Freeing companies from a U.S.- government mandate to offer employees health care is setting off a chain of events that may enlarge the pool of uninsured Americans. That may be good for President Barack Obama's health-care overhaul. The success of the 2010 Affordable Care Act is largely dependent on how many people are willing to buy subsidized health plans through government exchanges. Most of the people affected by Obama's decision this month to delay the employer mandate to provide health care will now be eligible to use the exchanges when they open Oct. 1. The law's creation of state-by-state marketplaces had targeted about 26 million of the more than 50 million uninsured Americans for coverage.
Stand-alone EDs, which are often located near high-end shopping centers and target consumers with private insurance, bill like regular emergency deparments. Insured patients have little incentive to drive past more expensive, freestanding EDs because their co-payment is only $50 or $100, modestly more than what it might cost for a visit to an urgent-care center or doctor's office. Their insurers pay the balance. Insurers have little power to stop patients from using the facilities because by state law, they must pay for ED coverage any time a patient perceives they have an emergency, regardless of whether that turns out to be the case. For that reason, the freestanding EDs have no need to contract with insurers and offer discounts.
Your doctor hands you a prescription for a blood pressure drug. But is it the right one for you? You're searching for a new primary-care physician or a specialist. Is there a way you can know whether the doctor is more partial to expensive, brand-name drugs than his peers? Or say you've got to find a nursing home for a loved one. Wouldn't you want to know whether the staff doctor regularly prescribes drugs known to be risky for seniors or overuses psychiatric drugs to sedate residents? For most of us, evaluating a doctor's prescribing habits is just about impossible.
BOSTON — About half of the state's primary care practices are closed to new patients and wait times to see a primary care physician remain long, according to the results of an annual survey released Monday by the Massachusetts Medical Society. According to the survey of 1,137 doctor's offices, 51 percent of family physicians and 45 percent of internists are accepting new patients. Family physicians and internists are the two most common types of general practitioners. The results are similar to last year's survey that found 50 percent of family doctors and 51 percent of internists open to new patients in Massachusetts.
Uncle Sam wants your doctor go to digital. And the federal government is backing that up with money for practices that start using computerized systems for record keeping. Nearly half of all physicians in America still rely on paper records for most patient care. Time is running out for those who do to take advantage of federal funds to make the switch. So practices like are scrambling to get with the program. Nearly 200 patients come through the office on a typical day. Doctors and staff pop in and out of exam rooms and offices constantly, carrying big stacks of manila folders holding patient charts.
This past spring, Sen. Max Baucus (D-Mont.) called the impending implementation of the Affordable Care Act "a huge train wreck." His words caught my attention because the last time the federal government delivered a new health-care benefit to more than 40 million people, I drove the train. As secretary of health and human services during President George W. Bush's second term, I faced the daunting task of rolling out Medicare's new prescription drug benefit. Commonly referred to as "Part D," the program is considered a tremendous success: Premiums have remained low, the program operates well under its projected budget and 90 percent of seniors are satisfied with their plan.