by John Geyman, M.D. www.johngeymanmd.org Traditional, or Original Medicare, turns 50 on July 30, having had many challenges and achievements from the days of its passage to today. It is time to celebrate its many successes, note some of its current challenges and threats to its future, and briefly discuss how it gives us a […]
by John Geyman, M.D. www.johngeymanmd.org You might think that we learned the lesson of discredited managed care in the 1990s. The term “managed care” is confusing to many, but really amounts to managed reimbursement rather than managed care, whereby a set prospective annual payment is made by federal/state governments, as in the case of Medicaid […]
“I think that the momentum for a single payer system will sweep the country . . . it will be such a huge popular issue . . . that even if it’s not successful the first time, it will eventually be.” —Hillary Clinton
After five years’ experience with the ACA, we now know that insurers themselves are a major barrier to achieving the kind of access to affordable care that our population so desperately needs.
The proposed legislation casts in concrete an almost laughable complex and expensive clinical record-keeping regime, while preserving the very volume-enhancing features of fee-for-service payment that caused the SGR problem in the first place. The cure is actually worse, and potentially more expensive, than the disease we have now.
“Although the past decade has witnessed a fair amount of experimentation with performance-based payment models, primarily P4P programs, we still know very little about how best to design and implement value-based payment programs to achieve stated goals and what constitutes a successful program.” – 2014 Rand report
by John Geyman, M.D. Author of How Obamacare is Unsustainable. Now that Obamacare (the Affordable Care Act or ACA) is just turning five years since its enactment in 2010, it is time to assess its progress and shortfalls. This is the first of three posts that will deal with its experience toward its major goals—expanding […]
While there may be merit in some of these proposals, Brill’s brief prediction of how they would reform our system is unpersuasive and comes across as only wishful thinking, uninformed by evidence. His “plan” would just add another layer to our flawed system…
by John Geyman, M.D. http://www.copernicus-healthcare.org Having just finished reading Bob Herbert’s excellent book, Losing Our Way: An Intimate Portrait of a Troubled America, I am struck by the parallels between trends in public education and in health care. Herbert, opinion columnist for the New York Times for 18 years and now a Distinguished Senior Fellow […]
The prices and costs of cancer care in the United States have been growing so fast, for so long, that they are now a “canary in the coal mine” of an unaccountable health care system. Many cancer patients are now forced by their increased cost burdens to forego necessary care and die earlier without adequate care. There is a fix—single-payer financing that eliminates profits and waste to the detriment of patient care.
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