Here’s something I read recently in a blog post (The Limits of (Neuro)science at Neuroskeptic) that started me thinking: "Will science ever understand the brain? … The notion that humans are complex and hard, while nature is easy, is an illusion created (ironically) by the successes of reductionist science. Some of the biggest questions facing mankind for eons have [been] answered so well, that we don’t even ...

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More chronic illnesses, more diseases of old age, consumers demanding more quality and safety, physicians no longer in typical private practice, and high deductible health care polices are each about to cause major changes in the practice of medicine and how it is delivered to patients. Will this come about smoothly or, more likely, with some serious hand wringing? Health care delivery will change substantially in the coming years. This is ...

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A recent survey by Deloitte of physicians opinions on health care reform has drawn some very differing conclusions from partisan commentators. The 501 physicians answered a number of questions, the most notable of which included a dichotomous question on whether the Affordable Care Act was "A good start" or "A step in the wrong direction." The question was split 44% to 44%. All respect for Mr. Pollack and Dr. Murthy writing ...

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Medicare needs to cut costs. It has chosen methods to cut costs that will damage the basic health care services needed by most Medicare patients. And instead of calling this cost cutting, it uses terms such as "shared savings." Even worse, the “shared savings” will result in even less health spending in United States locations that already have lowest health spending. Innovative designs are not the problem. The problem is ...

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Last June the American Academy of Family Physicians (AAFP) sent a letter to the AMA’s Relative Value Scale Update Committee (RUC) demanding specific changes to the ways that the RUC conducts its business. Primary care has been severely compromised by the RUC’s recommendations, and there was an implicit threat that the nation’s largest medical society would withdraw if the demands were ignored. I co-authored a Kaiser Health News article ...

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Up until now, I hadn’t considered to write an article on healthcare reform simply because of the divisiveness and the complexity of the issue. But after listening to the Supreme Court session and the arguments made on both sides, I can’t help but comment on one popular argument that continuously resurfaces. Yes, it’s the infamous "broccoli argument." In short, the argument states that if government were given the power to force individuals to ...

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Have you ever been in a negotiation with a health plan for a network participation contract and had the impression that the plan knew all the rates that you had agreed to in confidential negotiations with other health plans?  Allow me to reassure you:  you are not being paranoid.  It is quite likely that the plan you are negotiating with knows exactly what rates and terms you have agreed to ...

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With all the debate about how to best implement coordinated care that benefits patients while being feasible for providers and economical for the government, it’s ironic that little attention has been given to a decades-old managed care model that does all this. But as Medicaid reform progresses in New York and elsewhere, that may be about to change. The program is called PACE, or the Program of All-inclusive Care for the Elderly, ...

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I am often fascinated by the simplified dichotomies and ironies of the health care discussion. Some argue that the individual mandate infringes on individual rights yet one could argue that tying health insurance to a particular employer is in itself a violation of individual liberty.  When Patrick Henry stated, “Give me Liberty or Give me Death” in protest of the Stamp Act of 1775, he helped swing the assembly (including ...

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Imagine an America with no health insurance companies. What do health insurance companies do? They take as much money as possible from people who want health insurance coverage. They pay out as little money as possible -- so-called medical loss -- to settle claims from creditors for health services and products that have been delivered. They keep as much money as possible for the incomes of their executives and other employees, and to ...

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