For its many users, health care’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking, and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more health care services, regardless of whether the additional care adds value. I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a ...

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As policy experts cling to pay-for-performance (P4P) as an indicator of health care quality and shy away from fee-for-service, childhood immunization rates are being utilized as a benchmark.  At first, glance, vaccinating children on time seems like a reasonable method to gauge how well a primary care physician does their job.  Unfortunately, the parental vaccine hesitancy trend is gaining in popularity.  Studies have shown when pediatricians are specifically trained to counsel parents on ...

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Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week -- eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93. If rheumatoid arthritis progresses unchecked, it is as debilitating of a disease as can be imagined. Don’t think garden variety arthritis that only interferes with activities like, um, gardening. Think: finger and wrist joints so inflamed it feels like your ...

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I was talking to a physician in my hospital several years ago, and he expressed his frustration that the annual well-child exams for his four kids were expensive. Puzzled, I stated that I found it odd that a doctor’s own health insurance plan had poor coverage for routine care, and he replied that his group jointly decided on a plan with considerable upfront out-of-pocket costs. Why would doctors buy bad ...

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I have been doing health care research and advocacy for over 20 years. I've seen a lot of passion, anger, and rhetoric around the issues. The health care crisis is simple in that everyone needs health care. The question is what to do about it and who should pay for it. It's not an easy answer. For starters, we have turned into a culture of entitlement. This includes health care. It ...

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We were once a nation noted for its achievements. We are now a nation that gets nothing done, unable to make even the slightest movement forward despite multiple national crises -- a desperately broken health care system, a horrifying opioid epidemic, sickening gun-related mass murders, the threat of nuclear war, and massive storms resulting from man-made climate change. In the face of such monumental challenges, when bold action is needed, ...

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The main justification for single payer seems to be that access to affordable quality health care is a right. Nowhere in our constitution does it say that anyone has a "right" to individual services or property. Housing, food, health care, even cell phones have become "rights." What our constitution does say is that each citizen does have the right to equal protection under the law, equal access to the courts ...

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It’s a peculiar kind of civil war we are waging in America. 30,000 of us die each year from gun violence, exceeding the number killed annually on all sides in the Syrian civil war. On October 1, we saw more than 58 people slaughtered and hundreds injured in a carefully planned attack. At a concert. In Las Vegas. For no apparent reason. My professional interest in this problem began during my ...

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While driving home from a weekend trip, my children were watching The Lorax in the backseat, and I couldn’t help but think how acutely applicable its theme is to the current state of medicine in America. Just as seemingly small changes in the name of “progress” slowly altered the environment in The Lorax, a handful of mostly well-intended modifications have transformed the landscape of medicine into something unrecognizable and unsustainable. We ...

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STAT_LogoDear Shonda Rhimes, the brilliant mind behind my favorite television show, We need to talk about “Grey’s Anatomy.” I’m a fan. A really, really big fan. The kind of fan who -- in the last 48 hours -- rewatched all of last season’s episodes to prepare for the season premiere, and who has blocked off every Thursday night this ...

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