Most of us have grown accustomed to Google and Facebook. When I had an Android phone, I quickly got over the initial creepiness factor of going into a restaurant, bar, or store and having a message from Google popping up with reviews, menus, or coupons. I liked that Google could recommend times to leave or asked if I went to a certain spot often. But Facebook and Google are basically …
Why Internet privacy matters for patients
The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword “access.” Access to medical care does not entail the ability to reliably obtain medical care much as medical insurance reform is not, in point of fact, healthcare reform. Regardless, the conflation of …
The emergency department and “access” to care
It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork.
The problem is that it won’t work.
For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now …
3 myths about a single-payer system and why it’s doomed to fail
When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic.
“Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Landing Pages Choices Commissioner’ to determine …
How politicians mislead their constituents on health care
I grew up in the United Kingdom and have friends and family who rely on the National Health Service. I’ve written previously how I believe that, despite the idea of a completely free at the point of use health care system sounding very noble — and there are certainly many great things about the NHS — it’s not a model that has been copied in any other country.
As someone …
How to fix the NHS. And what the United States can learn from it.
When I tweeted this on Monday morning about the House GOP bill to “repeal and replace” the Affordable Care Act, I had no idea that it would result in me appearing on MSNBC’s Last Word with Lawrence O’Donnell or that it and my other tweets would be referenced by NBC News, a New York Times editorial, or for that matter, a retweet from singer-songwriter John Legend!
I mention …
Why the American Health Care Act must be stopped. Now.
The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed, “We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients, and they’re equal that we prioritize the commercial insured patients enough so … We can …
The American Health Care Act isn’t perfect. It’s pragmatic.
Uncertainty surrounding health system reform and the future of the Affordable Care Act has left many physicians with questions about how current proposals will affect them and their patients. Stakes could not be greater for patients who may again face the stark, life-or-death choices arising from the possible loss of health insurance. As a longtime member of the American Medical Association’s Board of Trustees and a former president of the …
Physicians must speak out on heath reform to make a difference for patients
At this point, much has been made of the health care bill the Republican administration has put forth to replace the ACA. We’ve heard the details of the bill, we’ve seen the numbers. We know that the U.S. Congressional Budget Office has forecast that 24 million more people will be uninsured by 2026 if House Representatives replace the ACA with the current bill proposed by the Trump administration. We know …
Help me help you: I’m not a politician. I’m just a doctor.
I’ve had many opportunities to address physicians across the spectrum of health care settings, from those who run private practices, to those who work in large and small groups, to those who are hospital affiliated and employed. I often ask them the question “who controls the practice of medicine?” The answers I receive vary: government, insurance companies, hospitals, health systems, lawyers, employers and, rarely, patients. But one answer I never …
Why physician-led organizations work
If you are planning on complying with Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), make sure to allot the appropriate time and funding necessary to update/upgrade your practice. Realize that the measures will be arbitrary, the data implementation arduous and the moments for live patient care fleeting. Expect that, no matter how Herculean the task may be, the finish line will move often and unexpectedly. Prepare to get …
Don’t like insurance and Medicare? Just say no.
As a doctor, I am guided by the code of medical ethics. The code is made of up of four principles: autonomy, justice, do good and do no harm. These principles guide me and my colleagues, including the fifteen doctors in Congress, as we care for others. In the debate over the fate of the Affordable Care Act, thirteen of the fifteen doctors in Congress have publicly stated that they …
Why the American Health Care Act takes us in the wrong direction
As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017. Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues. Coincidentally, March 8 was also the day two House Committees began deliberations on …
The fundamental problem with the American Health Care Act
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I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons …
The AMA’s letter on the American Health Care Act was too narrowly focused
The Congressional Budget Office (CBO) has estimated that 14 million of people would lose coverage in 2018, 21 million in 2020, and 24 million in 2026 if the House Republican plan is allowed to significantly amend the Affordable Health Care Act (Obamacare).
In my last post, I called the House Republican bill “mind-boggling” for the negative impact I believe it would have on the number of those uninsured and …
The CBO scores the Republican health plan. What does it mean?
Like they have a gun to their heads, congressional Republicans, led by Paul Ryan, are moving ahead at warp speed to pass a sweeping new health care bill to replace Obamacare. Despite an almost deafening roar of objections from the many people who would lose coverage or whose insurance costs might go up; from major medical groups; and even from within its own party, they continue onward with this health …
The Republican health plan just doesn’t make sense
Pause with me for a moment and create an image in your mind of the quintessential healthy person. What do you see?
I picture someone who is slim and agile. They probably bike or walk to work and engage in daily exercise. They cook for themselves, use fresh vegetables and few processed foods. They find satisfaction in their career and home life, mange stress well and devote time to meaningful hobbies …
Why Obamacare wouldn’t have worked anyway
Quality metrics and pay-for-performance have now been in existence long enough to start accumulating some efficacy data. And the picture does not look good. Paying doctors to improve their quality metrics does not, in general, improve those quality metrics. Like all good scientists, we can now either question the data, or discard the hypothesis.
Most payors and administrators appear to be reacting to the lack of efficacy data on …
What was the hypothesis with pay-for-performance?
Having graduated from medical school in 2008 and internal medicine residency in 2011, I am a physician-child of the Affordable Care Act (ACA) era. The belief that “health care is a human right” ran deep through my upbringing and life experiences, but training during a period of such intense debate over health care reform reinforced this ideal. My professional identity developed interwoven with a compelling national conversation about access and …
Who if not me will make my patients whole?
In no other field is change received with so much resistance and skepticism than in medicine. The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy.
As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress. As the world is witnessing an unprecedented technological …
We must challenge the health care status quo
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