In our recent paper criticizing how industrial quality improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or practices whether physicians like it or not, or whether it’s really useful and fair or ...

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President Trump campaigned on repealing and replacing Obamacare. Congress, when campaigning for reelection every two years, promised the same. Yet Congress can’t seem to get the job done. First, they needed the House, then the Senate, finally the White House. All delivered to GOP control by the voters. With the reasonable expectation of repeal and replace. Yet nothing from Congress but a dial tone. The House passed an Obamacare-lite bill, tweaking ...

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Medicaid is the largest single health insurance program in the nation, spending more than $500 billion to serve the most vulnerable people with some of the highest need, including children, pregnant mothers, people with disabilities, the poor and the elderly living in nursing homes. Recent proposals to repeal and replace Obamacare – such as the American Health Care Act (AHCA) – would fundamentally change the Medicaid program. ...

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An excerpt from Distracted: How Regulations Are Destroying the Practice of Medicine and Preventing True Health-Care Reform. If you want to learn what is wrong with the American health care system, just follow ...

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For years, health care reform has pursued the holy grail of higher quality at lower cost. I’ve always believed it’s achievable, and now it’s needed more than ever. The U.S. health care system is failing. Costs continue to increase faster than our nation’s ability to pay, and the quality of our outcomes lag those of most other industrialized nations. People increasingly ask me what concrete steps could make a difference. The ...

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While Thomas Jefferson may have written that “All men are created equal” in our Declaration of Independence, nothing could be further from the truth when it comes to health care in the United States. As a physician, I have pledged to ease suffering and heal those who are sick. However, I find that my job has become increasingly difficult over the last several years. The Affordable Care Act (ACA) has ...

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During my salad days, I — like a lot of physicians — thought I could take on the world. Despite working in a smaller, community hospital, our ER saw a lot of the same type of orthopedic trauma I saw during residency. And my young partners and I took virtually every case that came in except spinal trauma. We did this whether we were on unassigned ER call or not ...

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I once participated in a discussion about a research study that was drawing data from charges submitted to Medicare and patient outcomes. The head of the project was referring to the financial data as costs, and I simply asked, “Isn’t this really charges, what Medicare is being charged by the hospital?” The response was a sort of non-answer, and then the person concluded, “It probably doesn’t really matter whether we ...

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Single-payer health care remains the holy grail for Democrats seeking the ultimate in command and control government. Wealth redistribution on a previously unimaginable scale. The nanny state government controlling all aspects of everyone’s life, as few human activities don’t influence health in some way. Congressional Democrats are locked and loaded with federal legislation expanding Medicare to everyone. Specifically, this bill would provide, “all individuals residing in the United ...

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"Choose your battles carefully," goes the old saying. My physician colleagues would do well to heed that advice. For the past several years, physicians in many states have been engaged in battles with nurse practitioners in their respective states who are seeking to remove antiquated regulations. These regulations preclude nurse practitioners from practicing to the full extent of their education, as recommended by the Institute Medicine report:
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