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Medical debt increasingly cited as factor in bankruptcies

Nearly two-thirds of bankruptcies in early 2007 were due in part to medical debt -- an increase of more than 20% since 2001 -- according to a national study of more than 2,000 cases. Of those who filed for bankruptcy due in part to medical debt, 92% had debt of more than $5,000 or 10% of their income, according to "Medical Bankruptcy in the United States, 2007: Results of a National Study," published in the May 18 issue of the American Journal of Medicine. The study is based on questionnaires returned by 2,314 debtors, plus court records and phone interviews. The study is a follow-up to a similar 2001 analysis based on bankruptcy filings in five states. The earlier study found that medical problems contributed to at least 46.2% of bankruptcies in those states. The newer study -- which required larger debts to label a bankruptcy as medically related -- found that the bankruptcies of 62.1% of people who filed between Jan. 25 and April 11, 2007, were at least partly related to medic ...

House health reform bill first to tackle Medicare physician pay

Washington -- Upcoming cuts to Medicare physician rates would be expunged and the payment formula replaced with a modified system under a national health system reform proposal offered by House Democrats. The plan, in the form of an 850-page discussion draft, was unveiled June 19 by the three House committees with primary jurisdiction over health care -- Energy and Commerce, Ways and Means, and Education and Labor. It would start by erasing required pay cuts that have accumulated under the existing Medicare physician payment formula, the sustainable growth rate formula. After wiping the budgetary slate clean in 2010 by establishing a new SGR baseline and giving physicians a cost-based update for the year, a new system would launch in 2011 that could allow for positive rate updates going forward. Physician rates are currently cut across the board when annual spending on doctor services exceeds a target growth rate based on the nation's gross domestic product. Under the new system, ...

Hospital system tries letting patients read physicians' notes

Tom Delbanco, MD, conducted an experiment in the 1970s in which he asked patients to take their own notes during clinical visits and compare them to their physicians' notes. The experiment didn't last long, he said, because when patients asked other physicians for notes, "doctors thought the patients were crazy," he said. "They literally said, 'I am calling a psychiatrist.' " Now, more than 30 years later, Dr. Delbanco, an internist at Beth Israel Deaconess Medical Center in Boston and professor of general medicine and primary care at Harvard Medical School, is trying again. He is one of the leaders of an experiment at Beth Israel that allows patients unfettered access to their doctors' notes made in relation to their visits. The idea is to see how granting real-time access to clinical notes will change the dynamic between physicians and patients. "In spite of a lot of enthusiasm ... no one really knows what will happen," said Jan Walker, RN, an instructor of medicine at Harva ...