In the aftermath of the decisions by state governors and legislators not to expand Medicaid, the grim numbers are beginning to roll in. Failure to expand Medicaid will cost states more than 19,000 lives and over a billion dollars per year.

And that, sadly, is only the beginning.

To read the full column, click here .

The 2013 Medicare Trustees report is out, and it proves once again that the so-called Medicare funding crisis is a myth that has been manufactured by political leaders more interested in cutting the size of government than in assuring access to health care for all.

Those may seem like strong words, but we have been waiting for a long time for government leaders to tell us the truth about Medicare. That it hasn't contributed to our budget deficit. That its trust fund is solvent.

To read the full column, click here.

I applaud the efforts of the Miami Herald Editorial Board to refocus our collective attention on the out-of-control Medicare fraud in South Florida. Several former and current leaders of organized medicine in Florida have attempted to address and resolve this problem only to find themselves rebuffed by a wall of silence, feigned commitment to seek solutions, or refusal to accept responsibility. During my tenure as President of the Dade County Medical Association I traveled to Jacksonville to meet with the leadership of First Coast Service Options, advertised as "one of the nation's largest Medicare administrators for more than 45 years...

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Dr. Wollschlaeger is a frequent contributor to FHIweekly and Specialty Focus. You can read more of his articles by visiting
http://floridadocs.blogspot.com.

A Kaiser Health News sampling of the latest headlines about Obamacare reflects our continuing anxiety over the law just months before it is fully implemented.

The most interesting to me was this one. According to a new CNN poll, only 43 percent of the public favors Obamacare. But of those who oppose it, only 35 percent do so because it is too liberal. Sixteen percent say that it is not liberal enough!

No matter how you feel about Obamacare, one of the most significant changes it facilitates will be the integration of health and behavioral health care - meaning that care for both physical and mental illnesses will soon be delivered together.

This only makes sense. People with cancer, for example, often develop depression or anxiety that complicates their care. And people with mental illness often develop physical conditions - sometimes as a side effect from the medications they take - that can cut twenty-five years from their lives.

Integrating health and behavioral health care has not been the norm over the past century.

In a nutshell, this is because regular health care evolved from an acute care model - the idea that we could cure disease with aggressive, short-term interventions. Mental health care evolved from a chronic care model - that mental illnesses could be managed, but not prevented or cured.

What we have learned in the last 20 to 30 years shows that both models can be useful in treating all diseases.
 
So we began to manage some diseases that we could not cure using a newer chronic disease model. HIV/AIDS treatment is an example, but so are today's treatments for many chronic conditions, including cancers, heart diseases, diabetes, and hypertension. And we began to use an acute care model to treat mental illness, offering short-term stabilization in addition to longer-term therapies.

With diseases co-occurring and treatments often intersecting, care integration was the logical next step.

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Fifty-four percent of Iraq and Afghanistan war veterans who have sought treatment in the VA system since 2001 have been treated for mental disorders.

This is the second most-frequent diagnosis among these veterans. It is an indicator of the profound effect recent war service is having on the mental health and well-being of our veterans.

To read the full column, click here.

Health policy has often been in the news headlines this month.

To cite three examples, CDC released a new report about causes of death. CMS published data showing wide variations in hospital charges for common procedures. And, in the context of a newly-reported Oregon Medicaid expansion study, states have been making decisions about Medicaid expansion.

Let's look at the mental health policy stories behind the headlines.

To read the full column, click here.