I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons ...

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The Congressional Budget Office (CBO) has estimated that 14 million of people would lose coverage in 2018, 21 million in 2020, and 24 million in 2026 if the House Republican plan is allowed to significantly amend the Affordable Health Care Act (Obamacare). In my last post, I called the House Republican bill "mind-boggling" for the negative impact I believe it would have on the number of those uninsured and ...

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Like they have a gun to their heads, congressional Republicans, led by Paul Ryan, are moving ahead at warp speed to pass a sweeping new health care bill to replace Obamacare. Despite an almost deafening roar of objections from the many people who would lose coverage or whose insurance costs might go up; from major medical groups; and even from within its own party, they continue onward with this health ...

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Pause with me for a moment and create an image in your mind of the quintessential healthy person. What do you see? I picture someone who is slim and agile. They probably bike or walk to work and engage in daily exercise. They cook for themselves, use fresh vegetables and few processed foods. They find satisfaction in their career and home life, mange stress well and devote time to meaningful hobbies ...

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Quality metrics and pay-for-performance have now been in existence long enough to start accumulating some efficacy data.  And the picture does not look good.  Paying doctors to improve their quality metrics does not, in general, improve those quality metrics.  Like all good scientists, we can now either question the data, or discard the hypothesis. Most payors and administrators appear to be reacting to the lack of efficacy data on ...

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Having graduated from medical school in 2008 and internal medicine residency in 2011, I am a physician-child of the Affordable Care Act (ACA) era. The belief that “health care is a human right” ran deep through my upbringing and life experiences, but training during a period of such intense debate over health care reform reinforced this ideal. My professional identity developed interwoven with a compelling national conversation about access and ...

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In no other field is change received with so much resistance and skepticism than in medicine.  The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy. As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress.  As the world is witnessing an unprecedented technological ...

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A month into Donald Trump’s presidency, it is clear we are in for a wild and dizzying ride.  As is typical in matters of opinion, post-mortem analyses on how we got here are frequent and varied. However, I believe the Affordable Care Act was the iceberg which sunk Hillary Clinton’s ship.  Sure, there were both real and fabricated scandals which dampened enthusiasm among potential Clinton voters.  There were the emails.  There ...

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It won't work. Obamacare works for the poorest that have affordable health insurance because all of the program's subsidies tilt in their favor. Obamacare doesn't work well for the working and middle class who get much less support -- particularly those who earn more than 400 percent of the federal poverty level, who constitute 40 percent of the population and don't get any help. Because so many don't do well under the law, ...

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Rationing of health care services according to an individual’s ability to pay — or, as the case may be, the inability to do so — is becoming more prevalent in the United States, both in the public and private insurance spheres. Commercial payers, for example, increasingly require doctors to follow a complex and time-consuming authorization process. Recent surveys show that 75 percent of doctors complain about this often unnecessary step. Insurance ...

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