A guest column by the American College of Physicians, exclusive to KevinMD.com. Recently, I was invited to speak at an ACP chapter meeting on the topic of shared vision. In the talk, I used as examples Dr. Martin Luther King Jr., John F. Kennedy, and Steve Jobs, leaders whose visions inspired people and helped them to achieve great things. As I wrote the talk, it occurred to me that ...

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Those who resist health care reform point to America’s great cancer care – instead, we should protect “the best health care system in the world.” After all, if we’re the best, other countries should change, not us. Do we really have the world’s best cancer care? A good indication is the American survival rate for breast cancer, the world’s longest. But ...

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I recently said I would describe the essential elements of "true reform." I realize others might add or subtract from my list, but here it is – at least for today: Payment reform. I put this first because no matter what form or structure healthcare takes, without payment reform it will be doomed to failure. And by "payment reform" I mean switching from the "fee for service" model I discussed in ...

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The growing concern about reducing the cost of healthcare delivery is the major focus in revamping the U.S. healthcare system. There have been numerous attempts to better understand the key drivers contributing to rising healthcare costs, yet the ability to successfully control the rising trend has been met with consistent challenges. A key motivating factor of the Affordable Care Act was to drive ...

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Of all the complex, costly, and downright intimidating issues in U.S. healthcare today, Super Storm Sandy tops my list as the scariest. Even though hospitals from the Carolinas to Maine deployed their emergency plans and had extra providers on site to deal with the expected influx of patients, those in the hardest hit areas couldn't withstand such a powerful storm surge. Like many ...

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The 2012 Presidential election is over. Obamacare is the law of the land and is certain to remain so.  There was tremendous uncertainty not knowing whether the law would be repealed, revised or remain.  Many of us opposed the bill, and there certainly are negatives.  Like it or not, it is time to “get over it,” and not a second later than now.  ...

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I was chatting with someone who asked what I did for a living, and I told him I am a doctor. "The kind that helps people?" he joked. I knew what he meant. The MD is the practical fixer, the PhD the omphalocentric academic. Many believe in this dichotomy, as false as it is. And such a philosophy underlies the opposition to some elements of the PPACA, aka Obamacare. There's a board of ...

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The American Academy of Family Physicians (AAFP) took a bold stance in a report regarding the future of primary care in the US by reinforcing its endorsement of the Patient Centered Medical Home (PCMH), specifically led by physicians.  The report was supported by other large national physician organizations including the American Academy of Pediatrics, the American Medical Association, and the American Osteopathic Association. The report took a close look at ...

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If you get sick, health insurance should cover all the “stuff” necessary to make you better, right? While that sounds good in principle, Uncle Sam has made it a lot more complicated than that.  As we continue to struggle with health reform, this New England Journal article on “Medicare’s Enduring Struggle to Define Reasonable and Necessary Care” is very timely. According to Drs. Neumann and Chambers, Medicare has always covered medical services that ...

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Now that President Obama has won a second term, discussions about healthcare have seemingly disappeared from the public's radar. Big mistake – although I do understand the public's shifting interest in the General's sex life and, much more serious, the heartbreaking tragedy of the renewed hostilities between Israel and Gaza. I do expect that healthcare costs will be back on the radar fairly soon as discussions about the fiscal cliff intensify – ...

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