Wednesday, July 31, 2013

Kellogg on ObamaCare

James Kellogg has a nice overview of what's coming down the pike in his Grand Junction Free Press OpEd, "Obamacare is unhealthy for America".

Tuesday, July 30, 2013

Quick Links: Docs Avoiding Medicare, Patients Avoiding ObamaCare, Fat In NZ

Wall Street Journal: "More Doctors Steer Clear of Medicare: Some Doctors Opt Out of Program, Frustrated With Payment Rates and Mounting Rules" (7/28/2013).

From the article:
The number of doctors who opted out of Medicare last year, while a small proportion of the nation's health professionals, nearly tripled from three years earlier, according to the Centers for Medicare and Medicaid Services, the government agency that administers the program. Other doctors are limiting the number of Medicare patients they treat even if they don't formally opt out of the system.
NPR: "Canvassers For Health Coverage Find Few Takers In Boca Raton" (7/29/2013)

BBC: "South African chef 'too fat' to live in New Zealand" (7/27/2013)

According to the New Zealand government, "It is important that all migrants have an acceptable standard of health to minimise costs and demands on New Zealand's health services..."

Monday, July 29, 2013

Catron on IRS and Hypocrisy

David Catron's latest American Spectator piece, "IRS: Obamacare for Thee but Not for Me".

Here's the opening:
Among the most offensive features of the ironically titled "Affordable Care Act" is its designation of the Internal Revenue Service as the main enforcer of the law’s many mandates, taxes, penalties, and reporting requirements. It exponentially increases the power of a group of bureaucrats notorious for repeatedly abusing their authority. Now, highlighting the growing gulf between the government and the governed that has become the hallmark of the Obama era, these IRS enforcers are asking their congressional representatives to spare them the indignity of enrolling in Obamacare’s insurance exchanges...

Roy/Ungar Forbes Twitter Chat on ObamaCare

Forbes recently hosted a Twitter chat, with Avik Roy and Rick Ungar fielding question from their followers.

Here's the link to the transcript.

Here's the question I asked, with their answers:

Friday, July 26, 2013

MA to Link Medical Licensure to Electronic Medical Records "Meaningful Use"

Coming soon -- new licensure controls in Massachusetts.

PhysBizTech reports, "Rule links meaningful use with medical licensure":
Starting in 2015, doctors in Massachusetts will have to show health IT meaningful use proficiency as a condition for medical licensing.

By the medical society’s estimate, [Massachusetts Medical Society President Ronald]Dunlap said, "probably 70 or 80 percent of physicians in the state using computers are probably adept, yet at least more than half of them would not meet the meaningful use standard."
MA State Senator Richard Moore gives the government rationale:
My feeling is that every physician and nurse practitioner and others who are primary care providers need to be involved in and utilizing health information technology, and if they’re not, then I don’t think they're practicing safe medicine.
In other words, another government mandate rammed down the throats of practicing physicians in the name of "safety".   Of course over time, mandated electronic records will be used to ensure that doctors are practicing according to government guidelines -- which may or may not be what's in the best interests of the patient.

(Via @MedEconomics.)

Thursday, July 25, 2013

WSJ on the New York Model

WSJ: "Obama's New York Model"

They note:
The real news is that New York ruined its individual insurance market two decades ago by imposing the same regulations that ObamaCare is about to impose on every other state. If the Empire State's premiums do now fall, it will be because the Affordable Care Act partially deregulates New York insurance.
Incentives matter.  (Via Dr. Richard Amerling.)

Wednesday, July 24, 2013

Hsieh Forbes OpEd on Zimmerman and Responsible Concealed Carry

Yesterday's Forbes published my latest OpEd, "The Single Most Important Lesson Gun Owners Should Learn From The George Zimmerman Case".

Here is the opening:
I am a gun owner. I support the 2nd Amendment and the right to self-defense. Although I’m not a police officer or a gun expert, I am one of the 8 million Americans with a concealed weapons permit. And the most important lesson I’ve learned from the George Zimmerman case is, “Don’t go looking for trouble”...

