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Archive: July, 2013

POSTED: Wednesday, July 31, 2013, 6:00 AM
Filed Under: Katheryne Lawrence

When most of us head to the doctor, chances are that the person wielding the stethoscope has been certified to practice in their specialty by a member board of the American Board of Medical Specialties (ABMS). Board certification is an important measure of competence for American physicians. But just when did your doctor receive that badge of approval?

Until recently, most doctors who gained board certification did so at the start of their careers. That means a doctor who is 65 years old could have been certified as far back as 1973. What does this say about his or her competence today, 40 years later?

The answer given by most physicians is that they are as competent as ever. But how can you be sure? One approach to providing an answer is recertification - requiring that doctors retake the certification exam every few years.

POSTED: Friday, July 26, 2013, 5:00 AM
Filed Under: Robert I. Field
(AP Photo/Carolyn Kaster)

Obamacare’s rollout has entered the homestretch. The new insurance exchanges are scheduled to open for business in just over two months. Three months after that, the policies they sell will take effect. At that point, every American will enjoy guaranteed access to health insurance regardless of health status.

With the finish line in sight, opponents have become more strident than ever. Having failed to block the law in Congress, in the Supreme Court, and in the last presidential election, they are promising to throw everything else they can think of in its way.

Last week, the House of Representatives voted to postpone the implementation of two key Obamacare provisions – the mandates on individuals to have insurance and on large employers to offer it. That marked the 39th time the House has passed a plan to repeal or delay the law.

POSTED: Thursday, July 18, 2013, 2:44 PM
Filed Under: Katheryne Lawrence

The United States has too few doctors, and the Association of American Medical Colleges (AAMC) is projecting that the shortage will grow to more than 90,000 by 2020. The statistics are particularly troublesome for primary care, which accounts for half of the shortage.

Nearly 1 in 5 Americans lacked access to a primary care physician in 2009. That means we have only about half the needed supply for an optimal patient load of 2,500 patients per primary care doctor nationwide. The shortage continues to grow due to several factors, including low reimbursement rates for primary care, lower incomes than for specialty doctors, and high workloads.

Part of the problem is that doctors are retiring faster than students are graduating. They are aging along with the rest of the population, and 250,000 are expected to retire in the next decade. It takes 7 years from the start of medical school until a new doctor can enter practice. That forces many to accumulate a large amount of debt, so they are reluctant to take primary care positions that are lower paying than most specialist slots. Health reform will likely make the shortage worse, because it will add and estimated 32 million more people to health insurance rolls.

POSTED: Monday, July 15, 2013, 11:02 AM
Filed Under: Robert I. Field

What do we get when Congress cuts federal spending across-the-board? Does it bring lower taxes, smaller deficits, and less bureaucracy?

How about worse health care, less medical innovation, and lost lives?

The budget sequester that Congress enacted in 2011 began to take effect this year with spending cuts for most federal programs. So far, the majority of Americans have seen little change. Some may even applaud the idea of forcing the federal government to make due with less.

POSTED: Thursday, July 11, 2013, 5:30 AM
Filed Under: Katheryne Lawrence

In a major victory for gay rights, the Supreme Court last month struck down part of the Defense of Marriage Act (DOMA), the federal law that had limited recognition of marriage to one between a man and a woman. This judicial move may herald major changes for the gay community with regard to health care access and cost.

The decision in the case of United States v. Windsor found Part 3 of DOMA to be unconstitutional because it denies legally married same-sex couples equal treatment under federal law. One of the clear effects of this ruling is that same-sex spouses of federal employees can receive coverage through the Federal Employees Health Benefits Program for civilians and the Tricare program for military personnel.

Dr. Ardis D. Hoven, the president of the American Medical Association told that overturning the DOMA will help eliminate health disparities in same-sex households by ensuring that they are afforded the same health care rights as others.

POSTED: Monday, July 8, 2013, 6:00 AM
Filed Under: Robert I. Field

A key part of Obamacare will be delayed until 2015, putting it a year behind schedule. That is the provision penalizing large employers that don’t offer health coverage to their workers. (Click here to read the administration’s announcement.)

The law’s drafters included that provision to keep our current employer-based insurance system intact. They feared that companies might drop health benefits once health reform takes effect because the law enables their workers to find alternative coverage in the new insurance exchanges. They also wanted to encourage firms that offer no or limited policies, like some large retailers, to accept responsibility for their employees’ health care.

The penalty applies to companies with 50 or more full-time employees, and it can be steep. Depending on the kind of violation, it can reach as much as $3,000 for each uninsured worker.

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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