"Trump early next week is expected to sign an executive order directing aides to pursue the initiative, called 'most favored nation,' for a selection of drugs within the Medicare program. The idea would use the administration’s authorities to force prices down."
Did Medicare stop negotiating drug prices for 10 expensive drugs? 
https://www.politico.com/news/2025/05/07/trump-sweeping-medicare-drug-price-plan-00334167
New case study from the center left think tank #thirdway about #maine #hospital consolidation and how it's "ripping off patients"
As a Maine doc, the only omission I see is that they fail to discuss Maine's #certificateofneed law which allows hospitals here to block lower cost competitors. That's part of why we send some patients out of state for lower cost tests and surgeries.
https://www.thirdway.org/report/fixing-maines-broken-hospitals-a-case-study
#Capitation involves a lot more than paying #primarycare a monthly fee. It creates perverse incentives for #familymedicine docs and other PCPs to ration care.
#directprimarycare #costsofcare #healthreform
https://kffhealthnews.org/news/article/compensation-pay-primary-care-shortage-solution/
@petersuber
Much of this is due to #feeforservice billing paradigm and prepaying for routine care via #healthinsurance
For #primarycare, it's simpler to dump both. That makes primary care efficient enough that we can provide it (and free phone calls and messages) for $44 to $99/month when the hospital clinic down the street is charging $173 to $351 per visit.
Save the insurance for big , expensive problems.
All those false positives ("indidentalomas") from full body #MRI will get expensive workups and then follow up studies that will be paid by the rest of us via higher insurance premiums and taxes.
Get some data first please. Failing that, add a special tax on these to cover the extra workups upfront instead of socializing their false positive costs to everyone.
4. #maine is one of many states that still have Certificate of Need laws that had the goal of reducing oversupply/use of services but now protect hospital networks (mostly regional monopolies) from lower priced competitors.
It's not rare for me to send patients out of state for cheaper studies, procedures, etc. The price savings are often big enough to make the trips worthwhile for them. The shorter wait for consults are a bonus.
2. A large proportion, if not most, of medical care is routine, non-urgent and potentially 'shoppable' but we prepay for it with the same mechanisms we use for ER visits and big inpatient stays causing great harm. It's like using auto insurance for oil changes or homeowner's to have the plumber fix the toilet.
Yes, I'm biased as a #directprimarycare doc but this realization was a big part of why I left #insurance paid practice eight years ago.
#dpc
#costsofcare
@ProPublica
Another reason I'm glad we left the insurance racket eight years ago.
#healthinsurance
#MedMastodon
#costsofcare
#dpc
#directprimarycare
'And I would put my babies to bed, and they'd say, "How many charts do you have left tonight, mommy?"'
#PBS with a story about #directprimarycare ( #DPC ):
https://www.pbs.org/newshour/show/innovative-clinic-helps-doctors-avoid-burnout-and-makes-healthcare-more-affordable
#MedMastodon
#costsofcare
#familymedicine
https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html
'...Until the system changes, some doctors are finding ways to opt out. I spoke to several physicians who have started direct-care practices, in which patients pay a modest monthly fee to see doctors who can offer them more personalized out-of-network care, without having to answer to administrators or insurers..."
#familymedicine #directprimarycare
#MedMastodon
#costsofcare
@STAT #flu
The local branch of #maine 's big hospital network won't run flu tests locally. "Rapid" test results come back the next day so we added point of care flu testing this week to reduce antibiotic use for pneumonias that might be due to flu.
Since the tests only cost us $10, we don't charge for them. We try not to nickle and dime our patients.
@rvaughnmd @SolNataMD
No, we don't work for free but we only charge $35-$80/month so we get a nice socioeconomic mix of patients.
We also donate memberships to a free clinic to help the local safety net.
The alternative here is working for the local hospital monopoly with obscenely high prices and horrible access.
#costsofcare
#DPC
#directprimarycare
#familymedicine
#primarycare
I've been explaining to patients for years that they don't need annual lipids. Nice to have it confirmed again in this episode of my favorite podcast.
We even have some third party administrators (TPAs) that here require them of insured patients.
These are only about $20 at our office but the big hospital network here in #Maine charges over $100 for a lipid panel test. That comes out of pocket for many patients.
#medmastadon
#foamed
#costsofcare
BS Medicine-
https://therapeuticseducation.org/episode-528-proving-you-dont-need-to-repeat-cholesterol-measurements/
