The British National Health Service (NHS) was born in 1948, based on legislation passed that year mandating free high-quality health care for all paid by taxes. In contrast, the U.S. started Medicare in 1966 to provide health care to the elderly and the State Children's Insurance Program (SCHIP) in 1993 to fund health care for children whose parents were unable to afford it. Health care in the UK is still ...

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Many of us harbor an archaic view of what health care is, so let me offer a little history. During the past century, it's changed from Healthcare 1.0 to 2.0, and now it's Healthcare 3.0. In the early twentieth century, Healthcare 1.0 was a service, though it amounted more to personal contact than effective medicine. At best, medications and procedures were hit-and-miss, so doctors relied heavily on their relationship with their ...

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Medical students are told two things: The first is that we are the future generation of health care. We are the ones who have the potential to make a difference, and we will lead the revolution. The second is that our current spot in the medical hierarchy is definitively at the bottom of the totem pole, where we are too powerless and inexperienced to have any tangible impact. How can both be ...

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This is my 12th year as a physician in the United States. I was born in London, grew up in Berkshire, and decided to become a doctor when I was a teenager. I remember being asked what I thought about the National Health Service (or NHS, the UK’s government-run health system) during my medical school interview. That question is almost a rite of passage for anyone applying to medical school in ...

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As an American medical student doing an elective in Thailand, I was initially troubled when I saw how Thai patients were treated. I'm not speaking of the way Thai physicians apply medical science, mind you -- they rely on UpToDate and sundry U.S. guidelines just as we do -- but that was mostly where the similarities ended. Morning rounds with the team of residents (sans attending, but apparently there was one ...

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The Merriam-Webster dictionary has many definitions for the term system, but the most straightforward, and arguably the most applicable to our health care conversation is “a regularly interacting or interdependent group of items forming a unified whole.” The common wisdom is that our health care system is broken, and hence, our government is vigorously attempting to fix it for us through legislation, reformation, and transformation. We usually work ourselves into ...

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Most industrialized nations have long supported the idea that access to health care is a fundamental right, and have built centrally planned systems to accomplish that goal. The result has been universal coverage that delivers excellent-quality outcomes at lower costs than the United States. In some countries, such as England and Canada, the government controls both financing and certain aspects of health care delivery, while in others, including Australia, Sweden, and ...

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I am forced to attend one of these mandatory continuing medical education (CME) events. My malpractice insurance provider has a deal with the state medical association. To get lower rates, I have to be a member of the association and every 2 or 3 years attend a risk management training session. I make it on time, despite the traffic. As I walk into the lobby of this rather nice building, looking for ...

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United Healthcare announced that it plans on exiting most of the Obamacare insurance plans by 2017. Not their traditional commercial insurance plans or Medicare supplements, but specifically the insurance plans offered through the state exchanges of Obamacare. Didn’t President Obama tell Americans that if they liked their insurance plan, they would be able to keep it under Obamacare? Actually he did, at least 36 times. So what happened? In ...

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As physicians, we are charged with extending empathy to our patients. In addition to a professional responsibility, empathy is also a mechanism for improving patient care and professional satisfaction. It has been associated with better patient satisfaction, clinical outcomes, fewer medical errors and lawsuits, as well as provider happiness. However, while physicians can be expected to pursue the ideal of empathy towards individual patients, that of empathizing with populations is ...

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