Public Health & Policy

It’s time we look at the Australian health system for lessons

Policy

May 22, 2017

President Donald Trump in a recent press briefing with Australian Prime Minister Malcolm Turnbull announced, “Of course the Australians have better health care than we do – everybody does.” On the heels of the House narrowly passing the first in many steps toward Obamacare repeal and replace, President Trump’s comment caused a bit of a stir, to say the least.

MSNBC was all over it. Chris Hayes interviewed fellow socialist Senator …

This is the hypocrisy of American health care

Rebekah Bernard, MD

Policy

May 11, 2017

Physicians and patients are fighting a growing hypocrisy in American medicine. Examples abound, such as criticism that doctors are overprescribing antibiotics and contributing to resistance, while insurance companies simultaneously incentivize their members to use telemedicine programs or urgent cares instead of visiting their primary care physician.

My own insurance company, Cigna, recently sent me a letter notifying me that I will have a reduced co-pay if I …

Is health care a right or a privilege? Why can’t the answer be both?

Brian C. Joondeph, MD

Policy

April 18, 2017

Election Day 2016 should have been Christmas morning for Republicans. Long awaited control of the White House and both houses of Congress. A chance to deliver on an every two-year election cycle promise to repeal and replace Obamacare. In 2010 Republicans needed the House. They got it. In 2014, it was the Senate. Delivered. But we still need the White House they said. Asked and answered with President Donald Trump.

So, …

The problem with too many health insurance options

Tenessa MacKenzie, MD

Policy

April 2, 2017

Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control.

In my current position as a primary care physician at an …

We must challenge the health care status quo

Ioana Baiu, MD

Policy

March 11, 2017

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 …

10 questions to frame the health care debate

Umbereen S. Nehal, MD, MPH

Policy

December 10, 2016

We are at a watershed moment for health care, both nationally and in Massachusetts.

Massachusetts, the state that first piloted the model, “Romneycare” in 2006, that was disseminated to the nation as “Obamacare” is now going full steam ahead with ACO models under the newly approved 1115 waiver, that received the CMS green light in early November. Having expanded to near universal coverage in 2006, now, at the end of 2016, we are taking on …

I never want to be a government-employed physician. Here’s why.

Suneel Dhand, MD

Policy

December 6, 2016

Every health care system in the world is facing its fair share of challenges. Aging populations, the exponential increase in chronic diseases such as heart disease and diabetes, expensive new treatments—all at a time when most countries desperately need to curtail rising health care costs to save their economies. At the two extremes, we have fully public-funded (socialized) medicine versus entirely free-market (private) health care delivery systems. I’ve written previously …

Why do so many Americans hate their health care system?

Peter Ubel, MD

Policy

October 13, 2016

There is lots to love about American health care. We have some of the best clinicians in the world, as evidenced by the huge number of people who come to the U.S. from other countries when they are sick. Yet the American people are less satisfied with their health care system than are citizens of the majority of other developed countries.

Why do people in the land of the Mayo Clinic …

5 health questions every presidential candidate should answer

Robert Pearl, MD

Policy

December 2, 2015

With fewer than 100 days until the first primaries, the leading candidates have received ample airtime to address the important issues our nation faces. But even though health care accounts for around 18 percent of our nation’s GDP and consumes close to half of the total tax revenue collected by the federal government, their silence on providing solutions to the most pressing health care challenges our nation faces continues with …

Value to patients and value to society: How can doctors balance the tension?

Joshua Liao, MD

Policy

November 19, 2015

Amid ongoing health care transformation, clinicians will increasingly face the tension that the late physician and health services researcher John M. Eisenberg, MD, MACP, described over 30 years ago: providing high-value care with simultaneous commitments to patients and society.

Physicians have always been charged as patient agents to advocate for patients’ best interests. Simultaneously, however, they are tasked with considering the societal good by using resources wisely. While these commitments often …

7 ways physicians can improve health care quality

Robert Pearl, MD

Physician

August 16, 2015

Patients want to receive health care that is of the highest quality. Physicians want to provide it. But what is “high-quality health care?” On that, few agree.

Ask most Americans and they’re unsure where to find it. They know they want to be kept healthy, have rapid access to personalized care whenever they need it and be charged only what they can afford.

Ask the leaders of the national medical and surgical …

There are only 3 ways to allocate health care resources

David L. Katz, MD

Policy

July 8, 2015

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Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer — but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for the treatment of leukemia, but not for the stunningly rare kind of sarcoma with which Manny has been diagnosed. Nothing is …

The problem with cowboy doctors in health care

Christopher Johnson, MD

Policy

May 27, 2015

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Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas have studied and tried both to understand and to explain the amazing variations we see in how …

Physicians must unionize. Here’s why.

Margalit Gur-Arie

Physician

January 12, 2015

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If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …

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Physicians must unionize. Here’s why.

Health care’s future: An interview with a hospital CEO

Trudy Lieberman

Policy

December 10, 2014

Not long ago I interviewed Dr. Todd Sorensen, the CEO of Regional West Medical Center, a 184-bed facility serving a large swath of rural western Nebraska. I’ve known Dr. Sorensen since junior high school, and we’ve kept in touch over the years to discuss the health care system from his perspective as a physician and administrator and mine as a health …

There is no excuse for physicians to take advantage of vulnerable patients

Bob Doherty

Policy

October 18, 2014

Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times.

Mr. Peter Drier received a “surprise $117,000 medical bill from …

It’s time to talk trade-offs in health care

Dr. Saurabh Jha

Policy

October 10, 2014

An advantage of being a foreigner, or a recent immigrant to be precise, is that it allows one to view events with a certain detachment. To analyze without the burden of love, hate or indifference for the Kennedys, the Clintons or the Bushes. To observe with both eyes open, rather than one eye looking at the events and the other looking …

How hospitals discourage doctors: A step by step guide

Richard Gunderman, MD, PhD

Physician

September 26, 2014

Not accustomed to visiting hospital executive suites, I took my seat in the waiting room somewhat warily.

Seated across from me was a handsome man in a well-tailored three-piece suit, whose thoroughly professional appearance made me — in my rumpled white coat, sheaves of dog-eared paper bulging from both pockets — feel out of place.

Within a minute, an administrative secretary came out and …

5 things people get wrong about Canada’s health system

Kathleen O’Grady and Noralou Roos, PhD

Policy

September 14, 2014

The Canadian health care system is often held up as an example to model or to avoid at all costs in the debates on health care in America, and elsewhere. Yet there are a startling number of misconceptions — on both sides of the partisan divide — about how the Canadian health system actually works, often from experts who should know better. Here are the facts.

1. Doctors are self-employed, not …

Are American doctors paid too much or too little?

Kevin Pho, MD

KevinMD

August 15, 2014

A version of column was published in USA Today on July 2, 2014.

There are some who think that I’m overpaid as a physician, and that my salary fuels rising health costs. I can understand their point: A May 2014 survey released by the Medical Group Management Association found that internal medicine doctors like myself have a starting median annual salary of $190,000, …

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