Are Doctors Prescribing Too Many Pain Medications?

In October, I was asked to speak at a Mayday Foundation meeting about blogging and using social media to spread a message. The Mayday Foundation is a global organization dedicated to pain relief.

At the meeting I met Bob Twillman, a 2011-2012 Mayday Fellow, who also is the Director of Policy and Advocacy at the American Academy of Pain Management. After the meeting he wrote a blog post for TheHill.com’s Congress Blog focusing on what he describes as “the much-ballyhooed issuance of three papers (including one Morbidity and Mortality Weekly Report) from CDC last week on the issue of overdoses and deaths involving prescription opiods. ”

Twillman’s essay reminds us that limiting access to pain medications is not the way to limit overuse. As regular HealthBeat readers know, I am concerned about overtreatment. But most patients who overdose get their pain medications from someone else’s medicine cabinet—not from a prescription that a doctor wrote for them. Physicians should be able to prescribe these drugs for the many patients who truly need them.

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On Tour Now: The Balancing Act at the Center of Reform

After writing about “Essential Health Benefits” for HealthBeat, I wrote a shorter post for Time.com (the online version of Time magazine), updating what I had written here. 

This month, the public will have a chance to weigh in how they think “essential” should be defined.  See below for a link to places, times, and dates where “listening sessions” will be held in cities across the nation, as well as information on how to register. Time is of the essence. Insurers are calling for the Secretary of Health and Human Services to spell out the essential benefits that must be included in all policies sold to individuals and small employers by the end of December. 

This Time.com post appeared Tuesday. Below, the first half of the post (You can read the full piece on Time.com’s  “Moneyland”)  

At the end of the excerpt below, I comment on how both tax credits and the state-based Purchasing Exchanges will make insurance more affordable for small employers and individuals who are buying their own policies.      

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The Future of Health Care Reform: Health Wonk Review Raises Some Provocative Questions:

Should the Preventive Services Task Force Depend on Congress for Funding?

Should Doctors Who Share Decision-Making Be Protected Against Lawsuits?

If Doctors Don’t Tell Patients What They Are Doing, Is This Malpractice?

Should Physicians Who Want Tort Reform Give Something in Return?

Should Nurses with PhD’s be Called “Doctor”?

These are some of the questions I thought about after reading the latest edition of Health Wonk Review, hosted by Health Affairs’ Chris Fleming. In this two-part post, I focus on just five of the best health care posts of the past two weeks. Inevitably, I have omitted some outstanding posts. I urge you to read the full round-up here.
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The Future of Reform: Fleshing Out the Rules for Accountable Care Organizations

Today, the Obama administration released newly revised rules for “accountable care organizations” (ACOs) that are designed to persuade hospitals, doctors, and other health care workers to collaborate in providing better value for our health care dollars. In an ACO all providers involved in treating a particular patient or condition share a single flat fee. That fee will be higher if they succeed in achieving better outcomes for less, lower if they fail. In other words, providers are being asked to share in the risk that patients and payers now face when they agree to undergo treatment—or to pay for it. The lump sum payment creates an incentive for hospitals  and doctors to work together to achieve the best possible results. They will win the wager only if they co-ordinate care.

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Why Are Customers of This Health Insurer So Happy?

The following post originally appeared on the TIME Moneyland blog.

Kaiser Permanente’s stand-out performance in Consumer Reports’ national rankings of some 830 insurance plans raises an obvious question: What makes Kaiser so different? In a word: collaboration.

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Patients Prefer HMOs (And Other Healthcare Surprises)

The following post originally appeared on the TIME Moneyland blog.

Are health insurance plans with big brand names better than smaller insurers that most people have never heard of? “Not usually,” says Nancy Metcalf, senior program editor, at Consumer Reports. Unless, that is, the plan’s name is “Kaiser.”

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Health Insurers in the Spotlight

Consumer Reports Publishes Quality Rankings; HHS Makes Rate Increases Public; They Can Run, But . . .

Are health insurance plans with big brand names better than smaller insurers that most people have never heard of? “Not usually,” says Nancy Metcalf, senior program editor, at Consumer Reports. Unless of course, the plan’s name is “Kaiser.” As Metcalf points out, Kaiser Permanente, a non-profit that insures some 8.8 million Americans nationwide, stands “head and shoulders” above the other large insurers. In general, smaller plans outranked the well-known names, and surprisingly, when it comes to patient satisfaction, Health Maintenance Organizations (HMOs) received higher marks than Preferred Provider Organizations (PPOs) even though HMOs require that the patient remain “in network.”

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“Essential Benefits” that Insurers Must Offer Under Health Care Reform

Will Universal Coverage Mean “Medicaid for All”?

Often, I refer to the health care reform bill that President Obama signed into law in March of 2010 as “the Affordable Care Act” or ACA.  Friday,  as I read the Institute of Medicine’s (IOM’s) report on the “Essential Health Benefits” (EHB) that private insurers will be required to cover under reform, I resolved never to make that mistake again.

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