Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times.
Mr. Peter Drier received a “surprise $117,000 medical bill from …
An advantage of being a foreigner, or a recent immigrant to be precise, is that it allows one to view events with a certain detachment. To analyze without the burden of love, hate or indifference for the Kennedys, the Clintons or the Bushes. To observe with both eyes open, rather than one eye looking at the events and the other looking …
Primary care is essential to building a higher-performing health care system that promotes personal well-being and saves consumers and taxpayers money. Research shows that more primary care physicians in a community means lower rates of mortality, better preventive care, and fewer hospitalizations and emergency room visits.
Unfortunately, too many Americans lack easy access to primary care. Approximately 50 million Americans live in areas, mostly rural, with too few primary care physicians. …
The Canadian health care system is often held up as an example to model or to avoid at all costs in the debates on health care in America, and elsewhere. Yet there are a startling number of misconceptions — on both sides of the partisan divide — about how the Canadian health system actually works, often from experts who should know better. Here are the facts.
1. Doctors are self-employed, not …
Value-based health care is antithetic to patient-centered care. Value-based health care is also diametrically opposed to excellence, transparency and competitive markets. And value-based health care is a shrewdly selected and disingenuously applied misnomer. Value-based pricing is not a health-care innovation. Value-based pricing is why a plastic cup filled with tepid beer costs $8 at the ballpark, why a pack of gum …
Anyone from outer space reading the news and watching TV would think that the U.S. has some of the worst health care possible. The negativity appears to be pervasive. Controversy over this, outrage over that. Whether it’s inadequate health outcomes, policy debate, or scandals with patient care, the stories and discussion abound.
As someone who grew up and went to medical school overseas and then came to the U.S. for medical residency (along …
The Commonwealth Fund just published its fourth Mirror, Mirror on the Wall study comparing the U.S. health care system with other countries, and as in all previous studies, we ranked as the absolutely worst health care system in the developed world, bar none.
Yikes.
The Commonwealth Fund studied many health care domains, and we didn’t rank in first place for anything. The best we managed to do is place a lackluster third …
I have been writing a bit lately on the need for health care providers to talk with their patients about health care costs, if for no other reason than to enable patients to determine whether they can afford to pay for the healthcare that their doctors are recommending them to receive. I have been criticized for this position, on the grounds that I am rationing care from people with …
I recently read the New York Times article on the ridiculous amount that insurance company executives and hospital administrators make. So the reason that American health care is so expensive is not because doctors earn too much, or drug companies charge too much or device manufacturers are making ever more expensive devices with ever expanded indications. Except that it is all of that and more.
Hospital administrators and insurance company executives do …
The continued implementation of the Affordable Care Act (ACA) in 2014 will be as controversial as in previous years.
Here are five main areas of concern:
1. The individual mandate. By what right does the federal government “force” its citizens to buy a product they may not want? The Supreme Court upheld the mandate in 2012, but that does not end the matter. Partly — perhaps largely — because the ACA sets …
Health care reform is a reality. The ACA and its associated mandates have forever changed the landscape of medicine in the U.S. today. The Obama administration touts the goals of reform as providing affordable, cost effective, high quality care for all Americans. Certainly these are noble and lofty goals: But have we completely missed the mark?
Today, many remain uninsured and the majority that have signed up for the exchanges are simply …
Round and round and round we go yet again. The system is broken. Do something. Health care reform!
“Pay for performance” morphs into “measure (and pay) for quality.” The big problem is that no one has bothered to actually define the term, maybe because everyone assumes they know what it means — and that everyone else agrees with them. Wrong.
Quality is very much in the eye of the beholder, and …
As a future doctor, I believe that digital dialogue affords medicine a powerful responsibility to educate and engage. I believe physicians have a responsibility, as daily witnesses to the gaps and failures of public policy, to advocate for social justice and policy reform. I believe that medicine should extend beyond the proximate effects of illness and injury to address their root social etiologies.
I’ve always held these beliefs with firm conviction. …
“Do patients care about how much money their doctors make?”
This is the headline of a recently published post by Trudy Lieberman, and was written in response to the recent New Your Times’ coverage of Medicare disclosing payments to individual providers.
Now, I found the Times story fascinating on many levels, but I’ll admit it hadn’t occurred to me that the main value of this data release is that patients can …
There’s been a lot of hype about the “Ban Bossy” campaign in the news lately, and the talk is all over the map. I was thinking about it in regards to health care, especially nursing, since nurses are notoriously “bossy,” or at least referred to as such.
I can remember being a nursing student and talking with a physician about a patient during my clinicals. He told me, “You …
Next in a series.
Primary care physicians (PCPs) are becoming extinct. It’s true. Not many medical students choose primary care as their career path. Older PCPs are retiring early. Many others are closing their practices or seeking employment at the local hospital. And there has always been a shortage of primary care physicians in rural and urban poor areas. Today only 30% of all physicians practice primary care (compared to …
Next in a series.
Primary care physicians (PCPs) have too little time per patient which means too many referrals to specialists, too little time listening and thinking, no time to delve into the stress or emotional causes of many symptoms and substantial frustration by PCP and patient alike.
Previously in this continuing series on primary care, I described a patient with a straight forward if unusual symptom who was bounced …
If you learn nothing else today, I would ask you to learn that moral hazard is the cause of medical price hyperinflation.
Moral hazard is not just two words that don’t seem to go together. Moral hazard is when the person who bears the economic burden of a decision is not the decision maker. In the health care setting, moral hazard is when the third party payer (insurance/government) bears the …
The recent health care discussion in the media has centered around the implementation of the Affordable Care Act, now no longer a lengthy, inert document but rather a living, breathing manifestation of what should be a collective, unambiguous vision for the delivery of care in the United States. It is, however, anything but comprehensive in scope, and the coverage has primarily focused on crashing websites, politics, calls for resignations, and …
I first read Dr. Matthew Moeller’s piece from this past March for the first time this week after a classmate of mine passed it on to me. I’m a first-year medical student — bright-eyed but sleep-deprived, trailing the smell of the cadaver lab everywhere. I entered medicine fully aware of the long, arduous road ahead, almost exactly as Dr. Moeller described it; with many of my classmates in my …
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