Monday, July 22, 2013

Wednesday, July 17, 2013

Adalja on The Right to Terminate One's Life

Dr. Amesh Adalja discusses an important right in his latest Forbes piece, "Does The Right To Life And Liberty Include The Right To Terminate One's Life?"

He asks:
What underlies the belief that it is the prerogative of the State to interfere with the doctor-patient relationship to forbid a physician from assisting in the suicide of a patient who has no meaningful chance of recovery?
In particular, he contrasts that with:
The view that a person is not a sovereign individual provides the false philosophical underpinning for this viewpoint, nullifying the right to liberty. Opponents of assisted suicide place sovereignty outside the individual and view individuals either as the property of a supernatural deity or mere vassals of the State. To them, assisting with suicide is interfering with “God’s plan” or the “interests of the State” and therefore criminal. Any appeal to individual rights falls upon the deaf ears of those to whom the concept of individual rights is meaningless.
I agree with Dr. Adalja's position.  (I know many of my conservative friends will disagree.)

As far as implementing such a right, I do think it's entirely appropriate for the state to make sure that any cases of purported assisted suicide are indeed such, rather than murder disguised as assisted suicide.  For instance, some proponents support protocols where the patient must take one final affirmative action (such as pressing a button on a machine) to complete the act. Similarly, the state has an interest in insuring that any agreement for assisted suicide was made by a patient with sound mind and full understanding of the meaning of his choice (i.e., that he is giving genuine informed consent to the procedure).

Furthermore, such a right does not mean that physicians should be compelled to offer this service, just because a patient requests it. Physicians should be free to decline to perform this for reasons of personal conscience (unless they've made contractual agreements otherwise). But this is true of any medical procedure.

But these are discussions of how to implement a proper law. The broader principle of the right to one's life and the full implications of that are covered nicely in Dr. Adalja's piece.

Tuesday, July 16, 2013

Catron on Smoker Penalty Snafu

David Catron points out in his latest American Spectator piece that ObamaCare snafus will mean that non-smokers will involuntarily subsidize the health costs of older smokers

In effect, this is caused by a combination of price controls and bad software implementation.

From his piece:
Last week the Associated Press reported, “In yet another health care overhaul delay, the administration has quietly notified insurers that a computer system problem will limit penalties that the law says the companies may charge smokers. A fix will take at least a year.” How will this force non-smokers to subsidize smokers? Well, from the perspective of insurance carriers, smokers are high-risk customers. They get sick more often than non-smokers and their maladies are typically serious and expensive. So, if insurance companies want to remain solvent and they can’t charge smokers higher rates, they will have to increase premiums for everyone.
For more details on how this can create an unintentional benefit for smokers, read the full text of "Latest Obamacare Foul-Up Favors Smokers".

Thursday, July 11, 2013

Tuesday, July 9, 2013

Fumbles and Failures

David Catron discusses, "Another ObamaCare Fumble".

Here's the opening to his piece:
The White House says the decision, announced last Tuesday, to delay implementation of Obamacare’s employer mandate was made because “a dialogue with businesses” revealed the need to reduce the reporting burden it placed on employers. This tale is enough to make a cat laugh. This crew doesn’t do “dialogue.”
Your BS detector badly needs a tune up if it didn’t start buzzing when Valerie Jarrett blogged, “We’re listening.” The delay is obviously due to the ineptitude of the Obama administration, and this is the fourth major provision of PPACA to be repealed or delayed for the same reason...
The Heritage Blog offers this related list, "Obamacare's Dirty Dozen Implementation Failures".

Monday, July 8, 2013

Dr Kravtiz' Innovative Surgery Practice

Great story of how innovation and transparent pricing create a win-win for both patient and doctor:

"For the uninsured, Dr. Alan Kravitz knows a way to beat the pain" (Pittsburgh Post-Gazette, 7/7/2013).

(Via Dr. Amesh Adalja.)

Monday, July 1, 2013

IBD On Medical Record Privacy

Investor's Business Daily: "Think NSA Spying Is Bad? Here Comes ObamaCare Hub" (6/25/2013)

As always, the government says, "Trust us -- we won't misuse this data".

But privacy experts discuss reasons to be skeptical.