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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I'm a medical student. I spend every day of my life considering the well-being of my future patients, and the detrimental impact that various health care policy proposals will have. I'm not going to lie. The ACA has problems. It's not perfect, and I won't wave the flag and pretend it's the greatest thing ever. The reality is that the ACA plans are often cost prohibitive. The lack of a ...

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Of course, it matters a lot -- hospitals vary enormously on quality of care, and choosing the right hospital can mean the difference between life and death. The problem is that it’s hard for most people to know how to choose. Useful data on patient outcomes remain hard to find, and even though Medicare provides data on patient mortality for select conditions on their Hospital Compare ...

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It’s common knowledge in medicine: Doctors routinely order tests on hospital patients that are unnecessary and wasteful. Sutter Health, a giant hospital chain in Northern California, thought it had found a simple solution. The Sacramento-based health system deleted the button physicians used to order daily blood tests. “We took it out and couldn’t wait to see the data,” said Ann Marie Giusto, a Sutter Health executive. Alas, the number of orders hardly ...

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In a little piece of legislation known as the Affordable Care Act, preventive services are mandated to be covered with no out-of-pocket expense to consumers. According to the Healthcare.gov website, approved insurance plans must cover a “list of preventive services for children without charging a copayment or coinsurance.” Number 18 on that preventive care list is childhood immunizations for children from birth to age 18, acknowledging regional variation in the standard ...

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