There is no excuse for physicians to take advantage of vulnerable patients Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times. Mr. Peter Drier received a “surprise $117,000 medical bill from ...

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Around the country, for every health system that is successfully navigating the early years of value-based health care, there are several others that are failing -- even though many don’t yet realize it.   These failing organizationscan’t or won’t restructure themselves to deliver effective, efficient and affordable care. I’ve come to the conclusion, after observing struggling systems, that two basic characteristics are necessary for systems to transform themselves in response to external pressures: execution and motivation. Successful systems have ...

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The e-patient movement represents everything that is positive in medicine today.  This grass roots force has introduced shared decision making and empowered both physician and patient.  The quality of health care dialogue has risen meteorically both in the exam room and out.  Today's health care "consumer" is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health. It's awfully sad that it ...

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It’s funny to think that the internet and the online world, so entrenched in our modern day lives, is still a relatively new phenomenon. When I first started medical school (not really that long ago) we hardly used the internet and the concept of a web search barely existed. It only became widely available on home computers shortly after that. The invention of social media is newer still. If any of ...

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Insurance is without a doubt the best business on earth. Every month, insurance companies from many industries collect premiums from thousands of clients, relying on the statistical likelihood the companies themselves will collect more than they pay out. If the company has a poor year, they raise the premiums for the next year. It is a beautiful business model and a way to guarantee consistent profits year after year. Even ...

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What happens when the federal government and the states have split responsibilities for caring for Medicaid beneficiaries? Not much, other than casting blame on one another or on doctors for not providing the care. Buried on page 26 of the front section of a recent New York Times is a story about Medicaid patients not finding doctors or having to traveling long distances to find one. It says a federal inquiry finds ...

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Its time to talk trade offs in health care An advantage of being a foreigner, or a recent immigrant to be precise, is that it allows one to view events with a certain detachment. To analyze without the burden of love, hate or indifference for the Kennedys, the Clintons or the Bushes. To observe with both eyes open, rather than one eye looking at the events and the other looking ...

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The recent independence referendum in Scotland got me thinking. I must admit I was glued to the news over the last few days of campaigning. For those of you not following closely, it seemed as if the "no" camp had a comfortable lead right up until the last week when the opinion polls suddenly showed the "yes" camp pulling ahead. This rattled the establishment. The prospect of my country of ...

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Baseball fans like me take great joy in studying the way general managers assemble their rosters. The variations are fascinating. Some teams focus on pitching strength. Others go for speed or power-hitting. Each approach carries distinct advantages and disadvantages on the field. That same level of variation and strategic decision-making applies to health plans, as well. With the health care marketplaces reopening for enrollment on Nov. 15, anyone evaluating their coverage options should take ...

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On September 28, 1864, the first meeting of the International Workingmen’s Association (IWA) was convened at St. Martin’s Hall, London.  Among the attendees was a relatively obscure German journalist by the name of Karl Marx.  Though Marx did not speak during the meeting, he soon began playing a crucial role in the life of the organization, in part because he was assigned the task of drafting its founding documents. The work ...

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