Come, let us build ourselves a city, with a tower that reaches to the heavens, so that we may make a name for ourselves.
– Genesis 11:4
With these words, so begins the biblical story of The Tower of Babel. The tale was written, at least in part, to explain the origin of different languages. Essentially, a group of earth’s early inhabitants started to build a tower to the sky in order …
For years, policy experts have been predicting the end of fee-for-service. Yet it can be said of fee-for-service that, like Mark Twain’s alleged demise, reports of its death have been greatly exaggerated. (Actually, this is an often-used misrepresentation of what Twain actually said. After the New York Herald incorrectly reported that he was “grievously ill and possibly dying,” an “amused” Mark Twain wrote that “the report of my death has been …
Once the 2008 economic spiral began and, unemployment escalated with wallets and purses zipped closed, causes were not initially recognized. Since then, the causal details of this downturn were ferreted out pinpointing emanation from Wall Street banks.
Public discontent demanding change has been ignored allowing potential for recurrence. Why? Business has influenced legislators swaying their vote as they filled campaign coffers.
Two problems loom large over the American medical care system. First, we spend outrageous amounts of money on health care, with too many patients receiving too many services at too high a price. Second, our malpractice system is an international embarrassment, with too many health care providers sued by too many patients for too little reason.
Many experts have pointed out that these problems are two sides of the same coin. …
Infrastructure is never quite as interesting or exciting as innovation. The grand opening of a new building incorporating all the latest integrated technology is far more exciting than bridge repairs. In our fascination for the innovation, we often turn a blind eye to our nation’s crumbling infrastructure.
There are close to a quarter million primary care physicians in the U.S., more than any other individual specialty, and about half the total number of all specialists combined. Yet, somehow, primary care seems to lack the power and social influence necessary to chart its own professional course. As the availability and granularity of specialist physicians increased, the value proposition of a generalist primary care doctor seems to have become unclear to …
The nationwide shortage of physicians is a very real crisis across all 50 states, causing a huge strain at all levels of health care. Hospitals and clinics are struggling to hire, current physicians are overworked, and ultimately patients have to wait longer.
There are a number of reasons why this has happened, but one thing’s for sure: With the aging population, the …
The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity.
Holy crap: They’re really doing it. Or trying to do it. Who the hell knows what they’re trying to do? Not “them,” that’s for sure.
You should know that medical documentation has gone awry. But you really just have no idea. If you’ve been to the hospital or to the doctor’s office even once this year, I’m willing to bet that at least a portion of your medical information is now found somewhere within an electronic medical record (EMR). An EMR is really just some mega-computer that stores your health …
Of all the radical changes affecting health care that have sent providers reeling, we are about to experience the knockout punch: the effort to change health care reimbursement from a quantity-based to a quality-based system. Of all the changes to health care, I can’t think of any other that has been based on more false assumptions. Given the fact that there is always low hanging fruit, supporters of the quality-based …
Why is it so hard to make a dent in the huge volume of unnecessary health care? In the U.S., about 20 to 30 percent of the medical interventions American patients receive are useless and often harmful, and waste hundreds of billions of dollars each year.
Insurers have known this for decades. These days, many more doctors have begun to see the big picture, along with policy makers. But the …
Recently, the Department of Health and Human Services (HHS) announced an ambitious goal to have 85 percent of payments made to doctors linked to clinical quality measures within the next two years. HHS believes that incentives should be weighted almost entirely toward quality of care instead of volume of care. I guess if you’re a patient, you could ask yourself the …
Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid — two government programs facing potential cutbacks in 2015 — many rural hospitals may be fighting a losing battle.
Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious illness strikes. …
We all know that the U.S. system of paying for health care is tremendously complex and inefficient: a multitude of insurers, thousands of insurance plans, innumerable medical bills, countless incorrect and denied claims.
But just how much do we waste on this administrative morass?
I led a research team that recently reviewed all the available evidence and published our findings. The resulting numbers are staggering.
Compared with countries that have a single health …
As we enter year two of the Affordable Care Act, we have seen many issues arise during implementation. Through both executive order and executive memorandum, President Obama has unilaterally changed the law more than 100 times in order to advance his political agenda.
When it became important to publicize enrollment and increased coverage of the uninsured, the president, and the ACA provided for an increased payment scale for patients with Medicaid. …
In his popular tome, The Innovator’s Prescription, Clayton Christensen proposes several cures to health care’s cost disease, known as disruptive innovations. One is the replacement of physicians by advanced practice clinicians (APCs). That is, by nurse practitioners and physician assistants. APCs meet the requirements for Christenson’s disruptive innovators: They cost less (than physicians) and are good enough.
You may not be ready to admit it even to yourself, but you know it’s changing. Permanently. Some say it’s for the better. Others say it’s for the worse. Most don’t really care much one way or the other. After all, health care has been evolving and changing over thousands of years, and the experts best positioned to evaluate the health care turmoil of our times are yet to be …
Part of the fun of ringing in the New Year is looking back on the achievements of the previous one. And in 2014, there were plenty of health care success stories to celebrate: major medical advances, new technologies and the Affordable Care Act’s unexpectedly good first year.
At the same time, many of the health care changes in 2014 yield potential risks for patients, employers and the nation as a whole. …
In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed surgeon general.
To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the docs …
I recently spent time at the New York eHealth Collaborative’s Digital Health conference.
The meeting was full of interesting seminars, informational sessions, presentations on innovative technology looming on the horizon, and talk about the future digital face of health care.
The hallways outside the conference rooms were full of administrators, legislators, consultants, and representatives of companies building and designing new resources to help transform the health care system as they see it.
