If you live in the rural U.S., you probably face relatively limited access to the wonders of American health care.  There won’t be as many physicians per capita offering you their services.  This paucity of health care professionals will be especially stark for subspecialty care.  There are not many ENT specialists opening up shops in rural Texas when they can find jobs in Houston or San Antonio. This undersupply of physicians ...

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We all know that health care costs in the U.S. are too high.  But why is American health care so expensive?  Some experts blame the desire for profit.  Russell Andrews, a  neurosurgeon and author of Too Big To Succeed laments “the morphing of American medicine from a function of a humanitarian society into a revenue stream for health care profits, drug and medical device companies, hospitals, and insurance companies.  In essence, ...

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Lebron James: The king of junk food Lebron James makes over $19 million per year playing basketball for the Miami Heat. Not surprisingly, this salary is peanuts compared his endorsement earnings, which in 2012 topped $42 million. Although perhaps peanuts is the wrong word to use when discussing James outside earnings, which to my knowledge have not involved foods anywhere near as healthy as peanuts. Instead, according to ...

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It is pretty easy to be against Obamacare these days. The federal government can’t come up with a working website to help people buy health insurance. The president misled people about whether they could hold onto their old insurance plans. And come next tax day, the least popular provision of the Affordable Care Act -- the individual mandate -- will be implemented for the first time. Lost amidst all this controversy is ...

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In an earlier post, I presented some data on which kind of physicians in the United States are most and least likely to see new patients who receive Medicaid, the state/federal program to pay healthcare costs for low income people. Now a recent study lays out some reasons why many physicians are so reluctant to see such patients. Not surprisingly, it starts with low reimbursement rates. Medicaid pays about 61% ...

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Ask physicians if our messed up malpractice system causes them to practice “defensive medicine,” and most will probably say yes --  hard not to be paranoid with so many lawsuits affecting so many physicians. Some experts even contend that major reforms of our malpractice system could go a long way towards controlling spiraling healthcare costs. On the other hand, if you ask physicians whether they ever order unnecessary ...

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To almost every claim that the American healthcare system is overpriced, defenders of the United States can point to the comparison problem -- it is not fair to compare American surgeons, or hospitals, to our peers in Europe when American surgeons and hospitals are not the same as in those other countries.  Our surgeons are better trained, the defenders retort, and our hospitals offer higher quality care.  When quality measures ...

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In the wake of the horrific floods that struck Colorado recently, many people have debated whether global warming is to blame. The same goes for wildfires that hit that state this summer and for the massive tornado that struck in Oklahoma this spring. In the wake of that tornado, for instance, Senator Sheldon Whitehouse from Rhode Island claimed that Republican opposition to climate change legislation was at fault, for trying ...

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Healthcare markets are complex and confusing places.  But one fact is simple and straightforward:  all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics.  Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics. Bewildering until now.  Shreya Kangovi and colleagues at the University of Pennsylvania interviewed low income patients and discovered some fascinating reasons why they aren’t ...

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The urologist broke the news: "Out of 12 cores, three were positive for cancer, so you have a small amount of cancer." He would soon explain the treatment choices -- surgery, radiation, or active surveillance (watching the cancer closely with blood tests and biopsies). He described each option in elaborate detail, because he knew that the "right choice" would depend on what his 70-year-old patient thought about the pros and cons ...

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