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Tag Archives: Medical Policy


In Our Health System, ObamaCare is the Dangerous Pre-Existing Condition

By Nan Hayworth • The Hill

As a physician whose career in medicine was dedicated to preserving and improving my patients’ health, I know firsthand how important it is for everyone to have access to care. This is a fundamental precept, morally and pragmatically sound, that should be honored by all who seek to transform for the better America’s flawed system of health care delivery.

Regrettably, since its passage in 2010, the Affordable Care Act (ACA) has had the net general effect of raising the cost of health insurance while reducing the quality and variety of the services that insurance covers. This is the opposite of what was intended — but the suffering engendered thereby is real and painful.

The best-case remedy would be to repeal the ACA completely and replace it with a much simpler, more targeted set of common-sense interventions to empower consumers and ensure their access to Continue reading


The Nasty Surprises That Plague Our Health-Care System

By Charles Silver & David A. Hyman • National Review

If you’ve ever been in a collision, you’ve probably dealt with a body shop. In all likelihood, the process went smoothly. You paid your deductible, your insurer paid the rest, and that was the end of the financial side of the repair.

Health care works differently. After eight-year-old Ben Millheim injured himself during a camping trip, his family was stuck with a $32,000 bill from the sky-ambulance company that flew him 88 miles to a hospital in St. Louis. That was the balance that remained after the Millheims’ insurer paid $12,000 for the service. Elizabeth Moreno was stuck with a bill for $17,850 because a physician asked her to provide a urine sample. She didn’t know that the doctor’s testing lab was out of her insurance network. Moreno’s insurer, Blue Cross Blue Shield of Texas, which would have paid an in-network lab $101 for the service, refused to cover the bill at all. Fearing for his daughter’s credit rating, Moreno’s father bargained the bill down to $5,000 and paid.

The Millheims and Morenos are but two of the tens of thousands of families who receive surprise medical bills every year. These are “balance bills,” that seek to hold patients responsible for charges their insurers won’t pay. The problem is so bad and so Continue reading


Coalition Letter Opposing Blocking Parental Access to Critical Vaccinations

Coalition

To: Dr. Thomas R. Frieden, Director, Centers for Disease Control and Prevention CC: CDC Advisory Committee on Immunization Practices

Dear Dr. Frieden and CDC Advisory Committee of Immunization Practices Members,

We write to you today in support of a family’s right to access to safe, effective vaccines for their children. Vaccines have saved millions of lives since their invention and near universal vaccination rates have eradicated a number of horrible diseases from small pox to polio. Unfortunately certain diseases like Meningitis B, the cause of 40% of all meningitis cases in 2012, could persist because the Centers for Disease Control (CDC) may opt to block access to life-­‐saving vaccinations.

In late February, your Advisory Committee on Immunization Practices (ACIP) will meet to determine the accessibility of two vaccines the Food and Drug administration recently approved to prevent Meningitis B. ACIP, and therefore CDC, appears poised to recommend its usage only for “high-­‐risk group/outbreaks,” meaning private health insurance will cover the cost of vaccination only after an outbreak of this deadly disease has occurred. Continue reading


Health-care myths we live by

Medicaid-Medicare-Medicine-Medical Policyby Charles Krauthammer

Swedish researchers report that antioxidants make cancers worse in mice. It’s already known that the antioxidant beta-carotene exacerbates lung cancers in humans. Not exactly what you’d expect given the extravagant — and incessant — claims you hear made about the miraculous effects of antioxidants.

In fact, they are either useless or harmful, conclude the editors of the prestigious Annals of Internal Medicine: “Beta-carotene, vitamin E and possibly high doses of vitamin A supplements are harmful.” Moreover, “other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.” So useless are the supplements, write the editors, that we should stop wasting time even studying them: “Further large prevention trials are no longer justified.”

Such revisionism is a constant in medicine. When I was a child, tonsillectomies were routine. We now know that, except for certain indications, this is grossly unnecessary surgery. Not quite as harmful as that once-venerable staple, bloodletting (which probably killed George Washington), but equally mindless. Continue reading