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New England Leads Nation In Primary Care – Newsroom: Bernie Sanders – U.S. Senator for Vermont

June 30, 2013 Leave a comment

With Vermont leading the way, five of New England’s six states rank in the top six for primary care doctors per capita, according to datafrom the Association of American Medical Colleges. The sixth, Connecticut, ranks 12th. As the national shortage of primary care doctors expected to increase after the federal Affordable Care Act takes full effect next year, some are looking to New England’s states with an eye to what they’ve been doing right.

Several factors contribute to New England’s relatively strong position. Among them: strong public health programs ensuring that high percentages of residents have health coverage, meaning fewer doctors deliver uncompensated care. Massachusetts, which enacted a universal health care program in 2006, has about 97 percent of its residents carrying health coverage. In Vermont it’s about 94 percent.

This, is ocourse, the goal of health reform.  Get people insured, and get them in front of their PCPs for care before they are so sick that they need to go to the ER or be admitted to the hospital.  Two important things are needed — access to health care through affordable insurance and access to proactive, preventive care oriented primary care physicians.

See on www.sanders.senate.gov

Health Affairs: For States That Opt Out Of Medicaid Expansion: 3.6 Million Fewer Insured And $8.4 Billion Less In Federal Payments

June 9, 2013 Leave a comment

According to a study published in the June 2013 issue of Health Affairs:

[F]ourteen governors have announced that their states will not expand their Medicaid programs. We used the RAND COMPARE microsimulation to analyze how opting out of Medicaid expansion would affect coverage and spending, and whether alternative policy options—such as partial expansion of Medicaid—could cover as many people at lower costs to states. With fourteen states opting out, we estimate that 3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion. These effects were only partially mitigated by alternative options we considered. We conclude that in terms of coverage, cost, and federal payments, states would do best to expand Medicaid.

“Physician-owned hospitals seize their moment” – amednews.com

June 9, 2013 Leave a comment

Physician owned and operated facilities are not necessarily bad places to go for healthcare.

American Medical News, amednews.com, reported in April 29, 2013:

When the federal government sorted through the first round of clinical information it was using to reward hospitals for providing higher-quality care in December 2012, the No. 1 hospital on the list was physician-owned Treasure Valley Hospital in Boise, Idaho. Nine of the top 10 performing hospitals were physician-owned, as were 48 of the top 100.

Yet, physicians can no longer own hospitals to which they refer their patients and are severely restricted from expanding those hospitals whose physician ownership was grandfathered.

The continued distrust of physicians and their vilification by Congress and most every state legislature hurts healthcare.  It’s time to unburden physicians from lawyer mandated restrictions that never made any sense — repeal the Stark Law and every other restriction on physicians’ referring their patients to entities that they have an ownership in.  The laws and the regulations that have been put into place are beyond comprehension and require physicians who are trying to be compliant to spend unnecessary dollars on lawyers.  There are many appropriate tools for dealing with fraud and abuse by physicians who over utilize, or bill for services not performed, or who perform sub-par medicine — they can be professionally disciplined, lose their license, go to jail,  fined. On the private side, they can be sued.  Congress adopts these strict liability patient referral restrictions because they are easy to enforce.  That should not be the basis for interfering with an entire industry.

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