Earlier this year, I completed a medical rotation in Africa. It was an amazing, eye-opening experience. While I expected it might be difficult to acquire newer, more expensive medications and procedures, I had anticipated that, given limited resources, there would be some rationale in deciding which medications and procedures would be available. I was deeply mistaken in this assumption. During my time abroad, I watched several patients with heart attacks pass ...

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Doctor: “Phil, you have pneumonia.” Phil: “Oh noes. What shall I do?” Doctor: “Just take these red pills, here.” Phil: “Great! I feel better already! When can I go back to work?” Doctor: “I think in about 2 weeks. Or maybe 2 months. And actually, don’t take those red pills -- these blue ones are better. It could take a few years for you to get better, and I’ll be retired by then. Here, ...

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The janitor approached my office manager with a very worried expression.  "Uh, Brenda ..." he said, hesitantly. "Yes?" she replied, wondering what janitorial emergency was looming in her near future. "Uh ...well ... I was cleaning Dr. Lamberts' office yesterday and I noticed on his computer ..."  He cleared his throat nervously, "Uh ... his computer had something on it." "Something on his computer? You mean on top of the computer, or on ...

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Whenever a discussion of health care policy is initiated, the importance of health insurance, of extending coverage, takes center stage. The need for insurance quickly becomes an undeniable truth, a universal imperative. And no one ever seems to question this subtle premise before getting more patients fitted with shiny, new policies. This was precisely the case with the Affordable Care Act. My question, however, is simple. Where is the evidence that ...

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American consumers value the freedom to comparison shop. We like to survey a variety of options and select "the one" that what we really want. If we want triple-ply, select-a-size paper towels with a blue shepherdess imprinted on them, then we expect to be able to find them in aisle 9. Deny us options and we’ll take our business elsewhere. When it comes to health care, though, endless options may not ...

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For 11 years, Congress has failed to reform the Medicare physician payment system, and appears prepared yet again (for the 17th time) to fall back on another one-year patch for the unpopular sustainable growth-rate (SGR) formula to avoid a 24% cut in payments to doctors.  As House minority leader Nancy Pelosi said recently, “Instead of reforming the Medicare physician payment system, Congress seems intent on imposing yet another round of arbitrary provider ...

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How much Medicare pays doctors requires context The Centers for Medicare and Medicaid Services released a massive amount of information regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data.  For everyone else, here is a simple way to look up how much your own doctor made. I decided to search for myself in the database ...

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I am all for transparency when it comes to health care. So when Medicare announced that it would tell the public how much doctors are paid to treat Medicare patients, my first thought was "hooray." Another victory for consumer information. Then I began to think about this in more depth. The Centers for Medicare and Medicaid Services (CMS), in response to a ruling in a federal case in Florida ...

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If you live in the rural U.S., you probably face relatively limited access to the wonders of American health care.  There won’t be as many physicians per capita offering you their services.  This paucity of health care professionals will be especially stark for subspecialty care.  There are not many ENT specialists opening up shops in rural Texas when they can find jobs in Houston or San Antonio. This undersupply of physicians ...

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The Cayman Islands are nestled in the Caribbean Sea some 430 miles south of Miami. The three-island cluster is known for its inviting coral-sand beaches, laid-back island culture and tax-free status. While it lures many tourists and big banks, it’s not the first place you’d expect to find the future of American health care. That may change soon. Last month, I flew to the Caymans to moderate an afternoon-long panel on delivering ...

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