neuhofel (Ryan Neuhofel)

Follow

Comment history

Medicaid challenges loom, officials say

$2.5 billion for 300k people? That calculates to be $8,333 per person each year! or $694/month. Granted there are some "very sick" people in that pool, but certainly less than 20%. Surely, we can figure out how to provide neccessary health care for that amount of money. You can purchase "concierage" comprehensive primary care for about $100/month in many parts of the country. Call me a skeptic, but something in these numbers just doesn't add up.

April 26, 2010 at 5:15 p.m. ( | suggest removal )

Longtime doctor offers perspective on changes in health care

cont'd.

I believe this fragmented system is primarily reactionary due to over-burdened primary care system and NOT neccessarily best for patient care. Continuity of care is something that is sorely missing from most health care today - an ongiong relationship with a physician in multiple settings (office, hospital, etc) is a romantic notion, but something we should strive for. While "hospitalists" are one fix to this mess, I don't think it's ideal.

The patient load of each 'family doc' has been steadily increasing for the past 30 years - with the average established family doc having a 3000+ patient panel . . . which is nearly double-to-triple the load from 1970. Consequently, family docs have given up more-and-more services (house calls, hospital, etc.). In order to survive, we have been restricted to hamster-wheel practices created by the demands (and dollars) of middlemen (third-party payers).

April 22, 2010 at 9:34 a.m. ( | suggest removal )

Longtime doctor offers perspective on changes in health care

Lori,
Thanks for your perspective on the "hospitalist" trend. As a family doc-in-training (resident), I have recognized a great deal of public confusion about this terminology. A "hospitalist" is NOT a "specialist" in the traditional meaning - via formalized post-graduate training (residency and/or fellowships). They are defined by their setting of practice (ONLY hospital care), not specialized training. In fact, hospitalists can have a variety of backgrounds - the majority with residencies in primary care/general practice such as Internal Medicine, Family Medicine or Pediatrics. Due to Interal Medicine's focus on 'hosptial-based' care during residency, they tend to be more likely strict "hospitalists", but many Family Medicine physicians restrict their scope of practice to hospitals as well.

April 22, 2010 at 9:13 a.m. ( | suggest removal )

Obama launches attack on health insurance companies

seriouscat,
Thanks for the feedback. Unfortunately, most people are more interested in bickering about political boogeymen and strawmen than proposing actionable solutions. As a physician-in-training (Resident in Family Medicine), I am not waiting around for the Beltway blowhards or insurance companies to allow me to provide better, cheaper health care to my patients. After graduating residency next year, I am starting a medical practice in Lawrence that will hopefully provide an alternative to the status-quo, insurance-dominated system.

March 10, 2010 at 12:52 p.m. ( | suggest removal )

Obama launches attack on health insurance companies

I wish when somebody "attacked" me it was in the form of mandating people by my product or service AND buy more of it AND gave people who couldn't afford it money to do so. That is some viscious attack.

For anyone who truly wants the reduce the power and profit of the third-parties (insurance) in health care, there are several reasonable, immediate actions you can take without an act of Congress.
1) STOP joining prepaid, managed care health plans (traditional HMO/PPOs)
2) Buy a catostrophic, high-deductible insurance plan for expensive and unexpected events (true insurance, really)
3) Pay for routine care (preventive, maintenence, minor acute) DIRECTLY to your doctors

If your employer is providing you a managed care health plan - convince them to do the above. Such a movement would dramatically reduce the size of the private "insurance" industry and return health care to sensable place for patients and doctors.

March 9, 2010 at 12:09 p.m. ( | suggest removal )

Statehouse Live: Insurance proposal considered by committee

While I understand the distinction between group and individual policies, I cannot see how encouraging small business' to contribute to employees health care and/or insurance plans is a bad thing. Many small business simply cannot afford the entirety of a large group 'managed care' policy, but would still like to contribute in some way. This seems to be a reasonable adjustment to the currently biased tax-code.

March 8, 2010 at 5:42 p.m. ( | suggest removal )

Reform peril

nota,
Actually, Canada took it one step further and banned direct purchasing of health care - not just private "insurance" - for any medical service the national system 'covered'. So in essense it was illegal for doctors to accept payment from people outside their governement system. Predictably, there were thousands of "black market doctors" who operated in semi-secrecy for many years until their recent 2005 supreme court ruling on the right to private health care and private health plans.

March 6, 2010 at 5:42 p.m. ( | suggest removal )

Reform peril

jafs and beobachter,

Actually, TS's claim is fairly accurate. According to the CBO, the effective federal income tax rate for the following quintiles (1/5ths for the mathmatically declined) are

1st quintile (1-20%tile) is NEGATIVE 6.5%
2nd quintile (21-40%tile) is NEGATIVE 1.0%
3rd quintile (41-60%tile) is 3.0%

http://www.cbo.gov/ftpdocs/98xx/doc98...

I believe the break-even point for federal income tax is somewhere near the 50%tile of income, but couldn't find a solid source because the IRS/CBO mostly reports statistics by quintiles.

But, I'm sure there is somebody named Beck and/or a druggie who does work at the CBO, so I would be very skeptical of those numbers.

March 6, 2010 at 10:41 a.m. ( | suggest removal )

Reform peril

Unfortunately, the public - including these message boards - are generally focused on assigning bogeymen with evil motives. The politicians have fed that fire on behalf of their special interest groups. As a physician (or patient), I don't want to be a pawn in a high-stakes game for power and profit, nor am I going to wait for some magical solutions from Washington. If history is any indicator, the Beltway blow-hards will probably only make things worse. We must come up with tangible, local solutions where doctors and patients can 'opt out' of the current managed-care system and form a independent alternative to the status quo - hopefully a true patient-centered medical home that will lower costs, improve access and improve quality.

March 5, 2010 at 8:35 a.m. ( | suggest removal )

Insurance tyranny

Posse,
Thanks for the feedback. Most of the public discourse is focused on assigning bogeymen with various motives. Unfortunately, politicians have furthered that discussion on behalf of their special interest groups. I personally not going to be a pawn in a high-stakes game for power and profit, nor am I going to wait for some magical solution from Washington. Doctors and must must 'opt out' of the current system and form a independent alternative to the status quo - hopefully a true patient-centered medical home that will lower costs, improve access and improve quality.

March 4, 2010 at 3:30 p.m. ( | suggest removal )