“Hello Dr. Payne, thanks for calling back, there’s a consult I’d like you to see.” “What’s going on?” “Well there’s a patient up on 7 East who ...” “Wait a minute. 7 East ... isn’t there some other specialist covering there?” “No Dr. Payne, the schedule says you on Wednesdays.” “Oh, I’ll check that.” “OK, Dr. Payne, well we have this 72-year old, Mrs. Jones, who originally got admitted with pneumonia. She now has unusual inflammatory ...

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Competition often works. Competing dry cleaners or donut shops must either improve the quality of their product or keep their prices low, or customers will go somewhere else for their cruller fix. In time, the better businesses -- the ones that provide tastier pastries at a lower price -- will thrive, and less-good, more-expensive businesses will go away. In the long run, all customers benefit from competition between businesses. That’s how ...

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Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support conventional Medicaid, as opposed to supporting a much-needed revamp of this program, have succumbed to false advertisements. So let me review some facts, and suggest some common sense changes that ...

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American doctors are unhappy about a lot of things. Americans, in general, are unhappy about a lot of things. In many ways, both groups share similar concerns. But the road back to happiness may follow a similar path for both, as well. American doctors once felt part of something special. American health care, by reputation at least, was the best in the world, and we were its proud emissaries. We functioned ...

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The two biggest sources of frustration for the majority of physicians are the EMR systems and bureaucracy within the work environment that physicians are forced to deal with daily. EMRs are a ship that has sailed, unfortunately, and our only option currently is to try and improve this situation. However, the bureaucracy and administrative burdens that physicians encounter are issues that we should challenge, and I feel single payer is a ...

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At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America. First and foremost we must recognize we do not have “a health care system” -- rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, ...

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As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine. I think it is important to know all that goes into ...

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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 ...

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I told you so.  I also told the POTUS in my open letter, but he did not read it. Who could honestly believe the nation would support dumping coverage for 22 million people?  As David Leonhard wrote recently op-ed in the New York Times: “They [Republicans and President Trump] had only one big weakness, in fact: They weren’t dealing in reality.”  When faced with reality, it is interesting what a few good ...

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Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other. Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing. Yet even as cracks in America’s health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates ...

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