bringing additional demands by insurance companies that doctors and hospitals be held to higher quality standards. While this push by insurers on quality implies that consumers will get better care because doctors and hospitals will be measured against the best performers, there may be an unintended consequence: It could leave patients with fewer choices of medical care providers, depending on which health plans they purchase. Read more...

More Empowered Patients Question Doctors' Orders
Mary Brophy Marcus

USA Today, 9/01/10

In the past, most patients placed their entire trust in the hands of their physician. Your doc said you needed a certain medical test, you got it. Not so much anymore. Many physicians say an increasing number of patients are getting involved in decisions about their medical care, including medication choices, whether they need a specialist, and especially whether they need expensive diagnostic tests, which some health economists say are driving up the cost of health care.Read more...

Even With Malpractice Insurance, Doctors Opt for Expensive, Defensive Medicine
Manoj Jain

The Washington Post, 08/31/10

Most malpractice suits turn out to be against doctors who were not at fault. Of every 100 malpractice claims filed, only 17 appeared to involve a negligent injury, such as a medication overdose resulting in death, according to a 2004 New England Journal of Medicine review. This means that patients and lawyers appear to be suing the doctors and hospitals for non-negligent injury 83 percent of the time. Some researchers have likened our malpractice system to a traffic cop who gives out 100 tickets to nab 17 drivers who have run a red light, in the process ticketing 83 who drove through a green light quite properly. The second paradox is this: Studies of hospital records show that of every 100 injuries that occur due to medical negligence, only two result in malpractice claims. This means that 98 of 100 negligent injuries go unchallenged. To continue with the traffic analogy, of all the drivers who run red lights, only a very few are caught and receive a ticket.  Read more...

CBO Gives Us the Complete Picture Five Months Late
Keith Hennessey

KeithHennessey.com, 8/25/10

Last week CBO released their annual summer baseline update.  On page 6 (page 24 of the PDF) is a box titled “The Effects of Major Health Care Legislation on CBO’s Baseline.”  It provides an important new data point that was absent when the legislation was being debated. While I disagreed with some of the judgment calls CBO made during the health care debate, on the whole I think they did a good job under difficult circumstances.  This missing information, however, was and is a significant failing by the CBO.  Unlike with other major legislation, CBO’s scoring of the health laws blended spending increases and tax cuts into a single measure of deficit effects. The final scoring showed that these two bills combined would reduce the budget deficit over the next ten years. Read more...