A guest column by the American Medical Association, exclusive to KevinMD.com. Physicians contribute significantly to both the health of our patients and the economic health of our nation, and a new report shows that the 2 percent Medicare spending sequestration cut will put the jobs supported by the health care industry in jeopardy. The AMA recently teamed up with the American Hospital ...

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“The specialist rescheduled me again,” the patient told me, looking embarrassed.  ”I think he doesn’t want to see me any more.” “I’m sure that it isn’t that he doesn’t want to see you,” I replied.  ”This has to be a miscommunication with the front desk.  It happens all the time; it drives doctors crazy.” “I don’t know,” he continued.  ”I just got on Medicare, and I wonder if maybe he doesn’t want ...

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When I was traveling around the country interviewing for a residency spot in family medicine in the fall of 2008, I was eager to find a patient-centered medical home (PCMH). At every interview, I asked whether the program's clinic was a certified PCMH or whether it was moving in that direction. "Well, we don't yet know what that looks like" was the answer that I heard at nearly every destination. ...

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Greg Smith, formerly of Goldman Sachs, has described a positive organizational culture as being the “secret sauce of greatness.” What is the nature of this secret sauce? A simple, popular definition is that “organizational culture is the way we do things here.” The relationship between organizational culture and organizational success is unassailable. In our commercial dealings, has not each of us easily recognized when a business culture is truly customer-focused, and ...

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If you think health care is expensive now, wait until you see what it costs when it’s free. -P.J. O’Rourke I distinctly remember that in first grade I had an idea of breathtaking wisdom and profundity. Candy should be free. You may have had a similar thought at the same age. This idea was supported by an incontrovertible rationale, namely that I really liked candy. Tragically, it only took a moment for ...

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Excessive health care spending is overwhelming America’s economy, but the subtler truth is that this excess has been largely facilitated by subjugating primary care. A wealth of evidence shows that empowered primary care results in better outcomes at lower cost. Other developed nations have heeded this truth. But US payment policy has undervalued primary care while favoring specialists. The result has been spotty health quality, with costs that are double ...

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A staple of conservative critiques of universal coverage is that having health insurance doesn’t equal access. The corollary is that the uninsured already have access to care—from doctors and hospitals willing to take care of them on a charitable basis and from "safety-net" institutions. This argument isn’t new, having been made years before the Affordable Care Act became law. In 2007, the Council for Affordable Health Insurance opined that universal coverage ...

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Us and Them And after all we’re only ordinary men The wanna-be congressman appeared with his neat hair and pressed suit, a competent yet compassionate expression on his face.  ”The first thing I am going to do when I get to congress is to work to repeal Obamacare,” he said, expression growing subtly angry.  ”I will do everything I can to give you back the care you need from those who think big ...

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Which of the candidates for President proposes to give people a defined amount of federal money (call it a voucher) to buy coverage from competing qualified private insurers (under federal benefit mandates) offered through a health insurance marketplace run by government? The answer: Mr. Romney, and his new running mate, Paul Ryan. And President Obama. How is that, you say?  Isn’t the Romney/Ryan vision of how to reform health care diametrically opposed ...

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Medicare has moved to the center of this year’s presidential campaign for a single overriding reason: shrinking the nation’s long-term government deficit demands dealing with health care costs. No one – left, center or right – disagrees with that analysis. What they also agree on is that limiting health care’s inexorable growth will require cutting future payments to those who deliver care – the doctors and hospitals, the nursing homes and ...

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