An excerpt from Reshaping Health Systems: What Drives Health Care and How You Can Change It. Copyright © 2024, Wolters Kluwer.
Clinical case
Jessica is a 67-year-old woman having her very first visit with her new primary care clinician, Dr. Jackson. Jessica is accompanied by her husband, Daniel, and comes in with recent laboratory results from her previous clinician, whom she could no longer see because her clinic stopped accepting Jessica’s …
Most Texas politicians balk at even discussing Medicaid expansion. They fear the wrath of state leadership and the threat of being primaried by someone further to the right.
The expansion of Medicaid to the full extent permitted by the Affordable Care Act (ACA) is both an ethical and financial imperative. From a moral standpoint, expansion would provide health care coverage to a significant number of low-income individuals who are currently unable …
At age 80, I’m an “old guy.” I’ve been an avid reader and writer on multiple subjects all of my life. Though I write primarily about U.S. health care, I maintain a lively interest in politics generally. Since election day, I’ve been hearing stories that express a profound sense of trauma in millions of us. Many feel themselves to be in mourning for their beloved country. Others feel vindicated and …
Over the years, as members of the Health and Public Policy Committee (HPPC) of the Texas chapter of the American College of Physicians (ACP), we have focused on advocacy for what we believe is the most important health policy issue in our state, Medicaid expansion under provisions of the Affordable Care Act (ACA). Our efforts, and the work of many others, have had no discernable impact on state policy.
In the …
People enrolled in Medicare got good news recently. Their annual out-of-pocket costs for Part D prescription drug coverage will be capped at $2,000 next year. That should provide welcome relief to millions of older adults who worry about how they will afford health care now and in the longer term.
Unfortunately, not every person enrolled in Medicare is eligible for the $2,000 cap. A little-known penalty robs some people of the …
Much has been written about Robert F Kennedy Jr.’s radical health plans to eliminate fluoride from the drinking water and suppress vaccines, among other lame-brain schemes. But relatively few people are aware of his anti-psychiatry views, possibly endangering the health of a large swath of the populace.
Kennedy is pitching the idea that users of illicit drugs be sent to the “wellness farms,” and users of antidepressants and ADHD medications should …
I am a surgeon from a family of surgeons, all based in Massachusetts. Throughout my career, I have faced many challenges, both in and outside of the operating room. Like most doctors, I am saddened by the current collapse of our system in general and my own hospital in particular, which is facing closure due to mounting debt owed to private equity. For the record, I have been warning my …
Voting is one of the most fundamental rights in our democracy, and yet it can be incredibly challenging. Getting to your polling station, waiting in line, remembering to request your absentee ballot, checking your voter registration status—it is not a straightforward process. If you suffer from an unexpected illness or injury and find yourself hospitalized, it can feel impossible to make your voice heard and participate in an election. Fortunately, …
An excerpt from Prevention First: Policymaking for a Healthier America.
Little did I know that when Prevention First was first published in December 2019, a novel virus with pandemic potential had begun to stealthily spread in China. The subsequent global COVID-19 pandemic resulted in nearly 7 million deaths, exacerbated long-standing health challenges, and led to life expectancy declines around the globe.
With over 1.1 million American lives lost during the COVID-19 …
As Valencia, Spain, reels from devastating flash floods and the U.S. Southeast recovers from hurricanes Helene and Milton, I, like many other parents, look at my own kids with increasing concern about the ailing world they will inherit.
If a climate haven like Asheville, North Carolina, lying 2,000 feet above and 300 miles away from the ocean, can be swept away by a single catastrophic storm, how can we possibly keep our children safe?
Scientists have shown that ocean warming due to …
“Waste is worse than loss. The time is coming when every person who lays claim to ability will keep the question of waste before him constantly.”
– Thomas Edison
The escalating challenge of waste in U.S. medicine
The U.S. health care system is struggling with inefficiencies and waste that weaken its effectiveness, thus reducing accessibility and sustainability as a whole. According to a study by JAMA, between $760 and $935 billion is wasted …
Having spent two years in Oxford as a Marshall Scholar in the mid-1970s, I came back to medical school believing in a national health service—i.e., Medicare for all. But I learned firsthand that a monopoly can provide access without ensuring quality. When quality isn’t the priority, there’s no hope for lowering costs or alleviating suffering.
Medicare is already the single payer for dialysis and has failed patients miserably. As a result, …
My parents, both physicians, embody the American story. After completing medical school in Iran, they were recruited to the U.S. in 1968 to fill the gap left by doctors sent to Vietnam. Building a life from the ground up, they became pillars of their patients and communities — and our family, too. In 1992, they became citizens, finally gaining the right to vote, and they’ve never missed an election since, …
As future medical professionals, we see the real-life consequences of political decisions in emergency rooms, hospitals, and clinics. Despite a growing recognition that voting is directly linked to better health outcomes, however, health professionals are voting at lower rates than the national average. It’s time that we make a change this election.
We see patients denied essential services due to bureaucratic hurdles, such as insurance coverage gaps for life-saving medications …
Recently, I interviewed Dr. David Morris, a physician in Ireland and CEO of Verity Barrington, along with Geoffrey Roche, director of workforce development for Siemens Healthineers. Our conversation focused on successes in health care in both Ireland and America, and the lessons we can share to improve the system. A critical part of our discussion revolved around the role of health care boards. Geoffrey posed a pivotal question: “Where are …
Although Medicare for all seems to have gotten buried by politicians who label it as “socialistic,” it’s still an important idea that could be feasible if we approached it from a fresh perspective.
As patients, we may reflexively see Medicare for all as a panacea that would effectively remove most of our concerns about how to pay for our health care. But on the other hand, we may not realize the …
“Administrative harm is destroying American medicine” is the title of a provocative article published in the July 13, 2024, issue of KevinMD by Arthur Lazarus, MD, MBA. He references business entrepreneur and billionaire Michael B. Kim, who said: “Leadership without ethics is a body without a soul.” As examples of administrative harms, Dr. Lazarus cites “unrealistic staffing models, burdensome regulations, out-of-touch administrators, lack of frank feedback to leaders, and …
Hearing about the school shooting last week at Apalachee High School in Georgia, I couldn’t imagine the gut-wrenching pain that the victims and the local community felt as yet another mass shooting tore apart families.
The tragedy reminded me that no one is safe from the horror of gun violence. As a pain physician, I’ll never forget hearing one of my patients say, “If I don’t get the pain fixed, I …
In the shadow of America’s maternal health crisis, Medicaid mothers are fighting an uphill battle against systemic neglect. Many of these mothers are facing a cruel reality: the more they need help, the harder it is to get.
It is far from uncommon for new mothers in the United States to find themselves thrust into the throes of postpartum depression after welcoming a new life. Most of them, about three-quarters, …
During the Olympics and Paralympics, all eyes turn to the best of the best: incredible athletes who have dedicated their lives to the pursuit of greatness in hopes of earning one of the most sought-after titles in the world.
“Gold medalist” has a glorious ring to it, and the athletes who earn this honor have every right to be proud. But the mantra of the Olympic movement isn’t “get gold or …
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