My wife Beth and I had a rather spirited discussion about how we in the U.S. might be able to pay for the health care of our citizens. Being ever practical, and also owning the job of writing the checks that pay for the health insurance our company offers its associates (including us), Beth in effect is arguing for a national consensus on something we might describe as a baseline …
For its many users, health care’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking, and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more health care services, regardless of whether the additional care adds value.
I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a …
As policy experts cling to pay-for-performance (P4P) as an indicator of health care quality and shy away from fee-for-service, childhood immunization rates are being utilized as a benchmark. At first, glance, vaccinating children on time seems like a reasonable method to gauge how well a primary care physician does their job. Unfortunately, the parental vaccine hesitancy trend is gaining in popularity. Studies have shown when pediatricians are specifically trained to counsel parents on …
Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week — eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93.
If rheumatoid arthritis progresses unchecked, it is as debilitating of a disease as can be imagined. Don’t think garden variety arthritis that only interferes with activities like, um, gardening. Think: finger and wrist joints so inflamed it feels like your …
I was talking to a physician in my hospital several years ago, and he expressed his frustration that the annual well-child exams for his four kids were expensive. Puzzled, I stated that I found it odd that a doctor’s own health insurance plan had poor coverage for routine care, and he replied that his group jointly decided on a plan with considerable upfront out-of-pocket costs. Why would doctors buy bad …
I have been doing health care research and advocacy for over 20 years. I’ve seen a lot of passion, anger, and rhetoric around the issues. The health care crisis is simple in that everyone needs health care. The question is what to do about it and who should pay for it.
It’s not an easy answer. For starters, we have turned into a culture of entitlement. This includes health care. It …
We were once a nation noted for its achievements. We are now a nation that gets nothing done, unable to make even the slightest movement forward despite multiple national crises — a desperately broken health care system, a horrifying opioid epidemic, sickening gun-related mass murders, the threat of nuclear war, and massive storms resulting from man-made climate change. In the face of such monumental challenges, when bold action is needed, …
The main justification for single payer seems to be that access to affordable quality health care is a right. Nowhere in our constitution does it say that anyone has a “right” to individual services or property. Housing, food, health care, even cell phones have become “rights.” What our constitution does say is that each citizen does have the right to equal protection under the law, equal access to the courts …
It’s a peculiar kind of civil war we are waging in America. 30,000 of us die each year from gun violence, exceeding the number killed annually on all sides in the Syrian civil war. On October 1, we saw more than 58 people slaughtered and hundreds injured in a carefully planned attack. At a concert. In Las Vegas. For no apparent reason.
My professional interest in this problem began during my …
While driving home from a weekend trip, my children were watching The Lorax in the backseat, and I couldn’t help but think how acutely applicable its theme is to the current state of medicine in America. Just as seemingly small changes in the name of “progress” slowly altered the environment in The Lorax, a handful of mostly well-intended modifications have transformed the landscape of medicine into something unrecognizable and unsustainable.
Dear Shonda Rhimes, the brilliant mind behind my favorite television show,
We need to talk about “Grey’s Anatomy.”
I’m a fan. A really, really big fan. The kind of fan who — in the last 48 hours — rewatched all of last season’s episodes to prepare for the season premiere, and who has blocked off every Thursday night this …
It’s that time of year again, when we escape from the heat of New York City summers, and head to New Hampshire, to the Central Lakes District, where my wife’s family has had a house perched out over the clear waters of Newfound Lake for over 120 years.
It’s a small wooden house, with barely enough room for all of us squeezed in, painted bright yellow and orange, with …
One of the most popular narratives in American public discourse, especially as it pertains to health care, is that government is bad, and the free market, meaning private industry, is good. And the natural extension of this line of reasoning is that the government cannot, and therefore should not be part of any health care reform solution. Further, only the free market is capable of fixing things, and it was …
As Harvey’s devastation raged through Houston recently, the city’s mayor was compelled to address rumors that those seeking aid could be deported.
In the wake of a statewide ban on “sanctuary cities,” the mayor sought to reassure the Houston area’s more than 500,000 undocumented immigrants that they would not be targeted for deportation at emergency shelters.
The current conversation regarding health care reform in the U.S. is essentially pointless. It can be boiled down into four statements: Obamacare stinks, so we need to get rid of it; Obamacare doesn’t stink, so we just need to improve upon it; the insurance companies are to blame, so a government single-payer system is the best idea; the government is to blame, and only the free market can fix health …
This week is National Primary Care Week, an opportunity to engage medical students and healthcare stakeholders in a national discussion around the tremendous role that primary care plays in our health care system.
With so much debate about the high price of health care in the United States, too often one of the most effective methods of controlling costs is overlooked: primary care. A wealth of research continues to show that …
The main character in the popular film Groundhog Day is caught in a time loop where he must repeat the same day over and over again.
The U.S. Senate is now having its own Groundhog Day moment as it debates (yet again) a law to replace the Affordable Care Act. To add to the drama, Senator Bernie Sanders (I-Vt.) is promoting his single payer alternative popularly branded as “Medicare for All.” In a recent …
As many was in the health care world, I was shocked by the unlawful arrest of nurse Alex Wubbels. In health care, there is a brotherhood and camaraderie between our law enforcement officers and health care workers, especially nurses. We all are literally on the front line of public service on a daily basis, making this story even more disturbing.
Although the situation initially happened on July 26, …
Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to successfully navigate the program and avoid penalties for 2017.
A recent survey by the American Medical Association (AMA) …
Although I am now working part time, I still get my academy’s monthly newsletter. I pretty much ignore the ads and any clinical studies that do not directly affect the work I am doing now, but I still find myself drawn to stories with a political bent. Namely, those stories that reflect the latest health reform controversy. The vast majority of these stories do not mention anything really new, just …
