Wednesday, January 15, 2014

New Post 1 for my new students

There was a report issued in Modern Healthcare yesterday titled, "AMA fears privacy loss as Medicare moves to reveal Doc pay." I became aware of this because my own personal learning network brought it to my attention this morning.

In the article Joe Carlson discusses the balance between the privacy interests of physicians and the value of transparency regarding the incomes that physicians receive for services provided to their patients who have Medicare benefits. When values are in competion with each others reasonable people can certainly disagree about the nature of the "balance" between or among the values. The following statement in the news report caught my eye.

"The American Medical Association is warning that the Obama administration could violate physicians' privacy rights if it poorly implements its new policy for informing the public how much money Medicare pays to individual doctors."

The part of that statement that I notice in particular is the, "if it poorly implements" its new policy.

There is, of course, wide-spread and strongly felt opposition to the entire policy commonly known as "Obamacare." Some of that opposition is grounded in personal philosophies about the nature of freedom and the role of government. There is a substantial fundamental mistrust of central government that goes back to prior to the founding of our nation. A part of that is a pervasive belief that large governments do not have the capacity (ability and competence) to implement complex programs. Even those of us who generally favor what the new Affordable Care Act intends have concerns about the ability of "bureaucrats" to make it work well. The clumbsy roll out of the website is an example that for various reasons government agancies often appears to be able than other kinds of organizations. Basically, what I see is a vicious cycle of public mistrust creating constraints upon agencies which cause agencies to appear inept that then feeds back into public mistrust and perceptions that government employees are less than fully competent.

The facts are that policy implementation is often very difficult and that implementation of "Obamacare" is a minefield of challenges because of its complexity.

I honestly don't know how to balance the privacy concerns of physicians with the need for the system to be "transparent." I do think that to the degree that being a physician is becoming more "bureaucratic," physicians are opting for early retirements. I am concerned that going forward the shortage of physicians is likely to increase.

I am here asking my students to repond to this post by sharing their opinions and insights about these things. How do the competencies of administrators affect the ability of medical providers to deliver care to large populations of people? Is it possible that "Obamacare" is so bold an initiative as to be impossible to implement effectively? I ask that my students include a link in their reply to some other relevant online resource.


  1. According to this article and another article I read reported that information will be released on a case by case basis this leads me to believe there is some anonymity. The administrators and the providers would have to work together to come up with a solutions on this matter. I read in another article this would help repeals the SGR act which provides financial benefits and this new policy may help cut down on fraud and waste abuse.Two possible positives.

  2. After reading the first portion of this article concerns were raised in reference to the HIPPA law. Secondly and authorization of release of health info as a requirement came to mind as well. I am very curious myself as to what the Freedom of Info Act request system will consist of; will the request be submitted electronically or a paper copy. The internet has been around for many years now which gives Americans access to almost anything. It doesn't surprise me that US District Judge Marcia Morales Howard of FL ruled that physicians' privacy concerns no longer outweighed the public interest in releasing data.

    Today we live in a society that is based solely on competition. Administrators need to come together and agree on whats the best way to deliver care to our large population of people. However, that seems unlikely due to the fact that no one wants to be wrong and feel as if their way of doing things is the right way eventhough if it causes conflict amongst administrators. I honestly feel as if the Obamacare can work effectively although it will take take time. We as americans tend to react differently when change comes about so as of now, it is receiving a lot of back lash but honestly in the long run i feel as if it will be beneficial.

    1. Joe, for better or worse, healthcare administrators' primary responsibilities are to the survival of their own individual institutions. It seems to me that the new policies are an attempt to align self-interest (of hospitals and other medical care institutions) with the interests and needs of populations of patients, all within some kind of competitive system, while producing quality care. People do regard the common interest. But when facing harsh realities, people usually focus on their own interests and the survival of the institutions that employ them. I share you hope that "Obamacare" can work. Given political realities it is a miracle that it is as rational as it is. I agree with you that it can be good in the long run. It is so close to the core of a major political divide in the United States that it is unclear how long it has to play out before it may be substantially changed. Thank you for your thoughts.

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  5. Establishing a foundation of policies and procedures that systematically support cultural competence is a crucial component of meeting the needs of diverse patient populations. The role of leadership is inherent to these types of activities — leadership support is required to recognize, prioritize, and often drive efforts that establish policies and procedures to improve care and to better meet patient needs. A big reason Americans have hesitated to sign up for health insurance is they don't understand it. Obamacare – also known as the Affordable Care Act, or the ACA – is a law enacted to ensure that all Americans have access to affordable health insurance. It does this by offering consumers discounts (known as tax credits) on government-sponsored health insurance plans, and by expanding the Medicaid assistance program to include more people who don't have it in their budgets to pay for health care. The ACA also changed some of the rules insurance companies have to follow. For example, in the past if you had diabetes or some other preexisting medical condition, you could be turned down for insurance or your cost for coverage would be astronomical. Now you can't be turned down for any reason and the hope is that costs will be contained.