The release last month of the Bush administration’s 2008 National Drug Control Strategy was cause for optimism, but only barely.
On the plus side, the use of illicit drugs among young people has declined 24 percent since 2001, when the first such report was released. The steepest drops have occurred in the use of meth, LSD, ecstasy, steroids, marijuana, and other “street” drugs.
But kids, it turns out, are finding drugs closer to home, sometimes in the family medicine chest. According to the report, prescription drug abuse among the young is on the rise, especially the abuse of opioid pain killers. For youngsters 12 or older, in fact, a pain reliever like OxyContin is now vying with marijuana as the “gateway” drug of choice—the one that initiates even more serious drug abuse down the road. The administration has promised to step up its efforts to control the problem, through youth education and random testing but also through aggressive law enforcement efforts, aimed in part at the prescribers themselves. continues…
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From Medical Economics magazine, more on DEA ...
If a bill recently introduced in Delaware passes, state residents who suffer cardiac or brain death will become potential organ donors, whether that’s what they intended or not.
Earlier this year, Rep. Pete Schwartzkopf, a Democrat from Rehoboth Beach, co-sponsored legislation in which residents would automatically be enrolled as an organ and tissue donor when applying for or renewing their driver’s license—unless they check a box indicating that they do not wish to participate.
This opt-out model for organ donations, known as Presumed Consent, bucks the spirit of our current voluntary opt-in (Informed Consent) system. Presumed Consent changes the nature of the consumer’s decision. It’s more guilt-inducing—and harder—for consumers to actively choose not to help others in need than to passively let the opportunity to help slip by. Legislating an opt-out approach also implies that donating organs is the sanctioned social norm. continues…
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From Medical Economics magazine, more on informed consent ...
The announcement last month that New York Attorney General Andrew M. Cuomo was getting ready to sue UnitedHealth Group and its subsidiaries over “fraudulent, deceptive, and illegal business practices” drew a flurry of media and other attention.
At issue was the system the insurer has been using to set reimbursement rates for out-of-network services. The AG’s office alleges that the system incorporates intentionally flawed data, thereby yielding “unduly low reimbursements to members.” UnitedHealth Group, which has promised to cooperate fully with the AG, has defended its rate-setting methodology, adding that it’s “committed to fair and appropriate payment for physicians, the state’s other healthcare providers, and consumers.” continues…
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From Medical Economics magazine, more on organized medicine ...
Last month, New York became the latest state to confront a problem that other states have been wrestling with for some time—increasing the supply of physicians in their underserved areas.
New York, like other states with large swatches of rural land, has reason to act. One-quarter of the state’s population—roughly 4.9 million people—lives in areas with more than 3,500 people per physician. According to the state Department of Health, it would require an additional 300 primary care physicians or more in each of these Health Professional Shortage Areas to begin to right the imbalance. Many of these same areas are also short of specialists. Eight New York counties, for instance, have no gynecologists practicing obstetrics. And Western New York is hemorrhaging surgeons at an alarming rate. continues…
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From Medical Economics magazine, more on health policy ...
In the final scene of the movie Schindler’s List, Oskar Schindler, a German businessman, laments that although he saved over a thousand people from death at the hands of the Nazis, he didn’t help enough. “I could have done more” is a line that has now become a classic.
Talking to physicians in recent months, I’ve heard similar self-reproach. Doctors are very hard on themselves. High standards are part of your hardwiring, and if you fall short, your self-image of being a really good doctor takes a hit. continues…
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From Medical Economics magazine, more on medical profession ...
In the debate over healthcare reform, organized medicine, led by the AMA, has long favored a pluralistic approach, long on private involvement, short on government intervention.
Now the American College of Physicians has strayed from the established orthodoxy. In a paper released online in early December (and in the pages of the Annals of Internal Medicine this month), the ACP has put forth a number of recommendations, including one calling for universal health insurance coverage, either through a revamped pluralistic system—something along the lines of the Federal Employees Health Benefits Program (FEHB)—or, more controversially, a single-payer system. continues…
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From Medical Economics magazine, more on health policy ...
A new year, a fresh start. Perhaps 2008 will be the year for real progress in resolving the malpractice crisis. The public is slowly getting the message that stratospheric malpractice premiums ultimately harm them too, as good doctors flee certain states and drop important procedures. One alternative, health courts, makes a lot of sense, but its forward momentum rivals that of Sisyphus. With health courts, compensation judgments would be made outside the regular tort system. Specially trained judges would make decisions on an avoidability standard. Injuries would be compensated if they could have been avoided with best practice care. Negligence, by contrast, focuses on whether care fell below customary practice. continues…
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From Medical Economics magazine, more on litigation ...
Posted by
Wayne Guglielmo on December 21st, 2007. Filed under:
health plans,
aetna,
Cigna,
claims,
health insurance executives,
healthcare costs,
kaiser permanente,
managed care,
opinion,
patients,
physicians,
reimbursement,
United Healthcare,
wellpoint.
In the debate over rising healthcare costs, some see managed care as part of the solution, and some see it as part of the problem. Industry representatives, to no one’s surprise, place themselves squarely in the first camp. They blame rising costs on a gaggle of factors not of their own doing—overconsumption by consumers, physician overutilization, and poor-quality care, to name a few. To bring high-quality, cost-effective healthcare to all Americans, the industry has sought to tame these runaway drivers. The industry isn’t alone in seeing managed care as part of the solution. In an editorial late last month, The New York Times included managed care among the solutions to the cost crisis. Properly employed so as not to trigger another backlash, the Times editors suggested, it still has a role to play in keeping a lid on things.
But not everyone sees things that way. continues…
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From Medical Economics magazine, more on health plans ...
Late last month, New York Attorney General Andrew M. Cuomo announced that his office had reached an agreement with Cigna HealthCare on major revisions to its physician-ranking programs in the Empire State, and beyond. Under the new pact, Cigna promises, among other things, to broaden its ranking criteria beyond cost, use generally accepted national standards to measure quality, disclose program design elements to consumers and physicians, and hire an independent watchdog (subject to AG approval) to monitor its compliance.
The agreement grows out of Cuomo’s industry-wide investigation of physician-ranking programs. In separate letters to six plans, Cuomo and his staff raised a laundry list of concerns. continues…
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From Medical Economics magazine, more on health plans ...
At a recent medical convention, a doctor in her mid-40s came over to me and broke down crying. Fury and despair flashed in her eyes.
She had lost her hospital privileges for what she claimed was retaliation over reporting a surgeon who appeared inebriated during some procedures. Her former colleagues stopped speaking to her. Now she was practicing part time in another state and said she had lost her income, friends, and respect.
I can’t verify what actually happened. What struck me was that the event had occurred six years ago. This physician’s emotions and reactions were as powerful and as top-of-mind as if it had happened last week. She was still devastated, and her life seemed to be moving into a downward spiral. continues…
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From Medical Economics magazine, more on career ...
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