FTC’s proposed ban on noncompete agreements could be a game changer for some physicians
The past twenty years have been a period of declining political and economic influence for physicians. As many as a third of all physicians are now hospital employees, and as many as a hundred thousand more are employed by corporations, many private equity backed. However, as COVID scythed through the practicing physician community and the baby boom generation of physicians head for retirement, scarcity of physicians will increase their economic leverage and political power. How will physicians use this increased power? Read Jeff Goldsmith’s Op-Ed in STAT First Opinion Oct 14, 2022 Plus, a recent Federal Trade Commission proposed rule would outlaw non-compete clauses in employment contracts. Hundreds of thousands of employed physicians have non-compete provisions in their contracts. How likely is this prohibition to become effective, and how will carve outs effect the freedom of physicians to practice in the communities?
Hospital Systems: A Framework for Maximizing Social Benefit
Health Systems: a Framework for Maximizing Social Benefit. Health systems have been under more or less continuous attack during the past decade by academics and health policy experts for driving up healthcare costs. Yet they proved indispensable in the fight against COVID. This essay, written with fellow futurist and policy wonk Ian Morrison, explores how to maximize the social benefits health systems provide society.
Health Systems Made A Big Difference In The COVID Fight: Time To Reconsider Their Social Impact
Health Systems Saved Lives During COVID Large multi-hospital health systems have been in the political/regulatory doghouse for the past decade. However, they made a huge difference in the fight against COVID. They were able to mobilize caregivers and facilities at scale across regions to fill gaps left by crumbling public health infrastructure, and stood up testing, vaccination and telehealth offerings rapidly to respond to the pandemic. Policymakers should reconsider the social benefits created by these large complex organizations. With colleague Ian Morrison in Health Affairs blog
Relatively Modest Health Reform May Create More Value Than ‘Medicare for All’
Relatively Modest Health Reform May Create More Value than “Medicare-for-All” With the chorus of progressive voices advocating single payer and Medicare for All during the runup to the 2020 Presidential election, Jeff Goldsmith offers three strategies that would create more tangible payoff in improved health with a fraction of the cost and disruption. Read his thoughts in Health Affairs blog.
The Scorecard: The Great Trump Health Policy Train Wreck
The Great Trump Healthcare Trainwreck This posting provides a scorecard to evaluate President Trump’s performance in managing the multiple unsuccessful attempts to repeal the Affordable Care Act, and provide some clues to this political defeat.
California’s Coverage Expansion: Fiscal And Political Risks
California’s Coverage Expansion: Fiscal and Political Risks This posting explores how California got the number of uninsured in its state down to 7% by dramatically expanding its MediCal progam and standing up Covered California, one of the most successful health exchanges in the nation. Can this expansion be sustained as Congress considers unwinding the Affordable Care Act?
The Rust Belt Is Burning: Republicans Lay Waste to their Base on Health Reform
“Repeal and Replace ObamaCare” was one of the slogans that powered Donald Trump’s upset victory in the November 2016 Presidential election. How ironic, then, that the actual proposals would have badly damaged both the states and working class voters that put the President in office. Read about the cruel paradox of Repeal and Replace and why it ultimately failed.
Oregon’s High-Risk, High-Reward Gamble On Medicaid Expansion
Oregon’s High Risk, High Reward Coverage Expansion This posting explores how Jeff’s home state of Oregon dramatically expanded health coverage under the Affordable Care Act, and its effects on Oregon’s health insurance market and care system.
Pioneer ACOs: Anatomy Of A ‘Victory’
The Pioneer ACO was certified this spring as the first new Alternative Payment Model to be expanded under the Affordable Care Act. A close look at the program’s performance, however, reveals the use of “Lake Wobegon” accounting. The program lost nearly half its participants, and those with the most managed care experience fared the worst. Read: Pioneer ACO: Anatomy of a Victory
Primum Non Nocere: Congress’s Inadequate Medicare Physician Payment Fix
As Congress wrestles with how to end the Sustainable Growth Rate Fiasco, a bipartisan proposal has emerged which will probably make things worse than they are now. Read about Congress’ Inadequate SGR Solution.