Saturday, April 19, 2014
Inquirer Daily News

Robert I. Field

POSTED: Wednesday, April 9, 2014, 6:59 PM
Filed Under: Robert I. Field

Medicare paid a Florida ophthalmologist $26 million in 2012. It paid a Florida cardiologist $23 million. Dozens of other doctors received more than $4 million. And hundreds received well over $1 million.

These are among the more starling revelations contained in a trove of data on physician payments that the Medicare program released yesterday. (To access the data directly, click here.)  It was no secret that some doctors make a lot of money. But that much money, and entirely at taxpayer expense? That took many by surprise.

What is not a surprise is the distribution of Medicare payments to doctors. The highest earners were almost all specialists. An analysis by the New York Times found that all but a few of the doctors in the highest-paid 2% practiced in specialties and only a small portion in primary care. 

POSTED: Friday, March 28, 2014, 6:00 AM
Filed Under: Robert I. Field

We asked the Field Clinic advisory board for thoughts on the most important thing people should know about the impending end of open enrollment in the insurance exchanges on March 31.

Here is the observation of Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross.

Many people in our region who’ve signed up for individual health coverage since the start of open enrollment on Oct. 1 got a surprise – coverage can be quite affordable.  According to federal statistics, 85 % of people who signed up for health plans in states with federal exchanges – like Pennsylvania – received federal subsidies.  These can dramatically lower the cost.

POSTED: Wednesday, March 26, 2014, 5:14 PM
Filed Under: Robert I. Field

How can a corporation exercise religion?

Justice Sonia Sotomayor posed that question Tuesday, March 25th at the Supreme Court hearing on the Obamacare contraception mandate. (See my news report on the case in the Inquirer.)  Two private for-profit companies, Conestoga Wood Products based in Lancaster County, PA and Hobby Lobby Stores based in Oklahoma City, OK, claim their corporate religious beliefs would be violated by complying with the rule.  Justice Sotomayor wondered if they can actually have any.

Justice Elena Kagan asked how far corporations could go in the name of religion.  Could they refuse to cover vaccines or blood transfusions for their employees?

POSTED: Friday, January 3, 2014, 6:00 AM
Filed Under: Robert I. Field

If you visited the federal health care website,, in October, you know what a disaster it was. I tried accessing it on October 1 and gave up after staring at a frozen screen for 15 minutes.

The site’s problems went even deeper than the technical glitches. They included basic design flaws. Most notably, the site provided no information about insurance plans or how to sign up for them unless a visitor created an account. This discouraged window shoppers and those seeking general background – people who were often most in need of the site’s assistance.

President Obama promised that the website would work by November 30, but many remained skeptical that a debacle of that magnitude could be fixed so soon. However, the computer geeks must have accomplished something, because more than a million people succeeded in signing up for coverage by the end of December. More than 880,000 visited it on Christmas Eve alone. And almost a million more signed up on the sites run separately by 14 states.

POSTED: Thursday, October 31, 2013, 5:56 PM
Filed Under: Robert I. Field

It’s a train wreck.

The programmers knew a disaster was coming. The computer system they created was far too primitive to keep up with the traffic. A major crash was inevitable.

And what’s worse, similar computer failures are certain to continue. The system will never be able to handle the quantity of data involved. The whole idea was ill-conceived.

POSTED: Monday, September 16, 2013, 6:00 AM
Filed Under: Robert I. Field

Even the best initiative in the world can’t do any good if no one knows about it. That, apparently, is the thinking of Obamacare’s opponents. They have begun aiming their attacks on navigators, the people whose job it is to inform the public about how to gain coverage through the new insurance exchanges.

The Florida Department of Health issued an order this week that prohibits navigators from advising uninsured residents on the grounds of the state’s 60 local health departments. That will make it more difficult to reach those who need the law’s benefits the most.

In at least 16 states, laws have been passed or are under consideration to subject navigators to new layers of regulation. The Georgia insurance commissioner has declared that he will require navigators to pass the same licensing test as insurance brokers, even though their role is different.

POSTED: Monday, September 2, 2013, 6:00 AM
Filed Under: Robert I. Field

Just one month remains before Obamacare starts to take full effect. On October 1, insurance exchanges, the law’s centerpiece, are scheduled to open for business.

Many await with excitement the chance to gain coverage they have been denied up to now because of poor health. Others fear the launch of a new bureaucratic morass. But a large number of Americans just want to understand what is going on.

In a poll conducted last June by the Kaiser Family Foundation, 45% of respondents reported knowing “nothing at all” about the exchanges, and only 22% said they had heard “a lot” or “some” information about them. (Click here to see the full poll results.)

POSTED: Monday, August 26, 2013, 6:00 AM
Filed Under: Robert I. Field

Two major organizations announced significant changes in their health insurance benefits last week. They will no longer cover the spouses of employees who are eligible for benefits from their own employer.

United Parcel Service will implement the change for white-collar workers. The University of Virginia will implement it for everyone.

The reason given for the moves? Obamacare, of course.

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
Neil I. Goldfarb President & CEO of the Greater Philadelphia Business Coalition on Health
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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