UnitedHealthcare (UHC), the nation’s largest health insurer, will likely pull out of Obamacare in 2017. Citing high costs and huge potential losses, they warned that 2016 will probably be their last year offering health insurance through the Obamacare exchanges. Is this another example of greedy insurance companies with fat cat CEOs gouging the system? Or are economic realities interfering with the “hope and change” of Obamacare? UHC isn’t really selling insurance. Instead ...

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With fewer than 100 days until the first primaries, the leading candidates have received ample airtime to address the important issues our nation faces. But even though health care accounts for around 18 percent of our nation’s GDP and consumes close to half of the total tax revenue collected by the federal government, their silence on providing solutions to the most pressing health care challenges our nation faces continues with ...

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After reading my latest post about conflicts of interest in health care, my wife suggested that I write a piece about butterflies. Something pretty, she said. Natural. Peaceful. Since hostility is never my goal, I thought I’d give it a try. I read for an entire evening on butterflies -- their life cycle, behavior, mechanisms for protection, and how different cultures view them. All I could keep thinking about was how much my grandmother ...

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Whenever you read a health care article, paper, book, blog post or even tweet, that substitutes the term consumers for patients, and the term providers for doctors, or physicians, you should inherently assume that the authors are advocating for something that will not benefit you or the people you care for, something that will most likely harm you financially and if you happen to be less than independently wealthy it ...

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Recently, I have discussed networks (Internet and electricity), but I would be remiss if I didn’t spend a few moments on the networks that are most likely to rob us of personal choice and increase costs: Health care networks. Wait, didn’t President Obama promise us that the new health care law would preserve choice for us? Didn’t he promise us lower costs?  Well, in spite of much good ...

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The emergence of direct primary care (DPC) has the characteristics of a social movement, defined as a “purposive and collective attempt of a number of people to change individuals or societal institutions and structures.” Moreover, the DPC movement has thus far succeeded largely because it is based on a guiding set of strongly-held principles from which its founders have not wavered.  The concept of direct primary care as a reordering ...

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Amid ongoing health care transformation, clinicians will increasingly face the tension that the late physician and health services researcher John M. Eisenberg, MD, MACP, described over 30 years ago: providing high-value care with simultaneous commitments to patients and society. Physicians have always been charged as patient agents to advocate for patients' best interests. Simultaneously, however, they are tasked with considering the societal good by using resources wisely. While these commitments often ...

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Britain’s health secretary wants to uncharm his way to a revolution. To galvanize support for a seven-day National Health Service (NHS), which the NHS was before Jeremy Hunt’s radical plans, and still is, he asserted that thousands die because there is a shortage of senior doctors during weekends. This is an expedient interpretation of a study which showed that mortality was higher in patients admitted on weekends. Hunt ignored the
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Part of a series. “It is all about vigilance and caring. Our aim is to put the caring back into health care and we are serious about that. Our standards are not how many patients did you see today but how much quality did you dispense today,” Dr. Greg Foti told me about the clinic where he works in downtown Baltimore, MD. Individuals that have multiple chronic illnesses compounded by ...

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In July the investigative journalists at ProPublica released an analysis of 17,000 surgeons and their complication rates. Known as the Surgeon Scorecard, it set off a firestorm. In the months following, the primary objections to the scorecard have become clearer and were best distilled in a terrific piece by Lisa Rosenbaum. As anyone who follows me on Twitter knows, I am a big fan of Lisa -- ...

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