If a foreign government took the United States surgeon general hostage, I’m confident we’d be pretty upset. I think we would be working on reprisals, and maybe even prepping a SEAL team.
I don’t know if it’s better or worse that we need no help from a foreign power to take our surgeon general hostage. Our own political system manages, all on its own.
Admittedly, it’s not quite the surgeon general who …
By decisively taking control of the U.S. Senate and increasing their majority in the House of Representatives, the Republicans now have a chance to force some modest changes in the Affordable Care Act, but they will not be able to repeal or reverse it. But Republican gains in state legislatures and governorships may put the brakes on Medicaid expansion, leaving millions without coverage.
Nearly every day a press release from a health care provider or health care technology vendor shows up in my inbox urging me to look at what they offer and to write about it. Most of the time I don’t find their news worth passing along, but occasionally a pitch sparks a column idea. That’s the case with the press …
It is well known that Medicare expenditures threaten the financial solvency of the U.S. government. And it is pretty well agreed upon that some of our Medicare spending goes towards wasteful medical care.
But which medical care is wasteful and how much is such care costing us? A study in JAMA Internal Medicine provides a sneak peek at answers to these important questions. The research, led by Aaron Schwartz, a graduate student …
We have heard ad nauseum that the data collection mandated by Medicare and Medicaid is to improve quality of care. Significant taxpayer dollars have been expended as bonuses in the name of PQRS (Physician Quality Reporting System). With all this investment and mandating, one would assume that the PQRS must be highly indicative of better quality of patient care, right? Not so fast.
Two recent reports demonstrate how ineffective this program is and how much physicians hate …
I think it’s fair to say Jonathan Gruber will not be offered the role of Pinocchio. Although intelligence agencies, in search of the truth serum, might have an interest in the ingredients of what he drinks.
Please put away the pitchforks. Gruber deserves credit for honesty and bipartisanship. Plus a complete rejection of Disneyland economics. If you’re looking for transparency, the other face of honesty, Gruber is ground zero.
To me, Medicaid is Obamacare’s sleeping giant — the enabler of federal power and control over the health system. It is a far more powerful enabler than health exchanges, which have gotten most of the publicity. It surpasses the number of uninsured and underinsured that the exchanges have enrolled.
In the next year, four million more Americans will joing Medicaid’s rolls. It already covers one third of America’s uninsured. Under Obamacare, …
Just north of Denver, Jefferson County has become a battleground in the fight over performance-based pay for teachers. The recently elected school board plans on implementing “[a] compensation system that recognizes and rewards our great teachers,” according to school board president Ken Witt. The response of the local teachers’ union was for teachers to call in sick and enlist students in protesting what they describe as a proposed “patriotic curriculum.”
Man looks into the Abyss, and there’s nothin’ staring back at him. At that moment, man finds his character, and that’s what keeps him out of the Abyss.
– Lou Mannheim (Hal Holbrook) in the movie, Wall Street
We hear reform ideas all the time: Primary care physicians need to work at the top of license, physicians need to work in teams, health …
Last year the New York Times reported that the aviation industry had become so safe that one could fly every day for 123,000 years before dying in an aviation crash.
I wish we could say the same for the U.S. health care system. Nationally, problems with health care quality (doing too much, doing the wrong things, and doing too little when indicated) are pretty clear. The bigger problem is that the progress …
When I was in my residency training, pharmaceutical reps still roamed the land. Vast herds of gorgeous young women in tight skirts and stilettos traveled through doctor’s offices, clinics, hospitals and residencies all over creation. Their appearance was always a thing of joy, especially for sleepy, hungry physicians-in-training. Someone would run to the …
I talk a lot with different physicians about integrating NP/PA providers into their practice. I am frequently astonished by the level of reluctance, resistance and downright animosity from these physicians. Many times a doctor will have a medical “horror story” with the NP/PA playing the villain. One bad encounter or event seems to justify a complete rejection of the many positive …
As people select health insurance during open enrollment, what many don’t realize is how the creation of the health insurance exchanges or health insurance marketplace via the Affordable Care Act (a.k.a. Obamacare) will ultimately result in Americans becoming less healthy and more insolvent. Let’s review the pros and cons.
Although the Affordable Care Act provided important benefits of expanding and ensuring coverage with preventive benefits, insurability of all regardless of prior …
Such a no-brainer: If patients who receive care at hospital A are more likely to get readmitted to the hospital 10, 20 or 30 days after discharge than patients in hospital B, then hospital A must be doing something wrong. Perhaps clinicians at that hospital are less adept at diagnosing and managing patients’ problems. Perhaps the follow-up care at hospital A …
A while back I was sitting in a Toronto coffee bar and, as I often do in another country, I began chatting with people about their health care system. One employee taking people’s orders was about to go off duty and sat down to visit. “I’m tired of hearing you Americans talk about rationing in Canada,” he said. “Let me tell you how many MRIs I had when I was …
We’re ready to work on cost savings, just not for patients.
There is a tremendous amount of culture change needed to move from fee-for-service to value-based health care. One of the paradigm shifts is for hospitals to embrace the strategy of cost reduction as opposed to the traditional focus on top-line revenue. In a system that focuses on value rather than volume, increasing the amount of hospital resources a patient consumes …
Most mornings, I opt to take the red line commuter train from my apartment in Bethesda, Maryland to my hospital in Washington, DC. Despite the costly two-way fare, it’s a worthwhile journey because it’s a chance to observe the various other commuters making their way to all sorts of destinations. It’s a people watcher’s dream! Some look dressed to impress on Capitol Hill or in corporate offices. Others look as …
No matter what you call it, the law has two main goals: Insure more (all?) Americans, and in doing so, lower the aggregate costs of health care in the U.S.
After year one of the Act’s main rollout, there is no doubt about the first goal: Millions more Americans now have health insurance. Many have purchased it on the exchanges, whether they are state-run (best example might …
As an employed physician specialist working in an underserved community, I am thrilled with the Affordable Care Act (ACA). I was initially a skeptic of the program because of the cost to taxpayers, but I have since witnessed first hand the tremendous benefits. People with limited resources and real problems can now get help without suffering financial harm. Those with chronic …
The Affordable Care Act (ACA) has created an unprecedented opportunity to improve the well-being and economic security of millions of Americans, including lesbian, gay, bisexual, and transgender (LGBT) people and their families. Notably, health care reform has the potential to reduce and eliminate LGBT health disparities by improving access to quality, affordable health insurance coverage that connects LGBT individuals and communities with the care they need. However, this opportunity …
