I am going to make a prediction here. No matter who we elect in 2020, Bernie or Trump or anything in between, Medicare for all is not going to happen in America. One can run an electrifying campaign on the promise of Medicare for all, or indignantly against it, but this is pure theater on both sides. I don’t know if God can make a rock so big and heavy …
Why Medicare for all is not going to happen in America
For over a decade, Washington, DC has been busy with fixing health care. For over a decade, the same government bureaucracy, the same advocacy (read lobbying) organizations, the same expert think tanks, the same academic centers, the same business associations, with the same people hopping around from one entity to the next, have been generating and applying the same “innovative solutions” differentiated solely by their aggrandizing names. The result? Health …
The insanely brazen effort to remake medicine into a consumer industry
If you live or work in Washington DC, your number one health care question is how do I (or my meal ticket people) win the next election. If you live or work in Caruthersville MO, chances are that your most pressing health care question is how do I (or my immediate family members) get a hold of some insulin this month. Theoretically speaking, in a healthy democracy, the answers to …
No politician has a realistic solution for health care
Let’s burn health insurance down. Greedy corporate bastards should burn. Big Pharma and big hospitals should probably burn too. You know who else is really, really, bad? Wall Street. Let’s burn the banks. And let’s burn Big Tech and the entire Silicon Valley cartel. Let’s also burn Big Agribusiness that’s making us fat and sick. And let’s burn the Oil companies that are destroying the planet, and let’s burn the …
The problem with burning health insurance down
As is customary for every administration in recent history, the Trump administration chose to impale itself on the national spear known as health care in America. The consequences so far are precisely as I expected, but one intriguing phenomenon is surprisingly beginning to emerge. People are starting to talk about single payer. People who are not avowed socialists, people who benefit handsomely from the health care status quo seem to …
A single-payer system is the American way
President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican “thought leaders” in Congress were quick to supply him with their stale and superficial “plans” to repeal and replace Obamacare, which were written in protest to President Obama’s policies and were never meant to be implemented. When scrutinized by the …
Health care cannot be sustainably fixed in broad political strokes
It has come to pass: President Donald J. Trump. Are you scared? Are you planning to “resist” the policies you imagine President Trump will pursue by tweeting furiously with clever hashtags galore? Would you prefer to move my fastidious quotation marks from “resist” to “President”? This is, after all, the first President in a very long time to take office without the blessings and financial support of established “world order” …
Here’s what’s really scary about Trump’s health care
President Barack Obama, whether wittingly or not, invested his entire political capital in reforming health care in America. He gambled and lost. Not because he had nefarious intentions, but because he left the gory details to a corrupt Congress and a shady cadre of lying and conniving technocrats, ending up with something vastly different from what he campaigned on. From everything I’m reading now, President-elect Donald Trump is about to …
Obama gambled on health care and lost. Will Trump lose too?
The Merriam-Webster dictionary has many definitions for the term system, but the most straightforward, and arguably the most applicable to our health care conversation is “a regularly interacting or interdependent group of items forming a unified whole.” The common wisdom is that our health care system is broken, and hence, our government is vigorously attempting to fix it for us through legislation, reformation, and transformation. We usually work ourselves into …
This is why health care is not a system
For decades and decades we have been counting the number of doctors in America. For decades and decades we have been coming up short compared to other developed nations, and some less developed ones as well. A poorly educated person may be tempted to suggest that we should “make” more doctors. After all, there is hardly a shortage of young people willing and able to undergo the rigors …
The effects of cheap health care hacks will be felt for decades
At the J.P. Morgan Healthcare Conference in San Francisco, Mr. Andrew Slavitt, acting administrator at the Centers for Medicare & Medicaid Services (CMS), announced on January 11th that, “The meaningful use program as it has existed will now effectively be over, and replaced with something better,” and later clarified on Twitter that, “In 2016, MU as it has existed– with MACRA– will now be effectively over and replaced with something …
Meaningful use is dead. Is it time to celebrate?
“It was a dark and stormy night.”
My computer didn’t catch fire while typing the previous sentence. No alarms were triggered warning me about the quality of such opening. I wasn’t prompted to select subjects and predicates from drop-down lists. I typed the entire sentence, letter by letter, not at all dissimilar to its first rendering back in 1830. Computer software, in general, and Microsoft Word in particular, magically removed the …
How to put EHRs back on the right track
Whenever you read a health care article, paper, book, blog post or even tweet, that substitutes the term consumers for patients, and the term providers for doctors, or physicians, you should inherently assume that the authors are advocating for something that will not benefit you or the people you care for, something that will most likely harm you financially and if you happen to be less than independently wealthy it …
The clear and present future of consumerized health
There are three visions of peace in the seemingly never ending, but really rather brief, Israeli-Palestinian perpetual crisis. One peace features two independent countries living in collaborative harmony on a piece of land approximately the size of New Jersey. Another peace yearns for a messianic Jewish state stretching from the blue Mediterranean shores to the Jordan River, and possibly beyond. The third and final peace is expected to materialize after …
The crisis in the Middle East, and the crisis in American health care
Sixty years ago, before he became a controversial figure in the field of psychiatry, Dr. Thomas S. Szasz co-authored an article for the Archives of Internal Medicine (now JAMA Internal Medicine) on “The Basic Models of the Doctor-Patient Relationship,” which is well worth reading today, particularly for those who believe that patient empowerment/engagement is a novel and disruptive innovation of our digital times.
The paper is describing …
How can we measure the doctor-patient relationship?
The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory: the Defense Healthcare Management Systems Modernization (DHMSM) contract. And the winner is … Leidos, the contractor formerly known as SAIC. A couple of years ago, when the race for …
Cerner beats Epic in the DoD sweepstakes. What does that mean for the rest of us?
If someone was sitting on a veranda somewhere in the Alpha Centauri system, reading about health care in America of planet Earth, one would most likely conclude that the family of viruses known as the common cold are destroying a health system already crippled by a glut of poorly educated physicians practicing their miserable craft on a slow-moving …
It’s inevitable that physicians will evolve into virtualists
The latest salvo in the interoperability and information-blocking debate comes from two academic experts in the field of informatics, and was recently published in JAMIA. In the brief article, Sittig and Wright are endeavoring to describe the prerequisites for classifying an EHR as “open” or interoperable. I believe the term “open” is a much better fit here, and if …
An open and interoperable EHR: What exactly is that?
The Medscape Physician Compensation Report puts primary care physicians at the bottom of the heap, with a median earning of less than $200,000 per year in 2014. What if the largest insurer of older Americans took those numbers to heart and decided to give primary care a pay raise of 25 percent, in recognition of and better support …
Medicare is paying for chronic care management! Here’s what you need to know.
Did you know that you are a “telemedicine provider”? No? I can’t blame you for not knowing, but you are, and always have been. Well, maybe not always, but certainly since Alexander Graham Bell invented the telephone. Better yet, you provide free telemedicine services. Here is an idea: on the home page of your practice website, you should add a big …
You’re already a telemedicine provider. You just don’t know it yet.
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