Archive for the 'General Rationing Issues' Category

Fun With Randomized Trials, and Breasts

Friday, July 18th, 2008

The Cochrane Collaboration has created something of a stir with its latest review on the advisability of doing breast self-examinations, which concluded, in essence, that they’re not advisable. Specifically, they found that women who perform breast self-examinations end up producing more harm than good, so women should be discouraged from the practice.
The Cochrane Collaboration is […]

Posted in General Rationing Issues | 6 Comments »

How Covert Rationing Precludes Efficiency

Thursday, July 3rd, 2008

(Don’t forget to check out the Independence Day version of Medical Grand Rounds.)
Depending on which news source you read, physicians either are or are not about to get hit with a 10.6% pay cut from Medicare. (The actual outcome of the pay cut kerfuffle, some say, will depend on how many Republican Senators are buttonholed […]

Posted in General Rationing Issues | 4 Comments »

Proof That Warren Buffet Reads This Blog

Saturday, May 17th, 2008

Yesterday, Jacob Goldstein of the Wall Street Journal Health Blog reported that Warren Buffet greatly increased his stake in big health insurers during the first quarter of 2008. Specifically, he added 300,000 shares of WellPoint and 400,000 shares of UnitedHealth to the holdings of Berkshire Hathaway. Notably, the stock prices of both of these insurers […]

Posted in General Rationing Issues | 6 Comments »

Happy Anniversary, If I Do Say So Myself

Thursday, May 15th, 2008

They said it couldn’t be done.
They said, “An entire blog devoted to covert healthcare rationing? Ha!” They said, “Perhaps you’ll come up with a posting or two, but an entire blog? Why, you’ll run out of things to say inside of a week.” They said, “Covert rationing indeed!”
So today, on the First Anniversary of the […]

Posted in General Rationing Issues | 7 Comments »

Covert Rationing Makes Malpractice Reform A Bad Idea

Friday, May 9th, 2008

Our friend Kevin Pho was undoubtedly correct when he pointed out in his recent op-ed in USA Today that arbitrary and unrestrained medical malpractice lawsuits are a blight on our healthcare system. The always-looming threat of malpractice suits elicits expensive and wasteful defensive behaviors from doctors and hospitals, and is a major source of physician […]

Posted in General Rationing Issues, Medical malpractice | 10 Comments »

On Crying Doctors

Wednesday, April 23rd, 2008

The New York Times yesterday published an essay by Barron H. Lerner, MD, on the question of whether doctors ought to remain stoic at the bedside, or instead ought to openly display their emotions. Lerner himself seems neutral on this question, and offers arguments from both sides (i.e., the advantages on one hand of […]

Posted in General Rationing Issues | 7 Comments »

Never Events? Never Mind

Friday, April 18th, 2008

Medicare’s newfound passion for quality has found yet another avenue of expression.
A year ago the Centers for Medicare and Medicaid Services (CMS) announced it would no longer pay for the treatment of certain medical conditions that occur after patients have been admitted to the hospital. These conditions were:
* Bed-sores
* Two kinds of catheter-associated infections
* Air […]

Posted in General Rationing Issues | 5 Comments »

More Guidelines: What Are They Smoking?

Friday, April 4th, 2008

This is a heads-up for all you primary care doctors out there, who struggle during each and every patient visit to get through your Pay for Performance Checklist of Vital Healthcare Services (different checklists for different patients, of course, depending on their insurer), during the 7.5 minutes that the feds and the insurance companies have […]

Posted in General Rationing Issues, Primary Care in America | 8 Comments »

How to Invest in the New Medicare Audits

Tuesday, March 11th, 2008

Several bloggers (including DB and Catron) have commented on the recent unleashing of Medicare’s “Recovery Audit Contractors.”
The RACs are a fun tidbit brought to us by the Medicare Prescription Drug Act of 2003. Under the RAC initiative, private contractors will soon be dispatched across the land to perform audits of billing already done by insurers, […]

Posted in Wonkonian Rationing, General Rationing Issues | 1 Comment »

How to Think About the Obesity Dividend

Sunday, February 10th, 2008

An article published last week in the Public Library of Science Medicine Journal has created tremendous buzz in the media and the blogosphere. This article compared the lifetime cost of healthcare (beginning at age 20) for obese individuals and for smokers to the lifetime cost for non-smokers who maintained a healthy weight. Naturally, […]

Posted in General Rationing Issues | 8 Comments »

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