With the election of Trump and a Republican Congress, it looks like the ACA is doomed. Will it be repealed in whole or in part? Will something replace it? None of us, including the new administration, know exactly what will happen. But if it does get repealed, what exactly are the consequences? The ACA was never a full health care overhaul. It was a form of insurance reform that used subsidies ...

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In my previous post, "Have physicians finally joined the working class," I discussed the changes in the health care system regarding physicians roles in these systems. In this post, I propose two strategies that could help physicians regain some influence over their work and to participate fully not just in the execution of strategy from management but also have an input in creating it. Building unions There has been a ...

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Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election.  Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality.  What does the future hold?  What will the consequences be for my gay, minority, and Muslim friends, family, and patients?  How will this affect the vulnerable children that I care for every day? As I began to process ...

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My son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over-caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing drugs and engaging in unprotected sex. You should be rewarding me for being such a good kid.” “Reward you for not being bad?!,” I replied incredulously. That made no sense to ...

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The world is not going to end.  We witnessed a revolution earlier recently.  The people have spoken, and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo.  We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for health care.  Here is what we do know.  Mr. Trump is a successful entrepreneur.  Forbes describes the entrepreneurship pathway as having no ...

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While health care was a hot topic during previous presidential races, not much attention was paid to it in our current one. For the most part, many people think that Obamacare cannot continue as is: It costs too much, only a few insurances are now participating eliminating the market competition and laden with poor coverage with high deductibles. The world watched with bated breath as Donald Trump surprisingly won the ...

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On the election day that made Donald Trump the next president of the United States, I traveled to Lancaster, Pennsylvania to give a lecture. Long a conservative political stronghold, Lancaster County was dotted with "Make America Great Again" campaign signs, forecasting Trump's comfortable 47,000 vote margin there, which ended up being more than two-thirds of his 68,000 victory margin in Pennsylvania, one of the states that effectively decided ...

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Guess what America?  If you pay for health insurance, you’re giving billions upon billions to health insurance CEOs, hospital administrators, pharmaceutical company CEOs.  So, if you’re obeying the law, you’re contributing to their astronomical salaries. In fact, Cigna’s CEO made around $49 million this past year, if you read the various reports on the Internet.  The CEO at a non-profit hospital in New Jersey (Morristown Medical Center) made some $5 million ...

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According to recent research, a hug a day could keep the doctor away. According to another study, Twitter can predict the chance that people will experience heart attacks. A normal blogger would look at these two findings and tell a story about the relationship between stress and health. I’m not normal. I looked at these two studies and came to a different conclusion -- that we ...

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I have written before about predictions of the actual costs of Obamacare and the probable death spiral of increasing costs and decreasing participants. Several recent reports have brought more clarity to the cost realities. Recently regulators across the country approved rate hike requests by Obamacare insurance companies even greater than they originally asked for. For example, Pennsylvania regulators approved rate hikes of 33 percent, which was ...

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