“We are now contemplating, Heaven save the mark, a bill that would tax the well for the benefit of the ill.” The Conversation Although that quote reads like it could be part of the Republican repeal-and-replace assault against the Affordable Care Act (ACA), it’s actually from a 1949 editorial in The New York State Journal of Medicine denouncing health insurance itself. Indeed, the attacks on ...

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Recently, the AHCA was pulled from the House floor after not enough votes could be secured in favor of its passage.  A Washington Post article reported President Trump’s thoughts on the matter: “We couldn’t get one Democrat vote, not one. They [Democrats] own Obamacare.  So when it explodes … we make one beautiful deal for the people.” Journalist Robert Costa asserted “there was little evidence that either Trump or House Republicans ...

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Thankfully, the GOP did not pass Paul Ryan’s repeal and replace bill for Obamacare.  Immediately after, I saw a headline hopefully concluding, “Medicare for all may be next.”  In Medicare’s current form, this would be devastating for the health of America.  I am a young geriatrician; I know a heck of a lot about Medicare.  Most people don’t.  They just see it as a great perk of turning 65 in ...

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So the American Health Care Act was rejected.    And I want to scream!   Not because it failed, but instead because of the way the whole thing was handled.  While both parties will argue that they were trying to do what is best for the American public, I disagree.  As a physician, what I see are two forces who are more intent on winning a battle than in helping the public.   ...

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In striking contrast to the happenings in the U.S. Congress, Kate Middleton, future queen of England, spoke these words at London's Royal College of Obstetricians and Gynecologists on the occasion of a launch of educational films dealing with maternal mental health:

Nothing can really prepare you for you the sheer overwhelming experience of what it means to become a mother, It is full of complex emotions of joy, ...

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Health care reform as it is typically discussed in America is dead for now. By “as it is typically discussed,” I mean broad “big picture” health care reform, which deals primarily with how we organize payments: government vs. free market, multi-payer vs. single payer, profit-based vs. not-for-profit. The Democrats tried. Obamacare’s shortcomings stem largely from the fact that neither President Obama nor the larger Democratic Party had the political power ...

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Two quality metrics walk into a bar. One demands, "Give me the best beer you’ve got!" The other says, "Give me the second-best beer you’ve got." The bartender pours the beers and states, "You can have them both for free if you can tell me why this one is better than that one." Quality metrics were invented to quantify the ineffable, such as the taste of a fine lager or IPA. I see that ...

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Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control. In my current position as a primary care physician at an ...

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I was recently invited to speak at a conference in what is likely the nicest hotel I have ever set foot in. Partially hidden by an array of palm trees and adjacent to a golf course, I could easily see why the conference rate was $350 per night. Before making my way to the conference room, I paused in the dining area to go over my slides one last time ...

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President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican “thought leaders” in Congress were quick to supply him with their stale and superficial “plans” to repeal and replace Obamacare, which were written in protest to President Obama’s policies and were never meant to be implemented. When scrutinized by the ...

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